Report from the Parliament: Can Psychiatry At Least Be Curious?

Robert Whitaker
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In the past six years, I have had the opportunity to speak at several conferences or meetings that I felt had particular potential to stir some political activity that would challenge current psychiatric practices, and one of those events was the meeting convened in the U.K.’s Parliament on May 11th, which had this title for the day: Rising Prescriptions, Rising Mental Health Disability: Is There a Link?

Today, two days after the meeting, it’s too early to see where this effort will lead. The organizers, Luke Montagu, and James Davies, who co-founded the Council for Evidence-Based Psychiatry in the U.K., saw it as an important first step in getting the government to mount an investigation into this question. Personally, I had this takeaway from the meeting: Such efforts often feel like a Sisyphean task, akin to rolling a boulder up a hill.

Paul Flynn, the Member of Parliament who hosted the meeting, introduced it in a fitting way, describing how the increased prescribing of antidepressants and rise of disability due to depression was a topic of obvious societal concern. I was then given thirty minutes to make the case that there is a link between rising antidepressant prescriptions and rising disability rates. This isn’t the easiest thing to do in that time frame, given that the evidence to review is of many types, but I muddled through it okay. Basically, my argument was as follows:

  • There is correlative data from country after country showing this same link between rising prescriptions of antidepressants and growing disability due to affective disorders.
  • Antidepressants are causal agents, expected to change the long-term course of depression.
  • There is robust evidence of many types that, at the very least, provides a reason to worry that antidepressants worsen the long-term course of depression, as compared to natural recovery rates.
  • There is robust evidence that antidepressants increase the risk that a person with unipolar depression will have a manic episode and be diagnosed with bipolar disorder, which is a more “severe” disorder.
  • There is evidence that antidepressant use increases the risk that a person diagnosed with depression will end up “disabled” by the disorder.
  • Researchers have posited a biological reason for why antidepressants would increase the chronicity of the disorder over the long term.

After I had spoken, Paul Brett told of how antidepressants had shaped his life in precisely that harmful way.  Before being prescribed an antidepressant, he had an active, full life: he had been an athlete, enjoyed an active social life, had a good career in IT, and a good family life too. He was prescribed an antidepressant for a minor reason, related to stresses at work, and over the next few years, as he gradually worsened, he was prescribed one drug after another, and his life and health fell apart. He became socially isolated, stopped working, and felt unable to be a good father to his children. Then, when he tried to withdraw from antidepressants, he suffered grievous withdrawal symptoms. Today, he is free from the drugs and back to work, and otherwise putting his life back together. But he feels betrayed by a psychiatric profession that failed to warn him of all these possible hazards and never considered that it was the drug treatment that had caused him to worsen.

Next, Allan Young, chair of psychopharmacology for the Royal College of Psychiatry, spoke. There was an expectation that he might be hostile to my presentation, but that didn’t prove to be the case. He was just dismissive of it. He said that I had mostly cited U.S. studies, and while it might be true that outcomes were bad in the U.S., it was different in the U.K. and Europe. He alluded to a Swiss study that he said showed that drug treatments improved the long-term course of bipolar disorder.

Sami Timimi, a psychiatrist who is a member of the Council for Evidence Based Psychiatry, and head of medical education for one of the National Health Service Trusts in the U.K, then disputed Young’s claim. In fact, a high percentage of psychiatric patients in the U.K. had chronic outcomes, he said, which fit with the data that I had presented. Then Joanna Moncrieff spoke about how the chemical imbalance theory of depression was a “myth,” and how antidepressants couldn’t even be said to work over the short term, since, in clinical trials, they didn’t provide a clinically significant benefit over placebo. Andrew Green, chair of the British Medical Association’s Prescribing Subcommittee for general practitioners, told of the pressures on the general practitioner to prescribe antidepressants for patients who were struggling in some way. Finally, Baroness Stroud, who as executive director of the Centre for Social Justice is an influential political figure in the U.K., told a story about a young woman whom she had taken under her wing who had done poorly on psychiatric medications, but had then prospered once she came off the drugs.

