Blogs

When I teach workshops or lead discussions on coming off psychiatric drugs and alternatives, there are invariably parents present who are at loose ends. They want to know what to do for their children, how to help them best, and how it can be possible for their child to live without medication given all they have been through.

I've been working for 2 1/2 years on a system to provide non-medical care for people with emotional distress. I want it to be...

The Future of Mental Health interview series continues with interviews this past week with Claudia Gold on The Silenced Child, Robert Stolorow on emotional trauma and psychoanalysis, Gayle Flanigan on Rose Hill Center, Robert Salvit on Kabbalah and spiritual healing, Susan Raeburn on group psychotherapy, Robert Whitaker on Mad in America, and Isabel Clarke on psychosis and spiritual experiences.

As part of the Affordable Care Act, the federal government has made a commitment to integrate behavioral health with physical medicine. Physicians have saddled America with addiction to antidepressants, antipsychotics, and benzodiazpines. If the federal government decides that opiate addiction is ok, as they seem to have conceded, shouldn’t the question be “what is the cheapest and the safest opiate?” In Europe, heroin is an option right along with buprenorphine and methadone. It seems to me that the “back-door” legalization of opiates under the guise of “treatment” ought to at least be debated out in the open.

Dear Bob-- I've had a couple of remarkable conversations, not with my own patients, but with friends and acquaintances asking me for advice.  Each example...

Even though more and more researchers have become interested in investigating the complexities of voice hearing in and of itself (as opposed to treating it simply as one of a number of so-called "positive symptoms" of schizophrenia), the lack of a clear identification of the defining characteristics and significance of the experience for voice hearers makes it difficult to compare results across different studies.

Faced with questions about the $3 Billion fine imposed on GSK – is it just the cost of doing business? - Andrew Witty snapped back: “Although corporate malfeasance cases end up looking very big, they often have their origin in just… one or two people who didn’t quite do the right thing. It’s not about the big piece. The 100,000 people who work for GSK are just like you, right? I’m sure everybody who reads the BMJ has friends who work for drug companies. They’re normal people… Many of them are doctors."

Is it possible to create a “Rainbow Coalition” with a common agenda of (1) reforming prisons, (2) providing affordable housing, (3) limiting the use of psychotropic medications, and (4) providing community-based mental health and psychosocial support? Prominent psychiatrist Allen Frances asked us at the Mad in America Film Festival to join such a coalition. Rather than rejecting Frances’ agenda outright — as I appeared to do in a recent Mad in America blog — we should give his proposal a fair hearing. As always, the devil is in the detail.

While a 2-year outcome study by Wunderink, et al. has been cited as evidence that guided discontinuation of antipsychotics for people whose psychosis has remitted results in twice as much “relapse,” a not-yet-published followup of that study, extending it to 7 years using a naturalistic followup, finds that the guided discontinuation group had twice the recovery rates, and no greater overall relapse rate (with a trend toward the medication group having more relapse.)

We want to start an international initiative to promote the writing of recovery stories in every country, with the ultimate goal of sharing at an international level the most compelling ones from each country. Our proposal is born from an awareness that recovery stories are necessary today in order to give back to mental sufferance its meaning and transparency, to fight the biographical opacity of biological theories (the broken brain) and to guarantee decisional power to those who are offered (or imposed) mono-dimensional or dehumanizing treatments.

Doctors in the 1950s and 1960s made psychiatric diagnoses on orphaned children that led to treatment with antipsychotic drugs, and one of the drivers of this seemed to be that the Church got more money from the State as a result. The doctors, of course, also got paid. This feels like a seriously corrupt nexus operating with near impunity on the basis that no one is going to be bothered to investigate the fate of some orphans.

My name is Mark Foster. I am a family physician and writer from Colorado, and the co-Founder and president of a new non-profit called...

Dutch peer support education has changed dramatically over time since its inception. Peer support education has evolved over time from empowered and independent peer support education to institutionalized peer support education. In effect the (future) peer support workers in the Netherlands could become clinician-friendly peer support workers who merely represent peer support work in name but not in practice.

