The Mental Health System: Who's Crazy?

Law Project for Psychiatric The Mental Health Rights (PsychRights®) System: Who’s Crazy?  Public Interest Law Firm  Mission: Mount Strategic Litigation CiAitFdPhitiCampaign Against Forced Psychiatric Drugging and Electroshock. Alaska Pacific University February 22, 2012  Adopted Drugging of Children & Youth as Priority Few Years Ago

James B. (Jim) Gottstein, Esq. Law Project for Psychiatric Rights [email protected] http://PsychRights.org/

1 2

Adults While Some People find Neuroleptics Helpful . . .

 Psychiatric Drugs Causing Massive Amount of Harm  Life Spans Now 25 Years Shorter  Cut the Recovery Rate At Least in Half  5% v. 40% recovery Rate in recent study  6-fold Increase in Mental Illness Disability Rate  Current System Does Not Allow Non Drug Choices  Hugely and Unnecessarily Expensive  Tremendous Unnecessary Human Toll http://akmhcweb.org/Docs/AMHB/2 3 003BudgetSummitReport.pdf 4

5 6

1 Antidepressants

 Increase Suicidality & Violence  Addictive  Mostly No Better than Placebo  Lose “effectiveness” over time  Cause Mania  Bipolar Diagnoses  Explosion of “Rapid Cycling Bipolar Disorder” Source: Brain Disabling Treatments in Psychiatry, Breggin, Springer, 2008; Anatomy of an Epidemic, Whitaker, 2010. 7 8

Anticonvulsants Misbranded as Mood Stabilizers Stimulants

 No convincing evidence  Aggression  Can Cause: of short or long term  Insomnia  Hostility, Aggression, Depression & improvement in  Depression, suicide Confusion cognitive ability or academic performance  Headaches  Liver Failure  Brain Damage  Stomach aches  Fatal pancreatitis  Cardiovascular Harm,  Obsessive Compulsive including cardiac arrest Behaviors  Severe & lethal skin disorders  Stunts Growth  Quadruples Cocaine Abuse Rate  May Cause  Mania, psychosis, hallucinations  Many more  Mild cognitive impairment with chronic use  Agitation

Source: Brain Disabling Treatments in Psychiatry, Breggin, Source: Brain Disabling Treatments in Psychiatry, Breggin, Springer, 2008 Springer, 2008

9 10

Benzodiazepines Medicaid, SSDI & SSI

 Effective for only a few weeks  Medicaid Requires People to Be Poor  Highly Addictive  SSDI Requires People to Be Certified  Some Peopppyle Simply Can Not Get Off Permanently Disabled & Permanently Them Poor  Can cause mania  SSI Requires People to be Disabled &  Can cause violence Poor (as relevant here)

11 12

2 2003 Budget Summit Report Employment Findings Why? ...... Is society taking such a  Only 1% of Community Mental Health Center clients are receiving employment services from harmful, counterproductive the Community Mental Health Center.  Less than 1% of people go from SSDI to approach? Employment  Less than 10% of people on SSI are gainfully employed.

13 14

Fear and Absolution Other Factors

 Social Control  It is Not the Thinking, but Disturbing  Fear (Violence Myth) Behavior  People Diagnosed with Serious Mental Illness no More Prone to Violence  FDA Abdication/Capture by Industry  Magic Pill/Drug Culture  Absolution  By Accepting “Medical Model,” No one is  Psychiatry’s Drive for Legitimacy Responsible  Big Pharma Corruption of Research

15 16

The Medical Model, The 2003 Budget Summit Hunger Strike and the APA Report Query:  2003 Hunger Strike Challenged American Psychiatric Ass’n to provide Is the Budget Purchasing reliable scientific evidence of Medical Model and APA essentially admitted it  Housing Protection? could not.  Relationships Control?

 Query: Does a headache demonstrate  Jobs/Meaning an aspirin deficiency? in Life Stabilization?  Largest “experiment” demonstrated not genetic.  Recovery Dependency?