And so, once the panel had spoken, there had been no real rebuttal of the data that I had presented; Timimi and Moncrieff had added to the picture that psychiatric drugs weren’t producing good outcomes, and there had been two personal stories that served to corroborate the data I had presented. In the opposing camp, there had simply been an assertion that this was mostly an American problem.

Then members of the audience spoke, and most told of a need for psychiatry to change, or else they provided further accounts of lives diminished by psychiatric drugs. However, the editor of Lancet Psychiatry, Niall Boyce, was not so impressed. There had been no proper “scientific” presentation of data, he said, no discussion of the methodology of the studies, of such findings as “Number Needed to Treat and Number Needed to Harm,” (which are data from clinical trials related to efficacy sizes and risks of harms), and no evidence that I had done a systematic review of the research literature. How did he know that I wasn’t cherry-picking the evidence?

And thus, my feeling of rolling a boulder up the hill. It’s not that I would expect that either of these two mainstream representatives of British Psychiatry (from the Royal College of Psychiatry and a premier psychiatric journal), would be ready to accept the argument I had made. But one might hope that they would find a reason to support a further inquiry into the question, given that the rising disability rates tell of something going wrong with psychiatric care. That was the intended goal of the meeting, to figure out what further investigation was warranted. But instead, they had found a reason to dismiss it all with a figurative wave of the hand, which certainly helped thwart any next-step discussions.

As I said at the outset of this blog, I am not sure what will come of this inquiry. Kudos to  Luke Montagu, James Davies, and the rest of the leaders and members of the Council for Evidence Based Psychiatry for organizing the event. And Kudos to the All Party Parliamentary Group fo Prescribed Drug Dependence for hosting the meeting. It is hard to imagine a Congressional subcommittee ever organizing such a meeting in the United States. At the same time, it is easy to see that British Psychiatry, as an institution, isn’t ready to welcome such an inquiry, and therein lies the struggle: How can this institution be moved to a place of curiosity about the soaring disability rates for the patients it treats?

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47 COMMENTS

  1. Why, I’m just certain the Emperor is wearing clothing. Look at all those people who agree with me! While your evidence of direct observation of naked skin might be of some merit if it were verifiable, the tailors have carefully explained that this lack of visibility is due to your own personal disloyalty, not any lack of clothing on the Emperor’s part…

    Thanks for hanging in there, Bob. It is a Kafkaesque world at times that we try to impact. You have done more than anyone I know to keep that boulder from rolling back down the hill.

    —- Steve

    • Doctors arguing about whether “psychiatric drugs” are good or bad for people reminds me a bit of doctors arguing whether Cigarettes are good or bad for people. We all know the answer – but a corrupt professional can always attempt an argument.

      I’m diagnosed with the main disorders. I was longterm disabled while I consumed strong medication. I recovered in 1984 as a result of carefully stopping, and I have remained well since.

    • Indeed…where psychiatry is concerned it is simultaneously kafkaesque, Orwellian and Alice in Wonderland-ish .

      It seems to me that a major challenge is the respect and reliance society seems to have developed for psychiatry and psychiatrists to explain what seems inexplicable ie “madness” or various forms of non-criminal but very disturbing behaviour that are both distressing to experience and to watch.

      When we would REALLY like there to be an answer, we seek what appears to be a credible story and solution, and psychiatrists managed to be the only people offering any explanation other than demonic possession. AND they aligned themselves with big pharma to present a “cure”…. so they got the power….and they got plenty of it…only they can lock up a person who has committed no crime for an indefinite period and force unproven and highly dangerous “treatments” onto them.

      They get to testify as “expert witnesses” in court – their knowledge of human nature and the brain is unchallenged…and yet no true knowledge has ever been shown to exist. Their power is based on misinformation, myth, and fear, but as yet they have managed to maintain the illusion.

