Having previously completed a Masters in Psychology degree, a Diploma in Cognitive Behavioural Therapy and worked in the addiction fields for 8 years in the UK and Ireland, Martin worked as a ‘Peer Support Specialist’ for a year while in New Zealand. Due to his criticism of approaches in mental health and the damage he saw being inflicted on people, he left this position believing he was not the ‘peer’ services were looking for.
‘Loneliness does not come from having no people around, but from being unable to communicate the things that seem important to oneself or from holding certain views which others find inadmissible.’ – CG Jung
Peer support is being actively co-opted by the medical/pharmaceutical industry. I have no doubt about this having worked as a year as a peer support specialist in a community day service for people who were experiencing psychological or emotional difficulties.
I applied for a role as ‘Peer Support Specialist’ with some hesitation. It took me some time to consider whether I really qualified as a ‘peer’. During my late teens and early twenties my mind was often in dark spaces and I was experiencing anxiety while in social places, e.g. university lectures, bars. I did make an attempt on my life at aged 22. Thankfully I survived and I managed to avoid having contact with mental health services at the time. I never really defined myself by this period of my life though I knew I had to take care of myself so I wouldn’t go back to feeling so anxious and low again. I thought that I might have a tendency to be depressed but I never really thought of myself as having ‘depression’ as such.
The ‘peer support specialist’ job advert appeared in the service I was doing casual work for. It did not emphasise having a diagnosis or ‘mental illness’ to qualify as a ‘peer’ but rather having a ‘lived experience’ of distress. As it was a full-time role I decided to apply. I was successful and I would start in July 2016. Before beginning I had my doubts about the medical model for treating psychological or emotional distress. Among other books critical of psychiatry, I had read Thomas Szasz’s ‘Psychiatry: The Science of Lies’ and ‘Depression: An Emotion not A Disease’ by Michael Corry and Aine Tubridy. A month before the job began I had seen the movie, ‘Healing Voices’ (an excellent documentary critiquing the current way we treat ‘mental illness’) and this stirred in me more doubt about the medicalisation of life
I was delighted to start out in a role with a non-medical focus and a move away from clinical language and an ‘us’/‘them’ or ’expert’/’non expert’ approach. Most of my work was focused on group work and peer to peer interaction and learning. This included groups on mindfulness, anxiety management and a 4 week programme groups called ‘My recovery’ (Later changed to ‘My Journey’ because people felt ‘recovery’ implied that they were broken in the first place).
I offered some insights from some research I had done into life satisfaction and we had open discussions about the data I presented. I was also using the Intentional Peer Support manual as developed by Shery Mead in my work. Of particular interest and utility to me was the section on reframing ‘mental illness’ from clinical to non-clinical or non-medical language. This made sense to me as the more people I met the more I realised that many of these people had significant or severe trauma and that this preceded any diagnosis of a ‘mental illness’. The stories of their lives were often ignored or missed and the responses to their trauma from medical professionals were often couched in terms of ‘symptoms’ and ‘diagnoses’.
Around this time I also picked up Robert Whitaker’s ‘Anatomy of an Epidemic’ in the local library. This book neatly and clearly laid out what I had already suspected, i.e. the current approaches in psychiatry and psychotropic prescribing were actually exacerbating the problems people were experiencing rather than curing or fixing these problems. Further reading and exploration led me to rxisk.org and a focus on iatrogenic harm. Being a person who never experienced significant trauma in my childhood or teenage years, this iatrogenic harm insight helped me to put parts of the jigsaw of my own life story together. While I have had many experiences where I felt burned out, frustrated and where I feel that I can’t go on, I have only ever had one suicide attempt in my life. This was after being prescribed propranolol. After investigating this drug further on the rxisk.org website, I realised that attempting suicide is a pretty common reaction to this drug. This got me thinking even further. If I reacted to this drug like that how many other people are reacting to the drugs that they are on?
This reflection, the traumatic stories people were telling me and my previous reading, all pointed towards the diagnosing and drugging being more of the problem than the solution. Further reading, such as Joanna Moncrieff’s ‘The Myth of the Chemical Cure’, Peter Gotzsche’s ‘Big Medicine and Organised Crime: How Big Pharma Corrupted Healthcare’, visiting www.rxisk.org and www.madinamerica.com, chatting with people about their missed or ignored stories, and personal reflection on all of this, convinced me that the current dominant ‘diagnose and drug ‘em’ approach in psychiatry was causing far more harm than good. The only issue was figuring out how I could speak out about this and who would listen. I wasn’t a trained medical professional and I knew that I couldn’t give out medical advice.
I started referring people to www.rxisk.org for advice on their prescribed drugs they were given and to www.madinamerica.com for more advice and connection to other ‘peers’. I then started mentioning what I had learnt to my direct manager, to her manager and then to the clinical director of our service who was a psychiatrist.
Here is where I learnt about the brick walls that spring up when you start speaking out. One of the requirements of my job was to visit the local psychiatric ward where we received most of our referrals once a week for a handover meeting. This usually consisted of two psychiatrists, two registrars, a social worker, a psychiatric nurse, a ward lawyer, an occupational therapist and an associate clinical nurse manager. Here almost all the focus was on ‘compliance’, diagnoses, drugging and involuntary injections or ECT if the person wasn’t responding to the initial treatments. I thought this was shocking when I started going to these meetings but I also thought, ‘these are professionals, surely they know what they are doing.’ My reading began to suggest otherwise.