17 18

3 2003 Budget Summit Report Solutions Are Many Recommendations (Adults)  Hearing Voices  Funding Should Be More Explicitly Tied to Desired Network Results Approach  Medicaid/SSDI/SSI Should Be Re -Tooled as Possible  Strange or to Achieve Desired Results Unusual Beliefs (“delusions”)  The Planning Committee Should Review Whether the Current Level of Reliance on Psychiatric Medications  Psychosocial is leading to Desired Results. Approaches  Soteria  Open Dialogue  Peer Directed

19 20

Hearing Voices Network:

Question is not “what is wrong with you?,” but “what happened to you?” Help People Deal with Voices Similar Approach for Unusual Beliefs

22 21 August 24, 2010

The Soteria Project

Study First-episode schizophrenia patients treated conventionally in a hospital setting with drugs 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 . Results  At end of six weeks, psychopathology reduced comparably in both groups.  At end of two years: Soteria patients had better psychopathology scores Soteria patients had fewer hospital readmissisions Soteria patients had higher occupational levels Soteria patients were more often living independently or with peers Antipsychotic Use in Soteria Patients 76% did not use antipsychotic drugs during first six weeks 42% did not use any antipsychotic during two-year study Only 19 % regularly maintained on drugs during follow-up period

J Nerv Ment Dis 1999; 187:142-149 J Nerv Ment Dis 2003; 191: 219-229 24

4 Children & Youth Why? Without Any Credible Scientific Support:  Drug Companies Targeted Children & Youth  1 in 23 on stimulants (3.5 million) Market  No long term benefit; short term benefit mainly for adults   1 in 40 on antidepressants Many Financial Incentives to Drug Poor  Prozac Boys Study: 23% developed manic like symptoms; 19% Children & Youth (On Medicaid) more drug induced hostility  Schools  Bipolar Rate soars • From close to none in 1995 to 800,000 by 2003  Foster Parents • Then come the neuroleptics & anticonvulsants misbranded as mood stabilizers.  Psychiatrists  A little Over 1% Now on Neuroleptics, even some six month  Disempowered parents olds.   Child MH Disability Rate Soars from Essentially Zero in 1987 to God Help Foster Children & Youth 600,000 by 2007. 25 26

Solutions Are Many Most Psych Drugs Given (Children & Youth) Children & Youth Through Medicaid is Fraud  CriticalThinkRx.Org Module 8: Evidence-Based Psychosocial  Prescriptions are Medicaid Fraud if not for Interventions for Childhood Problems a “medically accepted indication,”  Help Parents meaning, one that is either approved by the FDA or “supported by citations” in one  Help Children & Youth of three drug compendia, including • Be Successful DRUGDEX • Deal with Their Problems  Anyone Can Sue On Behalf of Government to Recover for the Fraud and share in the recovery, if any.

27 28

$ Billion Drug Company Settlements Haven’t Stopped Psychiatric Drugging of Children & Youth Allowing Steps 2 & 3 of Fraudulent Scheme to Continue  $1.4 Billion Lilly—Zyprexa (2009)  $2.3 Billion Pfizer, including Geodon (2009)  $520 Million AstraZeneca—Seroquel (2010)  $258 Million Janssen—Risperdal (2010)  $313 Million Forest Labs—Celexa & Lexapro (2010)  Cost of doing business.  Caps Liability  Doctors Still Prescribing It  Medicaid Still Paying

29 30

5 Senate Investigation/GAO Responses: Report Program Evaluation Criteria

 PsychRights Proposing (Briefing Paper to Sen. Department of Health & Begich): Social Services  Announce that outpatient psychotropic drug prescriptions for use in children and youth that are not for medically accepted  Amount of Services indications are not covered under Medicaid, and will no provided (Money Spent) longer be reimbursed; except  The more disabled people  Quality of Beneficiaries’  Where abrupt withdrawal from drugs that are not for medically & more money spent on Lives accepted indications can cause serious problems, then allow them, the more successful reimbursement for responsible tapering; and the program(s)  Grant amnesty from False Claims Act liability for all past prescriptions that are not for medically accepted indications.