      Any real inquiry into this illusion would threaten THEIR existence, so an expectation or hope that they would participate in their own destruction is somewhat optimistic….to say the least.

      They CANNOT argue against the overwhelming evidence that their treatments cause harm, and so they simply do not not engage – they belittle and dismiss, they obfuscate, they mislead. To do otherwise would be to succumb to the ultimate existential threat.

      All they are using now is their accumulated positional power to halt the boulder that’s coming their way…eventually, though, they will be but tenpins as Sisyphus’ boulder crests the mountain and takes its journey down the other side.

      Hang in there, Robert.

  2. Talk about disabling, one of my buddies at AA got admitted to the hospital and they screwed with his “medications” gave him a seizure then reported his seizure to the DMV and now he can’t drive for 2 years.

    I see the damage they do all the time, that girl that came in telling me about the Effexor she takes and believing that the withdrawal reactions are her ‘condition’ coming back. Really, what were you like before starting those pills ? …

    Another new one, a Ritalin kid with a long story all the way to Xanax and the mood pills. A pharmaceutical wastebasket since he was 11. Now its clonopin they are feeding him but he won’t abuse those like the ones he got when he hurt his back and got the addict label.

    I wouldn’t even bother with this website if I didn’t see more harm then good on a regular basis.

    • Fellowship is a suitable place to see the damage caused by SSRI s, as people that attend meetings are open about their feelings.

      I notice people on SSRIs are often upset in a way that they are unable to get relief from.
      Whereas most people in fellowship talk about problems that they are managing with help.

      When I was coming off psychotropics (not SSRIs) I suffered terribly with anxiety but there was light at the end of the tunnel – and I knew this.

      • someone in an Al-anon meeting I went to said their Dr had given then an anti-depressant and that the Dr had said it was like insulin for diabetes.

        I challanged that, though I also said that if the person found it useful that was another matter. The woman who was taking them said she found them useful as it helped her get the courage to challange her alcoholic son.

        I was challanged on what I said and was told that this was not a matter for the group. I did not go back.

        • Hi John,

          I identify with you.

          The Big Book comes from the 1930s and people in fellowship think of the doctors as 1930 doctors. A lot of people in fellowship ARE aware of psychiatric drug damage but a lot of people ARE ‘spellbound’ (and they’re not going to get much contradictory information from their GP – because the GP is also in the dark).

          • A lot of people in 12-Step meetings are anti-drug not because of any enlightenment around the problematic nature of psychotropics but because from the beginning the “program” has looked askance at any kind of controlled substance as a crutch and/or sign of moral weakness (including, from what I understand, things even like methadone in Narcotics Anonymous).

            (I’m not a huge fan in case you haven’t noticed.)

          • truth 793810,

            There can be problems coming off ‘major tranquillisers’ without adequate preparation and ending up back in hospital – as has happened to me myself.

            I believe the rule is that people are not supposed to advise or interfere in other people’s ‘medical’ treatment in fellowship.

            The subject of medication in fellowship is contentious.

  3. “How can this institution be moved to a place of curiosity about the soaring disability rates for the patients it treats?”

    I actually think this meeting is a big step.

    I think the psychiatric industries replies are standard. They never ask to look at the evidence against the drugs or provide a coherent argument back. They just deny the problem and obfuscate.

    That is worth pointing out.

    But eventually it will be people damaged by these drugs doing banner drops in chemists, regulators offices, drug company offices etc etc that will get things changed.

    • I think that Allan Young, chair of psychopharmacology for the Royal College of Psychiatry, and the editor of Lancet Psychiatry, Niall Boyce are legitimate targets for a campaign. It might be that they do have credible scientific arguments that counter Robert Whittikers but have not presented them.

