Mental Health Advocates Protest Congressional Mental Health Bill

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Rep. Tim Murphy, a former psychologist, introduced the “Helping Families in Mental Health Crisis Act” to congress today, a bill aimed at stopping violence perceived to be associated with mental illness.  The bill seeks to establish court-ordered “assisted outpatient treatment” as an alternative to inpatient care, among other measures aimed at increasing the availability of mental health care. “This legislation would eliminate initiatives that promote recovery from serious mental illnesses,” said Daniel Fisher, M.D., Ph.D., a founder of the National Coalition for Mental Health Recovery.

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Further reading:
Rep. Tim Murphy to Unveil Mental-Health Reform (National Journal)
Mental Health Advocates Blast Rep. Tim Murphy’s Bill as a Costly Step Backward, to the Days When a Mental Illness Diagnosis Was a Life Sentence  (Sacramento Bee)

Press Release from The National Coalition for Mental Health Recovery, a coalition of 32 statewide organizations and others, about Tim Murphy’s bill:

Mental Health Advocates Blast Rep. Tim Murphy’s Bill as a Costly Step Backward, to the Days When a Mental Illness Diagnosis Was a Life Sentence

WASHINGTON (12/12/13) – Today, Congressman Tim Murphy introduced legislation that, if passed, would reverse some of the advances of the last 30 years in mental health services and supports. It would exchange low-cost services that have good outcomes for higher-cost yet ineffective interventions, according to the National Coalition for Mental Health Recovery (NCMHR), a coalition of 32 statewide organizations and others representing individuals with mental illnesses; the National Disability Rights Network (NDRN), the non-profit membership organization for the federally mandated Protection and Advocacy (P&A) Systems and Client Assistance Programs (CAP) for individuals with disabilities; and the Bazelon Center for Mental Health Law, a national non-profit legal advocacy organization.

“This legislation would eliminate initiatives that promote recovery from serious mental illnesses through the use of evidence-based, voluntary, peer-run services and family supports,” said Daniel Fisher, M.D., Ph.D., a founder of the NCMHR. “These services have a proven track record in helping people stay out of the hospital and live successfully in the community. Because hospitalization is far more expensive and has far worse outcomes than these effective, and cost-efficient, community-based services, this bill would cost more money for worse outcomes.

“Even worse,” Dr. Fisher added, “the bill greatly promotes stigma and discrimination by its unfounded and damaging connection between mental illness and violence.”

NDRN, NCMHR and the Bazelon Center note that the bill does not represent the mainstream of national thought, practice and research.

“This proposal targets the rights of individuals with mental illnesses and restructures federal funding to heavily encourage the use of force and coercion. It also would reduce privacy protections and rights advocacy,” said NDRN executive director Curt Decker.

“Most troubling, this legislation threatens to essentially dismantle the efforts of the Substance Abuse and Mental Health Services Administration (SAMHSA) to promote recovery and community inclusion for the broad variety of people in our community – and to do so at a time when SAMHSA’s efforts to ensure that effective behavioral health approaches are fully integrated into public health are essential,” said Harvey Rosenthal, a Bazelon Center trustee.

Among the problematic provisions of Rep. Murphy’s bill is the establishment of a grants program to expand involuntary outpatient commitment (IOC), under which someone with a serious mental illness is court-mandated to follow a specific treatment plan, usually requiring medication. Yet the facts show that involuntary outpatient commitment is not effective, involves high costs with minimal returns, is not likely to reduce violence, and that there are more effective alternatives.

“Force and coercion drive people away from treatment,” said Jean Campbell, Ph.D., one of the nation’s leading mental health researchers. “In 1989, 47% of Californians with mental illnesses who participated in a consumer research project reported that they avoided treatment for fear of involuntary treatment; that increased to 55% for those who had been committed in the past.” (Dr. Campbell was one of the two researchers.[i])

Rep. Murphy’s bill is based on a false connection between mental illness and violence. Study after study shows that no such connection exists. In fact, individuals with mental illnesses are actually 11 times more likely to be victims of violence than the general public.

Rep. Murphy’s bill also attacks the federally mandated Protection and Advocacy programs, which, together with the Client Assistance Programs, are the largest provider of legally based advocacy services to people with disabilities in the United States.

