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My first real introduction to the world of madness and “mental illness” was when I was 21 years old and I left home to start my mental health nurse training. Reflecting on my own experiences has led me to consider how the trauma of participating in the psychiatric system can affect the way we care for others.

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.

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.

On February 28th, the New York Times reported the latest psychiatric disorder “gene finding” claim in an article entitled “5 Disorders Share Genetic Risk Factors, Study Shows,” The Times reporter described a study that claimed to have identified shared genes associated with five psychiatric disorders: autism spectrum disorder, attention/deficit-hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder, and schizophrenia. We have seen thousands of such claims in psychiatry since the 1960s, and we have also seen that these claims do not survive replication attempts.

Those of you who read the New York Times may have seen its coverage of the British Psychological Society’s recent report, ‘Understanding Psychosis and Schizophrenia: Why people sometimes hear voices, believe things that others find strange, or appear out of touch with reality, and what can help.’ The report has been widely welcomed and many have seen it as a marker of how our understanding of these experiences is changing. The report has not been without its critics. We (Editor Anne Cooke and co-author Peter Kinderman) are coming to New York this month to launch the report in America.

Just being “safe and effective” is not a strong endorsement, and it lacks any justification for the exorbitant amounts of money that have been paid for these medications. Their commercial success was due to the fact that they were advertised as “better” not just safe. Texas and 36 other states have now realize that they were misled about second-generation antipsychotics being better, and they are recouping their money.

What would happen if the mental health system fully recognized the pervasive and profound impacts of trauma on their clients? How might a deeper appreciation of the multi-faceted sequelae of childhood maltreatment and toxic stressors reshape mental health services? While the implementation of trauma-informed care in mental health programs has made significant inroads, the dominant bio-reductionist model continues to constrain and undermine progress.

As Michael Fontaine's recent piece illustrates, history has a great deal to teach us about the nature of this complex thing called madness and how we, as a society, might respond to it better. It is not only fascinating to know that modern debates about the nature of ‘mental illness’ are reflected in ancient teachings, we can learn much from seeing the issues aired in a radically different social and historical context.

When people are seeing the world really different than we do, it’s often reassuring to think that there must be something wrong with them – because if they are completely wrong, or ill, then we don’t have to rethink our own sense of reality, we can instead be confident about that own understandings encompass all that we need to know. But it can be disorienting and damaging to others to have their experiences defined as “completely wrong” or “ill.” And we ourselves become more ignorant when we are too sure that there is no value in other ways of looking or experiencing.

Many of us feel at a loss to fight back against the tidal wave of negative opinion against us. We are wasting our breath arguing that the vast majority of us never commit acts of violence, that the medical model fails everyone and coercion drives people away, etc.

On March 18th, Ronald Pies, a psychiatrist based in Lexington, Massachusetts, wrote a letter to the New York Times. He argued in favor of the usefulness and harmlessness (when well used) of psychiatric diagnosis and wondered as to the misgivings so many seem to have. The Times invited its readership to participate in a dialogue by submitting responses to Pies’s piece. Laura Delano, Paula Caplan and I were among the relative few who managed to get our voices heard. Pies had the last word, though: He gave just two short sentences to my dispatchment, and summarily disregarded so many years of pain and loss and abuse of power.

I have long been concerned with the way society responds to people who come back from war. Veterans are routinely funneled into psychiatry’s grasp. Over the decades, some people who fought in wars have shared with me their experiences of being psychiatrized upon return from war. Sometimes these experiences included veterans being stripped of their second amendment rights, and a host of other constitutional, civil, and human rights violations as they began to be forced into complying with psychiatric regimens, and on several occasions this included veterans being subjected to electroshock.

‘Diagnosing’ someone with a devastating label such as ‘schizophrenia’ or ‘personality disorder’ is one of the most damaging things one human being can do to another. Re-defining someone’s reality for them is the most insidious and the most devastating form of power we can use. It may be done with the best of intentions, but it is wrong - scientifically, professionally, and ethically. The DSM debate presents us with a unique opportunity to put some of this right, by working with service users towards a more helpful understanding of how and why they come to experience extreme forms of emotional distress.

