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LOCAL Announcement :: Civil & Human Rights

Author Robert Whitaker Interview on FRSC Next Sunday

Former Boston Globe reporter Robert Whitaker, author of Mad in America, will speak by phone on Bathrobespierre's Broadsides, FRSC's late Sunday morning talk show 10 AM - 11 AM.
Robert Whitaker, author of Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill in America will be interviewed Sunday September 5th from 10 AM PDT to 11 AM on Free Radio Santa Cruz (101.1 FM or www.freakradio.org).

This will be a phone interview. Questions can be e-mailed in to the show at rnorse3 (at) hotmail.com or written in to the chatroom at www.pagesincolor.com .

Below are two articles, one by Whitaker, another by an opponent E. Fuller Torrey.

Should be real interesting.

Whitaker's book is also available at the Santa Cruz Public Library.



Here's a Chapter Outline of Whitaker's book:


Preface

The World Health Organization has repeatedly found that people diagnosed with schizophrenia in the U.S. and other developed countries fare much worse than schizophrenia patients in poor countries. In the poor countries, a high percentage of patients recover and lead active social lives. In the U.S. and other developed countries, most patients so diagnosed become chronically ill. An understanding of this failure of modern medicine can be found by tracing the history of medical treatments for madness to the present day.

Part One: The Original Bedlam (1750-1900)

1. Bedlam in Medicine

A look at early medical therapies for madness in Europe and the colonial U.S., and why those therapies were at times viewed as curative. The early therapies included bleeding patients, putting them in "tranquilizer chairs," spinning them, dunking them in water, and even holding them underwater until they lost consciousness. Such therapies arose, in part, because of a belief that "reason" was the highest human faculty, and thus the mad, having lost their reason, were "brutes" and needed to be treated as such.

2. The Healing Hand of Kindness

In the early 1800s, there arose a form of care in England and France known as moral treatment, which emphasized treating the insane with kindness and empathy, and avoiding medical remedies that "worked" by weakening the patient. Moral treatment emphasized that mental patients should be seen as part of the human family. This form of care produced good outcomes for more than 30 years.



Part Two: The Darkest Era (1900-1950)

3. Unfit to Breed

The eugenics movement took hold in the U.S. in the early years of the 20th century. This "science" preached that insanity was a genetic disorder, and that a gene for insanity was spreading throughout the U.S. population at alarming rates. As a result, the humanitarian attitudes common to moral treatment gave way to a belief, said to be grounded in science, that the mentally ill were a threat to the general well-being of the country. To counter this threat, eugenicists argued that the mentally ill should be segregated in asylums and forcibly sterilized. By the end of the 1920s, American society had embraced involuntary sterilization of the mentally ill as a progressive health measure, with the New York Times and numerous other newspapers editorializing in support of it. The asylums were also run on bare-bones budgets, a fiscal policy that was consistent with eugenic notions that devalued the mentally ill.

4. Too Much Intelligence

After the fall of moral treatment in the late 1800s, American psychiatry once again devoted itself to finding physical remedies for psychotic disorders. Therapies of every kind were tried. These ranged from water therapies like the continuous bath, in which patients were kept in bathtubs for days on end, to gastrointestinal surgery. Doctors also tried fever, sleep and referigeration therapies (this last one involving cooling patients to the point they lost consciousness.) Finally, in the 1930s, there arose a trio of therapies--insulin coma therapy, metrazole convulsive therapy, and electroshock--that all worked, as was freely acknowledged at the time, by damaging the brain.

5. Brain Damage as Miracle Therapy

The fourth "brain-damaging" therapeutic that was embraced in asylum medicine in the 1930s and early 1940s was prefrontal lobotomy. This operation was pronounced safe and effective in numerous trials, and in 1949 its inventor, Portuguese neurosurgeon Egas Moniz, was awarded the Nobel Prize in Medicine. Many physicians who tried it concluded that the operation could not possible harm the mentally ill, and during the 1940s newspapers and magazines regularly wrote about this "miracle" therapy for curing mental disorders. Today, this operation is viewed as a mutilating surgery, and its rise and fall provides a cautionary tale about the capacity of a society to delude itself about the merits of its medical treatments for the mentally ill.

Part Three: Back to Bedlam (1950-1990s)

6. Modern-Day Alchemy

In the early 1950s, chlorpromazine--marketed as Thorazine--was introduced for the treatment of psychotic disorders. Initially, physicians praised it for producing a "chemical lobotomy," and noted that it also produced symptoms similar in kind to the encephalitis lethargic virus. It was seen as a drug useful for quieting asylum patients, and not as a "cure" for psychosis. However, over the next decade, the drug underwent an image makeover (which was driven by the pharmaceutical companies), and by the early 1960s chlorpromazine and other newly introduced neuroleptics were hailed as "safe, antischizophrenic" medications.

