Mental Health: A Profession in Need of Objectivity 2019 ISEPP

20 for 2020 is a newsletter sent to 20 people in preparation for the U.S. Presidential election of 2020. This is the sixth newsletter and its subject is mental health care in the U.S. how it is failing and the need for change. Nov 2020

According to the National Institute for Mental Health, mental illness accounts for more disability hours than any other cause and over 41,000 people commit suicide each year, more than double the rate of homicide and aids combined. In additional, conservative estimates put the direct and indirect cost of mental illness at over $300 billion annually, placing it third in cost behind heart conditions and trauma injury. The ISEPP International Society for Ethical Psychology and Psychiatry 22ndAnnual Conference: Do No Harm? How the Ethics of Psychology and Psychiatry Have Become Unethical, Oct. 11-13 2019 Baltimore MD, suggests that there are major problems with many if not most of the approaches to treating mental illness in the United States. Here is a summary of my experience at the conference:

“What happened to you vs What’s wrong with you” How we approach a situation makes a difference.

I arrived at the conference early and had Friday free. I decided to attend Mass at The Baltimore Basilica, America’s First Cathedral which is also a tourist attraction complete with a guard. 

I arrived at the Cathedral early so as to have time to pray. While I was praying a man who was obviously deranged and in distress entered the Cathedral and started to walk around. He went behind the altar and looked at a painting. As it was nearing time for Mass, the female guard approached him and said something to him. This upset him and he swore at her and made a scene. She remained calm and did not reply. He then moved around the Cathedral making noises. The priest entered the Cathedral and was walking up the center aisle toward the back to get changed. The man came up behind him. The guard called out “Father he is behind you.” The Priest then stopped and the man came beside him. The man put out his hands and the priest put out his hands and the priest prayed for about two minutes. The man’s disposition totally changed. He calmly said “Thank you Father” and quietly left the premises.

What a poignant way to start the conference I thought as I gave a prayer of thanksgiving. No escalation just meeting the person’s needs. Caring. Praying. Staying calm. Respecting them as a person. 

I will now briefly summarize the presentations given that evening and the next day at the conference.

At the welcome reception, Dr. Gail Tasch, MD a Mayo Clinic trained psychiatrist gave a talk and explained that she works in a hospital psych ward in WI with adolescents and that she has decided to work to take her patients off psychiatric medication. Dr. Tasch explained that she has seen that many of these children left on medication end up going on assistance and living in group homes once they turn 18 and that there is very little future for them. Her experience has taught her that the diagnoses given can be inappropriate and even harmful to the children and that in most cases the children are suffering trauma or undo stress from very difficult life conditions and that the medications do not address these problems. Dr. Tasch went on to explain that the medications are poorly researched, have little efficacy and that when multiple drugs are prescribed, it is off label, experimental and there is no research for that treatment. Dr. Tasch was congratulated as it was announced that she is now a Board member of ISEPP.

The kick off presentation on Saturday, “Psychiatric Diagnosis is THE Fundamental Problem Plaguing the Mental Health System was given by Paula Caplan, PhD a psychologist and researcher who served on and resigned from the committee that wrote the DSM 4. Diagnostic and Statistical Manual 4. The DSM is the “Bible” from which diagnoses are given based on the patient having a percentage of the symptoms listed for the various disorders. There is a Practice Guide that accompanies the DSM that tells how you treat the diagnosis. The diagnoses are used to affirm that the patient is suffering and to provide an access for services- so insurance can code and pay. The DSM is not scientific, it provides a list of vague symptoms and if the patient has two of the six symptoms for example they are given the diagnosis. There is subjective bias throughout and a cajoling to big pharma. Paula resigned from serving on the committee when she became aware of this. Dr. Alan Frances, who served as chair for the DSM 4 went on to consult for Johnson and Johnson and wrote the marketing plan for the drug Risperdal, arranging for journal articles to be written about it as a break through treatment. An $8 billion verdict earlier in the week had just been given against J & J for its knowing and suppressing that the drug causes some adolescent males to grow female breast tissue. Paula encourages a congressional investigation into the use of the DSM. I agree.

