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The November 5 hearing on the UN Convention on the Rights of Persons with Disabilities in the Senate Committee on Foreign Relations reached new heights of absurdity and opens new ground for concern. It may be worse for us to ratify with the reservations, understandings and declarations (RUDs) being proposed, and with the legislative record that is being created for the specific purpose of rejecting any application of the treaty's standards to US law than not to ratify at all. All the proponents of CRPD ratification who are allowed a voice in these discussions are in agreement that the US ratification is aimed ONLY at giving the US greater influence over other countries and over the development of customary international law, and NOT at improving the enjoyment of human rights by persons with disabilities in the US itself.

On 25 October 2013, the World Health Organization issued a press release promoting guidelines produced by the Patient-Reported Outcomes Safety Event Reporting (PROSPER) Consortium. The consortium aimed to “to improve [drug] safety reporting by better incorporating the perspective of the patient” with the aim of the guidance produced “to ensure that the patient ‘voice’ and perspective feed appropriately into collection of safety data.” Rather than 'quietly protecting the health of every person on this planet, every day' it seems clear that WHO is quietly protecting the interests of pharmaceutical companies and their advisors on planet 'profit from patients', every day.

On October 1st the Connecticut State Legislature’s reactionary response to the tragedy at Sandy Hook Elementary school went into effect. Public Act No. 13-3 requires all people that voluntarily admit to a hospital for mental health reasons (not solely for drug or alcohol treatment) have their names placed in a database administered by the Department of Mental Health and Addiction Services - for the purpose of automatic suspension of Second Amendment rights.

It was an awesome experience to give a TEDx Talk at my old school, because, frankly, it was an acknowledgement by an elite institution that I've done something in my life worth listening to. I hope you appreciate my talk and share it with others. So many people who are affected by the mental health system in North America today have no idea how much the rise of the DSM and biopsychiatry has to do with the Reagan era and neoliberal economic policies that reshaped the whole language and culture of mental health. It's like a bulldozed neighborhood with shiny new buildings, after a while people forget how they got there and they just seem "normal."

Many months ago I wrote a guest piece on Mad In America entitled, “Corrections Officers, Not Clinicians.” And since that time I have walked away from that job because of the irreconcilable conflicts between its mission and my own heart. I have become convinced that, as an institution, the public mental health system of the United States is a disaster. There are always individuals within any system who are doing noble, beautiful things - For me, one part of my path toward healing included the connection I made with a therapist - But that doesn’t absolve us of the responsibility to confront institutional norms that are oppressive and dehumanizing.

GSK's continued failure to provide true transparency flies in the face of what the overwhelming majority of people signing consent forms probably intend - which is to make their data available for scrutiny by independent experts. If those who participate in trials thought some remote risk of a breach of privacy were being used to prevent disclosure of details that would save someone else's life - but threaten GSK's profits - most of us would likely be horrified.

Whenever I write or speak publicly, I feel compelled to frame cutting, burning and hitting myself as something I used to do. I don’t actually outright say I’ve stopped, but I use the past tense and thus I suspect most hear it as implied. Somehow, the pressure to appear outwardly ‘all better’ in that way still seems big. Self-injury (of that type) ranks pretty high up there on an awful lot of people’s scary meters. Just saying you are someone who has ever done that sort of thing seems disconcerting enough for most.

Anoiksis (the Dutch association of and for people with a psychotic vulnerability) has introduced a new name for the disease schizophrenia: Psychosis Susceptibility Syndrome (PSS). Together with the old name, its attached prejudices, misleading significance and stigma can be thrown overboard.

When I pick up a pen, I put down my fear. Sorry, they don't both fit into my hand at once. Meditation teachers often say the hardest part is getting to the cushion. The hardest part of writing is probably picking up the pen. So, pick up a pen, I dare you. Write even if you think no one will read it, even if you don't want anyone to read it.

The buzz in academic publishing right now is the story about how several hundred open access journals accepted a fake research paper. Of much more concern is that there are top-tier medical journals which have published clinical trials, that were read by thousands of people, that influenced clinical decisions, that we now know were bogus, but have never been retracted.

It is no mystery why everyone at the McNair Discovery Learning Center is alive today. Antoinette Tuff was respectful, responsive and kind to a man with a gun. She shared her own difficulties and offered her own humanity. This kind of “Tuff Love” involves real risk, but not more risk. It reaches across vast expanses of human confusion and distress - not to manage, control or subdue - but to attempt connection and offer a lifeline back to humanity. It is the public safety work of the future.

In Butte County, California, Law Enforcement and NAMI have recently partnered to provide identification cards for people in the mental health system. The cards reveal the person's psychiatric diagnosis and current medication prescriptions. This White Card project may be well-intentioned, but it makes me very uncomfortable. I believe it is a form of psychiatric profiling that could be adopted by law enforcement around the United States.

According to a leading group of psychiatric genetic researchers, writing in 1999, “From the perspective of psychiatric genetics, the Human Genome Project is an immense factory producing and refining the tools we will need to discover the genes that cause mental illness.” A 2002 “speculative outline” by a group helping to revise the DSM envisioned a future DSM-5 practice of classifying disorders on the basis of "the patient’s genotype, identifying symptom- or disease-related genes, resiliency genes, and genes related to therapeutic responses and side effects to specific psychotropic drugs.” A dozen or so years ago, at least some of the DSM-5 architects believed that genes would at long last be identified and would be integrated into the next version of the DSM. As we know, this did not happen.

