Needed Reforms in Mental Health
Bartlett Club January 6, 2011
James B. (Jim) Gottstein, Esq. Law Project for Psychiatric Rights [email protected] http://PsychRights.org/ 1
1 Psychiatric Drugs Causing The Paradoxes . . . Massive Harm with Little Benefit
The Drugs Alleviate Symptoms in the 6-fold Increase in Mental Short Term, but Make Things Illness Disability Rate Dramatically Worse in the Long-Run Neuroleptics Cut the Recovery Rate At Least in (for most) . Half Service Eligibility Requires People to Prospects for Drugged be Permanently Disabled and Poor Children Dismal Neuroleptics Double Mortality in Elderly Life Spans Now 25 Years Shorter 2 3
Neuroleptics Misbranded as “Antipsychotics” Abilify, Seroquel, Risperdal, Zyprexa, Thorazine, Haldol
Ineffective and/or Intolerable for 75% Very Disabling for Many Developpped for Schizophrenia Used Way Beyond Now Chemical Lobotomy Dramatically Reduce Recovery Rates Dramatically Diminish Quality of Life (for most)
Courtesy of Robert Whitaker, author of Anatomy 4 5 of an Epidemic and Mad in America
Antidepressants Celexa, Effexor, Lexapro, Luvox, Paxil, Prozac, Wellbutrin, Zoloft
Increase Suicidality & Violence Addictive Lose “effectiveness” over time Effectiveness Questionable Cause Mania Bipolar Diagnoses Drug Cocktails
Courtesy of Robert Whitaker, author of Anatomy 6 of an Epidemic and Mad in America 7
1 Benzodiazepines (“Benzos”) Stimulants Ativan, Klonopin, Restoril, Xanax, Valium Adderall, Concerta, Dexedrine, Focalin, Ritalin, Strattera, Vyvanse
No convincing evidence Aggression Effective for only a few weeks of short or long term Insomnia improvement in Highly Addictive cognitive ability or Depression, suicide academic performance Headaches Some Peopppyle Simply Can Not Get Off Mania, psychosis , Stomach aches Them hallucinations Obsessive Compulsive Brain Damage Behaviors Can cause mania Cardiovascular Harm, Quadruples Cocaine including cardiac arrest Abuse Rate Can cause violence Stunts Growth Many more Agitation
Source: Brain Disabling Treatments in Psychiatry, Breggin, Springer, 2008 8 9
Anticonvulsants Misbranded as Psychiatric Drugging of Mood Stabilizers Depakote, Lamictal, Neuronton, Tegretol, Topamax Children
Can Cause: 1 in 23 on stimulants (3.5 million) No long term benefit; short term benefit mainly Hostility, Aggression, Depression & for adults Confusion 1 in 40 on antidepressants Liver Failure Prozac Boys Study: 23% developed manic like symptoms; 19% more drug induced hostility Fatal pancreatitis Bipolar Rate soars Severe & lethal skin disorders • From close to none in 1995 to 800,000 by 2003 • Then come the neuroleptics & anticonvulsants May Cause misbranded as mood stabilizers. Mild cognitive impairment with chronic use Many Now on Neuroleptics, even six month olds. Child MH Disability Rate Soars from Essentially Source: Brain Disabling Treatments in Psychiatry, Breggin, Zero in 1987 to 600,000 by 2007. Springer, 2008 10 11
Psychiatric Drugging of Recovery Principles Nursing Home Residents Hope Thousands Die Each Year from If it isn’t voluntary it Someone believes in isn’t treatment Neuroleptics Used on Residents Who you Force is Are Not Mentally Ill You have to take Counterproductive responsibility for your Different things work Neuro lep tics Dou ble Mor ta lity Ra te for different people (without necessarily being attributed to own mental health and behavior Unsuccessful the drugs in practice). Attempts Part of You have to learn to Recovery Process Dramatically reduces Quality of Life recognize your Diagnoses of Limited Many Seniors “come to life” when taken off symptoms. Benefit/Mostly Harmful the neuroleptic You have to learn what works for you. 12
2 Solutions Are Many The Soteria Project (Adults) Study First-episode schizophrenia patients treated conventionally in a hospital setting with drugs Soteria versus treatment in the Soteria House, which was staffed by non-professionals and involved no immediate use of antipsychotic medications. Results are from 1971-1983 cohorts, with 97 patients treated conventionally and 82 patients treated in Soteria House . Open Results Dialogue At end of six weeks, psychopathology reduced comparably in both groups. At end of two years: Soteria patients had better psychopathology scores Peer Directed Soteria patients had fewer hospital readmissisions Soteria patients had higher occupational levels Soteria patients were more often living independently or with peers Hearing Antipsychotic Use in Soteria Patients 76% did not use antipsychotic drugs during first six weeks Voices 42% did not use any antipsychotic during two-year study Network Only 19 % regularly maintained on drugs during follow-up period
14 J Nerv Ment Dis 1999; 187:142-149 J Nerv Ment Dis 2003; 191: 219-229
Hearing Voices Network:
