Foreign Correspondents

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.

Odysseus was in his 70s. Coming up to the 50th anniversary of a very happy marriage. He had formerly been a respected professional, a...

I know that this might sound odd coming from a critical psychiatrist, but I believe that psychiatry has a future. Furthermore, I maintain that a good deal of psychiatry as practised now is helpful and that many psychiatrists manage to play a positive and therapeutic role in the lives of their patients. However, I also believe that we are at our most helpful when we depart from the current biomedical ideology that has come to dominate in our profession. As a first step, we need to get beyond the reductionism that currently guides most psychiatric research and education.

In 2012, I found out that the ten biggest drug companies in the world commit repeated and serious crimes to such a degree that they fulfill the criteria for organised crime under US law. I also found out how huge the consequences of the crimes are. They involve colossal thefts of public monies and they contribute substantially to the fact that our drugs are the third leading cause of death after heart disease and cancer.

I am proud and happy to announce that our webpage DrivingUsCrazy was launched today. It will help us to get the word out about the international film festival taking place in Gothenburg, 16-18 October, 2015, and also to highlight the issue of madness every day until then — and hopefully for many days afterwards.

The Finnish Psychological Association held a meeting in Helsinki on 1 Sept 2014 titled “Mental Health and Medicalization.” I spoke at the meeting and four days later I sent a letter to another speaker, psychiatrist Erkki Isometsä. Professor Isometsä replied: “I will respond to it in detail within a few days..." As "Open Dialogue" is essential in science, I have published my letter to Isometsä here as well as on my own website, although I didn’t succeed in starting a dialogue.

This blog is a review of Gary Greenberg's book, Manufacturing Depression: The Secret History of a Modern Disease. I wrote it originally in 2010, but it was never published. By publishing the review now, I hope it will provide a useful reflection for those who have already read Manufacturing Depression, and an incitement to read the book for those who have not.

Good Pharma is the story of the Mario Negri Institute. Mario Negri was a wealthy patron who on his death in 1960 bequeathed a large sum of money to support independent pharmaceutical research to an upcoming researcher Silvio Garattini. Garattini and Alfredo Leonardi set about building an Institute centred on the new drugs and new techniques. They continue to grow without ever having patented any of their many discoveries or concealing any of the data from experiments that didn’t work out or accommodating any of their trials to industry’s wishes.

If we call someone mentally ill, in some ways we may be recognising their predicament as a powerful one, and their need for support. However, we may also be judging their state of mind as faulty. But what if what seems a faulty mind is much more than that? We can go deeper than trying to say what is wrong with someone, how ill they are, or what category they fit into. We can instead ask: How do parts of them feel? What might different parts of them need? And what are the contexts in which these experiences have emerged?

If not every week, then very often, we receive requests from people not living in Sweden asking if it would be possible to come to the Family Care Foundation and take part in our shared work. I often day-dream that I have a list of different places in different countries where it was obvious that the main task for the organization and everyone involved was to meet those we call clients and their families in a relational and dialogical way, where it was NOT important at all to define people in terms of diagnosis and where it was NO big deal to support people to get off medication. Where the big deal was about something else: to try to create a safe place and to make sense of experiences and to try to share the very hard things with each other.

Conflict is a pervasive human phenomenon that is at the heart of much distress and misery. Unfortunately, it is also seldom recognised; obscured by categories of disorder spelled out in systems such as the DSM, or brushed aside by other, fancier (but less accurate) ways of describing psychological turmoil and discontent. The source of psychological distress is not an ill, a disordered, or a dysfunctional mind but a conflicted one.

Subscribers to Mad in America might be interested in a Keynote Lecture given by Professor Nikolas Rose in Nottingham on May 15th 2013. In this lecture Professor Rose very thoughtfully challenges a number of the assumptions which underpin conventional and contemporary psychiatric practice. He asks five hard questions:

• Is there (really) an epidemic of mental illness?
• Does the path to understanding mental disorder lie through the brain?
• What is the role of diagnosis and of diagnostic manuals?
• Should we seek early identification of those at risk of future mental pathology?
• What is the place of patients, users, survivors, & consumers of mental health systems?

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.’

This column is partly a report on the marketing of Abilify, the atypical antipsychotic that has become America’s best-selling drug.   It’s also an appeal for advice and feedback from the RxISK and Mad in America communities, and a call for some brainstorming about strategy.  The plans laid out by drugmakers Otsuka and Lundbeck for Abilify’s future, and the cooperation they’re getting from leading universities, are alarming enough to me that reporting on them seems inadequate.  We need action, although I’m not sure exactly what kind.