7. The Patients’ Reality

Neuroleptics "worked" by blocking dopamine receptors (and not by normalizing dopamine levels.) The drugs occupied 70% to 90% of all D2 receptors, and this hindrance of dopamine function retarded movement, made people lethargic, and reduced visible symptoms of psychosis. Patients often vigorously resisted these drugs, stating that they induced great physical suffering and turned them into "zombies." In addition, contrary to what the public has been led to believe about the drugs' "efficacy," the research literature clearly shows that the drugs made patients chronically ill, and impaired recovery.

8. The Story We Told Ourselves

Although there was ample evidence that chlorpromazine, haloperidol and other neuroleptics were making people worse off, the story that we told ourselves about the merits of the drugs was quite different. The public was led to believe that those diagnosed with schizophrenia had overactive dopamine systems, and that neuroleptics normalized dopamine activity in the brain. By doing so, the drugs were said to effectively knock down psychosis, and prevent relapse. However, every element of that medical paradigm is easily proven false.

9. Shame of a Nation

Patient groups in the 1960s and 1970s often protested vigorously against the use of the medications, and fought in court for the right to forgo such treatment. What made their protests particularly powerful was that they came at the same time that the Soviets were using neuroleptics to punish dissidents. Although mental patients in the U.S. did win the right to refuse drug treatment, they often had to take the drugs in order to obtain social support services. They won the battle but lost the war. Also in the 1970s, the head of schizophrenia studies at the National Institute of Mental Health, Loren Mosher, conducted an experiment that compared two-year outcomes in patients treated with and without neuroleptics, and he, like others, found superior outcomes for patients who weren't put on the drugs. He was subsequently forced out of the NIMH for pursuing this research agenda. The result of all this showed up in World Health Organization studies conducted in the 1970s and 1980s: Whereas the majority of patients in poor countries, where neuroleptics were much less used, had favorable long-term outcomes, most patients in "developed" countries became chronically ill, and suffered from a very "poor quality of life."

10. Away from Nuremberg

In the late 1940s, American psychiatric researchers intent on investigating the "biology" of psychosis began conducting studies in which they gave mentally ill patients a variety of chemical agents--LSD, amphetamines, methylphenidate--expected to worsen their symptoms. This type of federally funded experimentation went on for nearly 50 years, with more than 1,000 mentally ill patients ushered into such experiements, including some people who'd come to emergency rooms seeking help. In addition, the paper trail for these symptom-exacerbation experiments shows that American researchers regularly misled patients about their intentions.



Part Four: Mad Medicine Today (1990s – Present)

11. Not So Atypical

In the early 1990s, new "atypical" drugs for schizophrenia were brought to market amid much fanfare, hailed as much more safe and effective than the old neuroleptics However, those claims arose from drug trials paid for by the pharmaceutical companies, and the FDA, in its review of the data, concluded that the trials had been biased by design, and that there was no good evidence that the new drugs were better than the old.

12. Epilogue

In Finland today, researchers are reporting great results with care that emphasizes social support and the selective use of neuroleptics. Some patients appear to do better without the drugs, while others do better on low doses. Any reform of care in this country will require a willingness to explore alternatives like the Finnish program



FOR FURTHER INFORMATION See also "Robert Whitaker, Mad in America author, Interview Sunday" 26 Sep 2003, also on the www. santacruz.indymedia.org website.
 
 


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Whitaker Will Be Asked About Bush's New "Mental Health" Initiative

Bush plans to screen whole US population for mental illness
by Jeanne Lenzer
bmj.bmjjournals.com/cgi/content/full/bmj;328/7454/1458


A sweeping mental health initiative will be unveiled by President George W Bush in July. The plan promises to integrate mentally ill patients fully into the community by providing "services in the community, rather than institutions," according to a March 2004 progress report entitled New Freedom Initiative (www.whitehouse.gov/infocus/newfreedom/toc-2004.html). While some praise the plan's goals, others say it protects the profits of drug companies at the expense of the public.

Bush established the New Freedom Commission on Mental Health in April 2002 to conduct a "comprehensive study of the United States mental health service delivery system." The commission issued its recommendations in July 2003. Bush instructed more than 25 federal agencies to develop an implementation plan based on those recommendations.

The president's commission found that "despite their prevalence, mental disorders often go undiagnosed" and recommended comprehensive mental health screening for "consumers of all ages," including preschool children. According to the commission, "Each year, young children are expelled from preschools and childcare facilities for severely disruptive behaviours and emotional disorders." Schools, wrote the commission, are in a "key position" to screen the 52 million students and 6 million adults who work at the schools.