So I started to make some noise about what I believed and what I was seeing and hearing from the ward and from the people I was talking to. Our service was funded by the local district health board, i.e. public funding and these were the same funders who gave their money to mainstream mental health services in the district. While my direct line manager, a nurse, was sceptical about the benefits of prescribed drugs, my manager’s manager, a psychotherapist, had taken psychotropic drugs and she was convinced it saved her life. She wasn’t happy to hear my questions and criticism of the existing dominant models.
I e-mailed the clinical director of the service about the involuntary ECT and the amount of prescribed drugs that I saw people were on. He was dismissive of my concerns and used postmodernist justifications and talk of high versus low impact journals to counter some of the arguments I had made. He advised me to avoid getting into such discussions or debates about prescription drugs.
This strategy to raise awareness of what was going on in our service and at the ward wasn’t working. I was considering writing an e-mail to senior District Health Board (DHB) psychiatrists in management and influential positions who had expressed progressive ideas I had read or heard about. I was going to outline to them how bad current practices within the mental health services were and to show that there are better and more effective ways of working with people based on reliable scientific evidence and person-centred approaches. I was hoping to ask for their assistance to implement some changes. I showed this to senior management within Pathways to get their approval before sending it. They told me not to send this.
For suggesting this potential e-mail in the first place I was told not to contact or lobby any DHB staff, i.e. anyone employed in public health services in New Zealand, in my professional or personal capacity. I was advised not to debate or express my views on current practices in the workplace. I was also told that advocacy on behalf of people that visited our service was not something within my job description and that if I wanted to do this I would need to look for another job.
I then decided to give Pathways management a detailed outline of changes that I felt could help to save lives and potentially millions of dollars of taxpayers’ money. This included such things as helping people taper off their prescribed drugs and the introduction of Open Dialogue. I never received feedback about this information. My direct managers encouraged me to get involved in the development of policies and procedures as one of their policies is about encouraging the involvement of people with lived experiences at the policy level. I reviewed a few policies, focusing on the medication policies. When I delivered feedback about these policies to senior management, where I pointed out how Pathways were underestimating the dangers of some medications and that much of their information in their policies wasn’t based on reliable evidence, I received responses from senior management saying that I was not a suitable person to review this material.
Following on from this, I had a disciplinary investigation for expressing some criticism towards our service to a person using our service and for sharing some information with her that was critical of current practices . I was told to ‘pull back’ if the majority did not share my view. I asked for clarity about what I should do when the majority are following unreliable or non-evidence based approaches that could be dangerous and damaging to the people we work with. I never received a response to this e-mail.
I handed in my notice shortly after this. There is only so much banging your head off a brick wall that you can do. Finally at the last ward meeting I attended, I let the psychiatric staff know how I found their language and behaviour humiliating, derogatory and dehumanising and I reminded the doctors about their Hippocratic Oath. A complaint was made about this to management in Pathways. After this, my manager told me not to have any further contact with clinicians or ‘clients’. I left work two days earlier than expected as it was going to be very difficult to avoid any interactions with people. She also told me that she would make any future employers of mine aware of my remarks to the psychiatric team in any future reference. Just one last pat on the back for the road.
I am now back in Ireland. I don’t think that paid peer support work is for me anymore. But if you think it is for you here is my advice for being a ‘peer support specialist’ within the mainstream mental health services.
‘Ten Rules for Being the Right Peer’:
Go n-eiri an bother leat (May the road rise to meet you)Share this:
Copyright © Data Based Medicine Americas Ltd.
I think we can see how being a Peer, the Right One or the Wrong One, is beset with difficulties – who has the prime motivation to help out the patient bedevilled by dogmatic medicals insistent on psychotropic drugs.
Peer support in mental health care: is it good value for money?
In the meantime, we believe that enough evidence exists to begin cautiously to employ properly trained and supported peer workers in mental health teams and to carefully evaluate their effects, including their impact on high-cost interventions like inpatient care. This is justified not only on financial grounds, but also because of the consistent body of evidence highlighting problems with the quality of inpatient care.
‘consistent body of evidence highlighting problems with the quality of care’
While there is an increasing body of evidence around the benefits of peer support roles in services, some studies have acknowledged that there have been challenges introducing them into mental health service teams. These challenges include establishing appropriate boundaries, and managing power imbalances in teams, which can result in peer workers experiencing stress, and the actual, or potential for, dilution of the role (Gilliard and colleagues, 2013). As it is a new role, in some cases it has lacked deﬁnition and this has been compounded by peer support workers having to integrate into teams where practice is not necessarily recovery focused (Bradstreet and Pratt, 2010).
‘where practice is not necessarily recovery focused’
And then we have the ‘unofficial’ peer support group
mary hennessey @cymraes5 Jan 24
So much talk today about prescribed drug withdrawal etc. New peer support group on this topic starts next week in PRESTATYN. 30/01/18, 6.30 pm Nant Hall Church Hall. All welcome.
Which, on the face it, is much more likely to succeed than the ‘official’ peer?
Thanks for your comment.
