Strictly speaking, the question is not how to get cured, but how to live
Joseph Conrad

This conference is long overdue, and reflects the current feeling that there is an urgent need for change within psychiatry. An ever-growing number of depressed individuals, their families, and mental health professionals are deeply disturbed by the way depression is being treated at present. Psychiatry is attracting much criticism and anger from those using the service.

Anti-psychiatry movements abound throughout the world, yet none exist in other branches of medicine. Why? Because these branches of medicine are accomplishing their primary task, that of delivering the best possible service. Meanwhile, there is a growing constituency of individuals worldwide who feel they have been traumatised during their psychiatric treatment, who have found their emotional needs sidelined, their treatment ineffective, their difficulties with the side effects of medication unresolved, and their spirit and dignity undermined. For the majority, little or no healing occurs during psychiatric treatment, merely containment by medication, and this fosters in sufferers a climate of hopelessness, despair, and fear, and leads to a life lived under-utilised and under-expressed.

Our conference is designed to stimulate a change in focus relative to how depression is understood, and to make a plea for an examination and a questioning of the efficacy of the prevailing disease model. This is a paradigm shift in consciousness whose time has come. The conference will offer members of the public, healthcare professionals and policy-makers a unique forum to hear four medical doctors who passionately feel that mistaking an emotional response for a disease is the source of the current crisis in psychiatry. They will be calling for a commitment to the agenda of healing depression, with full recovery the goal, free from the revolving door pattern of relapse and remission, and a lifetime lived in the shadow of medication, which now prevails.

Such change can never happen as long as depression is understood to be the result of a sick or faulty brain. Depression displays none of the characteristics of a disease, behaving instead like an emotion, with the attendant hormonal chemical shifts common to all emotions. Far from being imbalances, these changes reflect a changing status quo within consciousness. An everyday simple example demonstrates this. If you lose your job, or you lover rejects you, and you become depressed, your depression would immediately lift if your job was reinstated - or you found a new one - or your lover returned. However, such good news would not influence, for example, the course of your renal illness, muscular dystrophy, diabetes or cystic fibrosis.

This fundamental error of thinking, which treats an emotional response as a disease, underscores the current failure in psychiatric treatment, and is actively holding back the healing of sufferers.

Within the sick-brain model, depressive episodes are only coincidentally connected with upbringing, belief systems, coping skills, environments, relationships, socio-economic factors, and life events such as a broken heart, bullying, sexual abuse, substance misuse, a sexual disorientation, eating disorders, panic attacks, examinations, or workplace difficulties. Life's setbacks are not seen as causative. Treatment is aimed solely at anaesthetising the distress through medication, which acts merely as an emotional painkiller. In such a climate, sufferers remain passive, perpetually waiting for the medication to act, enduring appalling side effects, with their lives on hold, always fearful of a further eruption. When the medication and repeated hospitalisations fail to 'cure' the depression, as a last resort the use of electric shocks to the brain (ECT) is justified by this approach. This leaves in its wake indisputable, evidence-based brain damage. Every year an average of 850 individuals in this country are exposed to this dangerous intervention.

It has to be asked to what degree the disease model, with its hopeless outlook for the future, is contributing to the escalating suicide rates among our young. It's terrifying for a young person to be told that they have a life-long disease, relapsing in nature, requiring continuous medication, and possible hospital admission. (The latest statistics for 2003 show that 68% of admissions to hospital for depression were re-admissions.)

Many who have experienced hospitalisation are deeply traumatised by it. They have to associate with deeply disturbed long-stay patients; they experience lock-up wards; an atmosphere of fear and lack of privacy; primitive conditions; the absence of psychotherapy or meaningful rehabilitation programmes, in a place where the entire emphasis is on medication and containment. They feel they have lost all personal control as they battle against the stupefying effects of excessive medication. Many have no memory of family members visiting, an effect reinforced if they have had electric shock 'treatment'. When they finally emerge no better, and with the possibility of more of the same ahead of them, suicide may be a welcome alternative.

By contrast, when depression is understood as a legitimate emotional response to life's difficulties, and its attendant chemical shifts seen as secondary to changes in thoughts and feelings, just as in emotions such as anger, grief and love, then its treatment is radically different. Once given meaning, an individual's needs during their distress can be identified; hope, support and sanctuary provided; insight sought as to contributing factors; their inner resources and strengths fostered, and new skills learned to prevent recurrence. In this way, true healing is brought about and recovery made possible. Only within this emotional model is mental health education relevant, especially for the young, because only within this model does it make any sense to talk of preventative measures.

The conference will afford an opportunity to hear the keynote speaker, Dr Peter Breggin, author, and veteran international campaigner for change within psychiatry, articulate his fundamental conviction that the profession has taken a wrong turn, and that healing can occur without resort to the very real dangers of medication and electric shock treatment.

The day will include a film, Soul Interrupted, documenting the inner voice of individuals journeying through the psychiatric service, and a play, A Case to Answer, questioning the validity of the institutional view of depression, and the support of it by the pharmaceutical industry.

The cardinal aim of the conference is to generate scientific debate within the profession, stimulate creative thinking among policymakers and service providers, offer hope to sufferers and pave the way for a more compassionate and heart-centred delivery of treatment. In recent years great strides have been made in our understanding of how the mind works, psychotherapeutic skills have evolved, and the value of mindfulness practices and lifestyle management has been demonstrated. Never is it more applicable, never is it more true, that the key to mental health is prevention rather than cure, and that the greatest obstacle to this is psychiatry's own disease model. Surely it is a bitter irony that psychiatry draws its name from the Latin psyche meaning soul and iatriea meaning healing.

We don't have a healthcare system, we have a disease-care system
Jon Kabat-Zinn