Five Types of Mental Health Advocates

Corinna West

November 23, 2012

I’ve figured out there are five types of mental health advocates. We need to respect all five types of motivations and viewpoints in order to support or combat their agendas. The question for us, is how can we each of us maximize our own impact to share awareness of this situation and then impact change? The answer is that each of us has to work from our own passions and interests and talents and skills and motivations.

One of my friends, Anne Maria DeMars who was the first ever American World Champion in the sport of Judo, says, “Why do people keep asking us to give back all the time?”And I think the answer is that we give back as long as the giving still has a place where it can enrich our own lives. The helper principle is that helping other people helps us. Advocacy and social activism has been a powerful route to freedom for many people. One of my favorite poems, “Journey”, from one of my favorite organizations, Street Poets, Inc, says, “What can I do, about the poverty and the stress, the trauma and the deaths? What can I say to my people so depressed, evil spirits in they chest? How can I try? To get a decent job when I’m always pushed on down? I try and I try, but I really need, some love and patience and compassion from ya’ll.”

AnnMaria DeMars teaching a kids Judo clinic

AnnMaria DeMars teaching a kids Judo clinic

So while we each do we can do, I think it’s important to keep respecting what other people do that is different than how we go about doing things. And it would be good to have an overall scheme to link the people in different areas to work for united goals. I have no idea at this point what this linkage should look like. Maybe the National Empowerment Center should play this role, but for now they aren’t since they are busy on other stuff.  This is a graphic I made that shows the connection between what many of us in this community choose to focus on.

Five Types of Mental Health Advocates:

1. What Mental Health Reformers Sound Like:

This is from Bonnie Castro, a very solid and truthworthy peer worker fully on our side. I’ve always respected her work and her life history of moving beyond some very difficult circumstances. We used to have the same employer until that organization and I mutually figured out I would be better off starting my own business. This is an email she let me reprint that was written to a listserv of peer support organizations in Missouri. I called them out for promoting an article saying “A job is a very good accomplishment for a person with a mental illness.” I think working ought to be the norm, not any kind of accomplishment.

I’d rather stay in the trenches and do the work there. The system is a long way still from the change we want. In the same breath I can say we came a long way in the movement from where we have been in metal health. If this was 40 years ago, I may not be replying in this email and probably doing the medication shuffle in some asylum in south east Kansas.

I’m not the kind of advocate that will stand on the governors lawn begging for rights, demanding better treatment, studying research models, organizing protests, attending conferences every other month, calling our governor and presenting 50 workshops a year. Nope that’s not me. Too much time away from home. I have a lot of stuff to do that is not work related.

Bonnie Castro and Cameron at a team building event making the largest free standing object from a single piece of paper.

Bonnie Castro and Cameron Murray at a team building event making the largest free standing object from a single piece of paper.

I am the kind of advocate in the room with the client while they talk to their psychiatrist about being over medicated and exploring alternatives to their sleep problems. Rather its tea, hot shower before bed or Ambien, but it’s always the person’s choice not mine or their doctor’s. I leave the rest of the advocacy work for people who have time and a passion for that kind of advocacy. The skills I have are better used in direct work with people and providers. So while people are busy trying to fix Washington; I am busy trying to make those small differences in how a case manager talks to her client.

All research does is tells us the best way to treat people. I have seen organizations start programs based off best practices and its staffed by people who know nothing about the model except for the supervisor who resigns a year later because she was overworked herself. Staff continue to act like douche bags and the program flops 3 years later. Sometimes I wonder if all the problems in social work regarding human relationships couldn’t be fixed with a couple customer services trainings from Sprint. (HA HA! joke.) Social work is really a complicated word that means helping someone get better. At least that is what my teacher said the my social welfare class last year. We all have a part to play when the day starts.

Corinna, I appreciate you speaking your mind. This has made for some interesting brain stimulation on my day of referral calls. Continue to speak out loud. I know we won’t agree on everything but at least you put other perspectives in my mind, poked at my beliefs and stirred my pot. I always like that about you. I remember in the peer supporter meetings, I would be like “I don’t agree with her on that” but at the end of the meeting you made sense and had me rethink how I do a few things. I consider you a hard core advocate. You are willing to fight the fight with no gloves till the very end. You’re fearless in a lot of ways. Take the jump and see where you land, worry later.

2. What Human Rights Workers Sound Like:

This is Tina Minkowitz, , co-drafter of the Convention on the Rights of Persons with Disabilities and president of Center for the Human Rights of Users and Survivors of Psychiatry (CHRUSP):

Human rights is not so different than entrepreneurship, especially in the way we do it. It embodies a completely new approach.

The ECT Protest at Alternatives 2012 in Portland. Tina Minkowitz was there.

The ECT Protest at Alternatives 2012 in Portland. Tina Minkowitz presented a wrokshop on human rights at the conference.

It seems clear that the existing system has to be transformed in addition to whatever else we do. People are currently using and relying on that system, and it does appear to be at least in part meeting real needs. it would help in advocacy if we could articulate a position about how the alternatives relate to the existing system. It seems that often alternatives are positioned as the opposite in a way that means the existing system becomes the bad guy just in its existence. but if people agree that as an advocacy/policy position, we should incorporate both, how does it all fit together?

In an email I got from Europe a person mentioned the idea of “sanctuary” to have a space where you want to safe and enclosed in a nurturing way – what some people feel currently is a “positive” of forced treatment. I’ve been having some other conversations about this as well and think sanctuary is a good way to describe this need…  And the other thing is each of us needs to find the tools or practices or nurturing that works for us personally… There is both a need for support/solidarity surrounding us whether it’s support to be left alone or much more active support, and also for us as individuals to take action ourselves.

I’m looking for words that could describe elements of what would be desirable to have to meet people’s needs, once the destructive scaffolding of medical model violence and abuse and deprivation of autonomy is taken away. and i say this not in a “timeline” sense because it has to happen at the same time. but in the sense of how to imagine it in order to work for it as overall policy….

3. What Mental Health Entrepreneurs Sound Like:

This is from Chris Hendrickson, one of the founders of Street Poets, Inc.

4-5. What Disease Model Advocates Sound Like:

This is Natasha Tracy, a highly popular blogger who has resisted any attempt by members of our community to share science with her. She is quite likely pharma funded. But she has a legitimate point here in this post, and one that will piss many of us off, about being judgmental instead of compassionate. I couldn’t help but put in clarification points, though, in brackets, to counter the misinformation she puts out. The links in the blockquote are hers, not mine.

Electroconvulsive therapy is about 80% effective on depression [misquote here, see page 38 of her link] in both unipolar and bipolar depression, however, the most common bothersome side effect is that some memory is lost for the time around the treatment [straight out of the American Psychiatric Association spin manual]. Years ago, when severely depressed and suicidal, I told people, and I was absolutely serious, that I would rather die than let some barbaric quack run electrical current through my brain.  My brain was too precious to me.

Later though, after running out of treatment options and wanting to die, I changed my opinion – at least a little. While I still felt it was barbaric and mostly insane, I recognized that I needed to try it for my own recovery. In other words, my own situation got desperate enough and I really did prefer life, even an electrocuted one, over death. And many people have judged me for that choice suggesting that I stick a fork in a light socket and worse.