Creating Community Solutions, part of the national mental health dialogue project, was started over four years ago to engage the public around mental health. It was based on a concept called deliberative democracy, where people who disagree with each other engage in dialogue to come to different solutions for a problem. However, for many reasons, this particular project only engaged with one part of the community. The chance to hear from the public was completely missed. Here is how that happened.

The FDA's black box warnings on antidepressants, which incidentally were long overdue, had a negative impact on pharma-psychiatry's image, and on their business, but had no negative impact on client welfare. Nevertheless, psychiatry continues to resist the reality that their sacred drugs do in fact cause harm, and that the FDA warnings were needed. For psychiatry, business and professional status routinely trump client welfare.

Andreas Lubitz’s apparent intentional crash of Germanwings flight 9525 has brought discussions of the intersection of violence and mental disorder back to the front page. As the story unfolded I anticipated two reactions that typify the polarization of public discourse surrounding mental health issues. First, news reports that moralize about ending “stigma,” but that characterize people with mental health diagnoses in ways that perpetuate negative stereotypes.

The most difficult decision I have had to make as a clinician has been to send a person into a locked psychiatric unit for up to 72 hours. The emotional impact affects the individual who is going to be placed on the 72-hour hold, and their family. The emotions that are involved in the process of observing the person, collecting information, and finally making the life-altering decision are powerful and long-lasting for the person making the decision as well. That is, if they are compassionate and involved, and fully aware of the consequences.

This summer, Sera Davidow, Laura Delano, Sean Donovan and Caroline White began a collaborative process with many others from the Western Mass RLC and beyond to develop two new films (not yet titled) focusing particularly on the topic of psychiatric drugs. And that’s where YOU come in.

This past June, Illinois became the 3^rd state to allow psychologists to prescribe medications commonly used for psychiatric issues, after New Mexico and Louisiana have enacted similar laws.  When it comes to gambles for our profession, and frankly for the general public, it doesn’t really get much bigger than this. The following list provides a brief overview of some of the most serious issues that face this discussion, both for psychologists and the general public.

The wait has been exhausting, but it is possible that a flicker of light may finally shine on the dark recent history of psychiatric research at the University of Minnesota. Given these upcoming investigations of psychiatric research at the University of Minnesota, the time is right to look back at some of the disturbing, unanswered questions that have emerged over the past several years.

The general theme, that various "mental illnesses" are being "overdiagnosed" is gaining popularity in recent years among some psychiatrists, presumably in an effort to distance themselves from the trend of psychiatric-drugs-on-demand-for-every-conceivable-human-problem that has become an escalating and undeniable feature of American psychiatric practice. But the implicit assumptions – that there is a correct level of such labeling, and that the label has some valid ontological significance – are emphatically false.

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.

The central question that Will Hall asks is: What does it mean to be called crazy in a crazy world? The answers Hall receives in more than 60 interviews and essays from ex-patients, scientists, journalists, artists, and dissident psychiatrists and psychologists restores the full range of color to our humanity. Outside Mental Health reminds us that perhaps the most pathetic aspect “inside mainstream mental health” is how simplistic, boring, and reductionist it is—when our natures are so very complex, fascinating, and non-reductionist.

I have almost four months to go until I am done with the little pills. After that, I’m told it will take two to nine months until my brain will regulate, until I will be able to eat normally, to stand without shivering, to hold my children without fear of falling. I will make it. But I am here to state the obvious: Benzodiazepines are dangerous. We need more research. We need to know that an invisible epidemic is in our midst and there is much that can be done.

Some of you might know me from co-founding The Icarus Project, an online community, real-life support network, and alternative media project by and for people living with the complex gifts that are too often labeled as “mental illness.” Some of you might not know that I'm also a poet. I've been asked to share my work here on Mad in America. This first poem I'm going to offer you is about trauma and resilience; the ways that the world breaks our hearts, and the ways we survive to find our voices again.