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Anti-psychiatry refers to approaches (sometimes seen as a coherent movement) which fundamentally challenge the theory or practice of mainstream psychiatry in general, and biological psychiatry in particular. Common criticisms include that psychiatry: uses medical concepts and tools inappropriately; treats patients against their will or is over dominant compared to other approaches; is compromised by financial and professional links with pharmaceutical companies; uses a system of categorical diagnosis that is stigmatizing (the Diagnostic and Statistical Manual of Mental Disorders) and is perceived by too many of its 'patients' as demeaning and controlling.

A significant minority of mental health professionals and academics profess anti-psychiatry views, and even some non biological psychiatrists hold such views in regard to mainstream (biological) psychiatry . Psychiatrists generally view anti-psychiatry as a fringe movement with little or no scientific validity, although it is difficult to quantify the proportion of the general public or professionals involved, or the range of views held.

Despite its name, the movement is often seen as promoting a type of psychiatry itself, albeit one that is in stark contrast to current mainstream thinking. Thus many so-called 'anti-psychiatrists', including psychiatrists with non-mainstream beliefs, are keen to dissociate themselves from the term and the pejorative associations it has attracted .

There was opposition to psychiatry from its origins and as it became more professionally established during the 19th century. Disputes often concerned custodial rights over those seen as 'mad', including in the expanding lunatic asylums, and divergent theoretical interpretations of mental problems. Emil Kraepelin introduced new medical categories of mental illness, which eventually came into psychiatric usage despite their basis in behavior rather than pathology or etiology.

In the 1920s surrealist opposition to psychiatry was expressed in a number of surrealist publications.

In the 1930s several controversial medical practices were introduced including inducing seizures (by electroshock, insulin or other drugs) or cutting parts of the brain apart (leucotomy or lobotomy). Both came into widespread use by psychiatry, but there were grave concerns and much opposition on grounds of basic morality, harmful effects, or misuse. In the 1950s new psychiatric drugs, notably the antipsychotic chlorpromazine, were designed in laboratories and slowly came into preferred use. Although often accepted as an advance in some ways, there was some opposition, due to serious adverse effects such as tardive dyskinesia. Patients often opposed psychiatry and refused or stopped taking the drugs when not subject to psychiatric control. There was also increasing opposition to the use of psychiatric hospitals, and attempts to move people back into the community on a collaborative user-led group approach ('therapeutic communities') not controlled by psychiatry.

Coming to the fore in the 1960s, anti-psychiatry (a term first used by David Cooper in 1967) defined a movement that vocally challenged the fundamental claims and practices of mainstream psychiatry. Non biological psychiatrists R.D. Laing, Theodore Lidz, Silvano Arieti and others argued that schizophrenia could be understood as an injury to the inner self inflicted by psychologically invasive, “schizophrenogenic” parents. Arieti won the American National Book Award in the field of science for his work Interpretation of Schizophrenia, in which he rejects the medical model of schizophrenia and advances instead a psychological approach to the disorder. Psychiatrist Thomas Szasz argued that 'mental illness' is an inherently incoherent combination of a medical and a psychological concept, but popular because it legitimises the use of psychiatric force to control and limit deviance from societal norms. Adherents of this view referred to "the myth of mental illness" after Szasz's controversial book of that name. (Even though the movement originally described as anti-psychiatry became associated with the general counter-culture movement of the 1960s, Szasz, Lidz and Arieti never became involved in that movement.) Michel Foucault, Erving Goffman and others criticised the power and role of psychiatry in society, including the use of 'total institutions', 'labelling' and stigmatizing . The novel One Flew Over the Cuckoo's Nest became a bestseller, resonating with public concern about forced medication, lobotomy and electroshock procedures used to control patients.

In addition, Holocaust documenters argued that the medicalization of social problems and systematic euthanasia of people in German mental institutions in the 1930s provided the institutional, procedural, and doctrinal origins of the mass murder of the 1940s. The Nuremberg Trials convicted a number of psychiatrists who held key positions in Nazi regimes. Observation of the abuses of psychiatry in the Soviet Union also led to questioning the validity of the practice of psychiatry in the West . In particular, the diagnosis of many political dissidents with schizophrenia led some to question the general diagnosis and punitive usage of the label schizophrenia. This raised questions as to whether the schizophrenia label and resulting involuntary psychiatric treatment could not have been similarly used in the West to subdue rebellious, though basically sane, young people during family conflicts.

New professional approaches were developed as an alternative, or complement, to psychiatry. Social work, humanistic or existentialist therapies, counselling and self-help developed and often opposed psychiatry. Psychoanalysis was increasingly criticised as unscientific . Contrary to the popular view, critics and biographers of Freud, such as Alice Miller, Jeffrey Masson and Louis Breger, argue that Freud did not grasp the nature of psychological trauma. Conversely, proponents of psychohistory advanced theories to understand mental disorders in a way that closely resembled the models of the professionals who do indeed work in the traumatogenic-mode of parenting .

The anti-psychiatry movement was also being driven by individuals with adverse experience of psychiatric care. This included those who felt they had been harmed by psychiatry or who felt that they could have been helped more by other approaches, including those compulsorily (including via physical force) admitted to psychiatric institutions and subjected to compulsory medication or procedures. During the 1970s, the anti-psychiatry movement was involved in promoting restraint from many practices seen as psychiatric abuses. The gay rights movement challenged the classification of homosexuality as a mental illness, and in a climate of controversy and activism in 1973/1974 the American Psychiatric Association decided by a small majority (58%) to remove it as an illness category, although "ego-dystonic homosexuality" remained until 1987. Increased legal and professional protections, and merging with human rights and disability rights movements, added to anti-psychiatry theory and action.

