The Green Shadow Cabinet, launched in spring 2013, is led by 2012 Green Party presidential nominee Jill Stein. Its purpose is to provide an ongoing opposition and alternative voice to the dysfunctional U.S. government — and to demonstrate what a government of, by, and for the people (rather than of, by, and for, giant corporations) looks like. As the Green Shadow Cabinet’s Assistant Secretary of Health for Clinical Mental Health (appointed by Secretary of Health Margaret Flowers), my first action is to propose a Mental Health Declaration of Independence from Big Pharma. I invite a public reaction to this declaration, which is both abolitionist and restorational:
(1) abolishing the corruption by giant drug companies of mental health institutions, research, and practice; and
(2) exhuming buried truths about the relationship between a dehumanized society and emotional suffering.
Abolishing the Corruption by Big Pharma of Mental Health Institutions, Research, and Practice
In what has become a “psychiatric-pharmaceutical industrial complex,” giant drug companies have corrupted mental health institutions, research, and practice. Most major mental health organizations and institution from which the general public and doctors receive information are financially interconnected with Big Pharma. This practice needs to be abolished by law.
The official psychiatric diagnostic bible that is published by the American Psychiatric Association (APA) is called the Diagnostic and Statistical Manual of Mental Disorders (DSM). DSM-5 was recently approved by the APA, and according to the journal PLOS Medicine, “69% of the DSM–5 task force members report having ties to the pharmaceutical industry.” The corruption of the APA by Big Pharma is nothing new. On July 12, 2008, the New York Times reported the following about APA “In 2006, the latest year for which numbers are available, the drug industry accounted for about 30 percent of the association’s $62.5 million in financing.” Congressional investigators in 2008 also discovered that then president-elect of the American Psychiatric Association (Alan Schatzberg of Stanford University) had $4.8 million stock holdings in a drug development company.
The APA’s recently approved DSM-5 is an embarrassment even for some psychiatrists who had taken seriously previous DSM editions. Psychiatrist Allen Frances, former chair of the DSM-4 taskforce and currently professor emeritus at Duke, wrote in “Last Plea To DSM-5: Save Grief From the Drug Companies, “Making grief a mental disorder will be a bonanza for drug companies, but a disaster for grievers… Psychiatry should not be mislabeling the normal.”
Most mental health professional organizations that are not on the take from Big Pharma are opposing DSM-5. The Coalition for DSM-5 Reform is comprised of over 50 organizations including the Society for Humanistic Psychology (one of several divisions of the American Psychological Association that are in the coalition), the British Psychological Society, the Danish Psychological Association, the Association of Black Psychologists, the Association for Women in Psychology, Psychologists for Social Responsibility, and the International Society for Ethical Psychology and Psychiatry.
Within the psychiatric-pharmaceutical industrial complex, there is a government-industry revolving door of employment, a staple of industrial complexes. As I detailed in 2008 in “Psycho-Pharmaceutical Industrial Complex,” there has been a revolving-door of employment between giant pharmaceutical corporations and the U.S. Food and Drug Administration (FDA), as well as with the National Institute of Mental Health (NIMH). This makes it easier for Big Pharma to create and corrupt psychiatry “thought leaders.”
Perhaps psychiatry’s most influential thought leader is Harvard psychiatrist Joseph Biederman, who “single-handedly put pediatric bipolar disorder on the map,” according to pediatrician and author Lawrence Diller. Biederman’s financial relationships with drug companies was discovered by the public in 2008, when the New York Times reported the following about him: “A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials.” As part of legal proceedings, Biederman was forced to provide documents about his interactions with Johnson & Johnson, the giant pharmaceutical company; the New York Times reported Biederman pitched Johnson & Johnson that his proposed research studies on its antipsychotic drug Risperdal would turn out favorably for Johnson & Johnson — and then Biederman delivered the goods.
Due in great part to Biederman’s influence, the number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003. Bloomberg News reported in 2007, “The expanded use of bipolar as a pediatric diagnosis has made children the fastest-growing part of the $11.5 billion U.S. market for antipsychotic drugs,” and today this market has grown to $18 billion.
Biedeman is not alone among psychiatrists lining their pockets with drug company money. The New York Times (“Top Psychiatrist Didn’t Report Drug Makers’ Pay”) reported this about Charles Nemeroff: “One of the nation’s most influential psychiatrists earned more than $2.8 million in consulting arrangements with drug makers from 2000 to 2007, failed to report at least $1.2 million of that income to his university and violated federal research rules, according to documents provided to Congressional investigators.”
A 2008 Congressional investigation revealed a widespread financial interconnection between Big Pharma and psychiatric institutions and thought leaders. Unfortunately, the U.S. Congress has a history of occasionally exposing the corruption of a major industrial complex but then doing nothing about it; and this has been the case with Congress and the psychiatric-pharmaceutical industrial complex.