The commission also recommended "Linkage [of screening] with treatment and supports" including "state-of-the-art treatments" using "specific medications for specific conditions." The commission commended the Texas Medication Algorithm Project (TMAP) as a "model" medication treatment plan that "illustrates an evidence-based practice that results in better consumer outcomes."

Dr Darrel Regier, director of research at the American Psychiatric Association (APA), lauded the president's initiative and the Texas project model saying, "What's nice about TMAP is that this is a logical plan based on efficacy data from clinical trials."

He said the association has called for increased funding for implementation of the overall plan.

But the Texas project, which promotes the use of newer, more expensive antidepressants and antipsychotic drugs, sparked off controversy when Allen Jones, an employee of the Pennsylvania Office of the Inspector General, revealed that key officials with influence over the medication plan in his state received money and perks from drug companies with a stake in the medication algorithm (15 May, p1153). He was sacked this week for speaking to the BMJ and the New York Times.

The Texas project started in 1995 as an alliance of individuals from the pharmaceutical industry, the University of Texas, and the mental health and corrections systems of Texas. The project was funded by a Robert Wood Johnson grant—and by several drug companies.

Mr Jones told the BMJ that the same "political/pharmaceutical alliance" that generated the Texas project was behind the recommendations of the New Freedom Commission, which, according to his whistleblower report, were "poised to consolidate the TMAP effort into a comprehensive national policy to treat mental illness with expensive, patented medications of questionable benefit and deadly side effects, and to force private insurers to pick up more of the tab" (psychrights.org/Drugs/AllenJonesTMAPJanuary20.pdf).

Larry D Sasich, research associate with Public Citizen in Washington, DC, told the BMJ that studies in both the United States and Great Britain suggest that "using the older drugs first makes sense. There's nothing in the labeling of the newer atypical antipsychotic drugs that suggests they are superior in efficacy to haloperidol [an older "typical" antipsychotic]. There has to be an enormous amount of unnecessary expenditures for the newer drugs."

Olanzapine (trade name Zyprexa), one of the atypical antipsychotic drugs recommended as a first line drug in the Texas algorithm, grossed $4.28bn (£2.35bn; 3.56bn) worldwide in 2003 and is Eli Lilly's top selling drug. A 2003 New York Times article by Gardiner Harris reported that 70% of olanzapine sales are paid for by government agencies, such as Medicare and Medicaid.

Eli Lilly, manufacturer of olanzapine, has multiple ties to the Bush administration. George Bush Sr was a member of Lilly's board of directors and Bush Jr appointed Lilly's chief executive officer, Sidney Taurel, to a seat on the Homeland Security Council. Lilly made $1.6m in political contributions in 2000—82% of which went to Bush and the Republican Party.

Jones points out that the companies that helped to start up the Texas project have been, and still are, big contributors to the election funds of George W Bush. In addition, some members of the New Freedom Commission have served on advisory boards for these same companies, while others have direct ties to the Texas Medication Algorithm Project.

Bush was the governor of Texas during the development of the Texas project, and, during his 2000 presidential campaign, he boasted of his support for the project and the fact that the legislation he passed expanded Medicaid coverage of psychotropic drugs.

Bush is the clear front runner when it comes to drug company contributions. According to the Center for Responsive Politics (CRP), manufacturers of drugs and health products have contributed $764 274 to the 2004 Bush campaign through their political action committees and employees—far outstripping the $149 400 given to his chief rival, John Kerry, by 26 April.

Drug companies have fared exceedingly well under the Bush administration, according to the centre's spokesperson, Steven Weiss.

The commission's recommendation for increased screening has also been questioned. Robert Whitaker, journalist and author of Mad in America, says that while increased screening "may seem defensible," it could also be seen as "fishing for customers," and that exorbitant spending on new drugs "robs from other forms of care such as job training and shelter programmes."

But Dr Graham Emslie, who helped develop the Texas project, defends screening: "There are good data showing that if you identify kids at an earlier age who are aggressive, you can intervene... and change their trajectory."
 

