I am very thankful to the administrators of Mad in America for inviting Mad in Italy to write a blog regarding the possible development of a supportive network among all the “MAD” affiliates around the globe.
Such a project seems to be particularly crucial during the current pandemic in which the public health systems of the entire planet are engaged in a warfare against Covid-19, while at the same time continue to be the targets of privatizing efforts which are also dismantling the welfare system.
As I was reflecting on this gloomy picture, I came across recent news regarding a pharmaceutical giant trying to gain substantial control over the Italian medical education system.
The recent agreement among SIMG (Italian Society of General Medicine), FIMMG (Italian Federation of General Medicine Physicians) and Sanofi S.A., a French multinational pharmaceutical company headquartered in Paris, essentially delegates the professional education of physicians in training to the French multinational.
Without any doubts, this shift, already in motion worldwide, will radically change the degree of objectivity and independence of professional medical development and can be seen as another major step towards the privatization of the Italian medical system, in a critical moment when we would need more public health resources.
Serendipitously, I came across different articles focusing on the so-called “diseases of despair,” characterized by abuse of substances, high rates of overdoses, and physical problems, whose root causes can be identified in the gloomy socioeconomic outlook.
These conditions are particularly serious for middle-aged and older individuals. However, the current pandemic has unveiled huge class inequalities, and the currently unfavorable economic indicators anticipate that the “diseases of despair” will expand progressively across age groups in almost all the countries around the world.
One of the possible and most perilous consequences, based on current trends, is that this widespread emotional distress could be dealt with by the injudicious use of psychopharmacology and the utilization of mandatory treatment practices (e.g. assisted outpatient treatment).
Indeed, there is mounting anecdotal evidence that these practices are utilized more frequently during the current public health crisis, in the context of nearly total neglect of the psychosocial determinants of emotional distress and despair.
The Mad in Italy team, like all the “MAD” affiliates, has recurrently focused on these themes.
Laura Guerra, pharmacologist by training, has extensively addressed the issues related to the imprudent utilization of psychiatric medications; Dan Monticelli, expert with “lived experience” in the field of cannabis, has attempted to show the science behind the utilization of cannabis for chronic pain and emotional distress; in my role as a psychiatrist, with experience in public health and addiction, I have tried to establish an ongoing dialogue regarding the diffusion of the concept and practices of recovery and the development of a reliable peer specialists network in Italy.
Moreover, from the very beginning, we have tried to engage the Italian audience by actively participating in the most popular online behavioral health groups. We have organized conferences, presented on different behavioral health priorities, participated in online interviews, translated specialized literature in Italian and published books on mental health subjects. In this process we have become aware of our strengths and, at the same time, the need for improvement.
We agree that one of our major strength is our location in different geographical areas: Laura Guerra in Bolzano (Italy), Dan Monticelli in Las Vegas, Nevada (USA), and myself in Albuquerque, New Mexico (USA). Living in different realities provides us with a broader view than if we all resided in Italy. Our conversations and interactions often focus on specific aspects of the local and national behavioral health systems and provide us with insights on what to publish and how to analyze news and data. In this vein, we feel that additional perspectives from other experts around the globe would help us in contributing more effectively to behavioral health debates and initiatives in Italy. We believe that this support can be created by strengthening the network among the affiliates and friends of Mad in America.
It makes real sense that, in times of globalized medicine and psychiatry, the best way to build an alternative consensus and agenda is the development of an active international network fostering common initiatives and projects and providing needed support and feedback for local initiatives.
I can easily imagine all the “MAD” affiliates working together in an atmosphere of reciprocal support regarding specific initiatives or projects. This collaboration could include the development of “alternative” research projects to the conventional randomized trials with a focus on recovery models, withdrawal from psychotropics, and social and cultural determinants of health. In this framework, we will encourage the participation of consumers from around the world.
Of course, the establishment of such a network will require periodic online meetings in which we share our experiences as affiliates, express our needs, provide mutual professional and personal support, and develop an agenda for the creation of a “MAD International” network.
I hope that this invitation will be met with serious consideration, and hopefully enthusiasm, by all “MAD” affiliates. Hoping to hear your thoughts on the subject, I thank you all for your attention and support. Ciao everybody! Marcello