Foreign Correspondents

In August 2010, my friend and fellow ‘suicide mum’ Deb Williams and I established CASPER – Community Action on Suicide Prevention Education & Research. CASPER’s goals are to provide peer support to families bereaved by suicide, to educate politicians and opinion leaders on suicide and its prevention and to support families and communities to reclaim suicide prevention from medical professionals and governments.

The DSM claims to be a scientific system of classification. The validity of any system of scientific classification is the extent to which it can be shown to reflect the real world. Fifty years of study and investigation, and huge sums of money spent across the Western world on neuroscientific research institutes, on careers and equipment, has failed to establish the validity of a single psychiatric diagnosis.

One of the things debated and discussed in blogs such as this, and in a lot of other places, is the nature of “mental...

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.

Twenty-five years before Prozac, 1 in 10,000 of us per year was admitted for severe depressive disorder - melancholia. Today at any one point in time 1 in 10 of us are supposedly depressed and between 1 in 2 and 1 in 5 of us will be depressed over a lifetime. Around 1 in 10 pregnant women are on an antidepressant.

"The Antidepressant Era" was written in 1995, and first published in 1997. A paperback came out in 1999. It was close to universally welcomed. It was favorably received by reviewers from the pharmaceutical industry, perhaps because it made clear that this branch of medical history had not been shaped by great men or great institutions but that other players, company people, had been at least as important.

Why do stories matter? Why is it that what a psychiatrist says to a patient about their experiences can have such a powerful effect - for good or for ill? This is something that has puzzled me for many years. It still does.

The New Zealand government has just published research showing the numbers of children aged 2-14 years being diagnosed with mental disorders has doubled in the last five years with the key driver being an increase in anxiety disorders.

The American Association of Suicidology (AAS) has created a blog for suicide attempt survivors. By seeking out and actually welcoming the survivor voice, for the first time anywhere in the world by a mainstream suicide organisation, this represents a global breakthrough in the field.

There was a heart-breaking and disturbing story in yesterday’s Guardian newspaper entitled, My Daughter, the Schizophrenic’, which featured edited extracts from a book written by the father of a child called Jani. He describes how Jani is admitted into a psychiatric hospital when she is 5, diagnosed with schizophrenia when she is 6 and by the time she is 7, she has been put on a potent cocktail of psychotropic medications.

Over the last twenty years there has emerged a body of work that questions the assumptions that lie beneath psychiatric knowledge and practice. This work, appearing as academic papers, magazine articles, books, and chapters in books, hasn’t been written by academics, sociologists or cultural theorists. It has emerged from the pens and practice of a group of British psychiatrists.

In my last post, I argued that the single most damaging effect of psychiatric diagnosis is loss of meaning. By ruthlessly divesting experiences of their personal, social and cultural significance, diagnosis turns ‘people with problems’ into ‘patients with illnesses.’ Horrifying stories of trauma, abuse, discrimination and deprivation are sealed off behind a pseudo-medical label as the individual is launched on what is often a lifelong journey of disability, exclusion and despair.

We have just celebrated the anniversary of the rapidly expanding global Hearing Voices Movement which was founded more than twenty-five years ago following the ground-breaking research of Professor Marius Romme and Dr Sandra Escher. Romme and Escher have advocated for a radical shift in the way we understand the phenomenon of Hearing Voices; in contrast to traditional, biomedical psychiatry which views voices as an aberrant by-product of genetic, brain and cognitive faults, their research has firmly established that voices make sense when taking into account the traumatic circumstances that frequently provoke them.

by Eugene Epstein, Manfred Wiesner, and Lothar Duda Over the past 50 years, the psychiatric and psychotherapeutic discourses of the western first world have infiltrated...

I want to follow up my first post by outlining the principles of possible alternatives to psychiatric diagnosis – that is, alternatives in addition to the most obvious one, which is simply to stop diagnosing people.

There used to be a wonderful cartoon series called 101 Uses for a Dead Cat, which led me 25 years ago to give a talk at a British Association for Psychopharmacology meeting entitled 101 Uses for a Dead Psychiatrist. That was back in the days when Psychopharmacology meetings were places of debate and the British Journal of Psychiatry was guaranteed to have something of real interest in every issue.

‘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.

Suicide needs to come 'out of the closet' as a public health issue. But this in turn requires a broad, ongoing community conversation rather than the current status quo of 'experts' talking about us without us. We also need to move beyond the excessive medicalisation of suicide that blames it on some notional 'mental illness'. This is my first post where I introduce myself, telling you a little of how I came to do a PhD in Suicidology. And an invitation to join me in a radically different conversation about suicide, here at Mad in America.

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.

A couple of days ago, after two years of fighting, I received Mylan Pharmaceuticals assessment of the causal link between their drug Fluox and my son's suicide. Their conclusion is identical to that of the New Zealand drug regulator Medsafe, that the SSRI antidepressant Fluoxetine is the probable cause of Toran's death. The rating of 'probable' includes an assessment that Toran's suicide was 'unlikely to be attributed to disease or other drugs.'

This shorter-than-usual contribution signifies a departure from my earlier blogs. It is the first in an occasional series that uses semi-fictional clinical narratives to examine some of the difficulties that face people who use psychiatric services in England, and the psychiatrists and other mental health professionals who work in them.

Today I paid a visit to the Managing Director of Mylan Pharmaceuticals, Lloyd Price. Mylan is the company that manufactured the antidepressant Fluox1 which, according to the NZ government, is the most likely cause of my son's suicide. My dealings with Mylan in the time since Toran died have not been entirely fruitful.

Recently, two more waves of criticism have broken onto the beach of opinion concerning mental health services and practice. Allen Frances has mourned approval of DSM-5 in his Psychology Today blog and the British Journal of Psychiatry has published a paper by members of the UK Critical Psychiatry Network. What is notable about both of these is that they give further voice to criticism of conventional mental health services by those who have spent years providing and researching them.

What if your doctor told you about data collected on antidepressants AFTER they had been released on the market. New Zealand data that shows aggression and death are as common as dizziness in reports from doctors about adverse reactions to antidepressants. That suicidal ideation and suicide attempt are as common as insomnia. Imagine you were told that while being exposed to these risks, the data showed that the most likely adverse reaction you would experience would be that the drug didn't work or stopped working. How might your decision on this particular treatment option be affected?

In June last year, three months into a prescription for anti-depressant drug Efexor, former financial analyst Tim Hillier left his hotel to wander the empty streets of Alice Springs in an attempt to clear his head. An hour earlier, he had wagered $80,000 -- almost the entirety of his life-savings -- on a first-round Wimbledon tennis match featuring Aussie hope Sam Stosur.