In this letter Alan M Rosen comments on the analysis of the long-term future of clinical and academic psychiatry performed by Pat Bracken and Arthur Kleinman, previously published in the British Journal of Psychiatry.

Being aware of the obstacles to achieving integrated mental health reform, the author values the significant advances in the recognition of psychiatry as a discipline which needs to tolerate uncertainty and celebrate complexity, and which requires a multimodal approach to intervention.

"Isn't it better that we should make a stand for a more recovery-oriented, less alienating, less bureaucratically, less biomedically, less big-pharma and less colonially imposed mental health provision in both developing and developed countries? Isn't it preferable to be part of the struggle to get it right, even if against considerable odds, rather than just walking away from the campaign for improving "global mental health" because of legitimate concerns regarding currently dominant paradigms?".

http://bjp.rcpsych.org/content/190/1/81.2/reply#bjprcpsych_el_53943

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