Mental Health Treatment: Who’s Crazy? Social Work 608: Public Policy & Advocacy Melbourne Henry, PhD University Alaska Anchorage October 27, 2010 James B. (Jim) Gottstein, Esq. Law Project for Psychiatric Rights [email protected] http://PsychRights.org/ 1 1 Law Project for Psychiatric Rights (PsychRights®) Public Interest Law Firm Mission: Mount Strategic Litigation CiAitFdPhitiCampaign Against Forced Psychiatric Drugging and Electroshock. National in Scope Adopted Drugging of Children & Youth as Priority Few Years Ago http://akmhcweb.org/Docs/AMHB/2 003BudgetSummitReport.pdf 2 5 While Some People find Mental Health Treatments Neuroleptics Helpful . Facts Psychiatric Drugs Causing Massive Amount of Harm Responses Life Spans Now 25 Years Shorter Advocacy Efforts 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 Huge Unnecessary Human Toll 3 6 FACTS 4 7 1 8 11 August 23, 2010 August 23, 2010 Anticonvulsants Misbranded as Mood Stabilizers Can Cause: Hostility, Aggression, Depression & Confusion Liver Failure Fatal pancreatitis Severe & lethal skin disorders May Cause Mild cognitive impairment with chronic use Source: Brain Disabling Treatments in Psychiatry, Breggin, Springer, 2008 9 12 Antidepressants Stimulants No convincing evidence Aggression Increase Suicidality & Violence of short or long term Insomnia improvement in Addictive cognitive ability or Depression, suicide academic performance Headaches Lose “effectiveness” over time Brain Damage Stomach aches Cause Mania Bipolar Diagnoses Cardiovascular Harm, Obsessive Compulsive including cardiac arrest Behaviors Stunts Growth Quadruples Cocaine Mania, psychosis, Abuse Rate hallucinations Many more Agitation Source: Brain Disabling Treatments in Psychiatry, Breggin, Springer, 2008 Source: Brain Disabling Treatments in Psychiatry, Breggin, Springer, 2008 10 13 2 Benzodiazepines Children & Youth Effective for only a few weeks Drug Companies Targeted Children & Youth Market Highly Addictive Poor Children & Youth (Medicaid) Some Peopppyle Simply Can Not Get Off Them Disempowere d paren ts Foster Children & Youth Can cause mania God Help Them Can cause violence 14 17 Psychiatric Drugging of Medicaid, SSDI & SSI Children Medicaid Requires People to Be Poor 1 in 23 on stimulants (3.5 million) No long term benefit; short term benefit mainly SSDI Requires People to Be Certified for adults Permanently Disabled & Permanently 1 in 40 on antidepressants Prozac Boys Study: 23% developed manic like Poor symptoms; 19% more drug induced hostility Bipolar Rate soars SSI Requires People to be Disabled & • From close to none in 1995 to 800,000 by 2003 Poor (as relevant here) • Then come the neuroleptics & anticonvulsants misbranded as mood stabilizers. Many Now on Neuroleptics, even six month olds. Child MH Disability Rate Soars from Essentially Zero in 1987 to 600,000 by 2007. 15 18 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. 16 19 3 Big Pharma Corruption of Discussion Process Fraudulent Clinical Trials Ghostwritten Articles Continued Medical Education Sponsorship Buying “Key Opinion Leaders” Drug Detailers/Goodies to Doctors 20 23 Fear and Absolution Medical Model Promotion (Adults) National Institute of Mental Health: “Schizophrenia is a chronic, severe, and Fear (Violence Myth) disabling brain disorder” People Diagnosed with Serious Mental “Bipolar disorder, also known as manic- Illness no More Prone to Violence depressive illness, is a brain disorder that causes unusual shifts in a person’s Absolution mood, energy, and ability to function.” By Accepting “Medical Model,” No one is “Research indicates that depressive Responsible illnesses are disorders of the brain.” Source: NIMH website accessed March 23, 2008 21 24 The Medical Model, The Other Factors Hunger Strike and the APA Social Control 2003 Hunger Strike Challenged American Psychiatric Ass’n to provide It is Not the Thinking, but Objectionable Behavior reliable scientific evidence of Medical Model and APA essentially admitted it FDA Abdication/Capture by Industry could not. Magic Pill/Drug Culture Query: Does a headache demonstrate Psychiatry’s Drive for Legitimacy an aspirin deficiency? Big Pharma Corruption of Research Largest “experiment” demonstrated not genetic. 