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We are an unlikely duo, sharing secrets only known to insiders, the inmates and staff of Bader 5, Boston Children's Hospital's adolescent psychiatric unit. I am the nurse who blew the whistle that no one heard in 2010, she is the teenager who was imprisoned on Bader 5 for nine months in 2013. We met for the first time on this past Thanksgiving Day at Yale New Haven Children's Hospital, where she has been a *medical* patient for the past nine weeks.

With a diagnosis of schizophrenia, if internalized, comes the erosion of personhood, lowered self-esteem, shattered dreams, and a sense of disenchantment. The psychiatrist Richard Warner has even suggested that those who reject the diagnosis of severe mental illness may have better outcomes as they retain the right to construct their own narrative of personhood and define what really matters for them. Despite public education campaigns (or perhaps because of them), the stigma of mental illness is as enduring as it was 50 years ago.

I’ve been arguing against calling this movement that I’m a part of a ‘peer’ movement for a long time. What has happened with Michael Brown in Ferguson, Missouri has helped me to crystallize that point. If we do not see what happens to some of us in the psychiatric system as connected to what happens to others because they are black or because they are transgender or because they love someone else of the same expressed gender (or because they live in poverty, etc. etc.), then I’m not sure any of us really, fully understands what it is we are trying to accomplish at all.

As awareness spreads about there being something wrong with existing approaches to “psychosis” aka “madness.” Interest grows in exploring what to do instead. One meeting place for exploring this question of “what to do” will be the ISPS conference in NYC in March 2015, which is titled “An International Dialogue on Relationship and Experience in Psychosis.” This conference promises to stand out in terms of the variety of voices,  perspectives, approaches and traditions that it will bring together to focus on the deeper issue of how helpers can best understand and interact with those experiencing what is called psychosis.

Some readers of Mad in America may be aware that Scientific American published a short blog by me on 17^th November 2014 - Why We Need to Abandon the Disease-Model of Mental Health Care. This blog was rather wonderfully (and slightly embarrassingly) described by Phil Hickey on his website, Behaviorism and Mental Health, as “an important milestone.” My blog attempts to summarise many of the key points of a perspective widely shared on Mad in America: 

Evidence based care is supposed to drive up standards, ensure uniformity, establish best practice, guide clinicians and protect patients. This should be celebrated. Instead, evidence-based mental health is openly disparaged, and when psychiatrists don’t get the results they want, they ignore them, suppress them, or denounce them. These attitudes have repercussions on the training of psychiatrists.

Psychiatry clings to the broken brain theory, because without it, there is no justification for the employment of medical techniques in this area. Without the broken brain theory, psychiatrists are unnecessary, and even counterproductive. In their hearts, all psychiatrists know this, which is why they never address the fundamental question: why should all significant problems of thinking, feeling, and/or behaving be considered illnesses?

On November 16, 1989 in El Salvador, liberation psychologist Ignacio Martin-Baró was murdered by a Salvadoran government’s “counter-insurgency unit” created at the U.S. Army’s School of the Americas. This year, 25 years after his assassination, peace and justice activists around the world will honor Martin-Baró. Embarrassingly, the vast majority of U.S. psychologists and psychiatrists know nothing about Martin-Baró and liberation psychology. Why would mainstream mental health institutions keep U.S. psychologists and psychiatrists and the general public ignorant of the life and work of Martin-Baró?

The idea of schizophrenogenic or refrigerators mothers was an embarrassing era for psychiatry, and so psychiatrists were only too happy to explore the brain and the genome to unlock the secrets of mental illness. Today, the rhetoric has shifted away from intrapsychical conflicts and traumatic ruptures, and instead aberrant neurochemistry or delinquent genes are held as the source of mental illness. Regardless, the message is clear: mental illness is beyond our control and requires psychiatric intervention. The moral authority the mental health industry claims over our mental life rests on this claim.

I’ve heard countless horrific stories of abuse, neglect, trauma and most every form of torment that one human can inflict upon another. The sting of such stories never lessens. I’ve often marveled at the mind’s capacity to focus a sustained attention upon ever new ways to perpetuate and promote anguish. Sophia’s story, presented here, is tragically similar in regards to the abuse she suffered.

Is it possible to create a “Rainbow Coalition” with a common agenda of (1) reforming prisons, (2) providing affordable housing, (3) limiting the use of psychotropic medications, and (4) providing community-based mental health and psychosocial support? Prominent psychiatrist Allen Frances asked us at the Mad in America Film Festival to join such a coalition. Rather than rejecting Frances’ agenda outright — as I appeared to do in a recent Mad in America blog — we should give his proposal a fair hearing. As always, the devil is in the detail.