      If they do not have credible arguments then

      1they are corrupt and in the hands of the drug companies
      2 they are incompetant and should not hold thier posts

      A challange that undermines their authority with thier peers, MP’s, Dr’s and the public would be a usefult strategy. My preference would be to ask them for presentations that refute Mr Whittiker within a reasonable time, say two months and then invade of thier offices to do citizens searches for the data they have that refutes Mr Whitiker’s arguments.

      That is plainly not Mr Whittiker’s style. So I hope he finds some other way of challenging either these specific people or others that hold a similar role of supposedly upholding the science that psychiatry is based on.

  4. I think it might come down to some lawyers getting on board and agreeing to take our cases of harm on in enough lawsuits that will give anyone prescribing psychiatric drugs no choice but to take it seriously. There is no motivator like fear and money.

    That might just be the bottom line.

  5. Did the Lancet editor, Niall Boyce or Allen Young produce any systematic review that said it DIDN’T happen? Why does the evidence always have to be one way? Easy to fix – check numbers on welfare for psychiatric disability, present them with a questionnaire asking for drug history. Simple. Will they? Not if the psychiatry/pharma alliance (PPA) have anything to do with it. Don’t you just love the way they attack the messenger, 1st tenet of pseudoscience – hostility to criticism. If the psychiatric industry had its patients best interests at heart they should embrace the chance to prove the drugs are NOT causing harm, shouldn’t they?

  6. Robert,

    They are not going to be moved to curiosity. Their financial and professional survival depends upon dismissing and denying the facts you are uncovering. Even if some British psychiatrists privately felt curious, why would they publicly admit that? Their motive is in every case to deny and avoid arguments which threatens their professional position and ability to profit from continued prescribing of psychoactive drugs.

    They are very different than you – a financially unconflicted journalist who cares more about the people being harmed than about keeping your social standing or losing your income.

    When you said this, it sounded naïve to me:

    “It’s not that I would expect that either of these two mainstream representatives of British Psychiatry (from the Royal College of Psychiatry and a premier psychiatric journal), would be ready to accept the argument I had made. But one might hope that they would find a reason to support a further inquiry into the question, given that the rising disability rates tell of something going wrong with psychiatric care.”

    Hoping in this way is naïve. Why on earth would an establishment psychiatrist support a further inquiry into a set of questions that could eventually lead to the undermining of their professional position as doctors, the loss of their ability to earn very high salaries, and humiliation and embarrassment in general? Would you support such inquiries Robert, especially if they threatened your ability to pay your mortgage, support your family, be respected? I bet you’d be reluctant… and many of these people are much less honest and forthcoming than you are.

    Robert,

    They are not going to be moved to curiosity. Their financial and professional survival depends upon dismissing and denying the facts you are uncovering. Even if some British psychiatrists privately felt curious, why would they publicly admit that? Their motive is in every case to deny and avoid arguments which threatens their professional position and ability to profit from continued prescribing of psychoactive drugs.

    They are very different than you – a financially unconflicted journalist who cares more about the people being harmed than about keeping your social standing or losing your income.

    When you said this, it sounded naïve to me:

    “It’s not that I would expect that either of these two mainstream representatives of British Psychiatry (from the Royal College of Psychiatry and a premier psychiatric journal), would be ready to accept the argument I had made. But one might hope that they would find a reason to support a further inquiry into the question, given that the rising disability rates tell of something going wrong with psychiatric care.”

    You are an existential threat to them. Psychiatry is unlikely going to ever reform itself willingly. Kicking and screaming, if at all.

  7. Bob, I’m afraid that your final question, “How can this institution (psychiatry) be moved to a place of curiosity about the soaring disability rates for the patients it treats?” is based on a false presumption. The institution of psychiatry doesn’t actually treat patients; rather, it owns slaves.