The Hearing Voices movement is a beautiful thing, and last year it was 25 years old. What has happened in 25 years? A confidence has grown in a different approach to hearing voices, listening and embracing rather than trying to control and silence voices. Key to this has been Hearing Voices groups and conferences, where people who hear voices are listened to with openness and curiosity. It’s not about telling people who hear voices to throw away their pills if they are taking them, its about creating spaces to listen deeply to what is happening.

The recent furore surrounding publication of the new DSM has provided a much-needed opportunity to discuss and debate crucial issues about how we make sense of, and respond to, experiences of madness and distress. Many psychiatrists, psychologists and other mental health professionals have expressed their dismay about the dominance and inadequacy of a biomedical model of mental illness. Whilst we share these concerns, welcome these debates and support colleagues that are willing to take a stand, The Hearing Voices Network believes that people with lived experience of diagnosis must be at the heart of any discussions about alternatives to the current system.

It isn’t easy coming to a point in your career where you begin to question widely held beliefs about the nature of mental illness, and how it should be treated. Indeed it becomes starkly obvious that, no matter what you think and believe, even know in your heart to be true, the world runs along different lines. Sometimes I can be full of hope for change, but frequently it angers and frustrates; often I am rendered melancholic by the mountain that lies ahead. Let me explain.

On Monday a new study was published with the finding that there is a three- to four-fold increase in the rates of Autistic Spectrum Disorder and Developmental Delay in children, especially boys, born to mothers who have been on antidepressants through pregnancy. There are further studies with comparable findings in the offing. Not only this but it looks as though the SSRIs may redefine what it means to be a teratogen. Other teratogens produce their effects in the first trimester of pregnancy when organs are first being formed. But it looks like antidepressants used in the third trimester can lead to autistic spectrum disorder and developmental delay.

More than a year on from the release of DSM-5, a Medscape survey found that just under half of clinicians had switched to using the new manual. Most non-users cited practical reasons, typically explaining that the health care system where they work has not yet changed over to the DSM-5. Many, however, said that they had concerns about the reliability of the DSM, which at least partially accounted for their non-use. Throughout the controversies that surrounded the development and launch of the DSM-5 reliability has been a contested issue: the APA has insisted that the DSM-5 is very reliable, others have expressed doubts. Here I reconsider the issues: What is reliability? Does it matter? What did the DSM-5 field trials show?

What do you do when the media reports stories of children who have killed themselves on SSRIs? Position the stories of these children, not the drugs they were taking, as a suicide risk. Warn that more children will die if mouthy parents are allowed to speak and upstart journalists are allowed to report. And then position psychiatrists as the only people who can talk about suicide without producing an epidemic of self inflicted deaths.

On 6 January 2014, I published the article “Psychiatry Gone Astray” in a major Danish newspaper (Politiken), which started an important debate about the use and abuse of psychiatric drugs. Numerous articles followed, some written by psychiatrists who agreed with my views. For more than a month, there wasn’t a single day without discussion of these issues on radio, TV or in newspapers, and there were also debates at departments of psychiatry. People in Norway and Sweden have thanked me for having started the discussion, saying that it’s impossible to have such public debates about psychiatry in their country, and I have received hundreds of emails from patients that have confirmed with their own stories that what I wrote in my article is true.

Over the past few weeks I have been witness to, and increasingly involved in trying to stop one of the most extreme examples of psychiatric brutality I have encountered in my 40 years in this field. And I have encountered quite a few. I suggest you sit down before watching and reading. This is not your usual, run-of-the-mill psychiatric abuse story.

Would you accept money "with no strings attached" from a robber who, in the act of stealing, happened to kill some of his victims? Would you accept money that has been stolen? Would you accept sponsorships from tobacco companies for a meeting about lung diseases? Few doctors would. Why is it then that most doctors willingly accept sponsorships from drug companies that have earned much of their money illegally while being fully aware that their criminal activities have killed thousands of patients, the very people whose interests doctors are supposed to take care of?

Around the world, drug regulatory agencies spend billions of dollars engaged in activities which purport to ensure the safety, efficacy and quality of legal drugs. If the goal of regulation is to protect public health and safety, there can be no argument that it has failed. Safe drugs are not associated with annual rises in mortality and morbidity, effective drugs are not associated with increased prevalence of the conditions they are designed to treat and with greater chronicity of those conditions, quality drugs are not discovered to be contaminated with solvents months after their manufacture and release to the market. Effective regulation does not see companies repeatedly breaching standards and shrugging off sanctions.

Pharmalot has just posted a piece - 'Controversial FDA official, Tom Laughren, retires.' This is a must read for anyone with anything to do with mental health - both the post and the comments afterwards where some have posted that they still believe the Black Box warnings on antidepressants arose because of pressure from the Church of Scientology rather than in response to the data.The post will likely seem boring to many. But the comments won't - they seethe with anger.