Question is not “what is wrong with you?,” but “what happened to you? ” Help People Deal with Voices Similar Approach for “Delusions”
16 17 August 24, 2010
Solutions Are Many (Children & Youth)
CriticalThinkRx.Org Module 8: Evidence-Based Psychosocial Interventions for Childhood Problems Help Parents Help Children & Youth Deal with Their Emotions Help Children be successful
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3 Results to be Expected Program Evaluation Criteria
Department of Health & At Least Double the Number of People Social Services Diagosed with Serious Mental Illness Who Recover Fully. Should be at least 2/3rds to Amount of Services 3/4ths. provided (Money Spent) Quality of Beneficiaries’ Eliminate Much Suffering from Psychiatric The more disabled people Lives Confinement and Compulsory Drugging & more money spent on them, the more successful Dramatically Improve the Lives of Many the program(s) Dramatically Reduce Amount of Government Expenditures
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Response 2003 Budget Summit Report Department of Health & Recommendations Social Services Funding Should Be More Explicitly Tied to Desired Mainly Ostrich-Like, but Funding Results Consulting with Marty Irwin Peer Support Consortium Medicaid/SSDI/SSI Should Be Re -Tooled as Possible some on children & youth Soteria-Alaska to Achieve Desired Results drugging CHOICES, Inc. The Planning Committee Should Review Whether the Other Peer Programs Current Level of Reliance on Psychiatric Medications Locking Children Up & is leading to Desired Results. Drugging them in Alaska, rather than Outside (“Bring The Budget Building Process Should be Re- the Kids Home”) evaluated.
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Legal Coercion is Wrong- Law Project for Psychiatric Headed Rights (PsychRights®)
Involuntary Psychiatry Very Counterproductive Public Interest Law Firm Ex Parte Confinement Process Unconstitutional Legal Process is a Sham Mission: Mount Strategic Litigation “If the respondent wasn’ t crazy , she ’ d know what the Campaign Against Forced Psychiatric hospital wants to do is good for her.” Drugging and Electroshock. 10% or Less Involuntary Commitments Legally Children & Youth Inherently Forced Justified (JG Estimate) Legal Representation Is a Walking Ethics Violation
Involuntary Commitment and Forced Psychiatric Drugging in the Trial Courts: Rights Violations as a Matter of Course, 25 Alaska Law Review 51 (2008) 24 25
4 Current & Prospective PsychRights in Alaska PsychRights Efforts on Behalf Supreme Court of Children & Youth Myers (2006) Griffin & PsychRights v. Matsutani et Best Interests No Less Intrusive Alternative Available al., (Medicaid Fraud). Wetherhorn (2007) 42 USC § 1983 injunction that foster Unable to Survive Safely in Freedom children & youth not be drugged Wayne B (2008) unless Necessity of Transcript from Masters Psychosocial Interventions Exhausted Bigley (2009) Available means feasible Rational determined Benefits Procedural Due Process Rights Outweigh Harm PsychRights v. Alaska (2010) Informed Decision Maker No Standing Mechanism to Identify & Deal With 26 27 Adverse Effects
Suggested Reading Suggested Reading (cont.)
Anatomy of an Epidemic, by Robert Whitaker (2010 – in press). Community Mental Health: A Practical Guide (1994) by Loren Mosher Mad in America: Bad Science, Bad Medicine and the and Lorenzo Burti Enduring Mistreatment of the Mentally Ill, by Robert Soteria: Through Madness to Deliverance, by Loren Mosher and Voyce Whitaker (2001) Hendrix with Deborah Fort (2004 Alternatives Beyond Psychiatry, Peter Lehman & Peter Psychotherapy of Schizophrenia: The Treatment of Choice (Jason Stastny, MD, Editors ( 2007) . Aronson,,),y 1996), by Bertram P. Karon and Gary R. Vandenbos Agnes’s Jacket: A Psychologist’s Search for the Meaning of Schizophrenia: A Scientific Delusion, by Mary Boyle, Ph.D. (2002) Madness, by Gail Hornstein, PhD, Rodale Books, 2009. Let Them Eat Prozac, by David Healy, MD. (2006). Drug Induced Dementia, Grace E. Jackson, MD, Author Creating Mental Illness, by Allan V. Horwitz (2002). House, 2009. Commonsense Rebellion by Bruce E. Levine (2001) A Fight to Be: A Psychologist’s Experience from Both Sides Blaming the Brain : The Truth About Drugs and Mental Health (1998) of the Locked Door, Ronald Bassman, Ph.D. (2007) by Elliot Valenstein. Rethinking Psychiatric Drugs: A Guide to Informed Consent, Escape From Psychiatry, by Clover (1999) by Grace E. Jackson, MD, (2005) How to Become a Schizophrenic: The Case Against Biological Psychiatry, 3d Ed., by John Modrow (2003) Brain Disabling Treatments in Psychiatry: Drugs, Electroshock, and the Role of the FDA, Ed. 2 (2008) by Other books at http://psychrights.org/Market/storefront.htm Peter28 Breggin, MD.
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