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Ronald Pies, MD, is one of American's most eminent and prestigious psychiatrists.  He is the Editor-in-Chief Emeritus of Psychiatric Times, and he is a Professor of Psychiatry at both Syracuse and Tufts. I disagree with many of Dr. Pies' contentions, and I have expressed these disagreements in detail in various posts. But there is one area where I have to acknowledge Dr. Pies' efforts:  he never gives up in his defense of his beloved psychiatry, even in the face of the most damaging counter-evidence. For instance, on more than one occasion, he has asserted, with apparent sincerity and conviction, that psychiatry never promoted the chemical imbalance theory of depression!

For the past four years, I have been deconstructing my views of my profession. My focus has been primarily in two areas: the efficacy and safety of the drugs I prescribe and the so-called “alternative” approaches (in this I include many things such as Open Dialogue, Hearing Voices groups, and Intentional Peer Support to name a few). I have shared much of this in the blogs I wrote during this time. I am also interested in how we can improve and reform the public mental health system since this is not only where I work but where most people seek services and help. I wonder where – if anywhere – psychiatrists fit in to a reformed system.

In a 2013 edition of the Journal of the History of Biology, Norbert Wetzel and I published an article on the Swiss-German psychiatric geneticist Ernst Rüdin (1874-1952) and his close colleagues, and how their work and crimes in the Nazi era have been discussed or ignored by contemporary psychiatric genetic writers and researchers. Here I would like to summarize the main points we raised in that article, and to make several additional observations. Whether Rüdin reluctantly aided and helped implement the “euthanasia” killing program in support of the war effort, or more likely, that he saw it as the crowning achievement of his decades of psychiatric genetic research based on racial hygienic (eugenic) principles, is an issue that may be decided in the future.

That was the emphatic response from my grad school psychopathology professor 35 years ago, after I'd stated in her class that anyone could become psychotic given sufficient life stressors, losses and trauma. How many current mental health professionals, especially psychiatrists, also believe they have such strong egos that they never could experience extreme states?

The BMJ states that it takes on average eight weeks from submission of an article to publication. The review process for Restoring Study 329 took a year, with a three-month review process involving six reviewers to begin with, and then a further four reviews in a four-month process, leading to a provisional acceptance in March that was withdrawn.

So, thanks to everyone who has read and commented on my stories of reentry into the mental health system. I have now had eight nights of very good sleep and my mental health symptoms are back to the baseline. Baseline for me means I only get separated from consensus reality when a significant trauma occurs at the same time I'm having a pretty good sleep deficit. Usually I can manage it myself simply by being aggressive about handling — and increasing — the sleep. So this time I was unable to break that cycle and got some more drugs to help.

Losing someone you love to suicide can be a devastating experience. A legacy of torment is created where stigma, shame and secrecy reside. These are echoes of a world that does not know how to respond to what is now termed an epidemic. The baton of collective discomfort is passed from someone who has completed suicide to those intimately involved, making grieving suicide a lonely sentence of social disapproval. I know. This happened to me.

We first came under pressure to give our developmentally disabled and autistic daughter a psychiatric drug when she was in her mid-teens. She was attending a local school for autistic children but was unable to adapt to their program, and we were urged to consult a psychiatrist. What enabled us to resist the pressure to put our daughter on drugs?

The Open Dialogue approach is a model of mental health care that involves a consistent family and social network approach. All healthcare staff receive training in family therapy and related psychological skills. October 2015 sees the completion of the first wave of Peer-supported Open Dialogue (POD) training for National Health Service (NHS) staff in the UK, paving the way for the establishment of pilot POD teams in the NHS and a large-scale evaluation.

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.

By 2002 GlaxoSmithKline had done 3 studies in children who were depressed and described all three to FDA as negative.  As an old post on Bob Fiddaman’s blog reproduced here outlines, several years later they undertook another study in children in Japan. (Editor's note: This is a re-print, by David Healy, of a post by Bob Fiddaman)

It has been a little more than a year since you perhaps read Rob Wipond's story about Siddharta and I, From Compliance to Activism: A Mother’s Story. Some of you may remember that in August 2014, Siddharta was freed at last. His recovery from years of being drugged and treated as less than human, and the traumatization of confinements and imprisonment became my main focus. And how is Siddharta doing now? Well as his Mother, I would say he has made remarkable progress!

One of psychiatry's most obvious vulnerabilities is the fact that various so-called antidepressant drugs induce homicidal and suicidal feelings and actions in some people, especially late adolescents and young adults. This fact is not in dispute, but psychiatry routinely downplays the risk, and insists that the benefits of these drugs outweigh any risks of actual violence that might exist.