22 25 4 Solutions Are Many The Soteria Project (Adults) Study Hearing Voices 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 Network no immediate use of antipsychotic medications. Results are from 1971-1983 cohorts, with 97 Approach patients treated conventionally and 82 patients treated in Soteria House . Results Strange or At end of six weeks, psychopathology reduced comparably in both groups. Unusual Beliefs At end of two years: (“delusions”) Soteria patients had better psychopathology scores Soteria patients had fewer hospital readmissisions Psychosocial Soteria patients had higher occupational levels Soteria patients were more often living independently or with peers Approaches Antipsychotic Use in Soteria Patients Soteria 76% did not use antipsychotic drugs during first six weeks 42% did not use any antipsychotic during two-year study Open Dialogue Only 19 % regularly maintained on drugs during follow-up period Peer Directed 26 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” 27 30 Solutions Are Many (Children & Youth) CriticalThinkRx.Org Module 8: Evidence-Based Psychosocial Interventions for Childhood Problems Help Parents Help Children & Youth Deal with Their Emotional Problems 28 31 August 24, 2010 5 Most Psych Drugs Given Response Children & Youth Through Medicaid is Fraud Department of Health & Social Services Prescriptions are Medicaid Fraud if not for a “medically accepted indication,” Mainly Ostrich-Like, but Funding meaning, one that is either approved by Consulting with Marty Irwin Peer Support Consortium some on children & youth the FDA or “supported by citations” in one Soteria-Alaska drugging CHOICES, Inc. of three drug compendia, including Other Peer Programs DRUGDEX Locking Children Up & Drugging them in Alaska, Anyone Can Sue On Behalf of rather than Outside (“Bring Government to Recover for the Fraud and the Kids Home”) share in the recovery, if any. 32 35 CHOICES, Inc. & Soteria- Alaska CHOICES, Inc. Soteria-Alaska “Consumer” Run Opened in June of Non-coercive, Non-drug 2009 (& drug ) Cho ices In • 7 Year Effort to Open Community Goal: Replicate Available for people in Original Soteria-House the system a long time So Far: Drug RESPONSES Started Providing Withdrawal Program, Services in July, 2007 not First Episode Non-coercive 33 36 Program Evaluation Criteria 2003 Budget Summit Report Query: Department of Health & Social Services Is the Budget Purchasing Amount of Services Housing Protection? provided (Money Spent) Quality of Beneficiaries’ Relationships Control? The more disabled people Lives & more money spent on Jobs/Meaning them, the more successful the program(s) in Life Stabilization? Recovery Dependency? 34 37 6 2003 Budget Summit Report Recommendations Funding Should Be More Explicitly Tied to Desired Results Medicaid/SSDI/SSI Should Be Re -Tooled as Possible to Achieve Desired Results The Planning Committee Should Review Whether the Current Level of Reliance on Psychiatric Medications is leading to Desired Results. ADVOCACY EFFORTS The Budget Building Process Should be Re- evaluated. 38 41 $ Billion Drug Company Settlements PsychRights Strategic Haven’t Stopped Psychiatric Drugging Litigation (Adults) of Children & Youth $1.4 Billion Lilly—Zyprexa (2009) Force System to Honor People’s $2.3 Billion Pfizer, including Geodon (2009) Rights $520 Million AstraZeneca—Seroquel (2010) $258 Million Janssen—Risperdal (2010) Change Path of Least Resistance $313 Million Forest Labs—Celexa & Lexapro (2010) Help Create Environment Cost of doing business. Supportive of Other Choices Caps Liability Doctors Still Prescribing It Medicaid Still Paying 39 42 Goals Allowing Steps 2 & 3 of Fraudulent Scheme to Continue Substantially Increase Recovery Rate after diagnosis of Serious Mental Illness Substantially Reduce If Not Eliminate Force System Support of People’s Non- Medication Choices 40 43 7 PsychRights in Alaska Medicaid Fraud Supreme Court Initiative Myers (2006) Best Interests No Less Intrusive Alternative Available Designed to Stop Harmful Practice by Wetherhorn (2007) Causing Doctors (& other defendant Unable to Survive Safely in Freedom cl)tRliIitiFiilRilasses) to Realize Inviting Financial Ruin Wayne B (2008) if Continue Necessity of Transcript from Masters Bigley (2009) Cases Percolating in Various States Available means feasible Illinois Case Unsealed Recently Procedural Due Process Rights PsychRights v. Alaska (2010)