Jacob M. Appel, M.D. J.D.
Nearly a year has elapsed since the University of Toronto established the world’s first anti-psychiatry scholarship in November 2016, and now that the dust has settled, the moment seems opportune to consider the merit of the fellowship and the state of antipsychiatry more generally. The fellowship itself, a grant of up to $50,000 offered by Associate Professor in Adult Education and Community Development Bonnie Burstow to match donations, cites the alleged “enormous harm done by psychiatry” and will be awarded to the “thesis student conducting antipsychiatry inquiry” (1). The justification for the fellowship is intellectual parity. The university’s website explains that, “Given the overwhelmingly and disproportionate availability of ‘regular’ scholarships for studying issues related to psychiatry, equity and academic freedom themselves require that antipsychiatry scholars…have more equitable access to scholarship support.” However one feels about psychiatry as a medical discipline, or the current state of diagnosis and treatment, the concept of this fellowship raises several concerns that transcend the specifics of the anti-psychiatry agenda.
The most significant problem with an “anti-psychiatry fellowship” is that it presumes a particular result to research—a political goal—which is precisely what sincere scientific inquiry does not do. A university is certainly a place to study about anti-psychiatry movements: A dissertation on Thomas Szasz or R. D. Laing can prove just as rigorous and relevant as one on Sigmund Freud or John Cade, even if sympathetic to a leading critic of psychiatry. Similarly, serious inquiry into the efficacy of particular psychiatric interventions might well establish that they are not efficacious: Both proposed pharmaceutical treatments and psychotherapy modalities fail clinical trials all the time. Drugs are occasionally removed from the market place, black box warning are added to labels and even standards for commitment are adjusted. Certainly, abuses have occurred; thought leaders have been influenced by private industry. The structure of scientific research may favor overly optimistic interpretations of results. But the underlying goal of a traditional psychiatry department is not pro-psychiatry or anti-psychiatry—it is to uncover answers relating to the workings of the human psyche and pathologies of the mind.
The second major flaw in the creation of an “anti-psychiatry” scholarship is that it assumes all ideas are deserving of parity. Surely an astronomy program ought not offer fellowships aimed at reviving the geocentric theory of the solar system nor should equity lead to parallel studies in Darwinian and Lamarckian evolution. If anti-psychiatry is deserving of a scholarship, the standard for approval should be validity, not equity.
Yet the Burstow scholarship is symptomatic of a much larger problem with the contemporary academy: the rise of ideologically-driven fellowships and research more generally. Figures at all points on the ideological spectrum endow grants to further their political values or pet causes, whether social justice or libertarian economics. One could embrace this free-for-all in the name of academic liberty, allowing even flat-Earthers with committed patrons to advance their causes through our institutions of higher learning. Alternatively, some vetting might prove helpful if the universities are to further their presumed goals of expanding knowledge.
An observer would have to be willfully blind not to recognize the deeply troubling history of psychiatric interventions. We live in the shadow of frontal lobotomies and insulin comas, Willowbrook and Milledgeville, Packard v. Packard and Donaldson v. O’Connor. Legitimate debates are to be had on the iatrogenic effects of psychotropic medications, as well as the ethics of involuntary commitment and its alternatives. How an anti-psychiatry scholarship furthers meaningful inquiry and dialogue in these areas remains unclear. Now that the initial kerfuffle of the scholarship’s creation is over, it is not even apparent that anyone is listening—certainly not the mental health professionals whom the scholarship’s benefactors presumably most wish to reach.