My friend Al Henning, who died of depression after brain damage due to ECT and loss of hope thinking his illness was permanent

My friend Al Henning, who died of depression after brain damage due to ECT and loss of hope thinking his so-called bipolar illness was permanent

But this is ridiculous, closed-minded and hateful. No one has any right to judge another person’s treatment – ECT or otherwise – until they have spent time in their brain. Until they have spent time in their pain. No matter how bad your condition has gotten and no matter how much pain you think you’re in, if there’s one thing I have learned, it’s that it can always get worse [Especially when you've been repeatedly told that your situation is permanent and you might not able to contribute to society.]  And the person facing ECT is usually at worse. Usually at worse and with fewer options than you can understand. So if you feel self-righteous and if you feel that your opinion is warranted over those of us who have extensively studied [one side of] the treatment, tried the treatment and know many [people from one side of the story] who have had the treatment, that’s your business. But, at the very least, can you have the courtesy to admit that your opinion is the one that is right for you and not tar and feather the over 100,000 people who get ECT annually in the US [based on misinformation and force]?

Because until you do, all you’re doing is spreading hatred and judging people you fundamentally do not understand, whose pain you do not understand. All you’re doing is kicking people while they are so far down they cannot see the light. And is that who you really want to be?

 But Nastygrams are Never Productive….

Some people are aware of the message of this blog, that medications and labels help some people but harm many others. Many people, I would say most, disease model advocates are not aware of this message. But there are a few who cannot hear it when it is told to them repeatedly. I think some of these people need authority figures, some don’t fully understand science, some are too trapped by the income provided by lying, and some need the excuse not to reach their full human potential. I’ve always had a very hard time with the people on the right hand side of this chart, understanding their motivations. One thing that has helped me understand the disease model advocate doctors is reading 1boringoldman.com. Here is also a blog I wrote as I tried to figure out  how to handle  disease model advocates. 

I don’t know how many people in our world know they are causing harm, know they have a way to stop it and still won’t. Some, for sure. But most people have a story in their heads about how they are helping people. So this is why hate speech doesn’t move them forward, because acknowledging what we say would conflict with their own hero story. C.S. Lewis, said, “Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.”

Try Art or Humor Instead.

The difference between arguing data vs. emotions with a person

The difference between arguing data vs. emotions with a person. Via The Sacred Fire Community.

But my thought is that Nastygrams are never productive. I learned this from one of my most difficult roommates, a trauma survivor who may have had the worst case of Tardive Dyskinesia I’d ever seen. She’d spent 10 years on double the recommended max dose of Geodon plus several other antipsychotics at the same time. She sent a whole ton of nastygrams my way, because fighting was the only way she knew how to interact and she needed to provoke me to feel like she was in a dialogue. But the Nastygrams were never productive. So my thought is to ignore the people we have been unable to educate or maybe try to find someone they trust to send them information. If they can’t hear our data, maybe they can hear our feelings, our art, our humor, our humanity. It is much easier to reach someone’s heart than their mind.

And lets give huge amounts of respect, kudos, appreciation, admiration to people on the left who are honest, open, learning new things, but just have a different set of priorities than we do. Viola the revolution – we are in this together….


Corinna West

Wellness Wordworks: Corinna West  writes about the business she founded, which coordinates people with emotional distress who provide instant peer support for each other in exchange for helping anyone who is interested in expanding their online presence.

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49 thoughts on “Five Types of Mental Health Advocates

  1. yes, Natasha is frustrating to interact with but fun to see all the people who challenge her. It’s fun to post on her site if you like a lively game of ping pong, but not very productive.

    To win we need to find people who are receptive and find ways of turning them into activists, or find those who are a bit active and find ways of helping them be a little bit more active.

    Also we need to think strategically and find the groups and organisations who are likely to listen and then work with them to see if our movement can grow.

  2. Where do you place the scientologists and lesser known self-appointed masters of happiness who thrive on their professed hate of mental labeling and psychotropic drugs?

    Surely you know they do exist and target the sufferers your efforts want to help.

    Anyway, thanks for your writing. I am really thankful and especially for your letting me know about Bonnie Castro:

    ///I am the kind of advocate in the room with the client while they talk to their psychiatrist about being over medicated and exploring alternatives to their sleep problems. Rather its tea, hot shower before bed or Ambien, but it’s always the person’s choice not mine or their doctor’s.///

    She is my kind of person.

    • To be honest, I forgot about them. I think they claim to be working for human rights, so they would go under that area. But we might have to different between people who see mental health “treatment” as only harmful in absolutely every case like they do, and people who admit that there is some help sometimes along with the harm, as Tina does.

      I think it’s probably just as false to claim absolutely no benefit to our current paradigm as it is to claim there is absolutely no harm to our paradigm, as most disease model people do.

      Where would you put the “anti-psychiatrists?” And how would you define that term, anyway?

      • Hi Corinna,

        Thanks for answering me.

        If you were not taking holidays and good care of yourself and yourrelationship you would not be a good social mental health entrepreneur!

        To my mind an antipsychiatrists claims that the world would be better without never ever any drug prescription for mental symptoms and without not a single psychiatrist being in practice-except themselves when they were trained as psychiatrist that is-

        Nothing less and nothing more.

        The scientologists are antipsychiatrists, many activistys on MIA are and Dr Laing was one.

        Dr Szasz and Dr Breggin obviously are not.

        ( To my mind, Dr Szasz is antifreudian above anything to my mind and Dr Breggin is for the kind of psychotherapy he invented as the only cure but both were/are treating clients for money in their practice if I have been correctly informed.)

        • I heard on the radio today that there are very few psychiatrists in India compared to the USA yet people tend to get better much more often in India than in the USA for extreme mental distress, the kind that often gets diagnosed as psychosis or schizophrenia. This could be for social reasons but it could be because psychiatric practice stops people recovering. Mr Whittaker indicates that it is likely to be because psychiatric practice stops people from recovering as when drugs take off in a country recovery rates plummet. Therefore it might well be that the world would be better without any drug prescription for mental symptoms. However we do not have the research to be able to know, most of the research is from drug companies whose main job is to create profit, not cure.

  3. Corinna,

    As a volunteer for International Society for Ethical Psychology and Psychiatry (ISEPP)it is my way of giving back as I feel I have been very blessed.

    Membership in ISEPP is attractive to many as it welcomes both professionals and non-professionals alike.

    From my own experiences, it was very difficult to find providers who offered alternatives to main stream psychiatry and it was even more difficult to find a psychiatrist who would work with me if I used complimentary treatments to try and taper off of psych meds.

    Medical professionals risk their reputation and their credentials by offering evidence-based alternatives like Integrative Psychiatry/Functional Medicine.

    Volunteering for ISEPP gives me an opportunity to help provide support to mental health professionals who are open-minded enough to explore, expand and create awareness of evidence-based alternatives.

    Unlike any other health condition, mental/behavioral/emotional health conditions overlap into our criminal justice system, leaving those in need of help incarcerated and at the mercy of limited services and treatment options.

    Historically, mental health laws are unique because they have been designed to employ and empower medical opinion who select specific treatment options. Coercive mental health treatment contributed to the proliferation of the psychopharmacological revolution.

    Sanctioned by the Supreme Court in Buck v. Bell(1927), many individuals labeled with a mental disorder become part of a class of people who can be deprived equal protection, civil liberties and the liberty to contract. They are in need of a strong, ethical and united advocacy agenda that promotes best-practice standards of treatment and care.

    Individuals in the mental health system can be forced to contract the services of specific providers and forced to become consumers of potentially lethal products.

