Skip to ContentGo to accessibility pageKeyboard shortcuts menu
OpenStax Logo
Psychiatric-Mental Health Nursing

26.2 The Anti-psychiatry Movement

Psychiatric-Mental Health Nursing26.2 The Anti-psychiatry Movement

Learning Objectives

By the end of this section, you will be able to:

  • Discuss controversy about the practice of psychiatry and the DSM
  • Identify calls for treatment/medical diagnostic framework reform
  • Explain the nursing implications of the anti-psychiatry movement

The anti-psychiatry movement is a political/social movement and intellectual phenomenon that emerged in the 1960s as a public response to perceived injustices and inadequacies within the traditional psychiatric system. The movement, heavily influenced by figures such as R.D. Laing, Thomas Szasz, Franco Basaglia, Theodore Lidz, and Michel Foucault, questions the legitimacy of psychiatric diagnoses, the effectiveness of psychiatric medications and treatments, and the overall influence of psychiatry on society (Desai, 2005). It raises ethical concerns around involuntary commitment, restraints, and forced medication, asserting that these practices can infringe upon individuals’ basic human rights (Benning, 2016). While the anti-psychiatry movement has faced criticism for its radical perspectives, it has also inspired meaningful changes, such as enhanced client rights and the shift toward more humane, client-centered care in psychiatric practice (Kritsotaki, 2021).

Controversy Over Standard Psychiatry/Diagnostic and Statistical Manual (DSM)

The anti-psychiatry movement has been a significant critic of standard psychiatry, particularly as embodied in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM, the authoritative guide for diagnosing mental disorders used by clinicians and researchers, has faced extensive criticism and calls for reform. Critics argue that the manual’s categorical approach, which classifies mental disorders based on symptom clusters, inadequately represents the complexities and nuances of mental health. There are concerns about the reliability of diagnoses, the validity of diagnostic categories, and the potential for overdiagnosis and pathologizing of normal human behaviors (Fritscher, 2023). The movement has leveled criticism regarding the influence of the pharmaceutical industry on the development of the manual. In light of these concerns, there is a growing advocacy for a multidimensional model of mental disorders. This model proposes viewing mental health conditions on a continuum, rather than as distinct categories, to capture the range and severity of symptoms better. Additionally, proponents of this model suggest greater transparency in the DSM development process, ensuring that diagnoses are based more on empirical evidence and less on external influences (Bredström, 2017).

Critique of Standard Psychiatry from the Anti-Psychiatry Movement

Anti-psychiatry critics like Thomas Szasz argue that the medical model of mental illness, which conceptualizes these conditions as diseases to be diagnosed and treated, is fundamentally flawed (Benning, 2016). The movement asserts that this perspective oversimplifies complex human experiences and emotions by categorizing them into symptom-based diagnoses. Further, critics like R.D. Laing suggest that such an approach can invalidate clients’ experiences and may neglect the sociocultural contexts contributing to mental distress (Cooper, 2017). Anti-psychiatry also critiques the emphasis on pharmacological treatments, arguing that they can potentially result in overmedication and neglect alternative therapeutic options (Desai, 2005). Critics express concerns over the potential for coercive practices in psychiatry, such as forced medication or involuntary commitment, which they perceive as infringing on individual freedoms (Chieze et al., 2021).

Consumer/Social Scientist Perspective

The critique of traditional psychiatry has also been taken on by a consumer/social scientist perspective. These groups advocate for increased client rights, consideration of sociocultural factors, and individualized, holistic treatment approaches (Murray, 2014). Consumers often emphasize lived experience as a vital aspect of understanding and treating mental illness, something that the anti-psychiatry movement champions (Sunkel & Sartor, 2022). Social scientists, particularly sociologists, view the movement as highlighting the sociocultural construction of mental illness, underscoring the importance of understanding mental health within the context of social norms, power dynamics, and societal structures. They argue that constructing behaviors as illness emphasizes the potential negative impacts of labeling and stigmatization (Borelle, 2017). Although these perspectives affirm the importance of the issues raised by the anti-psychiatry movement, they also recognize the need for a balanced approach that appreciates the value of medical interventions when appropriate (Desai, 2005).

