Blogs

I’ve come to realize that the very good intentions of Congressman Murphy to fix an obviously not-working mental health prevention, intervention, and treatment “system” has caused him to be swarmed by a flock of flatterers flogging fraudulent “facts.” Thus, at the behest of my colleague, I wrote a letter to Congressman Murphy, who is obviously a leader for issues of mental health. My letter was delivered to him personally, and I share much of it here. The more I thought about the pickle the Congressman is in—surrounded by people either flattering him or yelling at him—the more compassion I have for him as a human trying thread his way through the siren songs.

As I write this, the New York Times is asking readers to respond to the question “What should be done to prevent mass shootings?” The more responses the New York Times receives from people who understand that the answer is gun control — not misguided legislation that would only harm those it purports to help — the more they will take notice. Please write!

It is time for a new understanding of suicidal feelings and actions. Perhaps a more open dialogue, without fear of sirens and police and involuntary hospitalizations, would have made a difference for one young man here in Asheville last month. Perhaps more public local conversation would have saved some of the 45 lives we lost here in Buncombe County in 2010. Perhaps a more public and safe national conversation would have saved some of the 22 veterans who died from suicide every day in 2010.

No culture or community or individual escapes the damage caused by war. War is the ultimate betrayal of humanity. It occurs when we have so completely lost our way and we cling desperately to concepts such as possessiveness, power and separation. Yet, psychiatry has declared war on big emotions; those very human experiences that help us find our way in times of difficulty. Big emotions are the heart’s way of calling out for support when we need someone’s good attention and thoughtfulness to help us get back to ourselves- to find our equilibrium.

As many MiA readers are aware, a substantial percentage of mental health-related research reports — hundreds of thousands of articles, including many of direct relevance to community-based activists, advocates and clinicians — are currently held behind paywalls. While there are now a growing number of initiatives intended to promote (free) “open access,” many important publications remain inaccessible. Many activists and scholars believe open access is a significant social justice issue. We have put together a shareable Dropbox folder with thematically grouped research articles, measures and evaluation resources.

This Wednesday, March 19th I will be speaking with the wonderful folks at Rethinking Psychiatry in Portland Oregon. These amazing individuals are working on reforming the mental health system and creating practical alternatives such as a Soteria-based housing model in the community. As I look at the present state of how we help people in severe emotional crisis I see enormous problems from beginning to end. I want to outline some of those main problems and then look at some ways we could work to reform them.

I've been on hiatus for a few months now, and I decided that an informal entry would be most fitting at this time. I have had one question on my mind lately: what would motivate Psychiatry to drastically change its mission and practices in a way that is most consistent with contemporary evidence and moral responsibility?

“Don’t look at me! Save yourself!” Andrew* was a 25 year old with an imposing build that was mollified only by his despair and terror. Andrew was losing his mind. I didn’t have to see Andrew and I somewhat wish I never did. I had received a call late at night from Andrew’s nurse. “You gotta give him something man, I mean, he’s freaking out and I feel really bad.”

The hospital rep brought Kristina into the hearing room, a windowless cubicle so crowded there was barely room for them to get to the...

The BMJ article on The Marketing of Serotonin has stirred some interest. There are some  highly technical comments on the BMJ site but of course the key point behind the piece is the rather obvious fact that twenty-five years ago many people were saying it was all a myth. The extraordinary Michael Leunig nailed it twenty years ago in the sketch above. (Leunig is wonderful across the board and razor sharp on medicine and mental health).

In addition to hosting the Panorama programs and The Famous Grouse history of Study 329, Study329.org has a comprehensive timeline on the origins of concerns about the SSRIs and the risk of suicide, initially with Prozac and subsequently with Paxil/Seroxat. The hope is to provide a comprehensive repository for anyone who wants to study SSRIs, RCTs, and Study 329 in particular.

How do we genuinely heal from the damage of racism and internalized racism, as well as mental health oppression, adultism and all form of oppression? We can change all the laws in the land – and we have changed many laws (civil rights laws, employment laws via the Equal Employment Opportunity Commission and the Americans with Disability Act laws) but that doesn’t change attitudes.

