People's notions about psychiatry need some perspective. As little as a century ago, most of the mentally-ill who were recognized as mentally-ill were locked up in asylums for life or "treated" with exorcisms, bloodletting, and other savage practices. Freud, Jung and psychoanalysis turned them into a curiosity, but they weren't able to do a lot for them either.

It took the neurophysiological model, famously advanced by Karl Jaspers (in General Psychopathology, 1913) to actually change the lives of the mentally ill. Granted it took some time for this model to take hold and be pursued by medicine, but the fact is that modern neurophysiologically-based treatments have given people productive lives, who just a few decades ago would otherwise have been shuffled off and allowed to suffer needlessly.

Put another way ... the millennia humanity spent without a neurophysiological model for mental illness, gave us absolutely no improvement in the lives of the mentally ill. It took that new approach to make even the modest gains we've made, possible.

The reason psychiatry hasn't advanced much in (say) the last 20 years, is society still hasn't come to grips with the existence of mental illness. Even now there are many who consider it a spiritual failing, not a disease, or a character flaw, mere eccentricity, laziness, etc. We have anti-psychiatry folks who propagate the myth that there is no such thing as mental illness, who apparently think the mentally ill should not be treated at all in any way, thus allowed to suffer in silence. Then there are things like Scientology ... the less said about them, the better.

Diagnosing mental illness remains problematic, almost entirely because of our prejudices about mental illness. The categories of mental illness that we have, are the relics of old (as in, pre-Jaspers) thinking about the matter. Pigeonholing patients into them, often doesn't work. A completely revamped diagnostic model is required. But that would require acceptance not only of mental illness as a reality (something that society as a whole appears not to want to do), it also requires medicine to rethink its manner of treatment (which will likely be resisted). Of course, no field of medicine is eager to undergo a revolution ... it's only prudent to be careful about making major changes. But substantial changes are needed nonetheless.

So you can see why I'm not hopeful.

What's probably worst of all is that ... in our Enlightened age, in which things like slavery have been abolished and equality and human rights are accepted as ideals, society largely doesn't wish to treat the mentally ill in an "enlightened" way. Consider that in classical times, folks like Socrates and Plato revered the mentally ill and sometimes even recommended they be taken care of, catered to, and their utterances recorded as potential divine insights; then look at how we treat today's mentally ill ... by denying their suffering, telling them that all they need is to "get right with God" or "pull themselves up by their own bootstraps" or just "get over yourself" ... ugh!

We all ought to be ashamed.