Social Control/Cultural Aspects

Mental health diagnoses and treatments are deeply intertwined with societal norms, cultural beliefs, and power dynamics in a given context (Ahad et al., 2023). The process of psychiatric diagnosis can act as a form of social control by medicalizing behaviors and experiences that deviate from societal norms, thereby reinforcing those norms (Telles-Correia et al., 2018). This is especially apparent in the historical inclusion of certain behaviors and identities as diseases. For example, homosexuality was once classified as a mental disorder in the DSM; it was removed in 1973 in response to evolving societal norms and scientific understanding (Drescher, 2015).

Cultural factors shape perception, diagnosis, and treatment of mental illnesses as well. Different cultures and societal groups have varying concepts of mental illness and how it should be treated. The Church of Scientology, for instance, has been a prominent and controversial force in the anti-psychiatry movement. The Church’s founder, L. Ron Hubbard, was a vocal critic of psychiatry, viewing it as a corrupt, coercive, and harmful institution (Kent & Manca, 2014). The Church developed initiatives like the Citizens Commission on Human Rights (CCHR), a Scientology-affiliated organization that campaigns against perceived abuses in psychiatric practice (CCHR, 2023). The Church’s criticisms echo broader anti-psychiatry sentiments about the medicalization of human distress, coercive treatments, and the dehumanization of clients (Kent & Manca, 2014). Nevertheless, the Church’s involvement in the anti-psychiatry movement is contentious. Some argue that it reflects the Church’s self-interest, given that Hubbard also founded Dianetics, a system that presents an alternative to psychiatry (Kent & Manca, 2014). The Church’s role in the anti-psychiatry movement illustrates how diverse groups can take up the critique of psychiatry for various motives (Benning, 2016).

Relationship with the Pharmaceutical Industry

The relationship between the anti-psychiatry movement and the pharmaceutical industry is characterized by deep tension. A significant concern within the anti-psychiatry movement is the medicalization—the process by which mental health issues are framed and treated primarily as medical conditions—of mental health and the consequent emphasis on pharmacological treatments. Many critics argue that medicalization benefits the pharmaceutical industry at the expense of client rights and freedoms (Ivanov & Schwartz, 2021). This perspective emphasizes biological and physiological explanations for mental disorders and often prioritizes pharmacological treatments over other forms of therapy. Medicalization can include categorizing various behaviors, emotions, and psychological states as medical problems that require treatment, often with medication (Fergusson et al., 2023).

Critics point to the close ties between the pharmaceutical industry and psychiatry, including financial relationships, which they argue may lead to conflicts of interest and potentially biased research outcomes. The anti-psychiatry movement also emphasizes the potential harms of psychiatric medications, such as side effects and withdrawal symptoms, arguing that the industry, with its pharmaceutical-focus approach, downplays or overlooks them (Cosgrove et al., 2014).

While the anti-psychiatry movement raises important critiques, it is important to note that pharmacological treatment can be beneficial and even lifesaving for many individuals. Balancing these critiques with the real needs of clients represents a critical challenge within mental health care (Stein et al., 2022).

Psychosocial Considerations

Key Positions Embraced by the Anti-psychiatry Movement

The anti-psychiatry movement follows several specific beliefs regarding mental health treatment:

  • Individual autonomy: The anti-psychiatry movement places great importance on respecting the autonomy of individuals diagnosed with mental health disorders. It critiques the paternalistic tendencies of some psychiatric approaches, where the clinician’s authority may overshadow the client’s voice and self-determination.
  • De-medicalization of human experiences: Advocates point out that some experiences labeled as pathological by psychiatry may instead be natural responses to stressors or social injustices. They question the boundary between normal and pathological, suggesting that psychiatry can medicalize human experiences and emotions.
  • Stigma and identity: Anti-psychiatry proponents assert that psychiatric labels can contribute to stigma, affecting a person’s self-perception and societal identity. They argue that these labels may lead to internalized shame and societal discrimination.
  • Role of societal power dynamics: The movement often underscores how prevailing societal norms and power structures can influence psychiatry. For instance, it has critiqued how certain behaviors are pathologized due to cultural bias or social control rather than evidence of dysfunction.
  • Trauma-informed perspectives: Anti-psychiatry advocates emphasize the importance of acknowledging and addressing trauma’s impact on mental health, often overlooked in traditional psychiatric models.

