Joanna Moncrieff

Joanna Moncrieff is a British psychiatrist and academic. She is Professor of Critical and Social Psychiatry at University College London and a leading figure in the Critical Psychiatry Network. Her books The Myth of the Chemical Cure and The Bitterest Pills are central texts in the critical psychiatry movement.

Career In 1989, Moncrieff qualified in medicine from the University of Newcastle upon Tyne, then trained in psychiatry during the 1990s. In 2001, she started at University College London (UCL), where she is currently a teacher and researcher. For 10 years, she was a consultant at a psychiatric rehabilitation inpatient unit, then worked in various community mental health services.

Moncrieff is a founder and co-chair of the Critical Psychiatry Network, a group founded in 1999 to scientifically challenge assumptions held by mainstream psychiatry about the nature of mental disorders and the effects of psychiatric interventions.

Currently, she is leading the NIHR-funded RADAR study, which is evaluating an antipsychotic discontinuation program for people with schizophrenia and similar problems.

Research and writing

Models of drug action Moncrieff states she is not completely opposed to the use of drugs for mental health problems, but believes that the action of drugs in these situations is misunderstood. Moncrieff developed two alternative 'models' for understanding what drugs might be doing when they are prescribed to people with mental-health problems. The current mainstream understanding of psychiatric drug action is based on a 'disease-centred' model that suggests that drugs work by rectifying the underlying abnormality that is presumed to lead to the symptoms of the disorder in question.

Moncrieff contrasts this with an alternative 'drug-centred' model, which suggests that since psychiatric drugs are psychoactive substances, they work because they change the way people think, feel and behave. According to this model, psychiatric drugs have no specific biological effects in people with a mental disorder, and they produce their characteristic effects in everyone who takes them. The changes induced by some sorts of drugs may, however, lead to the suppression of the manifestations (symptoms) of some mental disorders.

The Myth of the Chemical Cure traces the emergence and development of the disease-centred model from the 1950s onwards. It purports to highlight the lack of evidence for the disease-centred model of drug action for every major class of psychiatric drug, despite the psychiatric consensus.

It also explores supposed commercial, professional and political interests behind the disease-centred model.

Antidepressants Together with Mark Horowitz, in 2022 Moncrieff conducted the first systematic umbrella review of the evidence for the serotonin "chemical imbalance" theory of depression, which found that "there is no convincing evidence that depression is associated with, or caused by, lower serotonin concentrations or activity". The research has been called "important" and "the most comprehensive rebuttal to date". According to critics of Moncrieff, the conclusions of the paper are well-founded, but obvious because the serotonin theory has not been viewed as serious for awhile. Moncrieff believes that depression should be seen as a "mood state" rather than an illness, and argues that it's a largely normal reaction to adverse circumstances which some people are more prone to than others. Moncrieff also describes the cultural development of the new concept of bipolar disorder, which she refers to as ‘the medicalisation of "ups and downs"’. Research by Moncrieff and colleagues described and compared the subjective or psychoactive effects of different antipsychotics.

Psychedelic drugs Moncrieff has critiqued the use and study of psychedelic and related drugs, including psilocybin, LSD, MDMA, ketamine, and esketamine, for the treatment of psychiatric disorders like depression, highlighting a variety of concerns with regard to these agents.

Other drugs Moncrieff has critically reviewed the literature on the use of drug treatments like acamprosate and naltrexone for alcohol problems, lithium and the use of stimulants in children.

History and politics of psychiatry Moncrieff has developed a political analysis of the drivers of modern mental health theory and practice and explored the influence of neoliberalism. She has published papers on the historical context of the emergence of modern drug treatment, the history of psychiatric thought in the 20th century and of ‘rapid tranquilisation’ in psychiatry, as well as her books on the history of drug treatments.

Books The Myth of the Chemical Cure: a critique of psychiatric drug treatment, Palgrave, 2008. A Straight Talking Introduction to Psychiatric Drugs, PCCS Books, 2009. The Bitterest Pills: The Troubling Story of Antipsychotic drugs, Palgrave, 2013. Chemically Imbalanced: The Making and Unmaking of the Serotonin Myth, Flint, 2025