    Any individual psychiatrist may treat a particular patient, and the individual might be moved to curiosity in regards to that human relationship and its positive or negative results. Some individual psychiatrists might have great influence in a social or political context. But they usually want the machine that grinds out their status and their pay to keep running, and their curiosity will only be stimulated in the context of individual concerns (their own, or those of specific patients). There are so many individual minds to change: that’s the hill and the boulder rolling up, falling down. But there are also key individuals: identifying them is a bulldozer to alter the severe topography.

    In the early 1960’s people felt the same way about Southern segregation and Jim Crow laws as we feel about psychiatric slavery today. They “put their bodies on the gears and on the wheels, and on the levers and all the apparatus” and they made it stop. Those machine remnants of chattel slavery in the USA are dust now.

    The institution of psychiatry, as we know it, will be dust, perhaps sooner than we can believe. Your work, along with that of others, is already making the machine howl. We just have to keep on keeping on.

      • The UK’s National Health Service was the best most cost effective health service in the world. Noone goes bankrupt from medical bills as US citizens do.
        The NHS does not disable people, the NHS consists of all healthcare of which psychiatry is just one part of. It would be more accurate to state that psychiatry disables people.

    • I feel it’s a serious leap from looking at how drugs can make things worse to declaring whatever percentage of psychiatric patients ‘not genuine’. It’s similar to how this meeting was introduced with a claim that many depressed people just don’t realise they’re not meant to be happy, which e.g. people during the world wars knew. That’s actually a very specific hypothesis about a psychological causation of depression in peace-time culture and requires additional evidence than what was actually covered in the meeting that the meeting was meant to be about.

  8. Psychiatry will never be curious about problems inherent in its medicine because it is a medical science; you are asking psychiatry to question its right to exist.

    The meeting sounded promising to me; it exemplified how evidence and public opinion are mounting against psychiatry. Thank you for your community service in articulating problems caused by psychiatry. Psychiatry will suddenly collapse when opposition reaches a critical mass from one person too many mocking the emperor.

    Best wishes, Steve

    • Again, it’s worth adding that if “the emperor” is psychiatry itself, then he has a handful of high-level ministers or generals. Identify them accurately, by name and location, for the mocking. Without too much Sun Tzu, that remains the real shortcut.

      • For the mocking, state the plain truth. For example in the medical procedure of Electroshock they use up to 450 volts on the brain , while the normal brain voltage is in the microvolt range of 0.0001 volts.
        Some say ECT is targeted, but where exactly is mental illness located in the brain?
        They claim medicine for a chemical imbalance, but what tests were performed to detect this chemical imbalance? ( just drugs)

        • I’ve even heard psychiatrists say that the electricity targets the bad cells of the brain that cause the mental illness or depression. All I could say was, “Oh, really????????” I’ve heard some stupid things in my life but this one was at the very top of the list of stupidities. The problem is that everyone in the room believed this quack.

  9. Thanks Robert, Luke, James and all others involved in putting this together, hopefully, it will at least get some questioning the status quo. Although, allowing psychiatrists to poison the masses, then the governments winning billions in lawsuit settlements, due to the harm of the pharmacutical drugs, while the harmed masses get nothing, does seemingly benefit the status quo, in general.

    And right now, both England and the U.S. politicians are controlled by the bankers who create their money out of thin air, then charge the masses interest on this worthless paper money. Our founding fathers called them a “handful of ruthless men” and a “den of vipers,” if I recall correctly. And Thomas Jefferson did forewarn us of not just the central bankers, but also “the corporations that will grow up around them,” like today’s pharmacutical industry.

    It strikes me it’s all just about the pathological pursuit of profits by some psychopathic corporations that have no moral ability, nor legal ability, to act on the reality that it’s morally repugnant to put profits above people’s lives. It’s systemic problems, the entire structure of our civilization is built on a fraudulent banking system, and the “capitalistic” ambitions of the “handful of ruthless men” who have financed the existing system, including the miseducation of the psychiatrists.

