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Drug profitability requires three parties to work together – drug companies to make the drugs, psychiatrists to prescribe them and consumers to take them. Too often, though, patients have failed to play nicely and do their bit. They have banged on about tiresome things like adverse reactions and alternative treatments, they have expressed foolish opposition to the very concept of pharmacotherapy and questioned its efficacy. They have become medication non-compliant and undermined the profits of the pharmaceutical industry and the authority of psychiatry. They have been bad and landed themselves on a lot of people’s naughty lists and made the World Health Organization very sad and worried.

Here is a short review of the Tim Murphy mental health bill. I show the research that was left out when the bill was written, how advocates can approach the issue, and what the main problem with ignoring the research will be.

In our last blog, we focused on the fact that nutrient supplementation has not only been accepted in the realm of physical health in the past, but it has actually been endorsed by reputable sources such as the Journal of the American Medical Association editors who published the Fairfield and Fletcher articles 11 years ago recommending that all adults take a multivitamin to reduce their risk of cardiovascular disease, cancer, and osteoporosis (note that this is completely inconsistent with very recent studies reported in the Annals of Internal Medicine --- but that’s just the way science works, using different nutrients and different methodologies, coming up with discrepant findings, until facts finally emerge).

Two pieces of research have been published over the last two years that should prompt a major reorientation of the treatment of schizophrenia and psychosis, and a fundamental reappraisal of the use of antipsychotic drugs in general. Put together, these studies suggest that the standard approach to treating serious mental health problems may cause more harm than good. Long-term treatment with antipsychotic drugs has adverse effects on the brain, and may impair rather than improve chances of recovery for some. Many people ask me how the psychiatric profession has responded to this data. Surely, they think, it must have stimulated a major debate within the profession, and some critical reflection about why it took so long to recognise these worrying effects? Sadly, this does not appear to be happening.

E. Fuller Torrey is one of the strongest proponents of outpatient commitment — the process of mandating individuals to take psychiatric drugs for extended periods of time after being released from a hospital setting. He accuses Robert Whitaker of ignoring the plight of the homeless “mentally ill” who he believes would be better served by the modern mental health system and forced psychiatric drug treatment. Recently, Representative Tim Murphy introduced legislation that would sharply increase outpatient mandatory treatment. Let's take a look at how those who are homeless and suffering severe emotional distress are generally treated in the community, and the reasons they may resist the "treatments" that this legislation would force them to submit to.

I received the following question from a reader regarding the controversial CAFÉ – Comparisons of Atypicals in First Episode of Psychosis - study. (This was the study in which Dan Markingson committed suicide.) "It appears that there was no head-to-head with a control group taking a placebo pill. Nor was there a control group featuring 'old' types of 'antipsychotic'. If that was the case then it is very poor study . . . what on earth can you hope to show from the data?" I started to write a response, but the subject is complex, and my response became the following article.

Last week, Rep. Tim Murphy (PA) introduced the Helping Families in Mental Health Crisis Act of 2013 to Congress and almost simultaneously mental health and disability rights advocates voiced their opposition to the proposed legislation with a statement from the Bazelon Center for Mental Health Law. The bill, as many people who follow what's happening in mental health law know, calls for the enactment of assisted (involuntary) outpatient commitment laws at the Federal level and is purportedly crafted to ensure the safety of those deemed "severely mentally ill" by giving families, courts and mental health providers increased authority to commit individuals to outpatient treatment.

Mental health services today are almost completely dominated by the view that extreme distress such as psychoses are biological disorders that require treatment with drugs or other medical interventions. This is despite the absence of evidence that such conditions have a biological basis. In addition to this, recent work within the evidence-based medicine paradigm casts doubt on the effectiveness of most forms of physical treatment in psychiatry. At the same time the evidence accumulates that many physical treatments, such as the long-term use of neuroleptic drugs, are fraught with risks and danger.

