What, With What, and to Whom: The Limits of Psychiatry

Objective: To identify some general principles for use in deciding what is psychiatry and what is not. Method: An overview of matters referred to the Clinical Practice Advisory Committee of the Royal Australian and New Zealand College of Psychiatrists. Results: Three domains of psychiatric practice are identified: competence, ethics and performance. A number of quasi-paradoxical dichotomies in the nature of psychiatry have emerged: doctor-specialist, scientist-clinician, humane-commercial. These are not exhaustive. Conclusion: Some useful generalisations can be made about the limits of acceptable psychiatric practice but, within these, there is a need for further investigation of the realities of practice. A pilot study of clinicians' opinions is proposed.