What needs to be done? Let’s start by throwing out everything that has been created by Big Pharma corrupted mental health institutions and thought leaders. And let’s begin a “Mental Health Enlightenment” based on genuine science, which would mean an admission of exactly what psychiatrists and psychologists do and do not know.
Exhuming Buried Truths about the Relationship between a Dehumanized Society and Emotional Suffering
Big Pharma corruption of mental health institutions has also meant an ever-increasing focus on our biochemistry. We are diverted from the reality that many emotional problems are not caused by biochemical or genetic defects but are often natural human reactions to powerlessness, hopelessness, and loss of community and autonomy that have been created by public policies. Mental health is hugely political, and it is very much connected to the sanity and humanity of a society and culture.
In the United States today, Native Americans have the highest suicide rate among all ethnic groups, and suicide is the second leading cause of death among Native American adolescents. As I document in Surviving America’s Depression Epidemic, prior to colonialism and their subjugation, suicide was virtually nonexistent among young Native Americans. Social and cultural upheaval has resulted not only in depression and suicide for Native Americans but also in alcohol abuse and other destructive behaviors. Psychologist Roland Chrisjohn in The Circle Game (1997) notes: “In truth, does not the history of Jewish suicide during the holocaust, like the histories of suicide in the Arawaks, the Home Children, and the Marshallese Islanders, and countless other oppressed groups, teach us that suicide is in part a normal human reaction to conditions of prolonged, ruthless domination.”
As I described on May 6, 2013 in “What’s Behind ‘Substantial Increases’ in Suicide Rate for Middle-Aged Americans? Bad Economy Is Likely Culprit,” the Centers for Disease Control (CDC) reported on May 3, 2013 that the suicide rate among Americans aged 35–64 years increased 28.4 percent between 1999-2010, and the Lancet estimates that the three-year recessionary period from 2008 thru 2010 was a source in the United States for “4,750 excess suicide deaths.”
An exclusive focus on giant coroporations’ profits comes at the expense of important components necessary for mental health. One such component is community — face-to-face contact with emotional and economic interdependence. Another component is autonomy — the experience of some control over one’s life.
Postpartum depression occurs in 10 to 20 percent of women in the the United States but is considered rare in Fiji and some African populations, according to a 2004 BMJ article “Learning from Low Income Countries: Mental Health.” Based on a review of the literature, the authors concluded, “Structured social supports after childbirth are described in groups of women with low rates of postpartum depression.” Because of politics and public policies, many American woman lack social support before and after childbirth.
Genuine community in America is increasingly obliterated as social isolation increases. A major study reported in the American Sociological Review in 2006, “Social Isolation in America: Changes in Core Discussion Networks Over Two Decades,” examined Americans’ core network of confidants (those people in our lives we consider close enough to trust with personal information and whom we rely on as a sounding board). Authors reported that in 1985, 10 percent of Americans said that they had no confidants in their lives; but by 2004, 25 percent of Americans stated they had no confidants in their lives. This study confirmed the continuation of trends that came to public attention in sociologist Robert Putnam’s 2000 book Bowling Alone, which reported a decline in U.S. social capital (his term for social connectedness) in virtually every area people have historically found community.
Social isolation is related to depression and many other emotional problems. Increasing social isolation in America is not caused by genetics and biochemistry but by public policies that focus only on increasing the profits of giant corporations.
Large empires can enslave people, and large corporations can create standardized, assembly-line, robotic living. Until recently, it was common sense that all bigness was a threat to autonomy and freedom. Before the terms mental illness and depression entered our lexicon, it was basic common sense that if a few big guys had all the power, then the rest of us would have none, and if we had no autonomy or control over our lives, then we would more likely have emotional difficulties.
Because of corporate domination, Americans have increasingly lost community and autonomy, and have acquired instead the tyranny of institutionalization: domination by gigantic, impersonal, bureaucratic, standardized entities — visible in large corporations, the workplace, health care, schools, and much of our lives. This institutionalization has made many Americans feel small, isolated, helpless, scared, inattentive, bored, angry, alienated, and depressed.
In a Mental Health Enlightenment based on genuine science, mental health researchers and practitioners would be uncorrupted by Big Pharma. They would acknowledge what, scientifically, they do and do not know, and they would make clear to Americans how public policies affect our mental health.
Bruce E. Levine, a practicing clinical psychologist, writes and speaks about how society, culture, politics and psychology intersect. His latest book is Get Up, Stand Up: Uniting Populists, Energizing the Defeated, and Battling the Corporate Elite. His Web site is www.brucelevine.net
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.