Editorial Note: When I raised the specter of the Science Media Center and Sense about Science recently, some of the Americans I knew fell about laughing, figuring we are still a long way off being as censored as the US of A is. After calming down, one of them Johanna Ryan wrote this post.
In June 2014 the BMJ published a study by Lu et al supposedly of teen suicide. This was a group of researchers at Harvard University. The study claimed to have found a “33% jump in suicide attempts” among US teens after the FDA placed a Black Box warning on antidepressants for young people.
It received an avalanche of publicity, none of which cast the faintest doubt on its alarmist conclusions. With a publicity machine like this, it was no wonder most American journalists (and most doctors as well) hesitate even to mention any downside to antidepressants, lest they be accused of triggering a wave of teen suicides.
Dozens of leading academics wrote the BMJ to pour scorn on the study. It is a good candidate for the most egregious article BMJ has ever published. It showed neither a major decrease in antidepressant prescribing, nor a rise in teen suicides. The increase in suicide attempts it claimed to find was actually a rise in insurance claims for “psychotropic drug overdoses”, many of which would not have been suicidal.
The “Clay Center for Young Healthy Minds” was founded at Massachusetts General Hospital in 2013 and immediately took a lead role in press coverage of teen depression and suicide. Gene Beresin and Steven Schlozman, two Mass General child psychiatrists, are its leading figures. Beresin went on ABC News to promote the “study” and its alleged finding of a 33% increase in teen suicides. He and Schlozman co-wrote an Op Ed calling on FDA to repeal the Black Box warning, which Beresin called “the next closest thing to prohibition.”
The Clay Center is not a treatment or research institute. It’s a media and communications project. Its dedicated to “educating” journalists, policymakers and the public about the virtues of the Mass General approach to childhood problems. Mass General is known for an aggressive use of psychiatric medication in children. In particular it’s known for the work of Dr. Joseph Biederman promoting the controversial diagnosis of “childhood bipolar disorder” and its management with antipsychotics in infants.
From the start it has forged a close alliance with the American Foundation for Suicide Prevention, an influential nonprofit whose leadership roster reads like a Who’s Who of American psychiatry. Dr. Christine Moutier, AFSP’s current president and chief spokesperson, worked with Beresin in the 2014 media campaign. Both are articulate, engaging and much more media-friendly than most leading academic psychiatrists like Biederman. Both are also sufficiently far removed from the world of drug-company clinical trials and “key opinion leaders” that no sticky trail of Pharma money adheres to them personally.
I’ve found it useful (and occasionally fun) to keep tabs on what they say to various audiences. Take this 2013 blog article, where they reassure everyone that the very small uptick in teen suicides in 2004 or so – which they allege was related to the Black Box warnings – was just a temporary blip, and suicide rates have re-stabilized. Very much at odds with their 2014 hysteria campaign!
And this more recent article, in which they report that more youth are getting mental health treatment, but the increases are occurring among kids who are either mildly impaired, or “not impaired at all.” They are nonetheless “delighted” that so many are seeking help! No downside whatsoever when your child psych clinic fills up with kids who are “not impaired at all” (though they do worry that more disturbed children may still be undertreated).
Occasionally their promotions verge on the ridiculous: In August 2016, at the height of back-to-school season, the Clay Center solemnly announced that 50-60% of college students had a psychiatric disorder.
The Clay Center owes its existence to two big, “transformational” philanthropic donations. The biggest was from Landon T. and Lavinia Clay. Landon Clay is a venture capitalist and head of a Boston-based investment fund called East Hill Management Company, LLC. He was formerly head of Eaton Vance and ADE, two other major investment funds. He’s an alumnus and major donor to Harvard University, and is (or was) on its Board of Overseers.
So why has this become the Clay family’s cause? I expected a warm fuzzy story about how one of their children had a mental-health condition, or how Mrs. Clay was a schoolteacher who worked with troubled kids, or something similar. I didn’t find it.
East Hill focuses on biotech ventures, and is advertised as investing in “disruptive innovations” developed at UK universities. Its offices are in Rhode Island and Oxford, UK. Landon Clay is a director of Plasso Technology Ltd., Glycoform Ltd., Arradiance Inc. and other biotech ventures in which East Hill invests. He’s also given millions to Harvard for telescopes, a faculty chair in mathematics and other high-profile science projects.
Jeremy R. Knowles, twice Harvard’s Dean, was on East Hill’s Board until his death in 2008. As Dean, Knowles was responsible for major expansions of scientific research, including the Harvard Brain Science Institute which is heavily involved in psychiatric research at Harvard and Mass General. Knowles also served on the boards of Vertex Pharmaceuticals, Biogen, Celgene and the Howard Hughes Medical Institute (HHMI).
East Hill’s business model is to finance startup companies to develop various drugs, devices, etc., and then sell them to major corporations. Their scientific advisory board also included Robert May, a “former President of the Royal Society” and Oxford zoology professor, now a member of the House of Lords.
East Hill has a link to Sense about Science, the British think-tank and media center: Oxitec Ltd., a company developing genetically-modified mosquitoes in a scheme to eradicate mosquito-borne tropical diseases such as dengue fever. Oxitec claims its technology is safer and more sustainable than pesticides, but this claim has been controversial. East Hill was a major investor, and Clay was on its board until it was sold in 2015. Oxitec’s press officer, Chris Creese, has also been employed by or affiliated with SAS, and SAS has publicly defended the Oxitec project.
