Dear Prof. Subodh Dave, President-elect, 12 May, 2026th
We are writing on ME Awareness Day in relation to the Royal College of Psychiatrists’
ongoing work on ME and Long Covid, and in the context of your stated commitment to
integrating patient expertise into clinical practice and institutional decision-making.
This commitment carries significant responsibility in conditions where patients have
experienced harm from mischaracterisation, delayed recognition, and the privileging of
theoretical psychosocial explanations in clinical and academic settings.
We are particularly concerned by the inclusion of speakers Paul Garner, Alan Carson, and
Trudie Chalder in Congress programming, given their longstanding association with
psychiatric-led psychosocial frameworks applied to ME, which continue to shape the
clinical interpretation of Long Covid.
While the programme includes biomedical terminology and references to patient
experience, its overall structure continues to position psychosocial and behavioural
frameworks as the primary lens through which post-acute viral illness is interpreted and
managed.
For example, cognitive symptoms and potential neurological markers are framed within a
psychiatric-led session; personal experience of post-infectious fatigue is presented
alongside psychological recovery narratives; and cognitive behavioural therapy is
positioned in relation to routine specialist clinic outcomes. This sequencing shapes how
evidence is interpreted and which explanatory models are implicitly centred.
The inclusion of biomedical language does not in itself reflect a shift in underlying
paradigm when interpretive authority remains organised around behavioural and
psychosocial models. In this context, patient experience is situated within frameworks that
determine its meaning in advance, rather than as an independent form of evidence.
Since the emergence of Long Covid, there has been a substantial expansion of biomedical
research documenting multi-system physiological dysfunction, alongside long-
established findings in ME. This includes immune dysregulation, autonomic dysfunction,
metabolic impairment, genetic findings from DecodeME and post-exertional malaise,
reflected in current NICE guideline NG206.
Against this backdrop, the continued prominence of proponents of psychosocially framed
models in defining how these conditions are presented risks misalignment with current
evidence and the emerging paradigm.
Open Letter to the
Royal College of Psychiatrists
longcovidadvoc.com
@LongCovidAdvoc
Long Covid Advocacy
We therefore ask that the Royal College:
Ensure Congress programming on ME and Long Covid reflects current biomedical
evidence and clinical guidance, and is not presented through outdated behavioural or
psychosocial models.
Review how speaker sequencing and session framing influence the interpretation of
evidence.
Ensure that patient expertise is positioned as an independent form of knowledge, not
subsumed within pre-existing theoretical models.
Align all teaching and outputs with NICE guideline NG206 and the current evidence
base on Long Covid, ensuring that psychological aspects of care do not supersede or
redefine the underlying biological condition.
These are not abstract concerns. The framing of these conditions directly influences
clinical reasoning, service design, and patient care pathways.
We urge the Royal College, under your incoming presidency, to take a clear leadership
position in ensuring that its programming reflects current understanding rather than
inherited psychosocial interpretive frameworks.
Yours sincerely,
longcovidadvoc.com
@LongCovidAdvoc
Mr Tomaso Antonacci
Natalie Boulton
Dr Harriet Carroll
Dr Leanne Curelli
Prof Todd Davenport
Mr Yanto Evans
Dr Peter Gordon
Dr Laura Gray
Dr Deepti Gurdasani
Dr Elke Hausmann
Assoc Prof Rupert Higham
Dr David Joffe
Prof Doug Kell
Dr Asad Khan
Mrs Beatrice Khouri
25% ME Group
Dutch Platform for MDs with IACC
Forward-ME
Hope 4 ME & Fibro Northern Ireland
Inclusive New Normal
Keyworker Petition Campaign (KWPC)
Lab of Lived Experience
Liberal Democrat Disability Association
Long Covid Physio
Long Covid Scotland
ME Action UK
ME Association
M.E Foggy Dog
Not Recovered UK
Physios for ME
Organisations Individuals
…/cont.
longcovidadvoc.com
@LongCovidAdvoc
Richmond, Kingston & West London ME Group
Scottish Healthcare Workers Coalition

There4ME

WE&ME Foundation
Welsh Association of ME & CFS Support
Ms Elisabeth Klaar
Andrew Klaassen MD
Dr Marianne Lynch
Cass Macdonald
Dr Ben Marsh
Tom Molmens MD
Mr Michael Natt
Jolien Plantinga MD
Mrs Nicky Proctor
Dr Clare Rayner
Mr James Robertson
Dr Selina Shaw
Dr Charles Shepherd
Mrs Lindsay Skipper
Dr Nigel Speight
Dr Michael Stingl
Fen van Rhijn MD
Dr Joanne Van der Nagel
Dr Mark Vink
Mr Jonah Weisz
Organisations Individuals