“We urge Congressional leaders to engage in a meaningful dialogue with the mental health community to help them better understand what our systems are doing to best support the health and safety of people with mental illnesses and of all Americans,” said Dr. Fisher.

The National Disability Rights Network (NDRN) is the non-profit membership organization for the federally mandated Protection and Advocacy (P&A) Systems and Client Assistance Programs (CAP) for individuals with disabilities.

The National Coalition for Mental Health Recovery (NCMHR) works to ensure that consumer/survivors have a major voice in the development and implementation of health care, mental health, and social policies at the state and national levels, empowering people to recover and lead a full life in the community.

Media Contacts:
Harvey Rosenthal, 518-527-0564[email protected]

 

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].

27 COMMENTS

  1. “Rep. Murphy’s bill is based on a false connection between mental illness and violence. Study after study shows that no such connection exists. In fact, individuals with mental illnesses are actually 11 times more likely to be victims of violence than the general public.”

    It’s time to tell the truth.

    I have known violence ALL OF MY LIFE. Both in the family, in the neighborhood, in the community, in school and everywhere, and in every way.

    You’d HAVE TO BE SICK in some way to be violent. Since violence is the majority of my life and pretty much all I’ve ever known, I’d say there most absolutely, most certainly IS a link between mental illness and violence.

    My birth mother was a very, very sick and violent person. I went into a foster home to get away from her. In foster care, there were MANY and PLENTY of problems (in EVERYBODY – foster parents, foster kids, foster parent’s birth kids, social workers, you name it). Then, at 15 years old I was locked up in a mental hospital for 2 months where I got my ass kicked, many times. I call it PSYCHIATRIC VIOLENCE. Because that is exactly what it was.

    I really wish people would be more HONEST. Violence is all *I* have ever known, all of my life.

    Report comment

      • I’d put it another way – “Mental illness” (which I don’t regard as an illness per se) is not the cause of violence, it is generally the result of violence. And yes, violence can be passed on from those who are victimized to a new generation. So what we should be working toward is ending violence and abuse.

        I will point out, however, that despite the violence you’ve been subjected to, you are here protesting violence rather than carrying it on. It takes a lot of courage to do that, but people do make that decision all the time. So the second thing we need to do is help those victimized by violence to heal so they don’t continue to perpetrate it on another generation. As you well know, this is NOT accomplished by locking people up and shooting them full of Haldol!

        — Steve

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        • Steve,

          IMHO, it’s good you keep that term “mental illness” sandwiched between quotation marks.

          IMHO, it’s very helpful.

          I take that as your suggestion, to your readers, that: “mental illness” refers to whatever it may mean to whoever is speaking of it — nothing more, nothing less.

          Anyone who discusses “mental illness” expects or hopes that others ‘get’ what’s being discussed; but, one can never be sure.

          So, we find countless discussions of “mental illness” wherein the participants attempt to offer their own ‘understanding’ of what ‘it’ is all about…

          And, that is the kind of term, which “mental illness” is.

          (And, heaven help us when we hear of “mental illness” and “the mentally ill” in the news, where all discussions boil down to soundbites; who can really know what exactly is being discussed there, when someone says “mental illness,” is it not just what the supposedly ‘qualified’ reporter believes it is? Most often, when one hears talk of “mental illness” in the news, one can presume that ‘it’ is whatever a psychiatrist identifies as it; I mean “mental illness” is, then, up to psychiatrists to define.)

          But, “Mental illness” is an endlessly ‘plastic’ term, explained Thomas Szasz; therefore, he admonished ‘mental health’ professionals to just, please, stop trying to explain what it supposedly ‘really’ is; he hoped to inspire a movement which would end the tendency of therapists and others, to treat this nonsense term (“mental illness”) as an object of serious study, even reverence; except for pointing out that it is a metaphor, we should not hope to figure out what “mental illness” is, despite our temptation to do so, Szasz insisted.

          So, here, you say “it is generally the result of violence,” and I say I’d rather look to Szasz, on this matter.

          I will ask you, is it really, generally?

          (Of course, my question is rhetorical.)

          Szasz challenged his critics to just cease attempting to define what “mental illness” supposedly is — because there will never be anything even remotely like a consensus, regarding its meaning.