    Because individuals labeled with mental disorders can be perceived as a threat to themselves or others, psychiatry and the use of medication management as the primary choice of “treatment” has become an unregulated power-base of authority in the U.S.

    The topic of “mental illness” involves a broad-spectrum of concerns. My main advocacy agenda involves symptoms of psyhosis and mania.

    Advocates who support forced “treatment” of psychotic symptoms should consider the possibility the treatment they are advocating for could kill a person they claim to be advocating on behalf of, or cause that person to kill/harm others.

    Likewise, advocates who oppose forced treatment of psychotic symptoms should consider the accurate diagnosis and treatment of the symptoms could save the lives.

    As a mental health advocate, my agenda is very specific and based on the fact many medical conditions and substance-induced conditions can manifest as symptoms of psychosis/mania and be misdiagnosed as schizophrenia/bipolar disorder.

    My goal as an advocate is to raise the bar on forced “treatment” to include accurate assessment, informed consent and treatment options that include the right treatment.

    In 1996 I suffered an acute manic episode from toxic encephalopathy. I was misdiagnosed as having bipolar disorder with psychotic features at the same hospital that according to the published study pasted below, misdiagnosed a 15-year-old girl suffering from lupus. After treatment with steroids, she no longer required psych meds.

    In my opinion, trying to prevent prolonged suffering from being misdiagnosed is well worth putting time, effort and energy into.

    I’m not sure where I would fit in on your graphic.

    Kind Regards,
    Maria Mangicaro

    Neuropsychiatric systemic lupus erythematosus presenting as bipolar I disorder with catatonic features.

    Psychosomatics. 2009 Sep-Oct;50(5):543-7.

    Alao AO, Chlebowski S, Chung C.

    Source

    Department of Psychiatry, SUNY Upstate, NY 13210, USA. [email protected]

    Abstract

    BACKGROUND:

    The American College of Rheumatology has defined 19 neuropsychiatric syndromes associated with systemic lupus erythematosus (SLE) involving the central, peripheral, and autonomic nervous systems. Neuropsychiatric manifestations of lupus (NPSLE) have been shown to occur in up to 95% of pediatric patients with SLE.

    OBJECTIVE:

    The authors describe a 15-year-old African American young woman with a family history positive for bipolar I disorder and schizophrenia, who presented with symptoms consistent with an affective disorder.

    METHOD:

    The patient was diagnosed with Bipolar I disorder with catatonic features and required multiple hospitalizations for mood disturbance. Two years after her initial presentation, the patient was noted to have a malar rash and subsequently underwent a full rheumatologic work-up, which revealed cerebral vasculitis.

    RESULTS:

    NPSLE was diagnosed and, after treatment with steroids, the patient improved substantially and no longer required further psychiatric medication or therapy.

    CONCLUSION:

    Given the especially high prevalence of NPSLE in pediatric patients with lupus, it is important for clinicians to recognize that neuropsychiatric symptoms in an adolescent patient may indeed be the initial manifestations of SLE, as opposed to a primary affective disorder.

    http://psychoticdisorders.wordpress.com/2012/11/25/neuropsychiatric-systemic-lupus-erythematosus-presenting-as-bipolar-i-disorder-with-catatonic-features/

    Posted on Mad in America 11/25/2012

    • Maria,

      Thank you for your volunteer work with ISEPP and for bringing the topic of *underlying physical conditions* to the attention of MiA readers.

      As a former member of Safe Harbor’s Integrative Psychiatry group, I quickly learned that there are some *very good* integrative medical professionals, who are well-versed in addressing these underlying conditions – with Functional, Environmental, Orthomolecular and other forms of medicine.

      We need to *insist* that the *least restrictive*, *most therapeutic* options are used *first*, and that *coercive* psychiatry is *replaced* with *compassionate*, *safe* and *effective* treatment.

      Duane Sherry, M.S., CRC-R
      discoverandrecover.wordpress.com

      • I find, in my own clinical experience, prescribing homeopathy remedies useful when tapering off SSRI antidepressants:

        you prescribe them before starting the tapering off and you take care of having an independant psychiatrist doing the allopathic drug prescription to avoid the homeopathy prescriber being too optimistic-

        and beware that some homeopaths like some psychotherapists are dangerous and push for stopping at once the antidepressants or whatever treatment.

        Once, I even prescribed homeopathy to a women for menopausal troubles for which hormones therapy was not possible (she had had bilateral ovariectomie as part of breast cancer treatment). She was very happy with her antidepressant treatment although she had taken a lot of weight ( I had send her to a colleague to get that treatment a year before for a “post breast cancer treatment severe depression”) but her italian psychiatrist decided on his own to taper off her antidepressant and when I saw her a year later she was drug free and slim again!

        Thanks to you and Maria for recognizing that sometimes doctors can help!

        • Dr. Fulli,

          You are welcome.

          Consider symptoms of psychosis/mania could be caused by a number of medical conditions including but not limited to: brain tumors, cerebrovascular disease, Huntington’s disease, multiple sclerosis, Creitzfeld-Jakob disease, anti-NMDAR Encephalitis, herpes zoster-associated encephalitis, head trauma, infections such as neurosyphilis, epilepsy, auditory or visual nerve injury or impairment, deafness, migraine, endocrine disturbances, metabolic disturbances, vitamin B12 deficiency, a decrease in blood gases such as oxygen or carbon dioxide or imbalances in blood sugar levels, and autoimmune disorders

          I think any reasonable person would value medical care during an acute psychotic/manic episodes.

          We should all keep in mind that no person is immune from a manic/psychotic episode.

          If I could ask Robert Whitaker one question in an interview it would be: If you experienced an acute psychotic/manic episode, what treatment, if any, would you seek? and why?

          If you wouldn’t mind me asking, what would be your answer to this question?

          Kind Regards,
          Maria Mangicaro

          posted on Mad in America dot com 11/27/12

          • Maria,

            Thanks for your comment and work.

            To answer your question is easy: if I were myself to suffer a psychotic episode or even a severe depressive state, I would want a good doctor first and not a team of healers who could let me die of hypoglycemia or from a neurosurgical emergency or whatever.

            To be honest, being based in France where so many psychiatrists are psychoanalysts not interested in medicine , I would not trust a psychiatrist I would not know for sure to be good in general medicine.

            NB: I am middle-aged, do not consume streetdrugs, and never was psychotic so the chances for a medical illness causation would be very high but even for a younger person I would find non medical healer dangerous and would opt for a general hospital emergency room not call healers on the telephone but we are discussing an acute psychotic episode.

    • Maria, Maybe ISEPP can be the organization at the top that coordinates the three type of advocates? Although we would need to be 100% sure that we have enough input of peers. Most of us don’t want professionals telling us what to do any longer. This might include not scheduling your conference the same week as Alternatives.

      As far as lupus, one of the board members of my business had drug induced lupus: http://wellnesswordworks.com/drug-induced-lupus/

      • Corinna,

        If we consider the broad spectrum of issues that concern many regarding mental/behavioral/emotional health care, we start to realize there are more than 50 shades of grey in the antomy of the “mental illness” epidemic.

        But what if we could distinguish certain issues as purely black and white? right or wrong? we could start to really create transparency among advocates.

        For example, I am sure you are familiar with the war of the words between Bob and Dr. Torrey.

