The letter from Rodger et al uses our editorial to rehearse the well-worn arguments of the small group of so-called ‘critical psychiatrists’ who are active and vocal in criticising core aspects of the practice of psychiatry as a medical subspecialty underpinned by science. The views expressed in the letter are mainly tangential to the views we expressed in our editorial and the authors have made assumptions and accusations that are unsupported by our text.

We are very keen to encourage informed and constructive debate to advance patient care and mental health. However, it is important to make a distinction between the freedom that is properly enjoyed in academic debate and the responsibilities that come with professional practice. At present, those who work as psychiatrists are expected to practise in accordance with evidence-based standards. The standards we adhere to will of course change over time as the evidence base develops. This is expected by patients and colleagues and required by regulators.

We continue to believe that our patients are best served by seeing psychiatrists who are trained to make a thorough assessment, come to a diagnosis and shared formulation with the patient of their problems and use this to draw up an evidence-based management plan. It seems strange to us that this should be surprising, contentious or upsetting to the authors of the letter.