Potential impacts of the movement:

  • Clinical practice and policies: The anti-psychiatry critique has led to a shift in some areas of mental health practice and policy, promoting greater client involvement, a focus on recovery-oriented models, and increased trauma-informed care.
  • Consumer/survivor movement: Anti-psychiatry has inspired a broader consumer/survivor/ex-client movement, advocating for the rights and voices of people diagnosed with mental health conditions.
  • Paradigm shift: Some professionals advocate for a paradigm shift in mental health care from the disease model to a psychosocial model that recognizes the complex interplay of biological, psychological, and social factors in mental health.

Challenges of the movement:

  • Potential neglect of biological factors: Some argue that the anti-psychiatry movement’s emphasis on social and psychological factors might lead to an underappreciation of biological aspects of mental health disorders.
  • Risk of discrediting psychiatry: Some worry that anti-psychiatry sentiments may discourage individuals from seeking necessary psychiatric care or erode public trust in mental health professionals.
  • Absolutism: There is a risk of adopting an overly dogmatic stance. The medical and psychosocial models can provide valuable insights into mental health, and a balance of perspectives may be necessary.

Calls for Treatment/Medical Diagnostic Framework Reform

The DSM-5-TR is the latest edition of what has been the primary diagnostic guide for mental health professionals since its first edition in 1952. Criticisms of the manual have prompted significant calls for reform in the medical diagnostic framework for mental illness. Critics assert that the manual’s approach is too categorical, neglecting the often complex and nuanced presentation of mental illness (Stein et al., 2022).

The National Institute of Mental Health (NIMH) introduced the Research Domain Criteria (RDoC) framework, marking a shift toward a multidimensional approach in understanding mental health. This framework recognizes the complex interaction of genetic, neurobiological, and environmental factors in the development of mental disorders. Unlike traditional diagnostic systems that categorize mental illnesses, RDoC focuses on identifying disrupted brain processes and behaviors as the basis for understanding mental illness. According to Böttger et al. (2023), this approach is considered by some to provide a more accurate representation of the underlying pathophysiology of mental health conditions, offering a more nuanced and comprehensive understanding of these disorders.

Nonetheless, this model also faces criticism. This highlights the need for a balanced, biopsychosocial approach in the future development of the medical diagnostic framework. It is clear from the critics, however, that the time has arrived for treatment reform in mental health care. Implementation of a more comprehensive and inclusive diagnostic model could lead to improved client outcomes, increased understanding of mental illnesses, and reduced stigma (Stein et al., 2022).

Nursing Implications of the Anti-Psychiatry Movement

The anti-psychiatry movement has influenced nursing practice considerably, particularly in the mental health field. This movement fundamentally questions the legitimacy of psychiatric diagnosis and treatment, advocating instead for understanding mental health issues as human experiences rather than pathological disorders (Benning, 2016). This perspective has significantly influenced the nursing profession in several ways. It has promoted a more holistic and client-centered approach to care. Instead of solely focusing on symptoms and diagnoses, nurses are now encouraged to consider their clients’ lived experiences, personal narratives, and sociocultural contexts (Flaubert et al., 2021). This shift has been instrumental in developing therapeutic communication skills and fostering empathy in nurse-client relationships.

The anti-psychiatry movement also promoted a shift toward deinstitutionalization and community-based care. This impacts nursing practice as nurses increasingly deliver care in outpatient settings and in the community, requiring them to adapt their skills to diverse environments and work more closely with clients’ social networks (Fulone et al., 2021).