    Case in point, today’s “bipolar” drug cocktail recommendations include combining the antidepressants with the antipsychotics. Despite the fact the medical community should all already know combining these drug classes is unwise. Because it likely will make a patient “mad as a hatter,” via anticholinergic toxidrome poisoning. But since drug induced anticholinergic toxidrome is not a billable DSM disorder, well, suffice it to say, out of sight, out of mind.

    • My son is now collecting disability, because of the extreme adverse side effects from a powerful long-acting anti-psychotic drug he received. Luckily, I was able to intervene when my son’s psychiatrist recommended continued treatment with the same “bipolar drug cocktail” you mentioned.

      My son is now recuperating very slowly at home, away from traditional psychiatrists and their laser focus on prescribing more and more psychotropic drugs. We don’t know yet if he suffered permanent brain damage from his short stay in the hospital.

      We use sensible nutritional dietary supplements, including Cannabidiol (CBD oil), which is a proven anti-psychotic, anti-anxiety legal food supplement with zero side-effects. See http://www.ncbi.nlm.nih.gov/pubmed/22716160
      Unfortunately, we have to discontinue treatment 2 weeks before his mandatory monthly drug test, because CBD oil has a minuscule amount of THC, which can trigger a positive reading during a drug screening. Hopefully, countries around the world will change their outdated drug laws to allow this promising

      We are also about to start CES (Cranial Electrotherapy Stimulation), which is used effectively in VA hospitals to treat veterans suffering from PTSD and depression.

      Forward thinking psychiatrists would do well to get on board with the latest research and embrace strategies that help their patients to stay healthy, off drugs, and on a path to independence.

  10. Can Psychiatry at least be curious ? Consider this , feigned curiosity may appear in the form of “the endless need for more studies which are funded and tweaked to always call for more studies not quite conclusive enough and also there will be endless faked additional studies and stories funded to maintain doubt and confusion . Consider Fluoride in water, Mercury as dental material , Tobacco, probably more is sold worldwide then ever. There are so many organized big scale crimes for profit . Of course there are countless examples .
    A way must be found to counter the 4 or 5 dog defense which criminal cartels like psychiatry will /or are, using as the opposition to them gets stronger. Google ( The 4 dog defense ? ) I believe psychiatry , if our opposition to it is strong enough will as other cartels, corporations , complexes have , will begin to more obviously use the 4 dog defense to try to delay their demise interminably . We must somehow avoid falling into the trap of being manipulated in that way as have so many others . We will need all our creativity individually and together in small and large groupings to try to at least to put a major dent in the coercive force psychiatry with pharmaceutical -medical – government and population approval wields and yet remain un co-opted and not telegraph all our moves to the opposition . Hopefully we can all use the time we allocate in the most efficient way to at least end coercive psychiatry and it’s tentacles while somehow helping as many individuals as possible to escape or avoid it’s ravages somehow . Even if we help just one individual it can be very difficult and very important . Robert Whitaker’s example inspires us all . I hope the opposition doesn’t trap him or cause him to waste his energy .

  11. How about some emails, tweets, etc., (or even old fashioned letters) to Allan Young, chair of psychopharmacology for the Royal College of Psychiatry, and the editor of Lancet Psychiatry, Niall Boyce?

    John Hoggett’s idea above (May 14, 2016 at 5:10 AM) is the best immediate plan….

  12. Hi Robert and All, I really do not think psychiatry can be curious, at least not officially. But, it does not mean that our work is meaningless. Rather the contrary, it is even more important to find allies and people in a much wider context than in the so narrowing psychiatric system. MIA is a wonderful example of such a context, and there are others. Still not very many which are known, but still… Yesterday I met with Sera and Sean who are creating a documenatary about the myth of “chemical imbalance”, I am impressed by their dedication, and all the many people they have met and plan to meet. We are many- and we have to get oursleves known to the public. As for example by speaking in the parliament as you Robert did a few days ago in London. The work continues…