The roll-out for Mad in America Continuing Education courses is moving into its next phase —improved presentation of courses and a more aggressive marketing of what we believe are unique CME and CEU resources for professionals and advocates alike. If I needed any reminder of why our continuing education project is so necessary, all I need to do is continue to read through my Psychiatric Times email.

Bob-- Yet another challenging day. I had two more patients today whose trajectories would relate perfectly to Anatomy of an Epidemic. The first was an 61...

Last night I had the privilege of attending my first Family Den with other Mother Bears like myself—parents, spouses, siblings and adult children. All of us have family members who have experienced mental health challenges. All of us had a story to tell.

The University of Colorado has a long history of discrimination against people with lived experience of recovery from mental health labels. One Colorado advocate has made attempts for over 20 years to interact successfully with a faculty member who was a leader in the mental health community. Several of the CU faculty members are leaders in disease-mongering, or causing people to have false positive mental health diagnoses. This is what happens when clinical services are emphasized and recovery is unheard of.

These are troubling times for me as a physician and as a psychiatrist. They were even more so before I ran away… excuse me…...

In our nation's history, in the face of fear, we have often risen to achieve noble goals. Other times we have behaved tragically — for instance, interning and seizing property from Japanese Americans during World War II. Certainly, there were spies among us then. Only in hindsight did we recognize that our treatment of the larger group — who were not — was gravely mistaken. We are on the verge of witnessing such an event in our own time.

In the world of emergency medicine time is a critical resource. But Ryan McGarry, ER physician and stage IV lymphoma survivor, understands at the bone that idle minutes mean something very different to a patient. He recalls “waiting on news if the therapy is working . . . is there more disease that we didn’t know about, is it getting bigger . . . the clock was torture, watching that dial go around is torture.” McGarry horridly remembers what it’s like to wait on a simple, overdue dose of anti-nausea medication. He reflects, “You’re clearly at an advantage as a physician or provider at any level if you’ve been a patient. It’s just an unbeatable perspective.”

Tom Burns, M.D., Psychiatrist and Professor of Social Psychiatry at Oxford, recently said of Assisted Outpatient Treatment (AOT) that “compulsion added to otherwise decent care makes no difference.” This was no easy conclusion for Burns, who for twenty years “argued ardently” for Community Treatment Orders (CTO’s), which are described as the British version of California’s newly passed AOT laws. "I worked for more than 20 years to get the CTO law passed," he said. "I thought such laws were going to make a difference, but they don't."

If you haven't heard about the Village Shalom shooting yet, it happened. This time it's my own community. So I when I list these 9 ways to stop the next Village Shalom shooting know that I speak with full love and compassion. The main thing I want to share is the real story about mental health. Emotional distress can be temporary and transformative. Recovery can mean, "All this goes away."

I am a board certified psychiatrist and a Distinguished Fellow of the American Psychiatric Association. I mention these things only to indicate that I...

I woke up to the sound of steady rain. Outside, four inches of snow still lay on the ground from the previous weekend. The temperatures had remained just above freezing, and the rain that was scheduled to come would likely only be intensifying as the morning wore on. But I had committed to the long run, knowing that my training was as much about being prepared for anything as it was for preparing my body for the actual number of miles to come.

When I became a case manager at a community mental health agency in Cincinnati, Ohio, I had a bachelor’s degree in journalism, 11 months of experience working in the advertising world, and 10 months of serving with AmeriCorps under my belt. I was not the most qualified person for the position, but I was hungry for experience in the mental health field, and I was determined to be good at the job. My supervisor said he hired me because he knew I had the interpersonal skills to do the work, and that he could teach me the rest. Two of the main axioms I learned as a case manager were that mental illnesses are due to chemical imbalances, and psychotropic medications are the solution. As a result, I spent an abundance of energy negotiating with my clients to take their meds or try new ones that the pharma reps encouraged us to promote.

Last week the Sandy Hook Advisory Commission threw another crumb to the masses, letting them know that, well, even though they can’t get any of the records and documents they want, they’ll forge ahead and produce a report, making mental health recommendations, that has absolutely nothing to do with Adam Lanza’s mental health history.