Foreign Correspondents

In the last few years I’ve developed a sincere admiration for those youth workers who specialise in working with young people pushed out onto the edge of society. I’ve witnessed, first hand, the ease with which they can broach topics that would leave many of us feeling uncomfortable. The best of them can speak about sex, violence, drugs and exploitation in a real and pragmatic way that signals a deep acceptance and understanding of the dilemmas young people face – with no blame or judgement. This ability to transform the taboo into the ordinary is something I’ve tried to develop in my own work. Through Voice Collective, a project supporting children and young people who hear voices in London, I specialise in training youth workers to do the one thing that can push them far outside of their comfort zone – talking with young people about hearing voices.

Being an ex-accountant I am always interested in figures (not to mention that prescribed benzodiazepine drug addiction has played such a major part in my life). According to a yearly booklet released by the Home Office in the UK, benzodiazepine drugs accounted for more deaths than ALL the so-called hard drugs put together.

Prescription drugs like antidepressants, antipsychotics and so-called ‘mood stabilisers’ are widely promoted as good for your health. But the history of prescription and recreational drug use is more intimately intertwined than most people recognise. Attempts to disentangle the two have created a false dichotomy – with prescription drugs, at least some of them, set up as the ‘angels’ that can do no wrong, and recreational drugs cast as the ‘demons’.

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.

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.

Recently, This Morning featured a story on depression, in which Dr. Chris Steele advised participants that their depression was due to a 'chemical imbalance' (despite obvious environmental explanations) and that antidepressants - possibly for life - were the solution. However both the 'chemical imbalance' notion and the medical solutions it implies, for which there has never been any evidence, are outdated and now known to be harmful. Our letter asks Dr. Steele to refrain from using information that cannot be scientifically substantiated, as doing so has serious implications for the health and well-being of the viewing audience - which may be in violation of broadcasting legislation.

In England, childhood sexual abuse (CSA) has become big news. The increasing understanding of the level of childhood sexual abuse and how this produces mental anguish has of course reached the psychosis arena, and encouraged academic study. Whilst the majority of psychiatrists continue to privilege a biological explanation of psychosis, more and more workers recognise abuse as at least a trigger if not a cause of psychosis. It's important to develop thinking points for teams struggling with, or more generally avoiding, the CSA/psychosis link.

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.

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.

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.

Dr Paul Offit, chief of the Division of Infectious Diseases and Director of the Vaccine Education Center at Children’s Hospital in Philadelphia, recently published a book called: “Killing Us Softly: The sense and nonsense of alternative medicine.” It also goes under the title: “Do You Believe in Magic?: The Sense and Nonsense of Alternative Medicine” The book presents some evidence on alternative medicines like homeopathy, Chinese herbs, chiropractic adjustments and, of greatest interest to us, the evidence for and against nutrient supplements for the treatment of illness.

People have used psychoactive substances to dull and deaden pain, misery and suffering since time immemorial, but only recently, in the last few decades, have people been persuaded that what they are doing in this situation is rightly thought of as taking a remedy for an underlying disease. The spread of the use of prescription drugs has gone hand in hand with the increasing medicalization of everyday life, and a corresponding loss of the previous relationship that people had with psychoactive substances.

On Monday night, Irish television screened a documentary covering the events leading to the self inflicted death of Shane Clancy & the other young man he killed. In the documentary, psychiatrist Professor Patricia Casey is quoted as saying that she does not believe the SSRI Shane was taking played any role in the killings and that in her opinion they were caused by an undiagnosed psychiatric illness. Professor Casey did not meet Shane when he was alive. She has never spoken to his family, does not have access to his medical records or family history and has not spoken to his doctor.

Those of us who question psychiatry’s relationship with medication may be be dismissed as ‘Pill Shamers’ or branded as irresponsible and dangerous voices by those who are convinced medication is the only way of treating someone’s ‘illness’. The debate can feel like a fight between two intractably opposed sides, giving the impression that we must either be ‘for’ or ‘against’ medication. Unfortunately the information and space needed to explore our complex relationship with medication – as practitioners and people – is in short supply, making the concept of informed choice a bad joke. Over the next two years, we will bring together a book made of contributions from people who have successfully taken control of their use of medication.

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.

In order to explore the current political context of mental health services, as I will be doing in some upcoming blogs, it is necessary to establish what the modern mental health system actually consists of and what function it serves. It is only by tracing the historical development of mental health services, and analysing how and why the system arose, that we are able to fully comprehend its actual purpose.

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.

My last blog raised issues about the involvement of Shire Pharmaceuticals in lobbying for the inclusion of mandatory screening of children for ADHD in...

A memorandum submitted on the Children And Families Bill by the UK ADHD Partnership (UKAP) recommended that regulations issued to accompany the Children and Families Bill should include a requirement that “all children who receive two fixed term exclusions from school are screened for ADHD and, if appropriate, an assessment process for ADHD initiated.” The UKAP certainly appears to be a group the UK parliament should trust and, on the face of it, there is no reason that parliament should not adopt their recommendation. Except that the UKAP appears to be a front group for pharmaceutical company Shire, who manufacture the ADHD drug marketed as Vyvanase in the US and Elvanse in the UK.

Delegates attending the International Congress of the Royal College of Psychiatrists at London’s Barbican Centre in June this year will almost certainly not hear about the results of the seven-year outcome of the Dutch First Episode (FE) study widely discussed on Mad in America in recent months.

In 2006 I undertook a neuropsychology placement during my Clinical Psychology Doctoral training course. It was in a community brain injury service. I had the fortunate experience of undertaking not only neuropsychological assessments, but also therapeutic interventions and service projects. My eyes were opened in a very positive way. Things suddenly made sense; psychology, interactions, life, all became much clearer. I now understood that we are all unique, not only because of our experiences and views on life, but because of our neurocircuitry. I began to see how our unique cognitive profiles make us who we are.

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?

The Movement for Global Mental Health's objective is to ensure that people living in low- and middle-income countries have access to the best and most effective modern psychiatric drugs and therapies. In pursuing these objectives it assumes that to do so is a neutral project beyond political concerns. China Mills’ book Decolonizing Global Mental Health challenges this view.

In 2009, my friend Leonie’s 22-year-old son Shane killed himself and another young man after taking Citalopram for 17 days. Eighteen days after Shane’s death, Psychiatrist Dr Michael Corry publicly stated his view that he could not have done what he did had he not been on Citalopram. Initially Leonie admits to thinking he was mad. How could medicine prescribed by a doctor have anything to do with what had happened to her son?

At the Nordic Cochrane Centre, we have researched antidepressants for several years and I have long wondered why leading professors of psychiatry base their practice on a number of erroneous myths. These myths are harmful to patients. Many psychiatrists are well aware that the myths do not hold and have told me so, but they don’t dare deviate from the official positions because of career concerns. Being a specialist in internal medicince, I don’t risk ruining my career by incurring the professors’ wrath and I shall try here to come to the rescue of the many conscientious but oppressed psychiatrists and patients by listing the worst myths and explain why they are harmful.