I read through those articles. They do provide some good evidence for peer support being as effective and less costly as other ‘professional’ approaches. It was good to see that researchers have highlighted the problems with introducing peer support into existing services and how this leads to dilution of the person-centred, holistic aims of peer support and leads to a move away from recovery models. This was my experience and the power imbalances between my role and those of other workers certainly led to difficulties in trying to make my voice heard and in my attempts to influence change.
It was interesting to note in the Trachtenberg et al study that peer support with ‘intensive case management’ had worse outcomes (in terms of reduced hospital days) than peer support on its own. This would suggest that increased professional medical intervention and support leads to worse outcomes. It’s also interesting that they conducted a review on the cost-effectiveness of peer support. It would be very interesting to see an independent study on the cost-effectiveness of psychiatrists and other mental health professionals! The Cochrane review by Pitt et al, 2013, (mentioned in the Insights report), also states that ’employing past or present consumers of mental health services as providers of mental health services achieve psychosocial, mental health symptom and service use outcomes that are no better or worse than those achieved by professional staff in providing care.’ So this suggests that peer support costs less and achieves similiar results.
However it also highlights in the Insights report that ‘peer support is not intended to be a replacement for existing services or professional roles, but is designed to complement them.’ From my experience, person-centred and holistic peer support approaches that are focused on figuring out the truth of someone’s distress should be a direct challenge to the current mainstream ‘diagnose and drug ’em’ models, not complimentary. There seems to be considerable efforts to dilute and co-opt these approaches and find the ‘right’/’complementary’ peer so that the existing services remain in place. Perhaps there are some peers in existing services that are able to bide their time, remain person-centred, find professional allies that are pushing for truly progressive change away from a drug-centred model and they are able to influence change that way. I hope that they are succeeding at this.
The use of peer support ‘specialists’ in the mental health services could be of benefit in terms of cost, effectiveness and in promoting a person-centred holistic approach and the studies you shared seem to support this. Some peers may be doing fantastic work at gradually chipping away at the current system from the inside and I commend them for this hard task. Some peer support workers may be happy to be a complementary service that is not a real or substantial challenge to the existing mental health services. While others may be actively involved in propping up and promoting the ‘Mental Health Inc’ medical/pharma business model. Having read what I’ve read and seen the damage that is being done to people I could not be happy doing the last two. Rather than being a token peer that helps to show ‘progress’, I now believe that my energies are best served from working on the outside, highlighting what is happening from my experiences on the inside and trying to find ways to challenge the corruption and anti-scientific and anti-humanistic approaches that are ongoing within mental health services. In my opinion, peer support could succeed as a support service but only if it watches out for co-option and remains true to its person-centred, holistic aims and challenges existing services and dominant models.
All the best with your group,
Martin, I get the feeling from your article that you are not likely to keep quiet about the things you have seen and heard – and why should you. Employing ‘specialist’ peer support is the latest idea about ‘ways to silence the many’ it would seem. Looks good on paper, sounds good to those who are concerned about patient support – but where is it leading? To even further closing down of the rights of patients it would seem to me.
Keep shouting Martin – we are listening and will not be silenced whilst we have the energy to carry on.
Annie – I only wish that I could say that our group is ‘flourishing’ and therefore agree with your final question. Truth is that things are extremely slow – but we are not about to give up any time soon! At present, we may be unable to attract many to our meetings BUT just by actually having the meetings advertised we are able to prove, to those who question us, how difficult it is to get the message out to people.
The local mayor insisted on a photo taken, with him, on the eve of the first meeting. We had already taken a poster to the local paper beforehand to no avail. The mayor was certain that with his links to the local press, he’d have the article appearing in no time – to date, no sign of it in the press!
The most we can do, with certainty, is be available should someone need us – we cannot force anyone to attend. It would be great if the local doctors’ surgeries could take on board that what we offer could complement their work and would ease the pressure on their specialised, precious time.
Thanks for encouragement, Mary.
Yeah I do believe that peer support roles are being and can be co-opted into the current dominant mental health services and models and I would be concerned about where this will end up once services have incorporated the ‘right’ or ‘complementary’ peers. I still hope that there are some peer support workers or ‘specialists’ employed in mental health services that are awake to what is going on and are pushing back. They need all the support that they can get while the ones that are there giving mental health services the veneer of respectability and ‘progress’ could also be considered part of the current problem. They may have what seems like a respectable job that gives them a sense of self-esteem and self-worth but this is often achieved through compliance and not rocking the boat too much. That needs to be called out for what it is as well while we can continue to support the individual professionals, whether they be peers, counsellors, psychiatrists, psychologists, nurses, that are genuinely trying to make a difference despite the costs to their own job security and the legal and financial costs that may come their way.
Keep shouting as well, Mary
Just to be clear – our group is not linked to any GP surgery. We state that clearly in our leaflet as well as the fact that we are neither doctors nor nurses – just ordinary community members who have experience of withdrawal as patient and carer. We feel that dependence and withdrawal are almost impossible unless you have good support – that goes for the carers as much as the patient/sufferer. Not everyone is able to access support – a group situation can, hopefully, ease their suffering. Peer support does not offer anything medical – it simply supports with tips, from one to another, which may ease the dreaded journey. We would not encourage or discourage dependence/withdrawal but simply support wherever each group member finds themselves at that particular moment. We leave the medical entirely to the medics; our support is simply ‘lived experience’ shared.
