What would Batman do now?

Johanna Ryan in her post Dependence Day points to serious problems linked to psychotropic drug use in the military and what seem to be recent alarming developments, but there is a 60 year history here.

In the 1950s, the VA hospital system commissioned Norman Farberow to look at rising rates of suicides among veterans. He studied veterans hospitalized for either medical or psychiatric conditions during the periods 1950 through to the mid 1970s. The 3 figures below bring out the findings.

Figure 1 shows a set of fluctuating suicide rates year on year for veterans admitted to medical beds. The rates are higher than national suicide rates but these rates and their fluctuations are in keeping with what might have been expected in a set of younger men. The increases in the late 1950s and early 1970s may mirror the effects of the Korean and Vietnam wars, or perhaps other social factors or they may be entirely random.

Figure 1

 

Figures 2 and 3 are strikingly different to Figure 1. Figure 2 does not show the expected fluctuations linked to social factors or any randomness. It shows a steady rise in suicide rates in those who have been hospitalized for a mental condition. Until 1955 the rates are identical to the rates found in those hospitalized for a general medical condition.

But as of 1955, they start climbing in an uninterrupted fashion. The rises and falls we see in Figure 1 that might or might not be linked to social factors such as the Korean war are not there. This can be seen clearly in Figure 2 when the two sets of figures are superimposed and again in Figure 3 which show admissions to psychiatric beds on their own.

Figure 2

 

 

Figure 3

 

Why the bifurcation in 1955? This was the year of the introduction of chlorpromazine. Year on year after 1955 a greater number of tranquilizers (antipsychotics / neuroleptics) like chlorpromazine were consumed by veterans with mental health problems as an ever greater number of these drugs were marketed. These drugs were given to veterans who were depressed, anxious or psychotic – they were not as might be thought now restricted to veterans who were schizophrenic.

But as Johanna Ryan brings out, they were almost certainly not given at that time to soldiers returning to the theater of war. She calls on us to stand together and bring about improvements. We have to stand together but whether it will bring about improvements is another matter. The Department of Defense for instance know that the literature about most of the drugs being given to troops now is ghostwritten and that the excess of suicides and violent acts there have been in clinical trials of these drugs have been airbrushed out of publications. But even they seem hypnotized.

Patients complain that the wrong drug in the wrong dose makes them zombies, but it seems everyone else in the policy apparatus who has anything to do with authorizing the use of these drugs is also marching zombie like to the one tune – like North Koreans in fact.

When the wife of Randall Tobias (who was CEO of Lilly at the time) gets put on Prozac and commits suicide and it makes no difference, it gets harder and harder to see a way out. Why so serious? Well even Heath Ledger has committed suicide. Is this Batman’s stickiest moment?

Ominously there is no sign of Batman anywhere.

If Robin were still around he might say “Holy Healthcare Reform – someones killing our Veterans, what would Batman do now?”

The very last thing to do is what Batman offered Mr Freeze: “Give yourself up. We can get you help – medical help” (see So Long and thanks for all the Fish).

But the Cheshire Cat got the Robin. It left however a grin behind in a phrase that lingers – the opposite of a girl is a boy. For all complex problems, its better turn to Catwoman – Michelle, or Ann?  Or maybe Angela?

References

Farberow N, Ganzler S, Cuttler F et al (1978). Status of Suicides in Veterans Administration Hospitals. Reports 2-4. Los Angeles, CA: Central Research Unit, V. A.Wadsworth Hospital Center.

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