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Investigating the history of psychiatry can often unsettle our own ‘common sense’ on matters of mental health and illness. Reason and madness, we quickly learn, are not stable categories, but are shaped amid social contingencies and political agendas, frequently to the empowerment of some and the marginalization of others. This insight is brought home with a fresh—and disturbing— poignancy in Peter Barham’s Outrageous Reason: Madness & Race in Britain & Empire, 1780- 2020. Like his earlier work, the book showcases Barham’s keen perspective as both a chartered psychologist and trained historian, delivering a highly original, and profoundly challenging, critique of a colonial legacy, which, he compellingly argues, remains discernible within British mental health services—and wider societal perceptions of mental health and illness—today. It will make an important contribution to the libraries of academics and clinicians, while also remaining accessible to the lay reader.
The central argument of the book is that modern British psychiatry emerged not as an objective mind science, but as an ideological and institutional tool that has been used to bolster and enforce white, liberal conceptions of reason and mental health, and hence, to pathologize other groups and identities—in particular, non-whites, women, and the poor. Systemic racism, Barham contends, persists within psychiatric institutions and practices today, an issue that demands an unflinching reckoning with psychiatry’s colonial past. And so, through a series of case studies spanning more than two centuries, Barham explores the interplay of colonial agendas, racist ideologies, and institutional abuses that have attended and vitiated the modern psychiatric enterprise from the start.
Barham sets the stage for the study by exploring some of the key epistemological issues surrounding madness and diagnosis. Mental health patients endure a ‘credibility deficit’, with doubt being cast on the truth and reliability of their