          (Of course, everyone in ‘mental health’ circles well knows, Szasz built his career upon his practice of debunking what he called “The Myth of Mental Illness” — and all the unspeakable ‘medical’ crimes and associated bad ‘treatment’ and twisted logic that it begets.)

          Only very, very rarely do psychiatrists eschew the term, “mental illness”; but, it does happen.

          If you’re interested (and if anyone else is interested), here’s a link to a rather good article I ran across just this morning, “Who Is Mentally Ill?” by a psychiatrist named Steven Reidbord:

          http://www.psychologytoday.com/blog/sacramento-street-psychiatry/201312/who-is-mentally-ill?tr=HdrQuote

          I seldom find myself holding up psychiatrists’ writings, as exemplary representation of good reasoning; however, in this comment, I’ve done so twice.

          PLEASE, let no one fail to realize the fact, that I am extremely skeptical of all psychiatrists; it’s only because these two both do a great job of cutting through the ultimate lunacy that can result from engaging in conversations about “mental illness,” as though that term might actually means something that we could all agree upon!

          By the way, Steve, as is usually the case, when I’m reading your comments, here I’ve found myself agreeing with and appreciating your over all message…

          Respectfully,

          Jonah

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  2. Today on CNN some author who wrote a book about the Newtown Adam Lanza school shooting lied right into the camera and stated something like “The thing all the school shooters had in common was they didn’t get mental health treatment”.

    I was just watching to see if his face even flinched as he LIED to millions of viewers.

    Lier ! Index to SSRI Stories: School Shootings
    http://www.ssristories.com/index.php?p=school‎

    ———–

    CNN transcript 12/12/2013

    “MATTHEW LYSIAK, AUTHOR OF “NEWTOWN, AN AMERICAN TRAGEDY”: Thank you for having me. CUOMO: Good luck with the book. Few things need to be discussed more or am I wrong? Let’s start there. There are those who say, “Leave them alone. Nothing can be learned. Don’t obsess on the obvious.” And yet you don’t agree because you wrote the book. What do you make of that perspective, “Leave these people alone”?

    LYSIAK: I live there. I understand its perspective. But let me tell you something. I know there’s a tendency to act like what happened was a weather event. I’m convinced that this tragedy is something that could have been prevented.

    And when I tracked through Adam’s life — and I was able to access years worth of Nancy Lanza, the mother’s, e-mails — you can see this deterioration of mental health over the course of many years. And this was a mother who identified that her son was mentally ill and sought professional help.

    Still, Adam was not on medication. And the fact that we have a lot of dangerously mentally ill people around who are not being treated, to me says that you can expect this rising trend of mass shootings to continue unless we figure out a solution and that starts with the information and finding out why, which is what my book focuses on. ”

    ——————–

    Adam was not on medication ?????

    Really ? , seems he DID have exposure.

    ““When you get a haircut, do you look to see what the heck you look like? He never looked. So we knew instantly, immediately, that there was some kind of a problem,” she said. “We have a few clients that their children suffer from being autistic, but he was just — I don’t even think withdrawn is the right word. Removed.”

    As previously reported by The Times, friends of the family said he suffered from Asperger’s syndrome, a form of autism. As early as age 10, Adam Lanza was taking medication, according to his former baby sitter, Ryan Kraft, now an aerospace engineer in Hermosa Beach. ”

    Hairstylist remembers Adam Lanza: ‘I thought he couldn’t speak’
    December 20, 2012|By Kim Murphy

    http://articles.latimes.com/2012/dec/20/nation/la-na-nn-hairstylist-adam-lanza-20121220

    CUOMO: Now, that takes us to the seminal question, what could have been done differently? I believe, many experts suggest, well, that’s where the problem lies because in how we deal with mental health. A portion of the proceeds from your book is going to a charity in the name of one of the young victims there. It goes to dealing with brain health. People dismiss this, Matt. They say, “No, no, no. Don’t get away from the guns. This is about the guns. Don’t distract me. Mentally ill are not inherently violent. There’s no real factual correlative here. You can’t really say this.” And yet, almost every one of these mass shootings involves someone who has clear mental illness that hasn’t been dealt with effectively. What do you believe the reality is?