Thanks for clarification Mary,
That distance from medical practitioners who are ‘diagnose and drug em’ focused and who also wield a lot of power, pressure and influence probably helps your group and its members. It may give members a chance to be truly open about their experiences rather than worrying too much if they disclose or say the wrong thing for fear of bringing the weight of the mental health and legal establishment down on them. It does not sound like your group is in any danger of being co-opted. My warnings above about co-option and dilution of peer support are more related to groups who are funded by or have close ties with mainstream mental health medical services.
I do believe that people need to be careful when giving any direct medical advice to people. I also believe that we can not leave it solely to medics to voice concerns over current medical practices as this is too big an issue and concern to leave it to them to sort out themselves. Part of my ‘lived experience’ and understanding about my journey was coming across the works of the likes of Thomas Szasz, Robert Whitaker, Peter Gotzsche, John Read and the websites http://www.madinamerica.com and http://www.rxisk.org so I have shared these experiences and what they have meant to me with my peers also. This is not medical advice but reference to information that may help guide decisions in relation to prescription drugs and psychological treatments. Making sure people are making informed decisions about important life decisions is what we do as good friends, family members, citizens so I think helping to guide people to what you see as reliable information is also part of peer work.
Sounds like your group is helping people through difficult times and allowing individuals to come to their own conclusions about what they see is best for them. That is a far more liberating and dignified way of working with people than many approaches I have heard and witnessed. Keep up the good work.
Thanks Martin – you have it exactly right about the purpose of our group – to be totally open-minded whilst also educating ( we state that our info comes from RxISK.org).
Recently, I said in a comment that there was no recognition in the local press regarding our group – I have to eat my words! it’s there this week. fair play to the mayor, he’s obviously gone on to the Rxisk website and found out exactly what it’s about – as there’s a quote in the paper which he certainly didn’t get from speaking with us nor from our leaflet. I am impressed. May not alter the number attending the group but at least an extra person now understands what rxisk is all about – and that is good.
As someone who has spent way too much time banging her head against a similar brick wall, (not as a peer supporter but simply a person seeking change) I’d say your story rings all too true. Good for you for standing up to all of that.
In regard to peer supports being co-opted, here’s an interesting comment from a recent article on MIA:
John Hoggett February 10, 2018 at 11:37 am
…Some think that the most dangerous thing that the Black Panthers did was to run breakfast programmes for school children. Implicit in that action was the idea that the state is starving black children. They didn’t have to mount protests to show what they meant. This was a big threat to the white government. Perhaps peer support got coopted because it was a threat?
I’m hoping this applies to the potential power of face to face withdrawal groups. With careful planning these will not be easily co-opted.
Thank you for adding to the “for-real” peer-support which exists in the sharing and understanding found in this, and in similar inspirational and courageous blog exchanges.
Knowledgeable and fearless peer support and understanding which is so vital in our otherwise lonely and isolated existence following the loss and destruction of a delightful and inspirational soul, taken from us by the ignorance, dogma, and it has to be said: the evil which permeates the drug-dependent practice of psychiatry.
(“Evil is an Absence of Empathy”)
The failure of those “professionals” who found you so threatening.
Those who found you to be an increasing challenge to their abysmal standards and institutionalised cruelty.
A questioner of their abandonment of the basic tenets of good and decent medical practice and an informed observer of their daily drug induced harms.
Your presence brought intellect, training, compassion, empathy and insight.
Even more threatening to the establishment, you could communicate with real people whose health and whose hopes had been destroyed by the false beliefs (aka delusions) of those responsible for the greatest failure in medicine.
What is most distressing to read – (even more painful than feeling the coercion to conform and the contempt you experienced yourself – which reminds me of the institutionalised cruelty which permeates the atmosphere and ethos of what are described as hospitals): –
is a perception from your words that the attitudes you describe appear to drive out all those staff with empathy, care, compassion and humanity.
There now remaining a hard core of the punitive and the malevolent.
The punitive staff, by whom our loved ones are treated as deserving of punishment, not healing.
There was little but contempt for patients in these institutions which I found myself visiting. Contempt perhaps delivered with callous disregard for intensely drug-toxic “patients”and caring, terrified, despairing relatives. (The latter being perceived to be a great threat).
I could shrug off my 34 years of medical experience being rubbished and ridiculed. However, I couldn’t bare their absurd denials that our now destroyed loved-one had developed tardive dyskinesia whilst forcibly treated for a “mental illness” which was entirely a misdiagnosed adverse drug reaction.
An alleged place of “healing” where those with iatrogenic induced neuropsychiatric toxicities are bullied, abused and humiliated for assumed “attention seeking and manipulative behaviour”.
Abused because the levels of ignorance amongst staff re psychiatric drug toxicities beggar belief.
Such manipulative behaviours soon become “emergent mental illnesses”. The mindless roulette wheel spins again and another random round of medical drug-abuse is started with further multiple injuries.
“Tardive dyskinesia doesn’t happen with second generation antipsychotics”.
Human devastation caused by ignorance , denial and Pharma-propaganda leads to
destruction of our loved ones. Ignorance and denial which costs them their futures, costs us our reason for existing, and costs the State millions of pounds of misappropriated health service monies.
“The greater the ignorance, the greater the dogmatism”. (Sir William Osler).
