David Healy is well known for his respect for and emphasis on the need to learn from people who consult doctors. This relationship is and always has been compromised , by almost total medical freedom in the past and medics compliance with guidelines and over management these days. . The situation challenged by many survivors of psychiatry who have been harmed by the systems past and present have made some headway but are still relatively powerless as the massive increases in over-diagnoses and prescriptions reveal. There has never been an equal relationship between users and medics, The power imbalance in the past was partly due to lack of access to the internet and to some extent the class system which produced the medical profession. Pretty much anything could be defended by ‘in my clinical judgement’ or’ that is how I was trained’. Things haven’t improved , from freedom to practice with little accountability to doctors who have rolled over and accepted without much resistance to being used as a cog in a machine which so abuses the trust as well as the health of people . That some will fall in and prescribe in a way that makes a mockery of ‘in the person’s best interest’ in order to please their pay masters is frightening. How can the profession be proud of itself ?

• Affiliation: none
• Country: UK