    LYSIAK: I know you’ve covered several of the mass shootings, too. And, yes — look, if we don’t do something to treat these violently ill people, then this trend will continue. You can talk about all these other issues and they all might be important in their own right. But nobody’s ever explained to me a gun law that could have been passed that would have prevented this.

    ———–

    CUOMO: Now, that takes us to the seminal question, what could have been done differently? I believe, many experts suggest, well, that’s where the problem lies because in how we deal with mental health. A portion of the proceeds from your book is going to a charity in the name of one of the young victims there. It goes to dealing with brain health. People dismiss this, Matt. They say, “No, no, no. Don’t get away from the guns. This is about the guns. Don’t distract me. Mentally ill are not inherently violent. There’s no real factual correlative here. You can’t really say this.” And yet, almost every one of these mass shootings involves someone who has clear mental illness that hasn’t been dealt with effectively. What do you believe the reality is?

    LYSIAK: I know you’ve covered several of the mass shootings, too. And, yes — look, if we don’t do something to treat these violently ill people, then this trend will continue. You can talk about all these other issues and they all might be important in their own right. But nobody’s ever explained to me a gun law that could have been passed that would have prevented this.

    http://transcripts.cnn.com/TRANSCRIPTS/1312/12/nday.03.html

    I saw this live and did not hear the word

    CNN nothing but pharma ads in every commercial break !

    CNN never shuts up when it comes to pushing psychiatry, any one else notice how like every third story is about f_ing psychiatry and pushing it ?

    Report comment

    • What a crock! Almost every one of these shooters was receiving or had recently received “mental health treatment.” A lack of treatment was certainly NOT the problem! Treatment that doesn’t work or makes you more violent is the problem.

      —- Steve

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      • Since when have they gotten anything right in the past two years, what with the gridlock and the obstructionist attitudes held by so many in Congress? This bill with probably be right up their alley. I feel very pessimistic this morning but I have no faith in Congress to get anything right anymore.

        Report comment

      • According to Pete Earley, one key facet of the Murphy bill, is its focus upon “changing involuntary commitment laws to focus on a “need for treatment” standard rather than requiring dangerousness.”

        Earley explains that, “This shift has always been important to me because of how my own son and I were turned away in an emergency room. England and France have “need for treatment” standards with built in safeguards to protect individual rights. Focusing on treatment rather than danger should make it possible for people to get care before they are abandoned on the streets or become dangerous.”

        http://www.peteearley.com/2013/12/12/rep-murphys-bill-would-shift-focus-make-major-changes-in-mental-health-care/

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        • Correct. The text of the bill is here,

          http://murphy.house.gov/uploads/Families%20in%20Mental%20Health%20Crisis%20Act.pdf

          It is very disturbing for several reasons. First because if you read the actual text, it says that “being gravely disabled” should be a valid reason for civil commitment. The bill further defines what “being gravely disabled” is, in summary, “whenever a psychiatrist thinks you are gravely disabled”. So, if this bill were to become law, it would take us 40 years back. It would need to be challenged because it is in all likelihood unconstitutional.

          After my initial alarm, I have seen that the bill has received very little press. Fox News, which has editors that are too friendly to Torrey and the like, didn’t even mention it. So it is probably too extreme even for them. Which means that in all likelihood this bill will die.

          Nonetheless, that this bill exists in the first place should raise concerns that the enemies of our freedom do not rest. They are constantly trying to be creative in finding ways of curtailing our freedoms.

          Report comment

          • Fox News has a psychiatrist on staff ,Dr. Ablow, who has written extensively on the abysmal condition of the American psychiatric system. One of his articles , in particular, was an excellent list of reforms for hospitalizations. I thought it was excellent and if those things had been done for our loved one, she probably would be experiencing a far better outcome now.

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        • “need for treatment”

          Give me a break ! Prove it.

          There are no lab tests, brain scans, X-rays or chemical imbalance tests that can verify any mental disorder is a physical condition. This is not to say that people do not get depressed, or that people can’t experience emotional or mental duress, but psychiatry has repackaged these emotions and behaviors as “disease” in order to sell drugs. This is a brilliant marketing campaign, but it is not science.

