Advance Directives & Substitutes

It is time to create an entirely voluntary psychiatric system. International conscience is clear. The singling out of people with psychosocial disabilities is not worthy of a free society. There are better, safer ways to address legitimate public needs.

Dr. Dainius Pūras argues that the status quo in mental health treatment is no longer acceptable and demands political action to promote human rights.

Researchers examine psychiatrist-client interactions and find that clients are often left with few opportunities to make explicit requests to change their medication regimen.

Legislation is being advanced that would speed up the FDA’s approval process for new drugs and medical devices, according to a report by the Pacific Standard. Pharmaceutical and medical device companies have been lobbying heavily to reduce regulations and are winning over bipartisan support by attaching these measures to increased mental health funding.

“The pharma industry loses tens of billions in worldwide sales each year when patients don’t fill, or refill, their prescriptions,” Rebecca Robbins reports for STAT. So...

David Shern, from Johns Hopkins University, writes that the latest mental health “Murphy bill” in Congress is “an expansion of the approaches that got us into our current difficulties.” “Early intervention and prevention, assessable and patient-focused services with a rehabilitation orientation and increased funding for the community supports needed for successful recovery are the tickets to system improvement.”

In 2004, the FDA added a black-box warning to SSRI antidepressants on the increased risk of suicide among children taking these drugs. A new study suggests that this warning has increased the proportion of children who begin an antidepressant on a low dose, but the majority are still receiving higher than recommended doses.

Concerns have been raised about inconsistent and unreliable results, which may lead to injustices in sentencing or even wrongful convictions.

In this piece for STAT, Jennifer Adaeze Okwerekwu describes the value of psychiatric advance directives for those at risk of experiencing an emotional crisis. "'It’s something that can...

...but how realistic is it to expect that the biological skew of Western psychiatry can be sustainably changed one small step at a time?

At a recent conference on legal capacity, I was struck by the failure of another invited expert to adhere to the paradigm of supported decision-making as articulated by the CRPD Committee. We still need to work to ensure that this paradigm is well understood and appreciated, despite the progress made in national reforms.

Dennis Embry, a clinical psychologist and government consultant on mental health, shares a letter he sent to congressman Murphy warning him about how he may have been misled concerning his mental health bill. “I am specifically writing you about erroneous, false information you’ve been given about the National Registry of Evidence Base Programs and Practices. That erroneous information is likely to cause serious problems, which have been withheld from you.”

Two recent court rulings argue that pharmaceutical companies have a first amendment right to market drugs “off-label” with a lack of scientific evidence, threatening...

The report has succeeded in being supremely ambitious in its breadth, whilst remaining disappointingly cautious in its goals. The emphasis is on smaller changes in the immediate future, and kicking more progressive reform into the long grass. It alludes to but does not enshrine a rights-based approach.

A discussion of the role of epistemic injustice in the experiences of patients diagnosed with psychiatric disorders.

"HHS said it took pains to avoid any change to gun check reporting that would weaken physician–patient confidentiality and deter individuals from voluntarily seeking...

In an effort to reduce coercion, researchers isolate associated factors including age, relationship status, location, and diagnosis.

“We are concerned about the implications of this rule,” said Jennifer Mathis, a lawyer at the Bazelon Center for Mental Health Law, an advocacy group for patients. “It points a finger inappropriately at people with mental illness as a source of gun violence. It’s a bad precedent to start creating exceptions to the privacy law for people with mental illness, who are responsible for about 4 percent of incidents of gun violence.”

On Friday, Psych Rights won a legal fight in Alaska Supreme Court reversing an order for an involuntary psychiatric evaluation. Opinion →

Researchers believe that side-effect monitoring is critical because of the increase in the use of antipsychotics

Martha Rosenberg highlights how the popular antipsychotic Seroquel is a perfect example of how direct-to-consumer advertising made billion dollar blockbuster drugs possible before side-effects...

With the explosion of genetic testing and the emerging field of pharmacogenetics, patients can now take a DNA test and receive psychiatric drug recommendations customized to fit their genetic makeup. In an editorial for the latest issue of the Journal of Nervous and Mental Disease, Columbia University Psychiatrist Robert Klitzman warns that clinicians need to be aware of the limitations of these genetic tests being marketed to them.

Most Americans would agree that we have problem with mental health in this country, but what many do not know when they consider that people who are in distress are not getting the help they need is that hospitals in this country are not giving people a choice when they are in the most need. This is based on laws that currently exist in 45 US States, which allow individuals to be petitioned into an inpatient psychiatric unit against their will if they are deemed to be a “danger to themselves or others.” I have worked for 3.5 years as a Peer Support Specialist within my local public mental health system, where I see this happen to the individuals I serve, on a regular basis. I myself have been forced.

Various instruments of the United Nations have commented on forced treatment, or involuntary confinement, or both (for details, see Burstow, 2015a), and a number of truly critical additions to international law have materialized. Arguably, the most significant of these is the Convention on the Rights of Persons with Disabilities. What makes it so significant? For one thing, it is because this landmark convention puts forward nothing less than a total ban on both involuntary treatment and the involuntary confinement of people who have broken no laws.

Oryx Cohen at TruthOut explains why the "Helping Families in Mental Health Crisis Act (HR 2646) - commonly known as the 'Murphy Bill' - appears to cater more closely to the desires of pharmaceutical companies than to the actual needs of people in psychological distress, perhaps because of Murphy's connections to key lobbyists." "If the Murphy Bill is passed, psychiatric hospitals and pharmaceutical companies will reap huge financial benefits as a result of increased hospitalization and forced treatment."