Is Psychiatry Working?

Professor Femi Oyebode discusses the six-part BBC Radio 4 series that he co-hosted.

My involvement in the BBC Radio 4 six-episode series Is Psychiatry Working? was entirely fortuitous.

My co-presenter Horatio Clare was a next-door neighbour in Hebden Bridge. And before you ask why a Birmingham psychiatrist was living in Hebden Bridge, the reason is straightforward.

My wife, Jan, had been Director of the Clinical Psychology course in Birmingham for several years and was appointed as Professor of Dementia Care at University of Bradford in late 2011.

She needed a place to live, during the week, that had a railway station on the Trans Pennine line from Manchester to Leeds with a stop in Bradford. Hebden Bridge was such a place and is probably the prettiest of West Yorkshire towns and we were pleased to find a place to live there.

On a sunny day, the stones are burnished golden yellow, and the valley with Hebden Water running down it, is glorious. Horatio and I were neighbours, in a hamlet, Midgehole, just outside of Hebden Bridge.

Other neighbours told me in 2021 that Horatio had written a book, Heavy Light, about his experience of psychosis. There was much talk in Hebden Bridge about it. I ordered a copy to review for BJPsych but the review copy never arrived. So, I told Horatio about my wish to review his book for the Journal and he promptly gave me a signed copy for review. The review was published in 2021 (doi:1192/bjp.2021.134). After that we decided to sell up and we sold our property to Horatio and his partner so that they could expand to the extra space that two adjoining houses provided.

In early 2022 Horatio contacted me to ask whether I would join him in pitching the idea of a programme to the Radio 4 and I agreed. The commissioning editor Dan Clarke was already aware of me because he commissioned a programme presented by Joanna Cannon, writer and psychiatrist, on suicide, Papageno and the Poetry of Disquiet, to which I had contributed. To my surprise and Horatio’s, Radio not only commissioned the programme but commissioned six, 28 minute, episodes.

The aims and goals changed considerably over the five-month period of recording the interviews and recording the discussions between Horatio and me. Initially, there was a desire to focus on the historical development of psychiatry, to show how we got where we are. And we interviewed historians of psychiatry such as Claire Hilton and others.

Sadly, those interviews did not make it into the broadcast episodes. In the end, the decision was to follow Horatio’s story, to map the episodes on a structure that flowed from crisis, through to detention, then diagnosis, treatment, therapy and finally recovery. And I believe that structure, that shape populated as it was by the powerful voices of Antonio, Leah, Clare, Faiza and Luke helped to drive the narrative forward. The human stories gave momentum to the narrative arc. The personal stories provoked empathy and compassion and helped the listener to further understand what it is like to be in the throes of severe mental illness.

The contributions of Matthew Broome, Melanie Higgins, Katy Mason, Mike Slade and Lade Smith were wonderful. They showed what thoughtful, empathic and compassionate people most psychiatrists are. Then also how knowledgeable and authoritative we are and yet modest, humble even.

My own personal goal was exactly that, to show the humanity of psychiatrists and the complexity of the subject. My mantra at all our meetings was ‘if the BBC can put on programmes about quantum mechanics, why can’t we talk about the intricacies of the brain, of neurotransmitters and neuropeptides, of sodium-ion channels, and of positive predictive errors and salience. But, also of the interactions between the social environment, adversity and brain development and function, and very definitely about the understanding that attachment theory has brought to our subject.

The series received high praise from the BBC, from patients, the general public and practitioners. There is talk of other programmes, of possibly another series, and we will be at Hay-on-Wye on 28 May 2023. It was five months of worthwhile work.

Listen to all six episodes of Is Psychiatry Working? (BBC iPlayer required)