          Report comment

  3. I just read Early’s blog entry on this and I am really frightened. Cong. Murphy wants to have an assistant secretary of mental health and make it easier to commit someone involuntarily. OMG.

    Ok, instead of talking about this on this forum, what do we need to do to stop this bill? This would be a horrific setback for the cause.

    Report comment

    • Ok, instead of talking about this on this forum, what do we need to do to stop this bill?

      Keep pointing out that while posing as “authorities” on the mind and mental health, psychiatry has no scientific basis for any of its treatments or methods.

      Keep posting evidence debunking the main claims and methods of psychiatric pseudo-science.

      Keep posting reports of harm done by psychiatry.

      From what I read on that blog it looks like psychiatric treatment is what killed Pete Earley’s Son.

      I just don’t get it how when psych meds cause a kid to attempt/commit suicide many parents then go out and help pharma funded NAMI push drugs on MORE kids, I just can not understand that no matter how hard I try.

      Report comment

    • AA,

      I contacted MindFreedom and asked if an article could be posted on the website, along with a call to action, to proactively stop this bill.

      This is the link, if others are interested in doing so:

      http://www.mindfreedom.org/contact

      These are members of the Congressional Mental Health Caucus:

      http://mhcaucus.napolitano.house.gov/members.html

      These are members of Energy and Commerce Committee (Subcommittee on Oversight and Investigations)where the bill needs to be blocked; stopped in committee; never to see the floor of the House:

      http://energycommerce.house.gov/subcommittees/oversight-and-investigations

      Copy_cat,

      Thank you for the ideas and inspiration.

      Duane

      Report comment

      • No problem, You all inspire me too. It was this information (the truth) that’s found on MIA that saved me.

        What also keeps me going is I like attending those 12 step meetings for people recovering from chemical injury’s so I often hear psych med and inpatient nightmare stories.

        What bothers me the most is when reckless prescribers addict a person to drugs like Clonopin the industry then tricks them into blaming themselves “I am an addict/alcoholic…” It runs in my family… It’s my DNA.

        Stupidity !

        Being a Democrat or Republican also runs in family’s but at a higher rate, is that also genetic ??

        Report comment

        • Copy_cat,

          My curiosity is piqued, as you explain,

          “What also keeps me going is I like attending those 12 step meetings for people recovering from chemical injury’s so I often hear psych med and inpatient nightmare stories.”

          That such meetings are occurring, is news to me — and very interesting. I’ve long imagined that a 12 Step Program called “Iatrogenic Disorders Anonymous” could be helpful to people recovering from the effects of psychiatric drugs.

          And, as I’ve imagined that, I envision many people telling their psychiatric “hospital” horror stories; so, when you say you hear “psych med and inpatient nightmare stories” in a 12 Step meeting, I am immediately thinking, wow, that’s great news; IMO, there should be meetings of that kind promoted, in every city, where these stories are now occurring but not being openly discussed — especially, if/when they can be shared anonymously/safely, in an atmosphere of hope, such as 12 Step meetings can have.

          So… As soon as I read this comment of yours, here I am Googling around, looking for info on “chemical injury” + “12 Step” …but can’t find anything.

          What’s that 12 Step program called, which you’re referring to?

          Is it just one local meeting?

          Would you mind elaborating?

          Any details you can add without sacrificing the trust of the group would be great, thanks.

          Respectfully,

          Jonah

          Report comment

      • I have contacted Parker Higgins, of the Electronic Frontier Foundation, [email protected] , on the angle that the aggressive expansion of the HIPAA protections and the fact that under DSM-IV, up to 50% of Americans can be labelled as “mentally ill” ( http://archpsyc.jamanetwork.com/article.aspx?articleid=208678 ), if the bill “as is” were to become law, the spying work of the NSA would look amateurish in comparison with the abuse that would result from one’s inability to hide certain information from family members for life.

        We need to “expand the appeal” in addition to mobilize our natural allies.

        =================

        Hi Parker,

        First of all, I apologize for this anonymous email. Your name pops up in the internet as somebody associated to stopping Stop Online Piracy Act and the PROTECT IP Act. If these laws were bad, they are nothing compared to the invasions of privacy that could result if Tim Murphy’s proposal were to become law http://murphy.house.gov/helpingfamiliesinmentalhealthcrisisact , murphy.house.gov/uploads/Families%20in%20Mental%20Health%20Crisis%20Act.pdf .

