A scientist can never be one hundred percent sure about anything. Science is not about “true or false”. Science is a methodology to achieve as much objective and trustworthy knowledge as possible about the world we live in. Mental health science aims, among several other things, to increase our understanding of mental health disorders. An increase in our understanding of what mental disorders really are, will hopefully be followed by better treatment for the individual patient - less distressing symptoms, increased functioning, and improved quality of life.
Science says…
When we read or hear the phrase “science says…” in the mental health field, we must assume that several studies have revealed the same results repeatedly. The results and findings have undergone critical reviews from other researchers and there is little doubt about the findings.
If science says that psychotherapy is an effective treatment for patients with a depressive disorder or science says that antipsychotics are effective in treatment for patients struggling with hallucinations and delusions, there should be as little contradictory finding as possible. Before a treatment approach is implemented in clinical practice as a recommended treatment and the researcher claims that “science says….”, scientist from all over the world should have looked thoroughly at the results from different studies, using a wide range of different methodologies. Then, if the results are replicated in several other studies, with only small possibilities for any biases, the researchers and scientists can conclude - with this knowledge we have today, this should be a recommended treatment for patients with a mental disorder.
However, it is important to know that this does not mean that everyone would benefit from the treatment. It only says that several people will have more advantages than disadvantages receiving this specific treatment. If scientists say that they know that the treatment work, they are most certainly also quite clear about the fact that the treatment does not work for everyone. There is no treatment in medicine or in the mental health field that works for everyone. Very often we must change treatment approaches – another psychotherapeutic method or another antipsychotic- to achieve the best possible treatment for the individual patient.
It ain’t necessarily so…
In the research department at Oslo University Hospital, we had a slogan from the musical Porgy and Bess – “It ain’t necessarily so”- that constantly reminded the researchers that they had to be critical to their own findings. Could there be other ways to understand the results, and is this specific finding important for the patients? This is also a gentle reminder that we must be skeptical to our own data and findings. It could be that the result of a study is fraught with many errors and biases. To be open minded about the limitation of the research findings is of course of uttermost importance. Every study and research findings have limitations which it is important to be aware of and take into consideration before we say: “science says….”.
Research is, as the word explicitly says, to search again.
Science and uncertainty
There is no doubt; the human mind is complex. A lot of different approaches are needed to understand the human mind and the complexities of mental disorders (e.g., genetics, environment, life experiences etc.). The more complex something is, the more uncertainty there is in the scientific results. Each and every scientific method in the mental health field has its limitations and uncertainties. Further, these approaches can sometimes reveal quite different and conflicting results. This clearly shows the complexity of mental health disorders and the importance of the cooperation of researchers from different disciplines to increase our understanding and improve the treatment approaches for patients with mental health disorders. Science is continually developing. With new methods and new knowledge scientists constantly need to revise their previous findings. What is accepted as a “fact” today can be viewed differently tomorrow. We must remind ourselves that history has clearly shown that what we thought was true in science, often turn out to be wrong later.
Trust in science
Today, people mostly trust what the researchers says and the findings they have revealed. Researchers still have high credibility in society. However, it seems today, that there are more and more people who do not have confidence in the results that research shows. This is frightening, and something we must prevent as best as possible. Social media and a polarization in the society can be a threat to science and its sound methodology to create new knowledge. Social media, such as Facebook and Instagram, does not differentiate between reliable and unreliable research. It is thought provoking, that bad research with lousy methodology and incomprehensible results is spread more on social media than good research. Researchers must prevent this by communicating what the scientific method entails, incorporating critical thinking and source criticism.
Science improves mental health treatment
There are no alternatives to science and research if we are going to increase our understanding of mental health and improve the effect of the different treatment approaches. With all the limitations and uncertainty in science and research our understanding improves, and the treatment approaches are becoming more effective. I think all agrees that you receive better help from the mental health services today than for 60 years ago - 100 years ago and 200 years ago. Our understanding has increased to the best for the patients who struggle with mental health disorders. This is mostly due to the scientific understanding of mental disorders.
Luckily - science says that most people still trust what science says... □
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