Thank you for your courage in taking up the impossible advocacy of peer review, and for sharing your experience with such compelling writing.
Thank you for your kind and encouraging comments Tim,
Sorry to hear about the experience of your loved one and the impact it has had. The lies, deceit, lack of empathy and embracing of evil (while deluding yourself that you are doing good) is truly staggering and has caused a huge amount of suffering to many. I believe that stories like yours are what many medical professionals are afraid to acknowledge and listen to. This would be too hard for many of them to hear and believe and my experience has been that family members are often dismissed as nuisances, uneducated and misinformed plebs if they don’t agree with the mental health professional. This dismissal prevents a hard honest look at oneself and one’s behaviour in the mirror. Many mental health professionals (if they looked at the cold hard truth) may not like what they see – ignorance and dogmatism may be better.
The type of work environment, i.e. the language, attitudes and behaviour of staff, of the ward I visited once a week was toxic and if you were a sensitive person who was suspectible to these toxins you could be either corrupted by them, you could burn out/be forced out or you could try to maintain your humanity, compassion and empathy – I do believe that the first two behaviours are more common as the last does not seem to be encouraged as from my experience being sensitive to people’s plights seemed to be considered more of a weakness than a strength in these environments. Management needed staff to be there and get on with their job. However this was no excuse for some of the behaviour and language I saw and heard. I did meet a minority of workers at the ward who were maintaining their sensitivity and compassion but these tended to be new recruits or people of strong faith who already had had their run ins with management and were always close to burn out. I left before I was consumed by the toxins so that I could live to fight another day. Fortunately as a visitor to the ward I had that option while many locked on sadly never did.
I hope that you continue to tell your story Tim and that of your loved one. It will hopefully wake some people up to what is going on and his and your suffering will not be in vain.
All the best,
I am a victim of this over medicated treatment having been hospitalised and treated like a dog even forced to go through ECT my family were made to look stupid for caring and scolded like naughty children for trying to ask about the care I was being given I applaud you for writing this and your action it’s good to see that there are some decent people in this mad world of phyciatry that actually can see the harm that is being done , these people don’t truly care about us they just want us drugged up to keep us quiete so they can have a easy life , all we want is a life with some respect and dignity. Well done you sir for voicing your concerns I just wish there were more like you that feel this way
Thanks for your encouraging words Terry,
Sorry to hear about the way you and your family were treated. Unfortunately I do not think that this is uncommon. I have also heard of people being given forced ECT on the ward. When I made the clinical director, a psychiatrist, of the service I worked aware of this and pointed to the lack of evidence for its efficacy and potential damage it could do he told me to avoid getting into these debates and focus on my peer role. It appears any criticism of medical approaches is off limits to those who are not medically trained.
I believe that more people are becoming knowledgeable about what is happening in the mental health field through the likes of http://www.rxisk.org, http://www.madinamerica.com and writers such as Robert Whitaker and Peter Gotszche. Also the more we speak about and highlight it the more people will hopefully wake up the madness of it and with a bit of encouragement, speak out against it.
FYI ..I hope this helps you and any of the other readers.
Video Testimonials – Kelly Brogan MD
Ali. Bipolar Disorder, Eating Disorder, Psychosis, Anxiety, Brain Fog, Fatigue, PMS, Hormonal Imbalance, Suicidality, Insomnia, Resolved Disability, Medication Free, Spiritual Transformation. Rose. Depression, Anxiety, Brain Fog, Fatigue, Substance Abuse, Antibiotic Injury, Suicidality, Resolved Disability, Medication Free, …
Dr Brogan is a trail blazer having become enlightened to the “truth” a number of years back.
She was a well intentioned prescribing Psychiatrist, she has educated herself regarding all of the Dr”s and authors mentioned and offers hope to individuals such as myself to take back our power for personal self care.
thanks for speaking out! i wish there were more real peers like you and less peer specialists. keep up the good work!
Thanks for the encouragement and kind words Jasna,
I’ll try to keep speaking the truth as well as I can perceive it.
All the best,
Martin. I find this encourageing. Yet then, ofcourse, saddening.
Over most of your article, I picture you writing with a “baffled” expression on your face. Thinking that it can’t really be true that in support functions of any healthcare system, such total disregard for anything but “the beaten track”.
It sounds to me like you wanna help other people, but also, in doing so prevent as much as possible to further injure them. This last bit, the avoidance of further injury, is what sets you apart. Somehow other “professionals” aren’t as concerned of that. Why? Well, I just don’t know anymore. It is just a thing you assume, but now know is lost somewhere along the way. To reasons unknown/uncomprehensible.
But since you obviously speak of this as “something wrong”, I want to ask you, both in honesty and also a little for my own curiosity:
What is your reaction to that this is not a “new” dilemma? Little have changed in the guidelines on how to help people in distress, regardless what statistics say about it being helpful or not? I know I was shocked when I found out this has been an ongoing struggle.
What even motivates you to raise concerns, when almost all of your mentioned books and critics have been stuck in an uneven fight ever since spoken/published?
For every supporter on OpenDialogue, there are ten supporters for “undiagnosed mental health issues”
For every warning flag on over-prescribing of psychotropic drugs, there are 10 willing psychiatrists to call it “an actual under-prescribing”.
I am personally in awe to all the critics you mention, for giving me my self-respect and -worth back. But psychiatry is like that sticky stuff you always end up ankle deep in, in a nightmare. Not very ideal for an opponent.
