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

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 , 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”

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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.)

, by Robert Whitaker (2010 – in press).  Community Mental Health: A Practical Guide (1994) by  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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