        But how did this very important admission by Dr. Torrey get so overlooked:

        “In its 396 pages Whitaker got many things right, including criticism of the broad DSM diagnostic criteria for mental illnesses; the reckless prescribing of psychiatric drugs for children; and the prostitution of many psychiatric leaders for the pharmaceutical industry.”

        If these are issues that both Dr. Torrey and Bob feel are problems, shouldn’t advocates who support both Dr. Torrey and Bob be working together to highlight these issues and find solutions?

        These are the same issues highlighted by CCHR, so shouldn’t they be included as well?

        When we realize just how much information is being thrown around on the internet, are we overlooking prime opportunities to make real change?

        I just did a search on Mad in America and there is not one single mention of Gabriel Myers and only one mention of Rebecca Riley and Ke’onte Cook. This site has grown so much, but how are these very important cases being overlooked by so many Mad bloggers?

        These are cases that all mental health advocates should create an awareness of.

        What if it were possible to sort through all of the major issues in mental health care and create a uniform advocacy agenda based on a reasonable person standard?

        What would a reasonable person agree to advocate on behalf of?

        From what you are aware of, do you think it would be possible to create a single focused platform that all members of NAMI, all members of CCHR and all members of all other mental health advocacy organizations in between would unanimously agree to add to their agenda?

        As well, this platform would be one that Robert Whitaker, Pete Earley, Dr. Breggin, Dr. Torrey and all other individuals who write about mental health topics and maintain websites regarding the treatment of severe mental illness would agree to support through internet advocacy?

        What would it mean to our troubled health care system and stressed economy if we could find priority issues to push to the forefront in order to promote a set of benchmarking initiatives in specific areas of mental health care?

        Here is just one example:

        If we consider some individuals who experience symptoms that could be considered manic/psychotic are able to adapt to a certain lifestyle, we must also consider individuals who can not cope with mania/psychosis and either seek treatment or are forced into psychiatric care.

        Cases of acute psychosis/mania need to be considered by medical professionals as they could be symptoms of a lifethreatening medical conditions.

        We know that most mental health and medical professionals use the DSM with a “Chinese menu” approach of labeling symptoms of psychosis/mania as schizophrenia/bipolar and a silver bullet psychopharmacological treatment approach.

        Why would advocates not want to support Best Practice assessment of psychosis to ensure patients who are seeking help during a crisis mental/behavioral/emotional condition are not simply labeled “mentally ill”, treated with toxic medications, and leaving encephalopic condition caused by a virus, bacteria, toxin, or other medical condition overlooked and untreated?

        Patients being treated are entitled to accurate assessment, informed consent and integrated care.

        It is an ethical position for advocates to support psychiatry moving away from the “Chinese menu” approach and towards Best-practice assessment standards.

        CCHR Florida has the statement pasted below on their website.

        I think it would be wise of Mad in America dot com and the Foundation for Excellence in Mental Health Care to have similar statements.

        This is sound advice and CCHR Florida has helped prevent many individuals who were labeled bipolar/schizophrenic get help through medical doctors who use Functional Medicine. The Executive Director of CCHR Florida maintains the 24 hour hotline most of the time herself. In one month alone she helped 3 parents figure out their teenagers had a psychotic reaction to the routine use of over-the-counter cold medicine. Another case recently was psychosis from dehydration.

        Advocates need to stop taking sides and figure out ways to work side-by-side. We are all in this together. Regardless of being members of an organization or a religion, we are advocating for others, many of whom are among a marginalized population and do not have access to the internet and discussions on what they think would help them recovery.

        Advocates need to take responsibility and I think this statement on CCHR Florida’s website shows they are being responsible advocates.

        CCHR recommends getting a complete physical examination by a competent medical practitioner who does not prescribe psychiatric drugs. Very often when a person is experiencing emotional or behavioral problems, there is an underlying, undiagnosed medical condition causing the symptoms diagnosed as a psychiatric disorder. These conditions include, but are not limited to, allergies, infections, sleep disorders, toxins, nutritional deficiencies and hormone imbalances.

        The list below is of Recommended Medical Websites that many people have found helpful in finding a competent, non-psychiatric, medical doctor. CCHR provides these websites as a public service on a ‘buyer-beware’ basis, you must use your own judgment in deciding which site will best serve your specific needs, and you do so at your own risk.

        WARNING: No one should stop taking any psychiatric drug without the advice and assistance of a competent, non-psychiatric, medical doctor!

        Posted on Mad in America dot com 11/27/2012

        • ///WARNING: No one should stop taking any psychiatric drug without the advice and assistance of a competent, non-psychiatric, medical doctor!///

          On that point, I strongly disagree since a psychiatrist cannot pretend to be a psychiatrist if he doesn’t know how to taper off drugs or stop them to prevent lithium intoxication or in case of neuroleptic malignant syndrome or whatever emergency needing the side-effects of going cold turkey!

          In my view, many non psychiatrists will not know how dangerous it is to go cold turkey with SSRI antidepressant. I suppose they will know more about benzodiazepines.

          Altostrata will write that psychiatrists do not know how to taper off drugs but not that non-psychiatry doctors are better at it.

          My view is:
          WARNING: No one should stop taking any psychiatric drug without the advice and assistance of a psychiatrist or a competent in psychopharmacology , non-psychiatric, medical doctor.

          As I already answered to your question above in that file I would not trust a French psychiatrist -I would not know to be really competent in internal medicine – in taking care of a first psychotic episode of mine if I were to suffer from one at my middle-age for the first time in my life.

          I can add that I would not want a French psychoanalyst doctor to take care of any severe suffering of mine but, on the other hand, I trust only gynecologists more for female hormonal treatments of mental illnesses symptoms (idem with endocrinologists for thyroid hormone level induced mental illnesses )and I trust best psychopharmacologist psychiatrists with psychiatry drugs- Pr David Healy type – for sure.

          Not want psychiatry drugs like some religious people do not want blood transfusion is one thing, but if you accept it take it from the most competent one.

          My hope is that psychiatrists will register to the medical boards with sub-specialty like, why not tapering off drugs for difficult cases.

          “Bad Pharma” as Dr Ben Goldacre call them and academics on their payroll , at least in France, do more harm to non psychiatrist doctors’s practices with their marketing of drugs and the silly monoaminergic theory of mental illnesses than to psychiatrists.

          Sorry about my broken English but I really have no time to correct it.

          • Thank you for your reply.

            In his book Mad in America, Bob mentions “insanity” cures included pulling infected teeth.

            Some individuals suffering from a psychotic epidsode might actually benefit from a visit to their dentist and a prescription of the antibiotic flagyl.

            In my opinion, in cases of acute psychotic/manic episodes seeking/forced into treatment, our mental health care system would benefit greatly if medical doctors moved away from the “Chinese menu” approach of using the DSM and moved towards Best-practice assessment, integrated care and informed consent.

            Just because someone is in a psychotic state, does not mean they are ignorant enough to refuse an MRI to rule out a possible brain tumor, or other underlying medical condition that can induce psychosis/mania.

            Dr. Fulli do you think this is good advice for someone who experiences a first time psychotic/manic episode?

            “a complete physical examination by a competent medical practitioner who does not prescribe psychiatric drugs. Very often when a person is experiencing emotional or behavioral problems, there is an underlying, undiagnosed medical condition causing the symptoms diagnosed as a psychiatric disorder. These conditions include, but are not limited to, allergies, infections, sleep disorders, toxins, nutritional deficiencies and hormone imbalances.”