While the movement has contributed to positive changes, it also presents challenges. Nurses must grapple with the tension between medical models of mental illness, which emphasize biological factors and medication, and anti-psychiatry perspectives, which reject these models. This balancing act requires continual professional development and reflection on practice. The anti-psychiatry movement encourages a holistic, empathetic, and community-focused approach to care, but it also presents ongoing challenges as nurses collaborate with other professionals and navigate the complexities of mental health care.

The anti-psychiatry movement emphasizes the importance of addressing the holistic needs of clients, including their psychological, social, and spiritual well-being. Nurses should be aware of the broader context of clients’ lives and the various factors that contribute to their mental health.

Real RN Stories

Nurse: Zander, RN
Years in Practice: Eight years
Clinical Setting: Private psychiatric hospital
Geographic Location: New York City

When I first started working as a psych nurse, I was assigned to a great unit with a strong educational focus. I became good friends with Ruth, a nurse many years my senior, and some of her stories made me laugh, and some almost made me cry. One time in particular, we had just admitted a young adult from the streets who was fiercely opposed to being hospitalized and definitely opposed to taking any of the medication ordered for schizophrenia. I was annoyed when the client refused the meds especially after I did such a good job teaching. Ruth invited me to lunch, and we had a conversation about the differences between Ruth’s time and mine. Ruth told me that in “her day” the nurses were never told the client’s diagnosis and were just expected to keep them occupied and attend to their needs on the unit. She said that even though the nurses never knew what was “wrong” with the clients, nursing care was focused on the relationship, which Ruth looks back on as a good thing. This was one of those times when Ruth’s story almost made me cry.

Validation as an Approach in Nursing Care

An empathetic and holistic approach to care, validation therapy emphasizes understanding and respect for the client’s subjective experiences, particularly effective when working with individuals with neurocognitive disorders. This client-centered therapy uses validation, empathy, and active listening to connect with people in the late stages of life, often those living with cognitive impairments, to enhance their well-being and dignity (Fertalova & Ondriova, 2019).

In nursing practice, validation therapy guides nurses to view behaviors not as symptoms to be controlled, but rather as a form of communication. A client experiencing a mental health issue may be trying to communicate an unmet need or express discomfort. Instead of correcting or reorienting the client to reality, the validation approach suggests understanding the person’s perspective and validating their feelings (Scales et al., 2018).

The impact of this approach is twofold: it can help reduce stress and anxiety in the client and it builds stronger connections between the client and the nurse. It encourages nurses to become less judgmental, to listen deeply, and to respond to context and emotions rather than the literal statements made by the client (Hartley et al., 2020). Research indicates that validation therapy can improve the quality of life for people with dementia, decreasing negative behaviors and increasing positive emotions (Scales et al., 2018).

Safety and Crisis Intervention

The anti-psychiatry movement has led to a reevaluation of crisis intervention strategies, emphasizing the need for consent and autonomy in care. Proponents argue for the reduction of involuntary treatments and the implementation of alternatives, such as peer support, community-based services, and crisis intervention teams that prioritize de-escalation and voluntary cooperation (Bazelon Center for Mental Health Law, 2024). These approaches align with the principles of trauma-informed care, which acknowledge the impact of trauma on mental health and strive to create services that are compassionate and non-retraumatizing (Center for Substance Abuse Treatment, 2019).

The movement has underscored the importance of considering the social determinants of mental health, such as poverty, discrimination, and social isolation, in crisis intervention. This broader perspective encourages interventions that not only address immediate mental health crises, but also work toward systemic changes to prevent such crises from occurring (Kirkbride et al., 2024). The anti-psychiatry movement has significantly influenced safety and crisis intervention strategies in mental health care. By advocating for client autonomy, less coercive practices, and a holistic view of mental health, it has contributed to the development of more ethical and effective approaches to crisis intervention. It also presents challenges in balancing client rights with the need for safety in situations of acute risk, however. Future research and policy development must continue to navigate these complexities to improve mental health-care outcomes (Johnson et al., 2022).