After talking for awhile about big pharma corruption, the distortion of research and academic psychiatry, and the overselling of psychiatric medications a bright social work intern who has been on our team for about six months pointedly asked me, “So, do you enjoy helping people by prescribing medications or by helping them in other ways?” I had to pause for a moment to think about it. “I don’t enjoy prescribing as much as I used to.”

Responding to a letter signed by 175 scholars asking for an inquiry into the death of Dan Markingson at the University of Minnesota, the Faculty Senate voted to investigate clinical research at the university. But the university president says the Markingson case will not be part of the investigation. What is he trying to hide?

These 10 areas are not the only ways that mental health professionals can increase misery in suffering people, as there are other physical, psychological, spiritual, and societal adverse effects caused by psychiatrists, psychologists, and other mental health professionals. The article was written in response to AlterNet's recently republished Psychotherapy Networker article, "The 14 Habits of Highly Miserable People," authored by psychotherapist Cloe Madanes, which enraged many readers. The reality is that we human beings can sometimes become so trapped by overwhelmingly oppressive forces (financial, interpersonal, and otherwise) that lecturing us into behaving more joyfully only creates more pain. This leads to the first of "10 Ways Mental Health Professionals Increase Misery in Suffering People."

Before the early 1990’s the use of antipsychotic medications was largely reserved for adults with severe psychotic disorders; unpleasant involuntary movement disorders (extrapyramidal side-effects) and cardiovascular risks appear to have largely limited their use outside these disorders. The introduction and intense marketing of what seemed to be better tolerated and safer (now proven not to be), second generation atypical antipsychotics (AAPs) such as risperidone, olanzapine, quetiapine, ziprasidone and aripiprazole from the mid 1990’s led to a rapid expansion of antipsychotic medication use for a wide variety of unlicensed conditions and in more diverse clinical populations.

Ashley Smith was a very troubled and rebellious teenager. By the time she was 13, she was getting into trouble in school. On one occasion, Ashley was charged with the crime - actually a childish prank - of “throwing crabapples at a postal worker.” Ashley was convicted and sentenced to detention in New Brunswick Youth Centre. Prison psychologists and psychiatrists labeled her defiant behavior a “mental health issue”; a thinly disguised term for “mental illness.” There is no record of any detention or prison staff or health professional trying to understand Ashley’s resistance to authority as youth rebellion.

In Salem Village in the winter of 1692, nine-year-old Betty Parris and her 11-year-old cousin Abigail Williams began exhibiting strange behavior.  A local doctor could find no physical evidence of any ailment. When other young women in the village started exhibiting similar behaviours, Sarah Good, a homeless begger, Sarah Osborne, a woman who rarely attended church, Tituba, a slave from a minority ethnic group, and Dorothy Good, a four-year-old child, were accused of bewitching the girls. They were interrogated and sent to jail.

One thing that amazes us is that even though information linking nutrition to physical health is quite advanced, and generally very prominent in the media as well as in public awareness, people seem to be surprised when told that nutrients are essential for brain function. It may be silly to remind everyone of this, but we need to begin with this simple fact: the brain is part of the body. But to add some heft to this point, let us also recall that the brain is the organ of the body with the greatest metabolic demands (the heart is second).

When Richard Price was a young man, he experienced extreme states for which he was labeled schizophrenic and forcibly ‘treated’ with psychiatric medications, ECT, and insulin shock. He suffered from residual effects from this for the rest of his life. In 1962, Price and Michael Murphy founded the Esalen Institute on the Big Sur coast of Northern California. From its beginning, Esalen worked to create sanctuary for people who, like Price, experienced extreme states. "Esalen was Price's revenge on the mental hospital!" says Murphy.

