Thread by @CroakeyNews

Time for the keynote presentations - the first speaker is Prof Allen Frances, an internationally-renowned psychiatrist & author of 'Saving Normal' and 'Twilight of American Sanity: A Psychiatrist Analyses the Age of Trump' @AllenFrancesMD @DukeU #RANZCP2022

He will provide an address in praise of the #biopsychosocial model, which posits that psychological & social factors such as employment, housing & relationships are as important in understanding a person’s health as biological factors. @AllenFrancesMD @DukeU #RANZCP2022

It doesn't make sense to focus on one aspect of a person in understanding and treating psychiatric disorders- @AllenFrancesMD #RANZCP2022

Many different psychiatry models to apply in psychiatry care. The #biopsychosocial greats include Hippocrates, Galen, Darwin, Freud, Meyer and Engel - @AllenFrancesMD #RANZCP2022

Darwin is the greatest person in the history of psychiatry, @AllenFrancesMD said - he understood the scientific aspect of psychiatry as well as philosophical. #RANZCP2022

Human beings are much more alike than we are different, according to Darwin - @AllenFrancesMD #RANZCP2022.

Reductionism (whether it be biological, psychological or social) is always wrong - @AllenFrancesMD #RANZCP2022.

90% of US Natl International Mental Health funding is on brain/gene research. The research funding has been spent in a way that is really exciting, but maybe without a long-term payoff - @AllenFrancesMD #RANZCP2022.

Neuroscience greatly overpromised & underdelivered - to date, still no diagnostic biomarkers, not even for Alzheimers - @AllenFrancesMD #RANZCP2022

If we don't have a diagnostic biomarker for Alzheimers after 40 years of research, @AllenFrancesMD says he is skeptical we will have one for schizophrenia. #RANZCP2022

We have 86 bill neurons, 500 trill synapses- "It's amazing that most of us work as well as we do" - @AllenFrancesMD #RANZCP2022.

Genes also fail to explain psychiatric disorders - @AllenFrancesMD #RANZCP2022

Biological model of mental illness has been confirmed over and over in many ways- @AllenFrancesMD #RANZCP2022

Have to take into account biological factors, especially in individual cases, but they don't really help in population cases - @AllenFrancesMD #RANZCP2022

Trauma informed therapy has become the fan of the moment in the psychological aspect of #biopsychosocial model @AllenFrancesMD #RANZCP2022

Psychiatric hospitals in 1960s were making patients worse - overcrowded, no treatment, degrading @AllenFrancesMD #RANZCP2022

Have to defeat all 3 reductionisms (biological, psychological & social) and join them together as #biopsychosocial causation and treatment of #mentalillness @AllenFrancesMD #RANZCP2022

Have lousy medical treatment (specific reference to US) as funding predominantly on biological treatments & not on psychological and social @AllenFrancesMD #RANZCP2022

US is "worst of places in worst of times to be mentally ill right now" - @AllenFrancesMD #RANZCP2022
Trieste in Italy is one of best places because of holistic take on mental healthcare, incl urban green spaces.

We are over-treating people who would likely be better off without medication. Medications are needed, but never sufficient - @AllenFrancesMD #RANZCP2022

In US, training programs are failing, as psychotherapy neglected and community psychiatry is no longer taught - lack of community psychiatry has resulted in increase of homelessness & imprisonment @AllenFrancesMD #RANZCP2022

What are the solutions? - none are easy, and none are likely to happy - @AllenFrancesMD #RANZCP2022. NIMH funding needs to become more balanced. More social research needs to occur.

Community psychiatry needs to be restored. Treatments to rescue patients from prison and homelessness needs to increase @AllenFrancesMD #RANZCP2022

It's not the quantity of time you spend with a patient, but the quality - a psychotherapy conversation of any duration is greatly beneficial @AllenFrancesMD #RANZCP2022

Adding spiritual into the recovery model is also important @AllenFrancesMD #RANZCP2022

Q - Any reductionism seems to emphasise the need for explanation, assuming if we know this we can prevent illness arising. Is this a flawed assumption? Would money be better spent on alleviating distress?
A - yes, and I couldn't say it any better, says @AllenFrancesMD #RANZCP2022