legal 180x120Psychiatry’s "contract with society" across the UK is still based on "medieval times", according to a new report from the Mental Health Foundation (MHF).

The social contract between psychiatrists and society has always been implicit and has often raised issues in ascertaining responsibilities and roles that are also defined and delineated by the profession.

Ahead of the launch of ‘A Better Understanding: Psychiatry’s Social Contract’ at the Royal College of Psychiatrists next week [20 July], the Foundation took the lead in exploring psychiatry’s contract with society.

President of the Foundation, Professor Dinesh Bhugra CBE, said: "The existing ‘social contract’ is not well understood by all stakeholders and is only ‘variably fulfilled’ on both sides. Greater understanding is needed to bring about changes to encourage psychiatrists to practice collaboratively with service users and health colleagues.

"This would hopefully lead to an environment in which all health disciplines supporting mental health are better resourced and properly valued. Society too has its obligations: governments and politicians need to address the social inequality and stigma that contribute to mental ill health and ensure adequate funding is made available for the level of need."

Commissioned by Professor Bhugra, published by the MHF and written by Simon Lawton-Smith and Katrina Jenkins, ‘Psychiatry’s Social Contract’ aims to generate "a debate, and reach consensus where possible, on psychiatry’s role, responsibilities and relationships.”

The authors sought evidence from published literature on the issue, 2 online surveys, 12 interviews with senior figures in the field of mental health and 2 focus groups involving service users and carers. They looked at psychiatry’s role, responsibilities and relationships with not only society as a whole but also with specific interested parties, including: other health and social care professionals; health service managers; service users, carers and families; commissioners of services; the media; and policy-makers and politicians.

Their hypothesis is there is an implicit ‘contract’ or ‘understanding’ between psychiatry and society across the UK, based on reciprocity and mutual expectations. The ‘contract’, however, is not well understood by all stakeholders, and only variably fulfilled on both sides thus a better understanding of the idea of the contract is required.

Jenny Edwards CBE, chief executive of the MHF, said: "Psychiatry has an important role to play in maintaining and promoting good mental health, but is often the source of mistrust. Psychiatry needs to ‘explain better what it does’ and what judgments are made in its practice, specifically on the use of compulsion and medication. Our hope is that this publication serves as a catalyst for this necessary debate."

Read the report in full at: