Foreign Correspondents

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.

Cultural psychiatry provides a robust critique of a biologically orientated psychiatry. All cultures divide the world up into normal and abnormal; all have some notion of madness, but the idioms used to describe these states and the causes behind them can only ever be understood in the full context of the culture where they take place. It suggests that the very categories which are assumed to be natural occurring forms, are in fact just social and cultural constructions.

The story starts on 19^th of March, 1986, when I withdrew myself from 30 mgs of Ativan daily and 360 mgs of Opiate painkillers daily—all doctor-prescribed—with no support or assistance, other than the love and full support of my lovely wife Sue. It took me 15 months of hell on earth to withdraw.  So afterwards I researched the issues involved (after my brain had started to function again) and started on the long road of campaigning for dedicated withdrawal services by contacting our local newspaper and telling them my story. Horrifying as the facts read, not only was it a release for me to express my emotions and observations, but it slowly informed the general public of the dangers of long-term prescribed addiction.

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.

Before the early 1990’s the use of antipsychotic medications was largely reserved for adults with severe psychotic disorders; unpleasant involuntary movement disorders (extrapyramidal side-effects) and cardiovascular risks appear to have largely limited their use outside these disorders. The introduction and intense marketing of what seemed to be better tolerated and safer (now proven not to be), second generation atypical antipsychotics (AAPs) such as risperidone, olanzapine, quetiapine, ziprasidone and aripiprazole from the mid 1990’s led to a rapid expansion of antipsychotic medication use for a wide variety of unlicensed conditions and in more diverse clinical populations.

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.

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.

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.

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.”

In a recent blog, we talked about the fact that nutrition and poverty are linked, and how poor nutrition is likely a mediator variable in the relationship between poverty and illness. In other words, it is the suboptimal nutrition associated with low income which likely explains much of the vulnerability to mental and physical illness. Today we want to tell you about an amazing American program that is making great strides in addressing this issue.

Do you still need your psychiatric diagnosis? The answer for practical purposes is probably ‘Yes.’ In the current system, diagnosis is essential for accessing services and benefits and, particularly in the USA, for covering your treatment costs. But do you need to believe in your diagnosis? Do you have to accept this particular attempt to explain your difficulties, and to take it on as part of your identity by becoming one of the ‘mentally ill’? since psychiatric diagnoses have been admitted to be non-valid even by the people who drew them up, professionals should not be offering people the ‘choice’ of describing their difficulties in diagnostic terms in the first place. That would still leave people with the right to adopt whatever explanation suits them as private individuals.

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.

In Medicine there’s a saying “if you hear hoofbeats, don’t look for zebras.” It’s a reference to the wisdom of looking for the most likely explanations when making a diagnosis rather than looking for those that are rare and unusual. Hoofbeats are of course more likely to be the common horse than the rare zebra. My encounters with New Zealand’s pharmacovigilance system over the past four years have been akin to a safari, where I have witnessed scientists involved in pharmacovigilance and medicines regulators wildly hunting zebras while a rather large and obvious horse was standing on their toes.

The idea of spending more time as a bureaucrat in the US Embassy in Iceland did not appeal to me. I longed for the freedom that academics have. While pursuing that dream I stumbled into the world of international media, “chemical imbalance”, book publishing and a greedy professor of psychiatry which was a prelude to my second annus horribilis.

I really valued the massive Melbourne Hearing Voices conference last week. The theme of reconciliation between voice hearers and mental health workers was a powerful one. This emphasis on creating understanding conversations at the conference was encouraged with dialogues between people on specific subjects - medication, spirituality, psychological approaches to voices etc. - rather than keynotes. It seemed a move away from presentations of competing knowledges, toward a more dialogical conference; a respectful exchange of different viewpoints, feelings and values. When you have a range of views in a presentation it’s less easy to adopt a “good guys vs. bad guys” mentality; you start to see the complexities in more relief. The surprise for me was that I liked it.

John Foppes had been born with no arms, among a number of other serious congenital abnormalities.  Doctors questioned whether he would survive at all.  In his deeply motivating book, “What’s Your Excuse?  Making the Most Out of What You Have,” John describes his life of growing up with no arms into one of full independence, and his feelings of stigmatization and isolation even in the midst of support from others.  In the depths of his struggle, John also notes evident gratitude in what most perceived as a very unfair situation. 

One of the most remarkable aspects of Robert Whitaker’s (2010) outstanding book Anatomy of an Epidemic was his comparative data that contrasted outcomes for mental disorders prior to the introduction of pharmacological treatments with outcomes for mental disorders after pharmacological treatments became the main, and often only, course of action. I have asked people in workshops to estimate who might be better off – someone diagnosed with what we now call bipolar disorder prior to the introduction of lithium or someone diagnosed after lithium became a standard treatment. Almost without exception workshoppers estimate that the people diagnosed before lithium was available do much worse. Whitaker’s data indicate exactly the opposite. It’s a staggering finding.

Since the invention of the printing press, community-controlled publications have enabled the voices of those with little power in society to be heard. Gandhi said that without a journal, a community could not be united. Asylum magazine is a printed magazine, in existence since 1986, which provides a place where alternative voices in mental health can be heard.

GSK's continued failure to provide true transparency flies in the face of what the overwhelming majority of people signing consent forms probably intend - which is to make their data available for scrutiny by independent experts. If those who participate in trials thought some remote risk of a breach of privacy were being used to prevent disclosure of details that would save someone else's life - but threaten GSK's profits - most of us would likely be horrified.

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.

On 25 October 2013, the World Health Organization issued a press release promoting guidelines produced by the Patient-Reported Outcomes Safety Event Reporting (PROSPER) Consortium. The consortium aimed to “to improve [drug] safety reporting by better incorporating the perspective of the patient” with the aim of the guidance produced “to ensure that the patient ‘voice’ and perspective feed appropriately into collection of safety data.” Rather than 'quietly protecting the health of every person on this planet, every day' it seems clear that WHO is quietly protecting the interests of pharmaceutical companies and their advisors on planet 'profit from patients', every day.

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.

The World Health Organisation was established in 1945 to provide leadership on global health matters. According to its Director General Dr Margaret Chan, it...

In 2007 I returned to school to pursue a bachelor’s degree in psychology. I remember being confused by the over-emphasis on biological treatments for suffering which seemed to me much more spiritual and relational in nature. A few years earlier, my misgivings had been stirred as I sat on a California beach listening to a friend tell me about what it was like to be on Prozac. She told me that she couldn’t really cry anymore, or connect to her deeper feelings. She couldn’t orgasm. I recall my throat closing up, my thoughts running panicky and confused. I was so disturbed by the power of this drug to rob her of her tears and climaxes, experiences I associated with the more private, sacred parts of being human.

In 1995 I had a very frightening experience that I have never discussed publicly before. At that time the main symptoms I was experiencing...