Beyond the Prescription: Why Psychiatry Needs a Revolution (and a Sense of Humour)

A GP walks into a psychiatrist’s office and says, “I’ve got a patient who’s brilliant, struggles with social interactions, gets overwhelmed by sensory input, and questions the meaning of existence.”

The psychiatrist barely looks up. “Bipolar. Maybe a bit of Borderline. Here’s a prescription. Next!”

Sound familiar?

Welcome to modern mental health care, where we diagnose existential crises, “medicate” neurodivergence, and treat trauma like it’s some check-up to schedule for six months from now.

But here’s the kicker: the system we’re relying on is older than your grandparents’ flip phone. It’s time for a serious rethink.

What if History’s Geniuses Walked into Today’s Psychiatric Office?

Let’s imagine Einstein in today’s office. Picture him saying:

“Doc, I’ve got this crazy idea about relativity, but people keep telling me I’m not fitting in. Also, my hair… it’s a bit much.”

The psychiatrist reads through the DSM. “Hmm, social withdrawal, hyper-focus, a bit of eccentricity—sounds like ADHD. Let’s try a medication for that.”

Well, there goes the theory of relativity. Thanks, DSM.

Or consider Nikola Tesla. Imagine him, pacing in the office, talking about his obsession with numbers and pigeons. He’d likely be handed a prescription for OCD. Imagine if Tesla had taken those meds instead of changing the world with alternating current?

And Virginia Woolf—a literary genius—might describe her creative process as “riding waves of brilliance followed by deep bouts of darkness.” The prescription? Probably something for bipolar disorder. The result? Mrs. Dalloway and To the Lighthouse would never have been written.

JFK’s Libido: Not a Disorder, Just a Lot Going On

Let’s not forget about John F. Kennedy, the 35th president of the United States. If JFK had walked into a psychiatrist’s office with his well-documented personal challenges, he might’ve gotten a diagnosis for hypersexuality or impulse control issues.

But would that have stopped him from navigating the Cuban Missile Crisis with confidence? Unlikely. And yet, we often treat symptoms like these as problems to be solved, rather than as part of the human experience. Imagine JFK on a psychiatric couch: “Doc, I’m trying to prevent a nuclear war, but my… let’s call it ‘enthusiasm for life,’ is causing a little friction at home.”

Would the prescription have been a little less “enthusiastic” behavior? I’m not sure. Maybe we’d have had a more “chill” president, but we also wouldn’t have had the same level of courage in those tense moments.

Trump: Is This “Post-Psychiatrist”?

And then there’s Donald Trump, a walking, talking tempest of unpredictability. If Trump had wandered into a psychiatrist’s office, he’d probably be diagnosed with narcissistic personality disorder in no time. But knowing Trump, he’d probably take one look at the doc and say, “Doctor, you don’t understand. I’m a winner—everyone loves me, I’m terrific. Trust me, I’ve never been better!”

Trump probably wouldn’t sit down long enough for a prescription—he’s too busy making sure everyone knows how great he is. But imagine a world where he’d actually gotten treatment—maybe we wouldn’t have had a reality TV star in the White House. And, okay, maybe Twitter wouldn’t have been quite so entertaining.

Australia’s Mental Health System: Still Catching Up

When it comes to Australia’s mental health system, we’re still running on an old operating system. Sure, places like Melbourne and Sydney are making strides in trauma-informed, neurodiversity-affirming care, but much of the country is stuck in the past—distributing diagnoses like they’re coupons for free pizza. And ADHD? We’re still debating whether it’s “real” or just another social construct.

What Needs to Change?

The future of mental health care has to prioritize:
✅ Understanding over labeling—because maybe the real problem isn’t the individual, but how society is structured.
✅ Trauma-informed care—we need to heal the roots of trauma, not just treat the surface symptoms.
✅ Medication as a tool, not a first resort—some people need meds, others just need someone to listen.
✅ Neurodiversity as a strength—because if Einstein and Woolf had been medicated, we might not have their contributions to history.

The Family GP: A Dying Breed

Let’s not forget the family GP—the person who used to know us, not just as a file number, but as a real person. Unfortunately, the model is dying out, replaced by an impersonal, commercialized healthcare system that makes everything feel transactional.

But we can bring back that heart to healthcare, one that focuses on the person, not just the diagnosis.

Psychiatry at a Crossroads: Will Australia Step Up?

Australia’s at a crossroads. We can keep pretending the current system works, or we can step into a future where people aren’t just “managed”—they’re understood, supported, and empowered to thrive.

Because if we don’t make a change now, we’ll be in the same place in 30 years, only with even fancier pills and the same old problems.

It’s time for change, and it’s happening—one step at a time. Not because it’s easy, but because it’s hard.

Paul Alexander Wolf 🇳🇱🇿🇦🏴󠁧󠁢󠁥󠁮󠁧󠁿 🇿🇦🎶