Do we bring gifts to our family and community that are born of suffering but infused with spirit? Has our madness been in vain,...

This email came to me from one of my advocacy friends. It seems to me like this would be a super good opportunity to point out that "quality care" includes doing more good than harm, using evidence-based treatments, which may or may not be medication, and various other approaches we are all working for.

As I look back on the civil rights movement and all that my ancestors marched for, I sometimes feel as if the civil rights movement has been a dream deferred. We have come far but still have a long road ahead. The intersection of civil rights, poverty and the psychiatric survivors movement has played out now for four generations. Now the psychiatric movement faces its biggest hurdle. We are asking our allies, representatives and members of our community to stand up. We urge you not to endorse the Murphy Bill.

For some time now, the medical community—and to a certain extent, the general public—has understood that the reports in the medical literature of industry-funded...

Dear Bob: Saw a young man recently, early 30s, who wanted help withdrawing from benzodiazepines. He had been on escalating doses of Xanax for two years.  The...

A new generation of multilateral and bilateral trade agreements is likely to significantly threaten access and cost of healthcare, and limit signatory Governments sovereignty to prioritise health care policy to protect and improve the health of citizens. The Trans Pacific Partnership Agreement (TPPA), a Pacific Rim regional trade agreement involving 12 countries — including New Zealand, Australia and the US — is one such agreement, and it has the potential to significantly alter the domestic environment for health policy-making.

One of the most remarkable aspects of Robert Whitaker’s (2010) outstanding book Anatomy of an Epidemic was his comparative data that contrasted outcomes for mental disorders prior to the introduction of pharmacological treatments with outcomes for mental disorders after pharmacological treatments became the main, and often only, course of action. I have asked people in workshops to estimate who might be better off – someone diagnosed with what we now call bipolar disorder prior to the introduction of lithium or someone diagnosed after lithium became a standard treatment. Almost without exception workshoppers estimate that the people diagnosed before lithium was available do much worse. Whitaker’s data indicate exactly the opposite. It’s a staggering finding.

You may think I’m slow on the uptake when I say this. And maybe I am. But I recently came to the realization that products or lifestyles that are vigorously marketed and promoted are bad for you.

In 1993, the World Health Bank estimated that domestic violence, or intimate partner violence (IPV), was a greater cause of poor health than traffic accidents and malaria combined. It was believed that 5-20% of healthy years lost for women were attributed to IPV. By definition, violence is considered to be any physical, verbal, or sexual assault that significantly comprises a person’s body, trust, and sense of self. But it is not solely a female issue even as women are disproportionately perpetrated against in this way. Results from a study conducted in the United States found that 22.1 percent of women and 7.4 percent of men reported acts of IPV in their lifetime.

In recent months the English pharmaceutical company GlaxoSmithKline (GSK) has assiduously portrayed itself as an advocate of transparency, and in support of access to clinical trial data. Well, in support of "Responsible Access." "Responsible" here essentially means that a researcher commits to the primacy of RCTs and statistical significance over an analysis of adverse events. It would not, for example, be responsible to claim that an SSRI causes suicide, a statin muscle damage or cognitive failure, or hypoglycemics cause hypoglycemia unless a trial has shown this to happen to a Statistically Significant extent – and they never do.

For most parents, addressing the topic of death is an uncomfortable proposition. Yet, it may be one of the most important discussions we have with our children.  Our lifelong response to death often affects our mental and physical health.  We must teach our children practices from an early age that can buffer the unavoidable distress that would come if the worst occurs.

In graduate school at UT Austin, while engaging in electroconvulsive treatment, my academic advisor would refer to my resiliency. That I suited up, showed up. Graduate school gave me something to hang onto and to busy myself with intellectually; something that was rooted firmly, concretely, in time and space. But most of all it allowed structure back into my world. Conversely, while ECT was a last-breath attempt to abate all further SI (self-injury) attempts, it was intensive and invasive, affecting my cognitive abilities. I struggled with draft after draft for multiple coursework papers.