As I’ve told Bob Whitaker and many others, it’s taken me 45 years in my career to get to the point where I feel completely free to “do the right thing.” By that I don’t mean to downplay the work I’ve done in the public mental health and addictions systems. I’ve worked at virtually every level from psychiatric inpatient aide work to alcohol/drug counseling to clinical wok (mostly with young adults and adults), and many years in management and program development. In partnership with many people, I think I got a lot of good things accomplished.
But now, the Mad in America Continuing Education project moves me in a more recovery-oriented direction than ever, and has a specific focus on the ways in which most programs have over-used psychiatric medications to the detriment of the people we are serving. Yet, rather than getting stuck in regrets about how I could have been a stronger advocate and force for change in the past, I’m charging ahead with developing the core catalog of continuing education courses at MIACE. We are also now planning a marketing campaign to make our courses better known to providers, administrators, and others involved in mental health.
Course update: Over the past two months, we have posted several new courses, including Irving Kirsch’s course on antidepressants and the placebo effect, and a two-part course by David Healy on the history of psychosis and a deconstruction of the infamous study 329, a pediatric trial of Paxil. We also have a new course, by Adam Urato, an assistant professor at Tufts Medical School, that presents a thorough review of what science is telling us about the risks of antidepressant use in pregnancy to the developing fetus and newborn child. I think every family doctor, ob-gyn, and psychiatrist in the country should view this course.
And we have other courses in development. We just taped Larry Davidson of Yale University for his course on recovery this week, and are moving forward with a course using a tape made in Copenhagen in September by Peter Gøtzsche on his review of the research on SSRIs and antipsychotics. Chris Gordon of the University of Massachusetts and medical director of Advocates will be doing a 1 hour course on adapting Open Dialog to the United States. We have taped an initial module by Canadian researcher Bonnie Kaplan on nutrition and mental health.
One of our key challenges is now to expand our audience for our courses beyond the 500-plus people who have already taken one or more of our courses. I’ve visualized our market as an inverted triangle. The smallest group of potential viewers of our courses are those who are already primed to learn about the real effects, short-term and long-term, of psychiatric medications. This group is already convinced of the need to change medication practices, but is eager to know the research that supports this change.
The middle group in the triangle is composed of a larger group of people who, if they knew about us, would likely be interested in signing up for courses. They are aware of some of the problems with psychiatric medications, but aren’t really familiar with the research literature that documents these problems. For example, primary care physicians are daily inundated with patients who are anxious and depressed, and the quickest way to treat these patients is to prescribe benzodiazepines and antidepressants. But this treatment often doesn’t work very well, and integrated care systems are starting to wake up to the risks of such quick drug use. This is a group MIACE needs to reach, and I would welcome suggestions of how we can do so.
The largest group in this inverted triangle consists of the many, many health professionals who are unaware of the research telling of bias in clinical studies and the many problems with use of psychiatric drugs, particularly over the long term. How can we reach this group and introduce them to the science and evidence that demands that we rethink our societal use of these drugs? We have ideas, but once again, I would very much welcome your ideas.
I look forward to working with all of you and encourage each of you to sign up for one or more of our courses if you haven’t already. Our webpage is: http://madinamericacontinuinged.org/
Feel free to contact me by email at [email protected].
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.