Force in '‘mental health' care’ has been a popular topic for decades now, yet it’'s scary how similar the conversation remains. Jonathan Keyes'’s recent blog certainly generated quite a bit of commentary caught between conflict and assimilation, and the very mention of the infamous Treatment Advocacy Center gets many of us boiling over. Yet, the conversation has also seemingly lost its way. There’s a vastness between what we think we are demanding and what is actually being conveyed that can sometimes feel impenetrable. Often, I'’m not sure we'’re really even engaged in the same conversation, as much as we superficially may appear to be. I've said many things, but I'll summarize with the following statement: "“If you’'re going to force it, you better make sure that what you'’re forcing works.”" The facts of the matter are that forced treatment - –and particularly forced drugging - –simply doesn’'t work.

In my work facilitating depression support groups, I have discovered three essential factors to healing from depression, which I call ”the three pillars of mental health recovery.”  In my earlier blogs for Mad in America I wrote about two of these pillars --connecting with community and using a holistic approach to treat symptoms. Now I would like to present the first and MOST IMPORTANT pillar — Setting the Intention to Heal.

The psychiatric survivor movement (and our overall “movement,” some of whom don't identify as psych survivors) is about as diverse and varied as the world itself. We are becoming perhaps the largest social justice movement ever to exist. Almost all women and queer people have been categorized by DSM diagnoses for being women (PMS, postpartum depression) or queer (homosexual, gender identity disorder), not to mention all the other groups who have been affected. Everyone is a survivor of the effects of the psychopharmaceutical industry on our consciousness.

Sanctuary is a hot topic.  It is applicable outside of mental health.  I am learning that many, many, many people provide Sanctuary for a time in one way or another and for a number of different reasons.  So I keep thinking about it and asking people about it, and I want to share more of what I am hearing and learning.  The topics that seem to be "on top" for me right now are support, perfectionism, structure and flexibility.

Our lives changed the day we began looking inside ourselves for ways to move towards more joy and less suffering for us and those around us. We took ownership of the good and bad from our past and learned that if we came from a place of inner strength we could frame much of our future. The lessons and necessary mentoring that led to us reshaping our experiences happened within the context of addiction treatment. This treatment for us, and many others, consisted of working on ourselves with the guidance of people who had re-built - or built for the first time - daily lives rich in meaning and social connection.

What distinguishes the pharmaceutical industry from the producers of other potentially harmful products, is the fact that, governments have passed legislation allowing detention of potential customers and forced administration of its product to consumers who do not wish to purchase it. Imagine if goverments passed laws allowing other industries to detain potential customers and force them to use their products.

Thirty years ago, the prescription of neuroleptic drugs to children under 14 years of age was almost unheard of. It was rare in adolescents, and even in adults was largely confined to individuals who had been given the label schizophrenic or bipolar. By 1993 about a quarter of 1% of the national childhood population were receiving antipsychotic prescriptions during office visits. The percentage for adolescents was about three quarters of 1%. By 2009, these figures had increased to 1.83% and 3.76% respectively. The devastating effects of these neurotoxic drugs are well known, and it is natural to wonder what forces might be driving this trend.

A century ago Freud and Jung made us aware of the biases underpinning what patients say. Not everything should be accepted at face value. In particular claims of abuse may not be based on reality. We needed experts – analysts – they claimed, to tease out what is real from what is not. The Catholic Church was once intensely hostile to Freud, but when it came to child abuse adopting a Freudian approach was very convenient. But while Freud essentially denied that real abuse was taking place and got away with it in his life-time, the Catholic Church has learnt to its cost that many claims of abuse are real.

I really valued the massive Melbourne Hearing Voices conference last week. The theme of reconciliation between voice hearers and mental health workers was a powerful one. This emphasis on creating understanding conversations at the conference was encouraged with dialogues between people on specific subjects - medication, spirituality, psychological approaches to voices etc. - rather than keynotes. It seemed a move away from presentations of competing knowledges, toward a more dialogical conference; a respectful exchange of different viewpoints, feelings and values. When you have a range of views in a presentation it’s less easy to adopt a “good guys vs. bad guys” mentality; you start to see the complexities in more relief. The surprise for me was that I liked it.