Foreign Correspondents

This is a very important, well-written book which should become essential reading for anyone involved in the healing arts, since suffering is - or should be - at the heart of our endeavors. Suffering tells us what’s really important to us, and our approach to it tells us what we’re really made of.

Denmark is now screening pregnant women for depression. Given the clear risks and the unclear benefits of antidepressants, the process of screening pregnant women for depression can take on a bizarre dimension. Here, Peter Gøtzsche imagines one of the conversations that might take place.

The International DSM-5 Response Committee, sponsored by Division 32 of the American Psychological Association — the Society for Humanistic Psychology — now has an online petition against the DSM-5.  This is a truly international effort. Please support the petition by signing it at http://dsm5response.com

So now we know Soderbergh’s movie Side Effects is not so Black/Noir after all – more Fifty Shades of Grey. Emily Hawkins (Rooney Mara) is put on Ablixa by her psychiatrist Jonathan Banks (Jude Law) and while on it kills her husband. She apparently murders him while sleep-walking triggered by Ablixa and sleep walking being a perfect defense against murder she is acquitted.

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.

Since the 1980s, a type of psychotherapy called Cognitive Behavioural Therapy (CBT) has become dominant. Like it or loathe it, CBT is now so ubiquitous it is often the only talking therapy available in both public and voluntary health settings. It is increasingly spoken about in the media and in living rooms across the country. Yet when we speak about CBT, what are we talking of? For CBT only exists - as we will see - as a political convenience.

When a pharmaceutical company discovers a potential new drug, they undertake a mammoth project. The aim is to amass sufficient evidence that national organizations such as the FDA will approve sale of the drug, and the type of disorders for which it can be openly prescribed – the so-called “on-label” uses. In order to encourage companies to undertake this risk, governments place a pot of gold at the end of the rainbow.

‘Psychiatric prejudice’ is a term being bandied about these days, mainly by aggrieved psychiatrists. Ordinary people, other doctors and medical students are all prejudiced, they say, because they do not appreciate that psychiatry is a proper medical activity, and critics of psychiatry are prejudiced because their analyses undermine this medical point of view. However, many people remain inclined to view the difficulties we label as mental disorders as understandable reactions to adverse life events or circumstances and, importantly, evidence suggests they are more, not less, tolerant of such situations. In my view, there is a role for medical expertise in helping people with mental health problems, but that does not mean we have to call those problems illnesses.

Is "co-production" public service citizen involvement? Is it individual, ‘responsibilised’ health and social care consumerism? Is it power shifting to communities through participatory governance? Perhaps it’s the ultimate post-modern policy concept. But can it work for mental health?

For years, drugs were it. If you felt paranoid, heard voices or were diagnosed with schizophrenia, the only thing likely to be on offer was ‘antipsychotic’ medication. Like all drugs, these have a number of different effects on our nervous system. Some of the effects can be helpful, for example calming us down or making our experiences less intense or distressing. Others may be less desirable.

It was exciting going back to my old stamping ground. Years ago I’d worked in one of the local community mental health teams and had referred many women to the Drayton Park Crisis House. Walking up the steps of the house brought back memories of standing there with desperate and suicidal clients, some of whom had told me that they would rather die than go back into hospital. As you can imagine, to say I had been glad that there was an alternative would have been an understatement.

Evidence that antipsychotics cause brain shrinkage has been accumulating over the last few years, but the psychiatric research establishment is finding its own results difficult to swallow. A new paper by a group of American researchers once again tries to ‘blame the disease,’ a time-honoured tactic for diverting attention from the nasty and dangerous effects of some psychiatric treatments. People need to know about this research because it indicates that antipsychotics are not the innocuous substances that they have frequently been portrayed as. We still have no conclusive evidence that the disorders labeled as schizophrenia or psychosis are associated with any underlying abnormalities of the brain, but we do have strong evidence that the drugs we use to treat these conditions cause brain changes.

In the film Avatar, scientists are keen to exploit the moon planet Pandora which is inhabited by 10-foot-tall blue humanoids called Na'vi.  To do so they create Na'vi human hybrids called “Avatars” which are controlled from afar by genetically matched humans. When the scientists decide to destroy the eco-system of the planet to gain access to valuable minerals, war breaks out between the humans and the Na'vi. At this point the main character, Jake, who operates an Avatar, has to choose whose side he is on.  Eventually Jake's life is saved and transformed by the Tree of Souls, which the humans are trying to destroy. Why are Avatars in the news again? The latest innovation from psychiatric research is using computer-generated avatars to help people who hear aggressive voices.