More on the Psychiatric Drugs Racket

On August 31, Robert Whitaker sent me two e-mails containing the following:


"The new bit of material I have is this:

a) I looked at the number of people receiving disability payments due to mental illness in the U.S. (thus either receiving an SSI or an SSDI payment) since 1987, which was the year that the first of the new generation psychiatric drugs was introduced. And what you find is that the number of people so disabled has nearly doubled since then. In fact, I don't think there has ever been a society that has dubbed such a high percentage of its population mentally ill, and the disability numbers show that we have a system that leads to ever more people unable to work because of psychiatric distress. Here's the data:
SSDI Payments:In 1987, 875,000 people received SSDI payments because of mental illness. By 2002, that number had grown to 1.7 million people who got SSDI because of mental illness. An increase of 825,000 people over 15 years, or about 55,000 people per year.
SSI PAYMENTS: In 1987, 2.63 million people received SSI payments because of a mental disorder. In 2002, 4.07 million received SSI because they had a diagnosable mental disorder. Thus, the number of people with a mental disorder receiving SSI grew 1.34 million people over this 15-year period, or about 90,000 people per year.
TOTAL DISABILITY.: The number of people receiving SSI or SSDI payments in 1987 because of mental disorders was 3.505 million. The number receiving SSI or SSDI payments in in 2002 was 5.77 million. That's an increase of 2.165 million people in the past 15 years, or about 145,000 people per year.

b) Now I also tried to find some data on the increase in mental illness since the psychiatric drugs were introduced in the 1950s. Once again, the data is there of a worsening of mental health. Since 1955, the total number of "patient-care" episodes for severe mental disorders, on a per-capita basis, has quadrupled. (This is one metric the government uses to measure mental distress in the nation.) Similarly, per-capita outpatient admissions to mental health programs--a statistic used to measure milder disorders--have increased 250% since 1969.

c) Now I also looked at spending on psychiatric drugs since 1987, the year Prozac was introduced. That year we spent about $1 billion on psychiatric drugs. By 2002, this number had increased to $23 billion, and it will be over $25 billion in 2004. That is more than the gross national product of two-thirds of the world's countries. We spend about $13 billion on antidepressants today, which is roughly equal to the gross national product of mid-sized countries like Cameroon and Jordan.

d) This of course has brought great profits to the drug companies. Eli Lilly's capitalization on Wall Street increased from around $2 billion in 1987 to about $72 billion at the end of 1973. And so what you see is that the companies have been very successful in creating a mental illness business, with an ever greater number of people said to need these drugs.

e) Finally, I looked at data to see how the use of the drugs could be stirring this epidemic of mental illness. And what you find is three things.
1) First, even though a drug may show efficacy over the short term in alleviating a certain symptom (say having a small advantage over placebo in treating depression), over the long-term you generally see the target symptom actually ending up worse in the drug-treated patients than in the placebo patients. You see this in trials of antidepressants, antianxiety drugs, & in antipsychotic drugs.
2) The drugs do not balance brain chemistry. They create perturbations in normal chemistry (which is how Steve Hyman, former director of the NIMH, described their mechanisms of action. Thus, the drugs do create an abnormality in neurotransmitter function in the brain, and thus you could expect them to cause problems over the long term.
3) You see that some people who are treated for a milder disorder (anxiety or depression) will suffer a marked worsening in response to the drug (say a psychotic or manic reaction), and thus move on to a more severe disorder like bipolar. And you see this effect in the skyrocketing number of bipolar diagnoses.

ONE OF THE INTERESTING THINGS about the follow-up to Mad in America is that none of the information in the book was ever attacked as inaccurate. I had people say I selectively picked information (not the case), and people
attack me personally, but no-one said I had misquoted or misattributed a single fact.

...A COUPLE OF RECENT THINGS of interest. First, I was invited to write an article for a medical journal called Medical Hypothesis on the history of neuroleptics (you can pull it down from psychrights.org), and that article led to a summary of the information in it in the British Medical Journal. This was mainstream medicine opening up to this body of evidence just a bit, and I was pleasantly surprised by that.

I HAVE ADDRESSED A NUMBER of groups over the past 2.5 years, and been on a few panels, and two things of note. One, I think there is increasing recognition that our current paradigm of care is a failure, and change of some sort is needed.

Second, Jim Gottstein of psychrights.org in Alaska, brought me up twice to speak to mental health groups there, and he is now in the process of getting approval for an experimental home modeled on Loren Mosher's Soteria House. So that's a real beacon of hope for change....

I hope this gives us something to talk about..."
 

Re: Author Robert Whitaker Interview on FRSC Next Sunday

I agree with three main precepts: Psychiatry kills,Psychiatrists need to turn their paitients over to spiritual mediary treatments,pharmachetical co.s need to be monitored by a watch agency re: business ethics and connections to medical professionals
 

Re: Author Robert Whitaker Interview on FRSC Next Sunday

Mad in America is the most important book on the subject.

Robert Whitaker's voice is sane-ness itself.

Thank you for both.

Might he do an expose of the New Freedom Commission? It seems to work backward through Mad in America, identifying the things NOT to do.

That such a book is/might be forthcoming would help with the movement to expose NFC, eugenics, human research and all.
 

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