Stephen A Sheller, the attorney for the Risperdal lawsuit was the next speaker with “Big Pharma Big Greed”. He explained that the plaintiff Johnson & Johnson knew that prolactin increased the risk of male breasts and that in males with an elevated level of prolactin the drug Risperdal was known to cause the growing of female breast tissues. There is a relatively inexpensive blood test that can detect a person’s prolactin level and determine that this could likely happen. J& J however chose to produce articles that concluded (falsely) that there was no correlation between Risperdal and prolactin and went on to write articles to make the drug very popular. Sheller concluded that this is truly a battle against Evil. Sheller went on to explain that in New Jersey there are laws protecting drug companies from being sued for punitive damages and that this $8 billion dollar verdict was to send a message that this rogue company did something very bad. Sheller concludes by sharing other rogue marketing practices for Prozac and Seroquel and stating that the FDA is not protecting the public from these known to be dangerous drugs. Sheller believes that a lot can be done with honesty and integrity and that these drugs and all their political protection wear out the best of attorneys and put the public in harms way. People shouldn’t be given drugs that harm them.

Patrick Hahn, PhD gave a presentation on “Is Mental Illness in Our Genes” Patrick reviewed the history of psychiatric genetics beginning in the early 1900s and continued to present day, considering family studies, twin studies, and adoption studies. He concludes that none of these studies has shown a strong genetic component to schizophrenia or other so called mental illnesses and that most of these studies are flawed in many serious ways, ignoring the role of trauma and environment and not having diagnoses that lack are reliable and valid and in many cases may just be incorrect. Hahn also looks at DNA and explains that the scanned DNA of over 36,000 subjects and 113, 000 controls located 108 loci associated with schizophrenia yielding odds of 1.2 percent or less, which is about equal to its presumed prevalence in the general population.  Hahn concludes that the profit motive of the drug companies and experts to develop theories in many cases cannibalize what is really going on. If a child is being abused, do we stop the abuse/trauma or give a blood test or prescription. The most important thing about the brain is its neuroplasticity and that having good friends as a child helps in the resiliency to trauma.

Irving Kirsch, PhD presented "The Antidepressant Data are Clear: The Spin Remain” within which he summarizes is 2008 antidepressant meta-analysis that concludes that all subsequent studies including a comprehensive analysis conducted with the FDA have produced virtually identical results that anti-depressant- placebo differences are clinically meaningless. Recent data also show an increased risk of suicidal behavior caused by anti-depressants and that this risk is not just confined to young people. Kirsch concludes that antidepressants should not be prescribed to anyone who has not already taken them. Kirsch also cited that 27% of those on antidepressants say they are addicted. The drugs create a vulnerability to depression and that people on medication always crash. There is now an FDA approved placebo pill that is given to people for some medical ailments and they are told they are given a placebo yet they see improvement in their condition.

Tonier Cain-Muldrow was the final speaker of the day she is a trauma survivor. She was raised by an alcoholic single mother and suffered severe neglect yet coped by taking care of her younger siblings. Tonier took steps to avoid being molested by the men her mother had to the apartment but she was not always successful.  Social services later intervened and separated her from her family. She ended up becoming addicted to crack cocaine and prostituted herself. She had a long rap sheet. She was given multiple psychiatric diagnoses. She gave birth to a still born child in prison. Later when pregnant again she was made aware of a program where she could keep her baby. She prayed to God for acceptance into the program and was admitted. The counselor asked her what happened to her and she shared her life story and experienced healing and no longer craved alcohol or crack. She was taught life skills and how to bond with her child. She is now an author and owns multiple businesses and consultants on how to deal with trauma. She says you need to ask “what happened to you”, not “what is wrong with you” and that if you don’t believe people can be transformed the way she has been, you should not be in the mental health business. Tonier says you have to have hope. I agree. Very often it is trauma or distress that is the culprit, not an organic brain disease or something biochemical, and in order for healing to take place, people need to be listened to and the underlying causes need to be addressed. These issues must be faced with truth, compassion, science, hope and prayer.