Additionally, and largely separately, some contemporary cults or new religious movements, most notably Scientology, began challenging aspects of psychiatric theory or practice.

Anti-psychiatry came to challenge a 'biomedical' focus of psychiatry (defined to mean genetics, neurochemicals and drugs). There was also opposition to the increasing links between psychiatry and pharmaceutical companies, who were becoming more powerful and were increasingly claimed to have excessive, unjustified and underhand influence on psychiatric research and practice. There was also opposition to the codification of, and alleged misuse of, psychiatric diagnoses into manuals, in particular the American Psychiatric Association, which publishes the Diagnostic and Statistical Manual of Mental Disorders.

Anti-psychiatry increasingly challenged alleged psychiatric pessimism regarding those categorized as mentally ill. Mental health users argued for full recovery, empowerment and self-management. Schemes were developed to challenge stigma and discrimination; to assist or encourage people with mental health issues to more fully engage in work and society, and to involve service users in the delivery and evaluation of mental health services. However, those actively and openly challenging the fundamental ethics and efficacy of mainstream psychiatric practice remained marginalised within psychiatry, and to a lesser extent within the wider mental health community.

Modern psychiatric practice strives to create and use explicit diagnostic criteria for mental illness, such as the Diagnostic and Statistical Manual of Mental Disorders or DSM. This method of practice is often called neo-Kraepelinian, after Emil Kraepelin, an early psychiatrist who advocated such an approach.

One of the paradigms of the DSM manual, the concept of schizophrenia, has been challenged from various perspectives. Critics say despite media publicity it has yet to be proven that schizophrenia is a bio-medical condition . More significantly, the traumatogenic etiology of some types of schizophrenia has been considered by some as a revolutionary approach in the mental health field .

The fourth edition of the DSM is a list of 374 conditions. Only two of them, “Post-traumatic stress disorder” and “Dissociative identity disorder” are thought to be psychogenic or caused by traumatic experiences. Biological psychiatrists maintain that many other disorders are biomedical entities of unknown etiology. For example, in a statement released in September 2003 the American Psychiatric Association, that represents 36,000 physician leaders in mental health, conceded that “brain science has not advanced to the point where scientists or clinicians can point to readily discernible pathologic lesions or genetic abnormalities that in and of themselves serve as reliable or predictive biomarkers of a given mental disorder or mental disorders as a group […]. Mental disorders will likely be proven to represent disorders of intracellular communication; or of disrupted neural circuitry” .

Critics of psychiatry often complain about the futuristic stance (“will likely be proven...”) in this field. In the psychiatric profession, people labeled with a DSM disorder are usually treated with psychiatric drugs or electroshock. Since in some cases these various treatments are administered involuntarily, the lack of biological markers in the profession has been an issue of great concern among the critics.

Similarly, the fact that millions of children are being treated with methylphenidate (Ritalin) or other psychiatric drugs  has also been an issue of concern and even open censure and condemnation among the critics.

The focus on biochemical investigations of mental distress is seen by critics as unjustified. Most mainstream psychiatrists believe that the balance of neurotransmitters in the brain is the major biological regulator of mental health. In this theory, emotions within a 'normal' spectrum reflect a proper balance of neurochemicals, but abnormally extreme emotions, such as clinical depression, reflect an imbalance. Psychiatrists claim that medications regulate neurotransmitters and also claim they treat abnormal personalities by removing a neurochemical excess or replenishing a deficit. However current drugs, especially the neuroleptics, popularly known as “antipsychotics”, lack specificity, leading to counterclaims that they function as "chemical strait-jackets" . Critics also claim that the broad biochemical assertions and assumptions of mainstream psychiatry are not supported by evidence and are partly value judgements. Some also believe that the media has distorted information promoting the idea that autism is a physical disorder. Leo Kanner views autism as a psychological disorder resulting from bad parenting. Psychiatrists who do not accept the medical model of mental disorders, such as Peter Breggin, maintain that the labeling of children inflicts additional humiliation and injury to the self-esteem of an already traumatized child.

According to mainstream psychiatry, genetic and environmental factors both appear to be of vital importance in determining mental state and therefore certain genetic factors can predispose people to particular mental illnesses . To date - and in contrast to diseases affecting almost every other human organ but the brain - only a few genetic lesions have been proposed to be mechanistically responsible for psychiatric conditions , though there are reports of significant associations between specific genomic regions and psychiatric disorders . The reasons offered for the relative lack of genetic understanding is because the links between genes and mental states defined as abnormal appear highly complex, involve extensive environmental influences and can be mediated in numerous different ways, for example by personality, temperament or life events. Therefore while twin studies and other research suggests that personality is heritable to some extent, the genetic basis for particular personality or temperament traits, and their links to mental health problems, is currently unclear .

Anti-psychiatrists often argue that biological psychiatrists use genetic terminology in an unscientific way to reinforce their approach, for example by referring to findings of the genetic basis for illnesses and weaknesses, rather than the role of genetic factors in traits which may make some problems more likely in some environments and societies. Some propose that the biochemical differences observed in some mental illnesses are not the genetic cause, but rather the effect of a condition caused solely by psychological trauma . Others argue that there is no significant genetic component involved at all, suggesting instead that observed patterns of family transmission are neutral with respect to genetic versus environmental etiology . Some critics also claim psychiatrists disproportionately focus on understanding the genetics of those individuals with mental health problems at the expense of addressing the problems of the living in the environments of some extremely abusive families or societies .