Psychiatrists could be forgiven for avoiding this apparent critique of their profession. However, such aversion would be a shame, for while familiar ground is trodden here, there is much that is new, positive and worthy of thought.

The book consists of nine chapters, the first three occupying just over half the space. In this half the focus is on the ‘disease model’, diagnosis and the use of medication. Some of this is wearily familiar and we must ask whether full due is given to all available evidence. The roles of trauma and ‘life events’ in schizophrenia are offered to raise our credence that this problem is best considered psychosocial. A major alternative theory, that some manifestations may best be considered a developmental disorder (not everyone who meets DSM criteria will have been abused or traumatised) is not even mentioned.

On diagnosis. It is right that psychiatry should face shameful aspects of its history. The tremendous damage wrought by pathologising homosexuality for decades and the odious debacle of drapetomania should remain stark lessons. However, Kinderman might have done more to explain why these despicable examples have a substantive bearing on the question of diagnosis in general. On medication though, his particular brand of caution seems more laudatory than incendiary.

More interesting territory lies beyond. Regardless of readers’ prior commitments on the nature of mental health problems, Kinderman is going to find much agreement on the constructive thrust of chapters four to nine. A holistic approach to well-being; a proposal for comfortable, decent residential care for ‘respite’ rather than ‘cure’. In a field where attitudes are so important, changing the basic mission of services could have revolutionary implications.

The biggest controversy will be around Kinderman’s view of what psychiatrists’ role should be (although he is good on linking his position to debates from within the profession itself). From the perspective of this reviewer (a trainee clinical psychologist), it is an exciting notion that many of the leadership and legal roles of psychiatrists could be performed by other professionals. However, a more radical suggestion that psychiatrists should have only a medical consulting role, may alienate many. Whatever your view, Kinderman could open constructive debates with his bold proposals.