In my last two posts, Back in the Dark House Again: The Recurrent Nature of Clinical Depression and Am I Having a Breakdown or Breakthrough? Further Reflections on a Depressive Relapse, I have shared my recent relapse into depression. Although it has been tough, when I wake up each morning I am grateful for one thing — I am not suicidal. Others are not as fortunate.

How many times have you watched a news story or read a headline where a journalist or expert commentator making a statement or writing about an issue related to mental health uses the term “the mentally ill?” What image or thoughts does that bring to mind? For me, it evokes feelings of disgust and frustration over the ignorance associated with using this term as a blanketed reference to all persons who have been diagnosed or labeled with a mental health condition. Many who do not support the medical model of treatment for mental health problems believe mental illness does not exist all together.

We have silenced voices that need to speak. An epidemic of pill-pushing over the past 40 years has not repaired us, brought us closer together or happier and it certainly hasn’t cured us of any mass delusions. In fact it’s given us all new delusions to contend with, ones that are easy to spot if our minds and hearts are set on progress.

In a recent Huffington Post blog — republished at Mad In America — prominent psychiatrist Allen Frances declared: “Psychiatric coercion has become largely a paper tiger: rare, short-term, and usually a well-meaning attempt to help the person avoid the real modern-day coercive threat of imprisonment.” With Representative Tim Murphy’s bill — advocating for court-ordered “outpatient” psychiatric compliance — locked in committee, it is tempting to believe that Frances might be right. Does Murphy’s bill look scary to us, but actually lack any real teeth?

I think a better term to use is "medical harm aware advocate." It is a much better explanation of both the problem and the solution that we are working for. I've updated my graphic that explains why Allen Frances and mainstream mental health is using the word "anti-psychiatry" to avoid dialogue with our community.

Our main reason for beginning an awareness month is the need for recognition-- a yearning to make the word “iatrogenic” and its corresponding language available to our community, and to the greater public as a household name. We don’t have the luxury of raising money for research, racing for the cure, or ribbons. For that we would have to be on the map. Why is it that something this pervasive gets so little traction?

There is mounting evidence that benzodiazepines are causing Alzheimer's Disease. I cannot imagine any genuine medical specialty ignoring or downplaying information of this sort. But psychiatry, with the perennial defensiveness of those with something to hide, promotes the idea that they are safe when used for short periods, knowing full well that a huge percentage of users become "hooked" after a week or two, and stay on the drugs indefinitely.

Editor's Note: At the Mad in America film festival, Allen Frances, M.D., who was the chairman of the DSM IV task force, participated on a panel of psychiatrists who were asked to respond to the themes explored at the festival and to offer their own critiques of psychiatry. After the festival, he wrote a blog for the Huffington Post, which was partially inspired by his participation at the festival, and he then offered to re-publish it on MIA. It appears below. Also at the festival, Justin Brown sought to hand out a leaflet criticizing Dr. Frances’ writings, as well as his critique of those who criticize psychiatry. We asked him to submit a post for MIA instead, which is published below.

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.

Allen Frances was the chairperson of the DSM-IV Task Force, a former chair of the Department of Psychiatry and Behavioral Science at Duke University...

In the early hours of September 19 – about 3 AM, someone estimated – Gloria X. was awoken from her sleep at Trenton Psychiatric Hospital, the New Jersey State hospital. Her new (about 3 weeks) roommate, Florence, whom she had trusted, was on top of her punching her in the eyes. Florence pounded her eyes over and over and over – taking out 50 years of rage on Gloria. Why Gloria? No one knows. Or those who know ain’t talking.

If a person in mid-life is feeling anxious, or depressed, or can't sleep? No problem. No need to figure out the source of these concerns. No need to work towards solutions in the old time-honored way of our ancestors. Today, psychiatrists have pills. Pop a benzo! And by the way, you'll have a 40% increased risk of Alzheimer's Disease in your late sixties.

Before entering the field of psychology in the 1970s, I worked as a psychiatric nurse, gravitating to the community mental health movement, and then to anti-psychiatry politics. As a nurse at a psychiatric hospital in Santa Monica, also involved in union organizing and direct action politics with a feminist health collective, I was drawn to the radical wing of community mental health. Decades later, in producing a documentary film on the stories of people who entered the state psychiatric hospital in Oregon under the insanity plea, I had the chance to look back on that era through the lens of a fiction film that had made this hospital so famous.

I was honored to both attend and participate in the recent Mad In America Film Festival. I was asked to join a panel of psychiatrists who were asked to respond to the themes and questions explored in the festival. What follows are a lightly edited version of my remarks.