The Clay Center’s other large donor is Elizabeth Hayden, billed as “an educator who has dedicated her life’s work to children and families.” She is also the widow of James Hayden, a tech millionaire. The Hayden Fund, set up in his memory, is administered by The Boston Foundation, an influential block of philanthropic capital with a finger in every political and economic pie in the Boston area. The Hayden Fund is one of its “Donor Advised Funds” whose funders are actively involved in their charitable giving.
Ms. Hayden’s professional career seems to have been as a teacher and administrator in a few of the small, wealthy private schools patronized by the Clays. She is also on the board of Stonehill College, a small Catholic college in Easton, Mass. where she and her husband both went to school. A student of the sociology of the U.S. ruling class could have a field day with Stonehill. Its board is 100% alumni, and amazingly influential for such a small place. It includes Wall Street bankers, university presidents, political fundraisers and corporate execs – including a former head of Johnson & Johnson’s pharmaceutical division and a key political advisor to both Presidents Bush.
Elizabeth Hayden is said to have worked with Gene Beresin for years to make his media center project a reality. She may have been the person who recruited the Clay family to the cause.
The National Alliance on Mental Illness (NAMI) is listed as a key “partner” of the Clay Center, along with AFSP as mentioned above. NAMI has played an enormous role in establishing the “chemical imbalance” concept of mental illness in the media and public discourse, and it has received six-figure donations from just about every psychotropic drugmaker in the market.
AFSP, in turn, has been involved in a retooling and expansion of official psychiatry’s support system in the past three years. It has played a key role in founding a broader organization called the Action Alliance for Suicide Prevention, which draws in U.S. military and govern-mental agencies as well as corporate heavy hitters to back the brand of mental health care favored by Mass General, Charles Nemeroff and Big Pharma.
Its Board of Directors includes the CEO of AFSP along with top execs from Kaiser Permanente and Universal Health Services, the giant for-profit behavioral healthcare chain. It also includes Thomas Insel of NIMH and Thomas Frieden of the CDC as Ex Officio members.
The Action Alliance does not seem to have a medical advisory board. It can always count on the AFSP’s, which still includes Nemeroff as well as Jerrold Rosenbaum of Mass General.
It can also count on the Anxiety & Depression Association of America. This group began as the humble Phobia Society in the 1980’s and became the Anxiety Disorders Association in 1990. In 2012 it took on its current name, and a much larger structure. ADAA is mainly a professionals’ organization, and its leadership is heavily stacked with Harvard, Mass General and Boston University faculty. The three groups – ADAA, AFSP and the Action Alliance – have collaborated on a survey of support for mental-health spending and other projects.
The Clay Center website names WBUR, the Boston affiliate of National Public Radio, as an affiliate. It also seems to have strong ties to WGBH, Boston’s PBS-TV channel. Despite the “Public” in their titles, NPR and PBS get less than 10% of their money these days from the taxpayer. About half is from corporate and foundation sources (the rest being from individual-donor fundraising). Affiliates are often high-profile pet causes for local corporate philanthropy, which can tend to put limits on their independence. WBUR’s CommonHealth health-reporting project handles the station’s work with the Clay Center and other powerful nonprofits.
The Clay Center can also draw on the considerable media networks already developed by NAMI and the AFSP. Both are regarded as prime sources for “responsible” mental health information by most media – and both have relied heavily on funding and hands-on public relations support from Pharma to achieve that standing.
Because of the Sunshine Act and the general low opinion of Big Pharma shared by most Americans these days, complex nonprofit arrangements like the Clay Center will likely play a larger and larger role in advancing both drug research and a Pharma-centric health care system. This may make it harder for most people to spot any conflict of interest. The fact that rich venture capitalists give you money doesn’t strike everyone as grounds for suspicion, and I can’t point to anything as naked and obvious as an investment by Landon T. Clay in pediatric psych medications.
However, it is biotech money flowing into Dr. Beresin’s beloved project, which is extremely helpful to the bottom lines of Harvard and Mass General. That may not be sinister, but it is kind of self-serving, to say the least. Sort of like Silicon Valley capitalists financing laptops for schoolchildren. You may think laptops for schoolchildren are basically a good thing, but you can’t help noticing how good it is for Silicon Valley as well. It also means that one particular viewpoint in medicine is being artificially inflated above others that might have more to offer troubled kids. When busy reporters or public officials want to know “what the science says” about mental health, nonprofits like the Clay Center help insure they hear no inconvenient facts.
There is an interesting story Bob Fiddaman points out on his blog recently.
On May 18 2017, Chris Cornell, lead singer for Soundgarden committed suicide. The media reported his wife’s hunch the Ativan he was taking had caused his suicide. WBUR ran an interview with Kelly Posner on May 25, the same Posner who headed up the Columbia Suicide Classification group FDA had turned to between the two PDAC hearings in February and September 2004.
Posner dismissed the link to suicide. When quizzed about the fact her group had reported the data that led to the Black Box, she responded that both FDA and she knew there was no link but they were stuck with trials that were not designed to look at the issue and FDA being very conservative and super-concerned about patient safety had been ultra-cautious and issued a Black Box Warning that was strictly speaking unnecessary. Posner was looking forward to a day in the near future when all the new and better designed research coming through the system would lead to the Black Box being removed, because it had had terrible unintended consequences – a drop in diagnoses of depression and a resulting increase in suicides.
This is presumably the work of Robert Gibbons and Lu for godsakes. And what about the fact there is no evidence the drugs work?
Thirty years before a certain D J Trump began talking about fake news, medicine had entered a fake world. Thirty years before Alt Right and Alt Left we had Alt-Medicine – as Study 329 makes clear.