Thanks for your kind and insightful reflections, Ove,
You are right. I was ‘baffled’ when I first went to those handover ward meetings. When I saw how mental health ‘professionals’ were behaving, e.g. forced ECT as a common procedure, a focus on order and compliance, people being threatened with injections if they didn’t take their drugs, treating people as guinea pigs for toxic medications, and how they were speaking, e.g. calling people ‘feral’ and ridiculing family members, I was shocked. I had read about this type of behaviour back in the day and seen movies, e.g. One Flew Over the Cuckoo’s Nest, but I had thought that we had moved on from the cruelty of those days. I was naive. Clearly this psych ward (which I imagine is not the worst of them from personal stories I have heard) had not moved on. Perhaps because I was new to this environment and I only had to be there once a week while my main work environment was a non-clinical, open, relaxing, homely like peer support environment with couches, plants, books, this meant that I never had to ‘adapt’ to the psych ward environment to do my job. In the peer support environment I had colleagues who were also disgusted or at least concerned about the behaviour and language used by the ‘professionals’ on the ward so I had some support there so I didn’t feel so isolated in my viewpoints and I could bounce things off them.
You ask about my reaction to this old and ongoing issue? In relation to the guidelines: David Healy’s book ‘Pharmageddon’ gave me a good insight into why they are how they currently are.
For me, there is another piece of the puzzle that helps me put things in context. When I have started digging into things at first I approached it from purely an investigative scientific viewpoint. I was motivated by figuring out why our world is how it is and why people think and behave as they do. This was my original attraction to the discipline of psychology. I found the way I thought and the way people thought and behaved fascinating and I wanted to understand this more.
I wanted to understand things through use of reason, logic and evidence for myself and perhaps any understanding I did gain I could share with others. The one area I tried to avoid or dismiss as irrational was religious or spiritual answers that spoke of the ongoing battle between good and evil or light and dark forces that play out in ourselves and in our world. However as I have dug deeper and deeper to try to find answers these religious explanations have come to be a vital part of understanding what is currently happening in our world and have also offered explanations for patterns in my own life. I do not jump to these good versus evil explanations lightly as I think that there can be better explanations, e.g. people may say that a high school shooting is a sign of the forces of evil playing out in our world which I think is fair and accurate but we should not dismiss the shooter as ‘evil’ as there may be strong evidence that their behaviour was triggered by psych drugs and this behaviour is a reaction to the evil of deceit, greed, resentment and cowardice by those not willing to speak up playing out in our world. There are many people that hold some responsibility for events such as a high school shooting while there are some, e.g. those that have fully embraced deceit, resentment and lust for power, social status or money at any cost as ways of operating in the world, that are more responsible than others.
So my reaction to what I see in the world and in the mental health field particularly has been that I am convinced that the dark forces of evil do actually exist and they play out in cunning and manipulative ways. I believe that we need to pay attention to when and how they creep into our own lives and when they start dictating our behaviour. I know this from my life and work in the addiction and mental health fields. In one job I was the person going around to people’s houses making sure that they took their prescirbed drugs believing I was doing the right thing. I would do this in a nice, non-threatening way by my ultimate goal was to get them to take their drugs rather than truly listen to their concerns. I eventually realised I was a cog in a wheel that was causing a lot of dependence and destruction. I have also been in counselling roles where I have felt the thrill of control, power and social status and at times working in these roles was more about me and what I got from it than the person sitting in front of me. I still need to check this tendency every now and again and make sure my ego is not dictating my behaviour. So my reaction has been a recognition of the battle of good and evil and how this is an ongoing battle that has gone on since we, as flawed beings, succumbed to the temptations of evil. I believe that we will not defeat evil and darkness in this human life and create a perfect utopia (I believe this tendency can be very dangerous) but I do think that if we keep speaking the Truth which is a force of good and light we will begin the long and arduous journey towards a better world.
This leads on from the above to what motivates me? The Truth. I believe that truth is a force of light in our world and no matter how many dark forces are trying to suppress it and stamp out the light as long as there are people speaking and living the truth this light will never be diminished. I’m also motivated by others who speak the truth, like Robert Whitaker, Peter Gotzsche, David Healy, Open Dialogue researchers, and by seeing the consequences and hearing the stories of people following the truth that they speak of. This reminds me that the Truth is good. Like all of us, I’m also motivated at times by social status, money, control, power, evolutionary sexual drives but I try to be careful by monitoring which direction they are pulling me in. I have recently connected again with my Catholic faith (after having tried to tear it apart and dismiss it for a long time) as I believe that this helps me to live and speak the Truth as well.
Thanks for the questions Ove. It gave me time to think about, reflect on and articulate my reflections that helps me to hopefully understand myself and my motivation better.
ps: I do need to give credit to Prof Jordan Peterson (a clin psych professor on YouTube) for some of my above reflections and insights as while he does not have his eyes fully open to the problems of psychotropic drugs he has helped me on my journey as well.
pps: The song by the Irish folk singer, Luka Bloom, ‘Don’t Be Afraid of the Light that Shines Within You’ also motivates me 🙂 So, Ove, I hope that you can continue to let your light shine. All the best.