Client Education and Advocacy

The anti-psychiatry movement has played a significant role in advancing client education and advocacy within mental health care. Central to the movement is the belief in the autonomy and rights of individuals experiencing mental health challenges. This perspective has led to an emphasis on informed consent, the democratization of the therapeutic relationship, and the empowerment of clients through education and self-advocacy (Dalal, 2020). Education is essential for dispelling the myths and stereotypes about mental health disorders that often fuel stigma and discrimination (Ahad et al., 2023). Client education, from the anti-psychiatry viewpoint, involves providing individuals with comprehensive information about their diagnoses, treatment options (including potential risks and benefits), and the sociopolitical context of mental health care. This approach supports individuals in making informed decisions about their care, fostering a sense of agency and participation in their treatment process. The movement advocates for transparency and honesty in the psychiatric system, encouraging practices that inform clients about the nonmedical aspects of their conditions, such as the impact of social determinants on mental health and the potential for recovery outside traditional psychiatric interventions (Paterick et al., 2017).

Advocacy involves championing the rights and interests of individuals with mental health conditions. It seeks to foster societal change, ensuring fair treatment and equal opportunities for this group. Both education and advocacy facilitate the transformation of mental health care toward a more holistic, compassionate approach that respects the autonomy and dignity of individuals. As integral parts of the anti-psychiatry movement, they empower individuals to actively participate in mental health care, understanding all their options, rather than be passive treatment recipients (Saha, 2021).

Staff Education on the Perspective of the Client

Educating staff on the perspective of mentally ill clients is crucial to enhancing the quality of care provided. This involves adopting a client-centered approach that focuses on understanding individuals’ lived experiences and perspectives (Flaubert et al., 2021). Understanding the client’s perspective is vital in promoting empathy and reducing stigma among mental health professionals. Such understanding can also help professionals better comprehend clients’ needs and preferences, thus guiding the development of individualized treatment plans (Phelan et al., 2023).

Self-examination of bias by staff in mental health care is a critical aspect of providing equitable and effective treatment to diverse client populations. Bias, whether conscious or unconscious, can significantly impact the quality of care provided, affecting diagnosis, treatment decisions, client interaction, and overall client outcomes. Recognizing and addressing these biases is essential for improving mental health services and ensuring that all individuals receive compassionate and appropriate care, regardless of their background, identity, or circumstances (Gopal et al., 2021).

Clinical Judgment Measurement Model

Generating Solutions: Understanding the Client’s Perspective

The client is reluctant to attend groups on the unit or accept any medications. The client’s background and culture are very different from those of the nurse.

Nursing knowledge is required to appreciate the client’s perspective and generate a solution. The nurse takes a client-centered approach, focused on empathy. The nurse engages in self-reflection to identify personal bias that may influence the nurse-client relationship. The nurse uses these approaches to contextualize the client’s avoidance of treatments and to consider interventions that may align more with the client’s belief system.

Training programs like Mental Health First Aid (MHFA) and peer-support models aim to create a more compassionate and empathetic approach toward mental illness by fostering an understanding of the client’s perspective (Edgar & Connaughton, 2021). Educating staff on the perspective of the mentally ill client through programs such as MHFA is a cornerstone of effective, compassionate, and person-centered care in mental health services. Other areas of education opportunities may be during annual skills training sessions and in-service opportunities within health-care facilities.


This book may not be used in the training of large language models or otherwise be ingested into large language models or generative AI offerings without OpenStax's permission.

Want to cite, share, or modify this book? This book uses the Creative Commons Attribution License and you must attribute OpenStax.

Attribution information
  • If you are redistributing all or part of this book in a print format, then you must include on every physical page the following attribution:
    Access for free at
  • If you are redistributing all or part of this book in a digital format, then you must include on every digital page view the following attribution:
    Access for free at
Citation information

© Jun 12, 2024 OpenStax. Textbook content produced by OpenStax is licensed under a Creative Commons Attribution License . The OpenStax name, OpenStax logo, OpenStax book covers, OpenStax CNX name, and OpenStax CNX logo are not subject to the Creative Commons license and may not be reproduced without the prior and express written consent of Rice University.