          • MIND, a mainstream UK mental health charity, amended it’s recommendation on coming off psychiatric drugs. It used to recommend getting advice from a Dr but now it says it is up to the individual whether they do or do not. They came to this conclusion because of a study they did into people who tried coming off, and it seemed to make no difference as to whether they had medical advice or not. This makes sense to me as so many Dr’s deny the problems of coming off.
            http://www.mind.org.uk/help/medical_and_alternative_care/making_sense_of_coming_off_psychiatric_drugs

            In the UK it has been known for decades about the dangers of benzo’s and reports have been written yet prescribing practice has hardly changed and withdrawal problems still abound. I think things will only really change when people get really uppity and start having sit ins at psychiatrist and GP’s officers.

  4. Corina,
    I understand uou might be busy doing good things -as Pr David Healy who was attacked recently for not answering questions on “his MIA blog which is just a reposting of a foreign blog – and not able to answer comment but I would really like you to answer my yesterday question:

    “Where do you place the scientologists and lesser known self-appointed masters of happiness who thrive on their professed hate of mental labeling and psychotropic drugs?”

    I would dare to ask it twice because an hagiographic and very long post on two famous antipsychiatrists on another MIA blog fails to acknoledge that Dr S had and is wildly use by the scientologist as their best weapon to attract mental sufferers to their organizatio. ( NB: it was not a place where a psychiatrist could have post comment leading to any discussion worth having in my opinion).

    On the same line -sort of -I would strongly advise your readers to look at the link offered by MIA to another post of “Boring old man”
    http://www.madinamerica.com/2012/11/squishy/#comment-17816

    Worth meditating for antispsychiatry activists, in my psychiatrist biased opinion. Here a short extract, a few sentences:

    ///By the time the DSM-III came along, (…) the paradigm of psychological causation was the one being rejected. To me at the time, it was the baby in the bathwater of all the complaints about the power, the dogmatism, the speculation, and the fiscal drain of psychoanalysis. I agreed with many of those complaints myself, but what about the baby? ///
    And I would, in a sincerely kindly meant suggestion that, when you speak publicly outside of MIA and the likes minded, you should find an extra word for “Mental Health Entrepreneurs” in order to not find yourself in the same place as bas Pharma, private psychiatric facilities and the likes.

    All the best to you and your entreprise!

    • Sorry about the delay, I was challenging myself to see if I could manage my workaholism by leaving my computer off through the holiday. I mostly did it.

      I typically don’t describe myself as an anti-psychiatrist. The word has been used too often by establishment types to discredit peers by trying to lump us in with protest-only groups that don’t have any reform ideas. Sometimes I feel like “anti-psychiatry” is the “N-word” of our movement.

      I like the term social entrepreneur to describe what I do, because my business is about making change as well as making enough money to make the business self-sustainable. Some of my earlier post define this term, show the characteristics of social entrepreneurs, and encourage people to look in this direction. I just find that most people don’t know this term so I don’t always use it.

      • The term “scientologist” is an immediate red flag.

        It is a term that marginalizes. It dismisses any legitimate concern – including the danger and harm caused by psychiatrists.

        A message to shrinks:
        Stop calling people who disagree with your unscientific and harmful practices scientologists. Start taking responsibility for the way you live your (professional) lives.

        *Enough* with the marginalizing term!

        Duane

        • Duane,

          The ostrich posture is rarely smart and beneficial long term.

          This written, I agree that in the USA, you might very weel have different scientologists from the ones who had been put to criminal trials in France for abusing people suffering mental stresses including separating them from their money and friends and families-you have different rules here in the USA.

          I spend an interesting late afternoon in Verona in 2010 at a scientologist exhibition because a nice person gave me a leaflet for it: in a big square hall you had at least 8 large very screens who showed repeatdly the same moment of a Dr Sacks’s interview.

          To deny that the scientologists are-at least in Europe – pretending that Dr Sacks is one of them is just ostrich posture to my mind-and a very dangerous one at that!

          • Obviously for the USA readers, I wrote Sacks for Szasz. Sorry about that!

            NB: I like better, by far, what Dr Szasz wrote than what Dr Sacks wrote about autism but the scientologists are definitely using Dr Szasz for their propaganda.

      • Duane,

        In case you read French, here one current criminal trial of a criminal sectarian woman leader , an English teacher by profession claiming that she was a healer and a God’s spouse who put to slavery of sort, people who, having had a bad time in life, trusted her for relief giving her 90% of their salary to be humilated etc…Yo can bet that she didn’t like psychiatry at all:

        http://www.lepoint.fr/societe/l-epouse-de-dieu-devant-le-tribunal-des-hommes-27-11-2012-1534135_23.php

        This is the sad French reality and in the USA, it might be enough to know that one healer is an antipsychiatrists to be safe from harm.

        • Dr. Fulli,

          To pretend that conventional psychiatry is based on science is ostrich posturing.

          Psychiatry’s problems, including its *impending doom* have *nothing* to do with scientology.

          In short, psychiatry made its own (death) bed, and now it can sleep in it.

          To continue to discuss *scientology* is to ignore the *real* problem – psychiatry.

          Or, as my coach used to say when I was a kid, “Keep your eye on the ball.” My coach had some good advice, doc.

          Duane Sherry, M.S., CRC-R
          discoverandrecover.wordpress.com

          • ///To continue to discuss *scientology* is to ignore the *real* problem – psychiatry.///

            I can’t see any logic here Duane.

            It is like to pretend that to discuss Pr Obama or/and Pr Hollande (from France) whatever military putative action against , say… Syria is to ignore the real problem of poverty in the world or the lack of unsalted affordable water sources in the middle East!

            This will be my last answer to you because what you wrote shows that you are clever and educated enough but not in a disposition of mind to discuss your beliefs.

            I really do not have time to spend in an argument where in front of me somebody do not want to think upon what I argue.

            And by the way, Dr Szacz was definitly more on Maria ‘s side than in yours-to my mind.

            I am sure that with the people in your care you are more open-minded.

            Best regards.

          • May be you can use google translation services or whatever or ask a friend. My English is not good enough and really i have not the time to translate it but I wrote the essential facts: a self-appointed healer is answering on a criminal juridiction for having made up to 20 vulnerable people live in a big house and giving her most of their salaries accepting humiliations and sexual acts by promising them to get rid of some demonic possession.

  5. Corinna,

    Here is one of Bob’s recent lectures.

    His lectures support the disease model, don’t they?

    At this point I am at a loss why he does not incorporate the fact the most common cause of acute psychosis is drug toxicity from recreational, prescription, or OTC drugs and organic causes of psychosis are being overlooked.

    I am quite sure if he or one of his loved ones experienced a first time pyschotic episode he would want a physician who would test for and treat underlying medical conditions.

    Robert Whitaker – Global Psychiatric Epidemic – October 23, 2012 – CPH

    http://www.youtube.com/watch?v=VgS79hz1saI

    posted on Mad in America dot com 11/28/2012

      • Corinna,

        I’m not sure how this statement fits into anything that I am referencing.

        “Marijuana is not a food group like some people may be thinking.”

        Marijuana as a food group? I’m not really sure how this applies.

        The issues that I am concerned with involve the “Chinese menu” approach or using the DSM:

        1. Are certain individuals in our mental health care system suffering from underlying medical conditions misdiagnosed as sz/bp being forced to contract ineffective and potentially lethal treatments?

        Yes, there are many medical conditions and substances that can induce encephalopic conditions and manifest as psychotic symptoms.