This has got to stop. Around the world a million people die from suicide each year and the response internationally is to pour more funding and channel more people into psychiatric services. Three large studies have now found that the more we spend on mental health services the higher our suicide rates. In addition, a recent study has completely discredited claims that 90% of those who die from suicide are mentally ill at the time of their death. We need to use this evidence to stop the expansion of psychiatry as a suicide prevention measure.

I am trying to demonstrate, in a series of installments, how in the 21st century we still often fail to establish effective safeguards for the rights of people who end up in our psychiatric systems. This particular example is taking place in 2016, in Melbourne, and involves over 50 consecutive electro shock ‘treatments’ and multiple, sometimes very lengthy, periods of being tied to a bed. In this third installment, I offer my interactions with another body who is supposed to protect our rights when under the ‘care’ of psychiatrists, the Mental Health Tribunal.

During the past 29 years I have been diagnosed with anxiety, depression, PTSD, Biploar II and complex PTSD. I have tried numerous drug combinations and have been through ECT several times. None of this helped me. My road to recovery started when I decided to rebel against conventional psychiatry.

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.

I quit taking Prozac using a step-down method. Started in Sept. 2011 and finally off in January 2012. I experienced severe loss of balance early on, which progressed into full-blown ataxia & parasthesia. Have had extensive blood-testing & MRIs of brain & cervical spine, all negative! I have to believe this is a result of coming off Prozac, although most sites say the withdrawal side effects don't last this long.

A Colorado based company, Sundance Diagnostics, contacted me a few months ago to tell me about work they are doing to develop a genetic test to predict suicide risk when patients are prescribed antidepressant drugs. Their plan is to sequence the entire human genome of about 360 patients and controls to see if antidepressant drug risk can definitively be predicted.

For decades the gold standard for medical evidence was the review article - an essay looking at most or (hopefully) all of the research on a particular question and trying to divine a general trend in the data toward some conclusion ("therapy X seems to be good for condition Y," for example). More recently, the format of review articles has shifted - at least where the questions addressed have leant themselves to the new style. The idea has been to look at the original data for all of the studies available, and in effect reanalyze them as though the research participants were all taking part in one gigantic study. By increasing the number of data points and averaging across the vagaries of different studies, a clearer finding might emerge. The meta-analysis has gone on to be revered as a strategy for advancing healthcare. It has vulnerabilities.

Fifteen years ago this month we were sitting together in the basement of Peter’s house. We had felt a sense of despair at the widespread misinformation and atrocious stereotypes that were dominating media coverage of mental health at the time. We felt that our profession had a responsibility to challenge these stereotypes, and that as psychologists we had something unique to contribute. That was the time when research into the psychology of psychosis was beginning to burgeon, and many of our findings challenged not only the stereotypes but – perhaps more significantly - much ‘accepted wisdom’ within mental health services as well.

On several occasions I have written about the complexities of antipsychiatry politics, exploring more specifically, how to “do our politics” in a way that moves society squarely in the direction of the abolitionist goal. In this article, I am once again theorizing the “how” of activism—for understanding this territory is critical to maximizing effectiveness. However, this time round, I am approaching it from an angle at once more general and more practical. That is, I am investigating the tools or approaches at our disposal as activists.

In Salem Village in the winter of 1692, nine-year-old Betty Parris and her 11-year-old cousin Abigail Williams began exhibiting strange behavior.  A local doctor could find no physical evidence of any ailment. When other young women in the village started exhibiting similar behaviours, Sarah Good, a homeless begger, Sarah Osborne, a woman who rarely attended church, Tituba, a slave from a minority ethnic group, and Dorothy Good, a four-year-old child, were accused of bewitching the girls. They were interrogated and sent to jail.

Two pieces of research have been published over the last two years that should prompt a major reorientation of the treatment of schizophrenia and psychosis, and a fundamental reappraisal of the use of antipsychotic drugs in general. Put together, these studies suggest that the standard approach to treating serious mental health problems may cause more harm than good. Long-term treatment with antipsychotic drugs has adverse effects on the brain, and may impair rather than improve chances of recovery for some. Many people ask me how the psychiatric profession has responded to this data. Surely, they think, it must have stimulated a major debate within the profession, and some critical reflection about why it took so long to recognise these worrying effects? Sadly, this does not appear to be happening.

A report on antidepressant consumption released on 18 February 2014 by the OECD shows huge increases in prescribing of the drugs across most countries. According to the report a key factor driving this increase is the expansion of the off label use of the drugs for a vastly increased number of indications. While this may not seem like news, I think it warrants some analysis because I think what we are seeing is something more complex than simple market expansion.