Disclosure is an insufficient strategy for mitigating bias because bias does not result from the concealment of financial ties but from their effects. Even worse, social psychologists have demonstrated that when individuals disclose a competing interest, they give even more biased advice.

Over 100 million people in the US suffer from chronic pain – defined as pain lasting longer than 12 weeks. Up to 80% of those sufferers are women, many of whom report having been repeatedly brushed off or referred out by medical doctors who could find no discrete medical cause for the symptoms they reported. Some patients report an even harsher finding by their doctors: “To the best of my ability to determine, your pain is not medical in origin. I believe you need to be evaluated by a psychiatrist or psychologist who is qualified in psychosomatic issues.”

Twenty-five years after R.D. Laing’s death, are we more humane and compassionate in our treatment of those at our mercy? It is difficult to say. But one thing that we cannot deny, our culture has become even more “medicalized” than at any time in history. The medical metaphor that Laing found more or less acceptable when explaining what he thought therapy is, has become increasingly literal. More and more, anything that pains us is a condition that can be treated.

Last week Matt Samet posted about a setback he’s recently had. Setbacks for me remain routine and normal. They are part of the excruciatingly non-linear process of recovery.

Being the parent of a dead child is hard. Being the parent of a child who died from suicide may be even harder. I love my son and am proud of him and work to make sure that his having lived makes the world a better place.

Psychiatric molecular genetic research has failed to discover genes that underlie the major psychiatric disorders, the existence of which twin and adoption studies are assumed to have established. "Genome-wide complex trait analysis" (GCTA) was developed a few years ago as a means of solving what researchers call the "missing heritability" problem. One researcher believed that the new GCTA method would “drive a stake through the heart of” criticism of behavioral genetic theories and methods, and would finally put criticism of twin studies “to rest.” The opposite scenario appears to be playing out, however, as leading behavioral genetic and psychiatric genetic researchers struggle to prevent some recent negative GCTA findings and the obvious false assumptions underlying twin research from driving a stake through the heart of twin studies themselves.

If the blimp that is psychiatric treatment were a passenger aircraft, the authorities would have grounded it many years ago, but still it continues to inflict harm on countless thousands of people. I read Joanna Moncrieff's latest book with a growing sense of anger and shame. The roots of drug treatment in psychiatry are thoroughly rotten. They sustain the decaying trunk of psychiatric theory and practice through misrepresentations and untruths; it is snake oil peddled by quackery.

I understand that some people are staunchly opposed to public mental health services, and I understand why. However, millions of people reach out to these organizations and agencies for assistance in getting through difficult times. It is common knowledge that the “help” they get is not always helpful, but I have known a few people who found the support they were looking for and, let’s face it, until there are widely available and accessible alternatives that people are able to turn to, many people who are struggling reach out to public and private providers for help. Some people call me naïve because I have faith in the human capacity to make good choices, when given the opportunity and presented with evidence that supports a decision that is informed not only by data, but by recognition of their potential to be a force of healing and justice in the world.

Like most doctors, I feel like I prescribe medications ethically and effectively. The basic foundation for that confidence is three things: 1) Knowing that my primary motivation is almost always to help my patients. 2) I try to defend myself as best I can from being too influenced by the profit seeking motivations of the pharmaceutical industry. And 3) I try to resist responding to various self destructive motivations of my patients. Prodded by Robert Whitaker’s books, I feel the need to build a more comprehensive approach to ethical and effective prescribing than I was taught or modeled or even than is expected of me. Here are four more foundations I’m building: 1) Individualized prescribing, 2) Recovery-based prescribing, 3) Trauma-informed prescribing, and 4) Toxicity-informed prescribing.

At a time when psychiatrists are considering whether suicidal behavior constitutes a disorder rather than a symptom, there is strong evidence that physicians have far higher rates of suicide than the general population, with psychiatrists found to be at the highest risk of suicide. In light of this information, you may be asking yourself, as I am, whether it would be wise to conduct a brief mental state examination of any physician we consult (particularly any psychiatrist) as a way of ensuring our physical and emotional safety? To this end I have prepared a quick diagnostic test that you may carry in your pocket or purse for easy administration next time you are visiting a health professional.

I had the good fortune to be working at a dynamic Recovery program for adults beginning in 1990. I passionately believed that not only does recovery happen – but that we would be able to demonstrate it by reporting significant improvements in quality of life outcomes such as employment, housing and social supports. The program's commitment to Supported Employment, for instance, was emphatic and we took pride in doing “whatever it takes” to support our members’ integration into the community. The Recovery movement was just taking root in California and throughout the U.S. When I look back on the following 19 years, I can’t help but feel some sense of disappointment about the overall outcomes.

In my last blog, I talked about how I was attempting to cope with a “mini-relapse” without using psychiatric drugs. One Sunday morning in the midst of this episode I awoke in a particularly dismal state. I didn’t have a structure planned for the day. And without something to look forward to, both my anxiety and depression increased.