        Medical professionals should follow Best Practice assessment guidelines to rule out underlying medical condition and ensure medications are not used on a long-term basis.

        2. Are there any diagnositic tests for mental disorders?

        Yes, these are mental disorder as described by the DSM:

        293.82 Psychotic Disorder Due to Medical Condition, with Hallucinations

        293.83 Mood Disorder Due to Medical Condition

        293.89 Anxiety Disorder Due to Medical Condition

        There is a long list of medical conditions that can manifest as psychosis, including brain tumors and Hashimoto’s encephalopathy. An MRI and blood tests are diagnostic tests that can diagnose these mental disorders.

        Please listen to this interview,

        http://www.youtube.com/watch?v=pm77RQdtpSY

        Bob states quite clearly youth doing marijuana are are increased risk of ending up with a dx of bp.

        He also states he believes more than 50% of those labeled with mental illness entered into the system from the use of illegal drugs. He states he did not realize this when he wrote Anatomy of an Epidemic.

        These are emails responses I have had from Bob regarding underlying causes of psychosis.

        Best Practice assessment of psychotic symptoms is the most ethical standpoint an advocate could take.

        Why would we want to overlook a medical condition or a substance causing psychosis?

        Especially when that substance could be a psychiatric medication that induced a psychotic episode resulting in a parent killing their own child. eg. Ryan Ehlis, Dena Schlosser, Otty Sanchez, Julie Schenecker and David Crespi.

        Advocates need to get on the same page with this problem.

        1. APA seems to embrace psychotherapy/cognitive therapy Thu, May 10, 2012 4:01 am

        Hi Maria,

        I was speaking to a group of primary care physicians yesterday, and this very point came up. And that is, in the past, the first thing doctors did when presented with someone with psychiatric symptoms was think of possible physical causes (thyroid, vitamin and mineral deficiencies,), and of course environmental toxins.

        And your letter does highlight part of the problem, which is that those against the drug model usually have their own horse they want to ride, which is talk therapy, or some other form of therapy.

        But you are right–I think nutrition, environmental toxins, lack of sleep, other medications, etc., should be seen as possible culprits for psychosis (whenever someone presents with such.)

        All the best,

        Bob

        2. Integrative Psychiatry/Medicine Thu, Oct 6, 2011 8:49 am

        HI Maria,

        Thank you for this.

        I am very much looking forward to Dr. Shannon’s presentation. I also think that your story illustrates that when someone experiences a manic or psychotic episode, the first thing doctors should look for are agents (such as chemical exposure, psychoactive drugs–illicit or licit) that could have triggered such episodes.

        I hope that integrative psychiatry becomes the future.

        Bob

        3. Article: After Soteria House Shooting Victim Dies, Questions Remain July 24 2011

        Hi Maria,

        What happened at Soteria is such a tragedy. What the article didn’t state is that the woman who was killed was one of the home’s real success stories. She had gotten off medications and was doing so well. Her death is so heartbreaking.

        Regarding your other point here, well, I think all of psychiatry needs to think about this point, which is that many things can induce psychosis, including other medications, and thus they avoid seeing psychosis as necessarily a sign of mental illness. Physicians a century ago regularly thought that psychosis could result from poisoning, other diseases, etc.

        I recently was at an event where one of the psychiatrists said that he believed that 80% of those diagnosed with schizophrenia in recent years had been doing illicit drugs before they had their psychotic break.

        all the best,

        Bob

        4. Talk by e-Patient Dave from the Society of Participatory Medicine Wed, Jul 6, 2011 10:52 am

        Hi Maria,

        It was nice to meet Dr. Sinaikin there, and all in all, the conference was decent, and actually not too radical.

        I’m sorry to hear that ICSPP didn’t show much interest in Dr. Kohl’s presentation.

        And I agree with you on this–many, many things can induce psychosis (illicit drugs, lack of sleep, physical illnesses, etc.), and it’s a mistake to lump psychosis into one large cagtegory.

        I think the old adage of doctors needing to take a detailed case history (which is a form of participatory medicine) needs to be recalled and reintegrated into practice.

        Psychosis is just a symptom of something amiss, and often, not a disease unto itself.

        Thanks for this link. I’ll check it out.

        Bob

        posted on Mad in America dot com 12/2/12

  6. Hi Maria,

    Psychiatrists are doctors like dermatologists.Aren’t they?

    Would you dare to write that dermatologists must disappear because -to take only one example, the first and for a long time only manifestation of a Hodgink’s lymphoma can be a skin rash looking very much like common eczema?

    Would you dare to suppress cardiology because the cardiologists have been abused on the statines front by bad pharma marketing?

    My view is that psychiatrists should be good doctors first keeping in touch with the progresses of medicine in general and – like other specialists work with family doctors and ask other specialist for advice.

    I also think- personal opinion- that all childpsychiatrists should have qualified as pediatrician first. This case is a rarity in France and many French child psychiatrists-even academics are still accusing the mother ‘s behavior of producing autism and psychosis.

    When it comes to give a treatment for a terribly annoying treatement resistant skin rash, it would be ludicrous to think that a dermatologist is less able than any other doctor to treat it and for example tapering off the doses of corticotherapies!

    NB: You might want to use alternative therapies and it becomes another story -with naughty people out there on the internet as sure as you find honest practitioners of alternative medicines- but if you do not refuse allopathicic drugs, it is ludicrous to refuse the dermatologists expertise.

    If a client refuse psychiatric drugs fine but if he doesn’t -or if the law people make him obliged to take it- the ideal situation is a non paternalistic competent psychopharmacologist psychiatrist trained by honest academics.

    Please, Maria, do not idealize internal medicine or general practices. Bad Pharma marketing and clients wanting a quick-fix with drugs do exist in every medical discipline and sometimes an internist can make an honest mistake and send to the psychatrist an internal medicine case- so to speak- when a good psychiatrist will send the client back.

    Idem for a cardiologt is the same in psychopharmacology: better to find an honest psychopharmacolgy To refuse it is one thing. Fine with me – I have not prezscribe myself any of those medicine nor ECT (but I send some people to colleagues who do from time to time)- since 1989

    I know it is different in the USA and the doctor
    Would you dare to suppress cardiology because the cardiologists have been abused on the statines front by bad pharma marketing? will you

    • Maria was just quoting a statement made by a certain church. I think she’s pretty open to anyone who knows how to help, see her post about including all groups.

      But as far as coming off medications, it’s not always helpful to contact a doctor. The biggest study ever done on this, by Mind UK, found that doctors were the most unhelpful support people of all through this process. http://theicarusproject.net/alternative-treatments/mind-uk-study-on-how-people-come-off-psych-drugs

      As far as first episode psychosis, I would think a peer specialist could do a lot more help and a lot less harm than a doctor, and as far as I know, this is what Bob advocates for, a Soteria type process or Open dialogue or several other models that delay the use of medications and take a good look at life situations.

      • Hi Corinna,

        The church Maria was quoting is just illogical, to my mind, then: it should not focus against psychiatry for the reasons I explained already.

        ///As far as first episode psychosis, I would think a peer specialist could do a lot more help and a lot less harm than a doctor///

        At the very least, there is more logic in your view!

