Giving permission: A psychological approach to mental health and well-being Peter Kinderman Professor of Clinical Psychology University of Liverpool, UK

Kinderman, P. (2005) A psychological model of mental disorder. Harvard Review of Psychiatry. 13: 206–217. Biological factors Social factors Circumstantial factors Psychological and social problems Mediating psychological processes

Manifesto: Article 1: services should be based on the premise that the origins of distress are largely social Article 2: services should replace ‘diagnoses’ with straightforward descriptions of problems Article 3: services should radically reduce use of medication, and use it pragmatically rather than presenting it as ‘treatment’ Article 4: services should tailor help to each person’s unique and complex needs Article 5: services should offer care rather than coercion Article 6: mental health teams need to be radically different Article 7: mental health services should be under local authority control Article 8: we must establish the social prerequisites for genuine mental health and well-being

Kinderman, P. (2005) A psychological model of mental disorder. Harvard Review of Psychiatry. 13: 206–217. Biological factors Social factors Circumstantial factors Psychological and social problems Mediating psychological processes

The right place for mental health care is in the community – alongside GPs, public health physicians and social workers. There should be a network of community-based care teams, linked to social services provision and other local authority care and services, as well as to the NHS and third- sector organisations. This vision would see opportunities for GPs, properly trained in mental health care, to help support people’s well-being. It would obviously see many more clinical psychologists... But, as with our medical colleagues, they would be working in the community, not in hospitals or ‘clinics’.

Since our mental health and well-being is predominantly a social and psychological phenomenon, since diagnosis is unhelpful and the prescription of drugs should be reserved for a minority, we should see a much greater reliance on GPs to provide for the holistic healthcare of their patients. In this vision, medical psychiatrists would still perhaps have roles: as specialists, as consultants to GPs and as consultants to residential units. But we should see a major rebalancing of investment away from what is now traditional psychiatry towards a different system.

Peter Kinderman Professor of Clinical Psychology University of Liverpool,