The science of psychiatry in uncertain times: what does the future hold?

An unknown fact to most medical students is that psychiatry has been living in uncertain times for many years. High-profile psychiatric journals are publishing articles on the multiple problems faced by psychiatry, featuring worrying predictions for the future. Many groups of distinguished psychiatrists are involved in a global debate. These problems are numerous and disturbing, leading some psychiatrists to warn that psychiatry as we know it may soon be a thing of the past, its work progressively taken over by other specialties and professions, or simply left undone. The position of psychiatry at the core of mental health services is losing its stability, coming under threat by other groups looking to increase their field of expertise, such as psychologists and neurologists. In addition to this, psychiatry faces a worsening recruitment crisis, a negative image with both the public and other specialties, and a lack of confidence in the evidence base behind some of its most widely used therapies. As worrying as these issues are, further investigation shows that psychiatry has a much deeper problem within its core its current relationship and troubled past with basic science. Opinions on the future direction for research and patient care in psychiatry are numerous and conflicting. This essay examines these issues in the hope that they can reveal what the future has in store for psychiatry.