Martin. If you recognise the ‘good versus evil’ in this ongoing battle, I’m sure you will be a welcomed ‘peer’. Even likely to be an asset, for the ‘light’ side. Your words and explanations rings very true in my ears.
I was just curious over how an academic person like you, can become as intrigued by this large mess, almost without a personal ‘dark’ story. (Your dark period, as you mention, is dark enough, but also very likely to not be very uncommon. And I read into it that you personal ‘dark’ period isn’t your main motivation)
Because that fascinates me, the good, successful, intelligent and prosperous people who turn head on into this battle, without the obvious personal connection.
I’m 20 years in on the ‘recieving end’ of Seroxat, my motivation is obvious. And the ‘light’ I might have ever shined, has flickered and gone out. Left is a glowing ember, a wish to be ‘re-evaluated’, but now thorugh a lens that compensates for Seroxat.
Luka had a strong clear voice, I’ve had him on in the background while writing. Here is my prefered version of a ‘light’-song: https://www.youtube.com/watch?v=OLlfztPoyQk
Perhaps not as ‘refined’, but sure sends a similar message.
My best of wishes from a cold, 4ft deep snowy Sweden.
Glad the above made some sense to you. Thanks for the great YouTube piece you sent – beautiful and soulful 🙂
Sorry to hear about your Seroxat battle. Perhaps if your light is at a low ebb, a powerful light can still shine on you as Leonard Cohen says, ‘There is a crack in everything, that’s how the light gets in’ – https://www.youtube.com/watch?v=6wRYjtvIYK0
I don’t know why exactly I feel so passionate about this topic and why I have spoken out. Maybe it has to do with my upbringing. I have a large family, close neighbours, a large extended family who I see pretty regularly and we always were guided to look out for and take responsibility for each other. Thankfully I also grew up in a time and an area where psychological and medical interventions for young people were a rare occurrence in Ireland and I didn’t learn to trust or rely on these professionals too much. Also in ways I was raised to learn and revere Truth and my parents were flexible enough to encourage Truth seeking and exploration. Also when I went to university I missed most of the now prevalent worship of postmodernist/Marxist ideology that undermines Truth and diminishes the noble quest of searching for it. These are just some of the reasons I think.
Also luck, chance, fortune and grace have played their role. Probably more of the most fortunate experiences of my life was after I had a suicide attempt (pills which didn’t work) I went to A and E and a nurse saw and assessed me. He said that my system would be OK due to the type and amount of meds I took. He didn’t refer me to the psych ward or for immediate intervention. He said that there would be a follow up and there never was. At that stage I could easily have bee diagnosed with Major Depressive Disorder, possibly detained and given psychotropic meds that could have sent me down a darker and more oppressive path. Perhaps that nurse was disillusioned with the psych services himself and knew there was no point in referring me that way. It was a lucky escape and I got back to a better place eventually without much help from services. I saw a CBT therapist and clin psych at one stage and they were helpful – you know what really worked for me with the clinical psychologist was when I completely broke down, weeping in her office about the suicide attempt 6 months earlier and the guilt I felt about it. I looked up at her at one stage and she wasn’t breaking down or stoney faced but had tears in her eyes – that was powerful as it made me believe she was strong yet cared. I was in my early twenties, away from home in the UK so this was helpful at the time. I saw her one more time after that and this was sufficient to help me have a safe, cathartic experience and release some of my pent up emotions.
So my life has been graced with blessings at times so why not give back? That’s probably the best answer overall.
From a sunny early Spring day in the green pastures of Ireland,
All the best Ove,
Dear Martin M! Thank you for your insights! There are your lines that deeply resonate with me/my experience and what Jacquie Dillon calls ”survivors mission” and every line fits my own life:
I don’t know why exactly I feel so passionate about this topic and why I have spoken out. Maybe it has to do with my upbringing. I have a large family, close neighbours, a large extended family who I see pretty regularly and we always were guided to look out for and take responsibility for each other. Thankfully I also grew up in a time and an area where psychological and medical interventions for young people were a rare occurrence in Ireland and I didn’t learn to trust or rely on these professionals too much. Also in ways I was raised to learn and revere Truth and my parents were flexible enough to encourage Truth seeking and exploration. Also when I went to university I missed most of the now prevalent worship of postmodernist/Marxist ideology that undermines Truth and diminishes the noble quest of searching for it. These are just some of the reasons I think.
Blessings from snowy Lithuania!
Thanks for Being the Right Peer now on the outside, Marcus, and your total understanding of our place and your place.
In our place, Scotland, a group is tackling this head on with the Scottish Government
Burgh drug campaigner says government is ‘slamming the door in people’s faces’
fionahfrench 20th February 02:27 PM
Thank you very much to Craig Borland and the Helensburgh Advertiser for coverage of this issue. The failure of the Scottish Government to engage with Marion Brown and Ann Kelly and others in the prescribed harmed community is unacceptable. We have had to communicate with the BMA, London and the APPG, Westminster who in turn are liaising with Public Health England. Shona Robison states that patients can use NHS24. I conducted a survey of patients in the online community asking for their views on existing out of hours services (UK) and the majority said they could offer no help at all. The results of the survey were passed to Public Health England. Shona Robison also says the Govt is working on a range of measures. What exactly are these measures? Extended roles for pharmacists who have no more idea how to safely taper patients off antidepressants than the GPs who prescribed them in the first place. England is conducting research into tapering methods as are the Dutch.
