The British Psychological Society review

Sir: The British Psychological Society (BPS) document, Report on Recent Advances in Understanding Mental Illness and Psychotic Experiences, is a most thorough commentary on current practice and research in psychological approaches to the treatment of psychosis. Though our view is that the BPS publication downplays neurobiological developments and is written in a style that might lead to counterproductive defensiveness in many psychiatrists, we feel that the tone of aspects of the brief Psychiatric Bulletin review (November 2001, 25, 454-545) are unfortunate.

The BPS document needs to be read and discussed widely when it contains such cogent views that much contemporary practice and attitudes need to be changed. There are many constructive recommendations that would assist in fulfilling National Service Framework objectives.

Though the views expressed are those of psychologists, there is much that many psychiatrists would agree with and indeed a lot of the research quoted is that of psychiatrists'. We would have welcomed a review that encouraged our members to take much more seriously what well-respected colleagues in psychology are saying.

We will take just one area that the BPS report focuses on — family interventions. These were pioneered at places such as the Maudsley Hospital more then two decades ago and have consistently been found to have a power at least equivalent to medication in reducing the relapse rates that understandably burden Persaud (the reviewer) and so many general psychiatrists (not forgetting the patients and families themselves). Yet we understand that it is rare for a Maudsley trained psychiatrist to have been routinely trained in these methods, whereas we are sure that they are experts at the latest medications. We found it worrying that Persaud does not have the experience of working with a psychologist in an acute or early intervention service and seems unaware of parts of this country and other countries where psychologists are key members of teams running acute services along the lines recommended by the BPS, and getting improved results.

Our reading of the report is that psychologists are not suggesting that they run services without doctors and medication — as Persaud rather mischievously suggests — but in partnership. We would encourage College members to read the review and wherever possible form better relationships with well-trained psychologists, many of whom have a great deal to contribute to modern psychosis services.