31 32

Responses: Programmatic Progress

Department of Health &  CHOICES, Inc. Social Services  Soteria-Alaska

 Not Changing Paradigm  Funding of Care, but  Peer Support Consortium  Grudgingly Allowing Some  Soteria-Alaska Non-Drug Alternatives  CHOICES, Inc.  Consulting with Marty Irwin  Other Peer Programs some on children & youth  Locking Children Up & drugging Drugging them in Alaska, rather than Outside (“Bring the Kids Home”)

33 34

CHOICES, Inc. & Soteria- PsychRights Strategic Alaska Litigation (Adults) CHOICES, Inc. Soteria-Alaska

 Opened in 2007  Opened in June of  Force System to Honor People’s  “Consumer” Run 2009 Rights  Non-coerciNive, Non-  Goal: Replicate drug (& drug) Choices Original Soteria-  Change Path of Least Resistance In Community House  Available for people in  So Far: Drug  Help Create Environment the system a long time Withdrawal Program, not First Episode Supportive of Non-Drug Choices  Non-coercive

35 36

6 Goals PsychRights in Alaska Supreme Court  Myers (2006)  Substantially Increase Recovery Rate  Best Interests after diagnosis of Serious Mental  No Less Intrusive Alternative Available Illness  Wetherhorn (2007)  Unable to Survive Safely in Freedom  Substantially Reduce If Not Eliminate  Wayne B (2008) Force  Necessity of Transcript from Masters  Bigley (2009)  System Support of People’s Non-  Available means feasible Medication Choices  Procedural Due Process Rights  PsychRights v. Alaska (2010)  No Standing

37 38

Strategic Litigation PsychRights v. Alaska

(Children& Youth)  Sought injunction Against State to prohibit State administering or authorizing psych drugs to children & youth unless: PsychRights v. Alaska 1. Evidence-based psychosocial interventions have been exhausted, United States ex rel 2. Rationally anticipated benefits of psychotropic drug treatment outweigh the risks, PsychRights v. Matsutani, et 3. The person or entity authorizing administration al. of the drug(s) is fully informed, and 4. Close monitoring of, and appropriate means of  Contemplating Next Step(s) responding to, treatment emergent effects are in place.  Maybe Federal Civil Rights  Thrown out of Court for Lack of Standing Case(s)  Reviewing Options Including Federal Case

39 40

Medicaid Fraud Model Medicaid Fraud Initiative Complaint

 Designed to Stop Harmful Practice by  Drafted for Former Foster Youth to be Causing Doctors (& other defendant relator classes) to Realize Inviting Financial Ruin  But anyone with “non-public” if Continue information can be relator  Model Complaint  Defendants:  Cases Percolating in Various States  Prescribers & employers  2 Alaska & 1 Illinois Cases Dismissed  Pharmacies  Wisconsin Case Only Current One Known

41 42

7 Concluding Query Suggested Reading

 Anatomy of an Epidemic, by Robert Whitaker (2010 – in press).  Drugging Our Children, Sharna Olfman & Brent Robbins, Eds.  Is the country going to come to its (2012)  Mad in America: Bad Science, Bad Medicine and the Enduring senses or follow folly’s footpath? Mistreatment of the Mentally Ill, by Robert Whitaker (2001)  Alternatives Beyond Psychiatry, Peter Lehman & Peter Stastny,  Easter Island Inhabitants Cut Down All MD, Editors (2007). their Trees to Erect Statues for their  Agnes’s Jacket: A Psychologist’s Search for the Meaning of Madness, by Gail Hornstein, PhD, Rodale Books, 2009. Gods, dooming themselves.  Drug Induced Dementia, Grace E. Jackson, MD, Author House, 2009.  Dominican Republic, unlike Haiti,  A Fight to Be: A Psychologist’s Experience from Both Sides of the managed its timber resources for Locked Door, Ronald Bassman, Ph.D. (2007)  Rethinking Psychiatric Drugs: A Guide to Informed Consent, by future. Grace E. Jackson, MD, (2005)  Brain Disabling Treatments in Psychiatry: Drugs, Electroshock, and the Role of the FDA, Ed. 2 (2008) by Peter Breggin, MD.

43 44