There are an ever-increasing number of professionals and lay people who advocate for reforms within the mental health system. Even the staunchest of biological psychiatrists agree that changes must be made. When I first decided to pursue clinical psychology as a career, I did so with the intention of trying to change the system for the better, or at least to offer a different experience to individuals in distress. Personally, I believe that peer-led alternatives and independent funding are the things that advocates should focus more heavily on, but that does not solve the problem of what to do to decrease the amount of harm that is being done on a daily basis in the present. In this sense, I believe that a “harm-reduction” approach to dealing with the current system is the best way to get what we can until something better exists.

I believe if the public really knew and understood the reason why we who have survived medically-induced harm, and who do not have the human right to — with real evidence — legally expose this, they would support psychiatric survivors and help us to put an end to what has been called ‘the tyranny of good will.’

In the wake of yet another national uproar about a mass shooting, much of the public once again turns its eye towards supposed mental health reform as the solution to the atrocity of acts of gun violence carried out in public spaces by primarily young, white men. The issue of gun control has soared back up to the top of concerns being addressed by presidential candidates, and national discourse has fallen back into its routine, polarized stances. The Republican leadership continues to suggest that gun control is not the solution — there must be something wrong with “those people’s” brains.

We are among an increasing number of people around the world who know the importance of holding on to a humanistic idea, and of keeping in mind that people need—first and foremost—other people. People who are willing to take part, to share with us the horror and confusion, to invite the telling of a narrative, and to keep the hope alive.

For most people in the transgender community our earliest memories are experiences of being bullied, or not being loved by some family members because we looked and acted differently than other male or female-bodied persons. For me this led to an early onset of depression and being diagnosed in the third grade. My first attempt at leaving this world and the body I had grown to hate was at the age of eight. Feeling unloved by my family, and being in a body that had betrayed me, I felt disconnected from the world in general.

After each highly publicized gun violence incident, some lawmakers—whether with good intention, for political gain, or both—declare that we must have laws to keep guns out of the hands of people with mental illness. It is therefore stunning and profoundly important to note Sunday's blog post from the American Psychiatric Association's president, Dr. Renee Binder.

The joint ISEPP/UCLA conference was held in Los Angeles on November 14-16, 2014. Today, ISEPP and the UCLA Luskin School of Public Affairs are delighted to bring you videos of 13 of the 15 invited plenary talks. Each video is accompanied by a crisply written interview with the speaker, focusing on the goals of their work, challenges facing their profession, and how they evaluate any salient changes in mental health practice and research. These smartly produced and edited videos range from 20 to 30 minutes in length and are freely available on www.TransformingMadScience.com

Integration of physical and "mental health" care has been a popular topic in psychiatric circles in recent years. I've never been entirely clear about the nature of this proposed integration of psychiatry with primary care, though from what I've gathered, it sounds like there will be a psychiatrist, or other mental health worker, attached to primary care practices, either in the flesh or via computer screens. What has always been crystal clear, however, is that the proposal would entail a huge expansion of the psychiatric net.

The controversy over “Study 329” on the effects of Paxil in teen depression has raised questions about the state of ALL medical research. I decided to look at the research for the most recent psychiatric drug approved by the FDA, a new antipsychotic called cariprazine or Vraylar.  I located twenty studies of Vraylar on www.ClinicalTrials.gov, the U.S. government-sponsored registry for clinical trials.  Three were still in process, and seventeen were completed.  Not one had shared its results on the government website, a supposedly mandatory step.

In reviewing the classes I took in graduate school, nowhere was I taught that mental disorders are an illness arising from a chemical imbalance which needs to be treated with medication. If my university professors did not teach it, then where did I learn it? The answer lies in working in the field itself and hearing it from supervisors and other colleagues. But where did they learn it? Why do we to continue to blindly go along without questioning whether or not any of this makes sense or is helpful? We need to do better.

Psychiatry, at large, is coming under correction after decades of collusion with industry and media. Yes, those “healers of the soul” (can you believe that’s what the original meaning of psychiatrist actually derives from?) have to begin to take responsibility for their part in overdiagnosis and overtreatment of vast swaths of the population. What has been less explored is the collusive role of the media in generating public beliefs about mental illness and its best treatment.

This thought-provoking reflective checklist strategy is designed to challenge the increasing 'quick fix' mentality of many doctors who decide to move immediately from a possible diagnosis to medication. With school-aged children we need to promote their Safeguarding, and a Pause-Reflect-Review process that will, hopefully, reduce unnecessary prescribing.