Foreign Correspondents

Our success as a movement depends on our ability to sway the general public—and if the mainstream press and media never afford our books their due—not even the blatantly cutting edge ones (and if anything, these are treated worse) and the general public, as a consequence, remains largely unaware of their existence, the likelihood of succeeding in our primary mission(s) is substantially reduced.

One of the main arguments for continuing drug treatment for depression, psychosis and bipolar disorder is that you will get worse from stopping the drugs, especially if they are stopped abruptly. These are findings from mainstream psychiatry. However, if we combine this information with the methodology of the randomized controlled trial, we may see that these drug trials do not show efficacy of drugs, and may not be usable to show safety. The positive side to this is that the trials may actually demonstrate the healing power of our own minds.

It was May 19, 2003, in San Francisco; the first-ever (we think) symposium on micronutrient treatment to be on the schedule for the annual meeting of the American Psychiatric Association. There was moderate interest. This year, the two of us (both psychologists) presented many, many studies on the use of micronutrients to treat anxiety, stress, depressive symptoms, ADHD, aggression, mood, and addictions. The amount of data differed dramatically from 12 years ago, but the biggest difference was the response from psychiatrists!

In the 1950s, when the drugs we now call ‘antipsychotics’ first came along, psychiatrists recognised that they were toxic substances that happened to have the ability to suppress thoughts and emotions without simply putting people to sleep in the way the old sedatives did. The mental restriction the drugs produced was noted to be part of a general state of physical and mental inhibition that at extremes resembled Parkinson’s disease. Early psychiatrists didn’t doubt that this state of neurological suppression was potentially damaging to the brain.

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.

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

The simple act of defining doctors or patients concerned about adverse events as “critics” is a rhetorical stroke that marginalizes concerns – makes you a one-percenter rather than one of the ninety-nine percent. The pharmaceutical market is the least free market on earth.

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.

GSK has recently announced that it will cease paying doctors for promoting its drugs and sponsoring them to attend conferences and sever the link between pay for its sales representatives and the numbers of prescriptions physicians write. My reading of GSK’s annual report leaves me in no doubt that they are changing their business model because it is likely to increase their profitability – not because they are being forced to. There is a niche in the market for a pharmaceutical company to become the leader in ethical practice. It is not necessary for GSK to be ethical in reality but to create the perception of being so.

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.

The strongest evidence we have as to whether a drug causes a problem does not come from RCTs or any other controlled study but rather from good clinical accounts. Even if RCTs were done by angels, so there was no hiding, no miscoding, nothing untoward, RCTs can still hide adverse events. The onus is on large and powerful corporations who have a lot of resources to pinpoint the populations where the benefit is likely to exceed the risk, if they want to continue to make money out of vulnerable people.

Stephen Fry’s exploration of manic depression (in the current BBC series on mental health, ‘In the Mind‘) has drawn both praise (because of his attempts to destigmatize mental illness) and criticism (because he appears to have a very narrow biomedical understanding of mental illness).  I have sent an open letter to the actor which challenges some of his assumptions about mental illness, and offers a very different understanding to that promoted in his recent television programme.

‘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.

Right now in Britain there is a controversy shaping up between the commercial and financial interests of big managed-care corporations and the need to care for vulnerable people in the community, people with conditions like dementia and long-term psychoses. Conflicts of interest are nothing new in the contested field of mental health, but this one threatens not only quality of care, but the well-being of low paid workers, mainly women, who are employed as support workers.

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.

Julia has received a lot of media attention in the last few days as a result of her blinded RCT published in a prominent journal, the British Journal of Psychiatry, showing that micronutrients were better than placebo at improving ADHD and mood symptoms in adults. But what interests us far more is the amount of public emails we get as a result of this work. And the theme running through almost every email is that the child/adult/husband/wife has tried all kinds of medications and the symptoms are still there and, often, getting worse. Could the micronutrients help?

I had an epiphany the day I first saw my son in a coffin after his suicide. The moments following his hanging himself were...

Global leaders in the critical psychiatry movement met on 18 Sep 2015 for a one-day conference to address an urgent public health issue: the iatrogenic harm caused by the over-prescription of psychiatric medications. We were treated to an expert review of the ways in which the widespread use of harmful and barely (if at all) helpful medicines has become the mainstay of psychiatry’s contribution to society. At gatherings such as this, when people discover I am a psychiatrist I often become a lightning rod for their anger and frustration. It’s okay; it comes with the job, but a couple of things happened at Roehampton which reminded me why this can happen, and why all of this is so much more complicated than the simple black-and-white “Pharma and psychiatry bad, everyone else good.”

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.

The Scottish Anthropologist Ioan Lewis, wrote the book Ecstatic Religion in 1971, in which he suggested a ‘shaman is not less than a psychiatrist, he is more.’   He claimed psychiatry was just one of the functions of the shaman, and he invited comparison between shamans and psychiatrists.  Some diagnostic criteria for schizophrenia appeared rather similar to the desired conditions of shamans in an altered state of consciousness.  Other terms used (and misused) for therapeutic practitioners included: native or traditional healer, medicine man, witch doctor, soul doctor, sorcerer, magician, spirit medium, exorcist, curer, diviner and diagnostician.

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 almost two decades I was a victim of what I now am aware was psychiatric torture. I believe because I am a woman, it was easier to become a psychiatric victim and to be denied my right to be human. I got my first bolt of electricity just three days after childbirth on the thirtieth of January 1976. I continued to be electrocuted for the month of February until the middle of March, twelve more times while simultaneously being drugged into oblivion.

Danish psychiatry has been besieged by scandals. Or perhaps it is better to say 'exposed', as many of the scandals - like massive overmedication, deaths etc. - have been an ongoing problem for years. 2014 has started off with a bang. Two deaths due to psychiatric drugs acknowledged as being the cause of death. This is the first time this has happened.

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.

Following Richard Bentall’s inspired Open Letter to Stephen Fry, we – a group of people who have (and still do) use mental health services, who work in mental health, or who work as academics... or fall into more than one of those categories – have decided to write a parallel Open Letter to the BBC and other media organizations about their coverage of mental health issues. We need as many signatures as possible!