        This mail is going to be long and technical, so I ask you to please keep reading until the end. The reason I am so cautious with my privacy is that I was at the receiving end in Europe of the type of psychiatric abuse that would become the norm in the US if the bill were to become law with its current language. If you are curious about my story, you can read it here http://www.madinamerica.com/2013/01/ny-times-invites-readers-to-a-dialogue-on-forced-treatment/#comment-19770 . My story, while important to me, is irrelevant to what I am about to say so I ask you not to waste too much time with it and read the rest.

        That the bill is called “The Helping Families In Mental Health Crisis Act” should raise anybody’s eyebrows. There is much to dislike about it and I am sure your experts at EFF will find a lot more, but as far as I am concerned, I see two horrible implications,

        1- It overrides’ patients refusal to release medical information which is of psychiatric nature to immediate family members EVEN IN THE CASE OF ADULTS. That’s right, it is not a law that stops with parents accessing their non adult children’s records when they are not emancipated but for the rest of their lives. The Bill makes it clear that the APA’s Diagnostics and Statistical Manual is what decides who could be at the receiving end of this. Now, this year the APA’s released its latest edition, which by the law’s text, would be governing matters. The situation with DSM-5 got so out of hand that the editor of the previous edition, DSM-IV, got out of retirement in full force to fight its release http://www.amazon.com/Saving-Normal-Out-Control-Medicalization/dp/0062229257 . By the APA’s own estimates, up to 50% of Americans could be labelled as “mentally ill” throughout their lives, making this particular provision kick in. I hope I don’t have to explain
        anybody at EFF why in an era of electronic medical records, such a lousy standard could result in the invasion of everybody’s most sacred medical information.

        2- It requires states, as a condition of receiving certain grant money, to change their laws so that it is easier to forcibly drug and commit people against their will under the standard “gravely disabled”. The law’s own language indicates that this “grave disability” would be determined via a subjective determination by a psychiatrist guided by DSM-5.

        The law has the support of NAMI, which is really a front group of Big Pharma http://www.nytimes.com/2009/10/22/health/22nami.html?_r=0 . It is also supported by TAC and the APA who have been fighting for years for making it easier to drug people against their will.

        The bill is fiercely opposed by representatives of users of mental health services, http://www.bazelon.org/News-Publications/Press-Releases/12-12-13-Murphy-PR.aspx . Their representatives are in CC. I think that this is bigger than something that affects current users of services given the implications of an out of control DSM. The help of EFF would be greatly appreciated.

        Now, I want to make it clear that my politics are otherwise aligned with Murphy. I am a conservative Republican who believes in small government, opposes abortion and is in favor of traditional marriage. However, I will stop voting Republican if this thing ever becomes law.

        I have supported the EFF campaigns on its campaigns against the out of control NSA. A government out of control spying on its citizens is nothing compared to a government out of control sending its citizens to a psychiatric ward or forcibly drugging them, such as it happened here http://www.theblaze.com/stories/2012/08/24/orwellian-lawyer-of-former-marine-detained-over-facebook-posts-says-20k-civil-commitments-in-va-each-year-part-of-bigger-problem/ . This is one of the rare occasions for which there could be a bipartisan backlash against something that is nothing but an attempt by Big Pharma and the crooks at the APA to force drugs on people.

        I hope you can help on this.

        Report comment

  4. Maybe things will change when a page explaining the fraud, dangers and abuses of psychiatric treatment appears in first page search results for every combination of mental health keywords.

    I saw a woman get taken away in an ambulance a few days ago after she was upset and cut her wrist for attention, she was taking Chantix. I told her about Chantix suicides. Anyway she said to me “ya I stopped taking it and now my serotonin levels are dropping.”

    I tried to debunk, I said blaming depression on low serotonin is like blaming a headache on low aspirin in the brain. I said drugs that lower serotonin don’t cause depression so don’t worry about it.

    This damb brain chemical illness marketing fraud is so engrained in the pubic’s mind as fact and its hurting people.

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