        Anyway, we live in different societies: In France a psychiatrist has been held responsable by a criminal prosecutor and put to trial for not having prescribed neuroleptics in a depot form to a client who repeatidly stopped taking pills who killed his mother’s partner. (The client had been held legally irresponsable and not tried in court for the killing because of his mental state at the momen tof the killing):

        ///”J’espère que le tribunal aura le courage d’aller au bout de la démarche, en disant qu’un psychiatre défaillant peut être responsable des actes d’un malade mental qu’il avait sous sa garde”, a indiqué Me Chemla///

        /// “I hope that the judges will have the courage to keep going with what they started by telling that a psychiatrist who fails can be held responsable of his client’s acts “,said Me Chemla (the lawyer representing the son of the victim.

        http://tempsreel.nouvelobs.com/societe/20121113.OBS9108/marseille-une-psychiatre-jugee-pour-homicide-involontaire.html

        The next step,for the French prosecutors, will be to put to trial theirs doctors when any alcohol dependent client kills somebody when driving a car after drinking!

        I know, I should not comment on MIA because I just do not understand enough of the concrete situation here.

        All the best Corinna to you and your project.

        I would be the last person to think that it is helpful to contact many a doctor to support coming off medication but, in my opinion, this sad fact is due mainlu to:
        1) bad marketing from Big Pharma

        2) the silly persistence of the monoamine theory of psychosis and depression Big pharma marketing used with a lot of success (ending of a vicous circle).

          • Adult psychiatrist,psychopharmacologist by training with research (in my youth ) and still clinical interest on female hormones and mood disorders; homeopathy training (in France homeopaths must be MD),interest and some training (outside France) in adult autism and in social psychiatry.

        • By the way, and this really will be my last comment on this post of yours, the French psychiatrist was not only accused by an expert psychiatrist of not having prescribe depot injection of neuroleptics but she was also accused of letting her client out of the psychiatric ward although she tried to re-hospitalize her client shortly before the crime he committed and had let the police know that she wanted, for public safety reasons, her client to be re-hospitalized immediately but her client had escaped from her office and the client’s mother know that her son was dangerous.

          I , sincerely,would not be opposed to the calling of a peer support group in that kind of cases in order to either convince the client to be hospitalized or even to take care of him and garantee that he will not kill his mother’s partner as he announced.

          I admire all people in,volving themselves with helping psychotic persons in that time of ours where psychiatry suffer both from the American psychiatrists association ‘s DSM diagnostic mess with their committee electing diseaeses for academics ‘s own personal and criminal bad pharma marketing- not only in psychiatry:
          http://www.washingtonpost.com/business/economy/anemia-drug-made-billions-but-at-what-cost/2012/07/19/gJQAX5yqwW_story_2.html
          The first two drugs of the trio, Epogen and Procrit, were approved by the agency in June 1989 for patients with kidney disease. Amgen made both; Procrit was licensed by Johnson & Johnson. Amgen’s Aranesp would be approved in 2001.

          For a narrow portion of those patients — dialysis patients with anemia so severe they needed occasional blood transfusions — the drugs, if used in limited amounts, did offer a critical benefit, one that doctors say amounted to a revolution in treatment. Patients with severe anemia said it could restore their vitality. The new drugs allowed them to avoid the risks of transfusions, which can carry diseases and raise future complications for transplant patients.

          The trouble would arise as the drugmakers won FDA approval for vastly expanded uses, pushing it in larger doses, for milder anemia and for patients with a wider array of illnesses. Very quickly, the market included nearly all dialysis patients, not just the roughly 16 percent who required blood transfusions. The size of average doses would more than triple. And over the next five years, the FDA would approve it to treat anemia in patients with cancer and AIDS, as well as those getting hip and knee surgery.

          The key to their marketing was the claim that the drugs at higher doses could make patients feel better. By 1994, the drug’s label, approved by the FDA, advertised a range of benefits: “statistically significant improvements for . . . health, sex life, well-being, psychological effect, life satisfaction, and happiness.”

          Those claims, withdrawn 13 years later because they did not meet new FDA standards for proof, would be the basis of television and print advertising campaigns, pitched to people with potentially fatal illnesses.

          The drugs, according to one, offered “Strength for Life.” Reing a bell? To me it sounds like antidepressants’s criminal marketing.

        • Corinna,

          I’m not sure how this statement fits into anything that I am referencing.

          “Marijuana is not a food group like some people may be thinking.”

          Marijuana as a food group? I’m not really sure how this applies.

          The issues that I am concerned with involve the “Chinese menu” approach or using the DSM:

          1. Are certain individuals in our mental health care system suffering from underlying medical conditions misdiagnosed as sz/bp being forced to contract ineffective and potentially lethal treatments?

          Yes, there are many medical conditions and substances that can induce encephalopic conditions and manifest as psychotic symptoms.

          Medical professionals should follow Best Practice assessment guidelines to rule out underlying medical condition and ensure medications are not used on a long-term basis.

          2. Are there any diagnositic tests for mental disorders?

          Yes, these are mental disorder as described by the DSM:

          293.82 Psychotic Disorder Due to Medical Condition, with Hallucinations

          293.83 Mood Disorder Due to Medical Condition

          293.89 Anxiety Disorder Due to Medical Condition

          There is a long list of medical conditions that can manifest as psychosis, including brain tumors and Hashimoto’s encephalopathy. An MRI and blood tests are diagnostic tests that can diagnose these mental disorders.

          Please listen to this interview,

          http://www.youtube.com/watch?v=pm77RQdtpSY

          Bob states quite clearly youth doing marijuana are are increased risk of ending up with a dx of bp.

          He also states he believes more than 50% of those labeled with mental illness entered into the system from the use of illegal drugs. He states he did not realize this when he wrote Anatomy of an Epidemic.

          These are emails responses I have had from Bob regarding underlying causes of psychosis.

          Best Practice assessment of psychotic symptoms is the most ethical standpoint an advocate could take.

          Why would we want to overlook a medical condition or a substance causing psychosis?

          Especially when that substance could be a psychiatric medication that induced a psychotic episode resulting in a parent killing their own child. eg. Ryan Ehlis, Dena Schlosser, Otty Sanchez, Julie Schenecker and David Crespi.

          Advocates need to get on the same page with this problem.

          1. APA seems to embrace psychotherapy/cognitive therapy Thu, May 10, 2012 4:01 am

          Hi Maria,

          I was speaking to a group of primary care physicians yesterday, and this very point came up. And that is, in the past, the first thing doctors did when presented with someone with psychiatric symptoms was think of possible physical causes (thyroid, vitamin and mineral deficiencies,), and of course environmental toxins.

          And your letter does highlight part of the problem, which is that those against the drug model usually have their own horse they want to ride, which is talk therapy, or some other form of therapy.

          But you are right–I think nutrition, environmental toxins, lack of sleep, other medications, etc., should be seen as possible culprits for psychosis (whenever someone presents with such.)

          All the best,

          Bob

          2. Integrative Psychiatry/Medicine Thu, Oct 6, 2011 8:49 am

          HI Maria,

          Thank you for this.

          I am very much looking forward to Dr. Shannon’s presentation. I also think that your story illustrates that when someone experiences a manic or psychotic episode, the first thing doctors should look for are agents (such as chemical exposure, psychoactive drugs–illicit or licit) that could have triggered such episodes.

          I hope that integrative psychiatry becomes the future.

          Bob

          3. Article: After Soteria House Shooting Victim Dies, Questions Remain July 24 2011

          Hi Maria,

          What happened at Soteria is such a tragedy. What the article didn’t state is that the woman who was killed was one of the home’s real success stories. She had gotten off medications and was doing so well. Her death is so heartbreaking.

