Here's a skeptical view of psychiatry by Charles Barber:
The ultimate indicator of our newfound faith in scientific psychiatry may be the mysterious growth of the placebo effect in tests of the drugs the new psychiatry dispenses. When Columbia University psychiatrist B. Timothy Walsh analyzed 75 trials of antidepressants conducted between 1981 and 2000, he discovered that the rate of response to placebos, which are, of course, nothing more than sugar pills, increased by about seven percent per decade. Simply because people thought they were taking the all-powerful medicines, they thought they were getting better.
All of the evidence points to the conclusion that today’s full embrace of biological psychiatry is terribly premature, especially since we have available an increasing number of nondrug therapies of proven effectiveness. We are only in the very early stages of understanding how the brain works and what alters its functioning. Somewhere along the way we seem to have misplaced the notion that, at this stage of our scientific evolution at least, the brain’s capacity to understand itself is minimal.
Barber has a point. The advent of massive prescription of drugs for mental illnesses is based on some shaky foundations.
* mental illness is still poorly understood. What causes them? How do they work? What exactly are the disruptive mechanisms that are impairing function in the brain? These are unanswered questions. There is a stark contrast between a drug treatment for, say cancer or pneumonia, and a drug treatment for schizophrenia or bipolar.
Cancer and pneumonia are understood from the cellular level right up to the epidemiological level, and pretty much everything in between. The same cannot be said for schizophrenia, bipolar, personality disorders, ADHD or many other mental illnesses.
* non-drug treatments have taken a back seat. This is despite the fact that there is probably more evidence of the effectiveness of social and lifestyle factors in treating mental illness of almost every variety than there is of the effectiveness of drugs. For instance there is pervasive comorbidity between many forms of mental illness and recreational drug use (I include alcohol in that category). Stress, social isolation and poverty are all also risk factors for many mental illnesses.
* The definitions of various categories of mental illness are dubious- the problems with the DSM are well known. Unfortunately, this problem has been oversold by critics of psychiatry, mental illness skeptics, and other radical fringe thinkers. I don't want to side with those who deny the existence of mental illness or who say that the whole thing is a social construct. It is a real problem. But we really don't know what we're dealing with. What exactly is
schizotypal personality disorder, for example? What causes it, and what are the physical manifestations in the brain? What about
body dysmorphic disorder? In a scientific sense, we know almost nothing about them.