          Regarding your other point here, well, I think all of psychiatry needs to think about this point, which is that many things can induce psychosis, including other medications, and thus they avoid seeing psychosis as necessarily a sign of mental illness. Physicians a century ago regularly thought that psychosis could result from poisoning, other diseases, etc.

          I recently was at an event where one of the psychiatrists said that he believed that 80% of those diagnosed with schizophrenia in recent years had been doing illicit drugs before they had their psychotic break.

          all the best,

          Bob

          4. Talk by e-Patient Dave from the Society of Participatory Medicine Wed, Jul 6, 2011 10:52 am

          Hi Maria,

          It was nice to meet Dr. Sinaikin there, and all in all, the conference was decent, and actually not too radical.

          I’m sorry to hear that ICSPP didn’t show much interest in Dr. Kohl’s presentation.

          And I agree with you on this–many, many things can induce psychosis (illicit drugs, lack of sleep, physical illnesses, etc.), and it’s a mistake to lump psychosis into one large cagtegory.

          I think the old adage of doctors needing to take a detailed case history (which is a form of participatory medicine) needs to be recalled and reintegrated into practice.

          Psychosis is just a symptom of something amiss, and often, not a disease unto itself.

          Thanks for this link. I’ll check it out.

          Bob

          posted on Mad in America dot com 12/2/12

        • Dear Fulli MD,

          I am not quoting a church.

          The Citizens Commission on Human Rights (CCHR)of Florida is a not-for-profit organization.

          Members of CCHR are from many different religions. The organization was founded in part by the Church of Scientology but many of the members are Christian.

          CCHR has a long list of accomplishments that have helped to protect individuals in our mental health care system and they are credited for educating many individuals who did not know of the great harm psych meds can cause.

          • Hi Maria,

            I am glad that you are all for dialogue and understanding because I have things to get right with you.

            1) Corinna wrote to me it was a church. I did not care if it was a church or not. I just find illogical to be against psychiatrists and not against all doctors!

            2) I agree that “psych med” can cause great harm.

            3)I happen to think that some “psychotherapists” and healers also do great harm to their clients (and family) wellbeing and money savings.

            4) We can only hope for the distant future that knowing the causation of every illness doctors will also be able to prescribe an etiologic “non psych med” treatment.

            Sadly,for now medicine- not only psychiatry- more often than not has to use, symptomatic treatments.

            5)Life would be so simpler if only psychiatrists and other doctors prescribing “psych meds” were evils or only greedy for power or money…

            For example: In the catholic church priests and nuns have been known to abuse children in their full time care and not only sexually.

  7. Corinna,
    This is a good discussion. The social entrepreneur label fits you, and me too. Yet what I do in the mental health area doesn’t define my whole agenda. Mine is social policy activism, about making things better for us all, using politics, writing, education and whatever else is handy. Mental health themes run through some of today’s most critical issues, from poverty to health care to workplace violence to education. People who have first-hand knowledge of these challenges have something to contribute in all of these areas.

  8. Picking up on the word “entrepreneur”, I think of this TEDTalks (which I thought – with my severely mentally ill mind – was quite excellent):

    http://youtu.be/chXsLtHqfdM
    Ernesto Sirolli: Want to help someone? Shut up and listen!
    17 Minutes, 10 Seconds

    About:

    When most well-intentioned aid workers hear of a problem they think they can fix, they go to work. This, Ernesto Sirolli suggests, is naïve. In this funny and impassioned talk, he proposes that the first step is to listen to the people you’re trying to help, and tap into their own entrepreneurial spirit. His advice on what works will help any entrepreneur.

    The members of APA might want to tune-in and then challenge themselves to live up to their own mission statement.

    “Our mission is to advance the creation, communication and application of psychological knowledge to benefit society and improve people’s lives.”

    In other words, they claim that they are “most well-intentioned aid workers” who “think they can fix” (improve people’s lives).

    What Mr. Sirolli has to say is applicable to anything that takes two to make a thing go right.

  9. Hello,

    I agree with every point that Dr. Fulli has made above.

    Individuals labeled “mentally ill” are among the most vulnerable in our society and in need of hardworking advocates.

    Advocates need to find common grounds to create a strong and uniform advocacy agenda.

    Those we advocate for are at a disadvantage when advocates pursue arguments amongst each other rather than ensuring their agenda includes protecting the health, safety and welfare of mental health patients.

    What I appreciate about the Citizens Commission on Human Rights (CCHR)of Florida is the fact they expose crimes in our mental health care system, not just psychiatry.

    Here is a website created by a member of CCHR. There are more psychologists, social workers and counselors listed than psychiatrists.

    http://www.psychsearch.net/mug_shots.html

    As Bob has pointed out, many primary care physicians in our society are at fault for the proliferation of prescriptions for psychiatric meds, not just psychiatrists.

    Primary care physicians tend to believe the stigmatizing aspects of “mental illness”.

    I seem to be the only person who was very bothered by Dr Mark Foster’s Sept. 10, 2010 post on Mad in America describing one of his patients as:

    “A 31 year old blond woman with a history of traumatic brain injury and partial hemiplegia. She also has Hep C and a history of severe polysubstance abuse. She states “I don’t want any more drugs” and then promptly asks to be switched from Effexor to something else because it doesn’t help anymore, and by the way could I give her something for pain and for anxiety and for sleep? She tells me she’s taking 6-8 tylenol PMs twice a day to help her sleep. She says she’s “addicted to sleep” because that’s the only way she can avoid the impulse to go back to illicit drugs. And by the way, she’s trying to get pregnant. (Gulp)

    I switched her from Effexor to Trazodone. She is a difficult patient, a bottomless pit of needs with no coping mechanisms, and I don’t have a clue how to help her. She is truly a “broken brain”–literally–and will always be disabled. In her case, keeping her semi-sedated makes some sense–to spare herself and society the legal and criminal consequences of her mind unleashed. It seems to be what she wants. In her case, I made a med change that may address one aspect of her problems (sleep) and hopefully spare her the liver damage from the Tylenol, and then we live to fight another day.”

    The stigma of being labeled “mentally ill” prevents many individuals from receiving adequate medical care.

    At one point I had 3 different psychiatrists tell me that I was depressed, all three offered a prescription of prozac. My complaints were that I was so tired I could not get out of bed and I felt like I was dying. I did not complain or indicate that I was sad or depressed. Finally a relative suggested I have my thyroid levels checked. Hypothyroidism made complete sense once I looked up all of the other symptoms I was having. My primary care physician was reluctant to run the test and almost accused me of being a hypochondriac. My TSH came back at a dangerous level of 147. I have witnessed other mental health patients deprived adequate medical treatment and dental care while being treated in psych wards at a cost of over $800/day.

    Much human suffering could be prevented if better medical and dental care was afforded to those labeled “mentally ill”.

    Bob pointed out in Mad in America that cases of “insanity” were cured by treating infected teeth. He went on to include the mistreatment of patients who became victims of “bad medicine” but he missed the main point that treating infected teeth can abate symptoms of psychosis. Today, holistic dentists take into consideration tooth decay and abscessed teeth can be contributing factors to schizophrenic-like behavior.

    Preventing and ending unnecessary suffering should be a concern for all mental health advocates, regardless of what type they are considered to be.

    Posted on Mad in America 12/5/2012

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