What exactly is being done in Scotland? There is no support for patients who have been made dependent on prescribed drugs and there certainly is no help for those damaged by the drugs. There has been no attempt to quantify the extent of this problem. We don’t even know how long patients have been taking drugs of dependence, there are no statistics to my knowledge. On 18 January, Maureen Watt had precisely nothing to say on the subject and in my opinion should resign from her post. To preside over ever-increasing prescribing rates whilst denying any knowledge of the harm being done indicates she has no understanding of the ramifications of her stated mental health policy.
I am deeply disappointed in the Scottish Government who now sees fit to liaise with Public Health England simply because they have announced a year long review. Patients in Scotland have been telling the Scottish Government about this problem for several years. Why should we expect PHE to extend its review to Scotland, it has no access to prescribing datasets here. Where is the leadership in Scotland? It is dismal. The Dept of Health in London has failed to act on the issue of drug dependence for decades and veteran campaigners have little belief they will act in a meaningful way now. The prescribed harmed community in Scotland expect the Scottish Government to take a lead on this issue and to demonstrate their commitment to protecting the people of Scotland. I listened to a debate on ME/CFS today in the House of Commons, led by Carol Monaghan, SNP. it was excellent, this is the sort of action we expect for the prescribed harmed community in Scotland. The prescribed harmed community is considerably larger than the ME/CFS community but they too have been neglected for 30 years because of the influence of psychiatry and their erroneous theories and beliefs.
Fiona articulates very well the crisis in Scotland which carries over to Wales and Ireland.
Do you have any ideas how you can work as a Right Peer Outsider to help us, given your immense talent for ferreting out the obvious failings .. thank you Marcus
Hi Annie, just to let you know it’s Martin, not Marcus, by the way
Thanks for highlighting what is going on in your part of the world. I read through the articles and comments. It sounds very frustrating for the activists and people who have harmed by these drugs, far more so than my own experiences, which helps put been in context. It was good that a local paper ran with this story. Shame it gave the last word to the Scottish Government spokesperson but the comments after it can hopefully open people’s eyes further. I can imagine the situation is similiar if not worse here in Ireland due to us having 8 of the 10 pharmaceutical companies in the world based here and the influence they have on our compliant government, civil servants and medical professionals and pharmacists.
I’m not sure what I can do to help you in this situation. Please feel free to share the above with anyone you know if that helps and also I have an extended version of the above with more extensive notes from the ward meetings I attended if you want this. Please e-mail David Healy and he could perhaps send your e-mail onto me? My experiences could just be dismissed as ‘it happened in New Zealand but it doesn’t mean it’s happening here’ but it might be worth making some people aware of what is happening in a first world modern and ‘progressive’ mental health service.
I think starting locally with one’s own friends, family, community, local councillors or local MPs (if you feel they can be trusted and aren’t bought off or brainwashed already) and explaining what is going on to them in the psychiatric world and the dangers of psychotropic drugs may be more effective way of making the citizens aware of what is going on. I know that there are efforts from organisations with vested interests to undermine and control local grassroots organisations but they will probably find it harder to influence and undermine tightknit and knowledgeable community groups than national and European officials. I’m not a fan of Big Government and giving them too much power so by having strong, knowledgable and cohesive community groups who could liaise with other community groups this may give power back to the people rather than the political, medical or pharma establishment. I’d still lobby government and European officials as well as I’m not so skeptical that I believe that they are all in the medical/pharma industry’s pocket as there may be some that are still open to the truth and are trying to be servants of the people rather than dictators to them.
Also there are members with health services that occasionally speak out. I had plans to contact them in NZ, as I spoke about above but was told I’d be disciplined if I did and I backed down on this one as I wanted to keep my job at the time. (As a person on a work visa in NZ I didn’t have any rights to social welfare and I felt this economic pressure to remain quiet though I still think I could have taken the risk). However here in Ireland I am entitled to social welfare when I’m not working so this provides some sort of a safety net and I can manage on this for now as long as I don’t crave too much unnecessary stuff and live more of a minimalistic lifestyle (Not watching TV or listening to ads on radio helps this). In my opinion, our systems are set up so that citizens can be protected from some economic hardship but we need to find ways to not want or crave so much stuff so we don’t become robots to the marketing that is thrown at us daily and the attempts to drive you to buy more materialistic stuff so you can have the ‘perfect’ life. So I think people will need to take the risks and contact those speaking out and share what is happening in their situations but prepare yourself, beforehand if you can, for the consequences and the hardships that will follow. This is part of the reasons for me why spirituality and my faith have become important again. (This is kind of a aside and may sound like rambling but I hope that it makes sense).
Some ideas…Hope they are of some use. I’m involved in a different political grassroots campaign not so connected to psychotropic drugs here in Ireland but when this campaign is over and I hope to devote more energy to highlighting what is going on in the mental health and medical world.
All the best in your campaign in Scotland. Like us Irish ye have fought tougher battles that were often seen as unwinnable in your time so keep up the fight 🙂
Martin -Just a few thoughts. Firstly though Respect to you for speaking out and spelling it out to those who were so good at getting rid of the very type of person so needed in mental health. Sadly this sort of disempowering attitude towards people who dip their toes into the ‘user-expert’ field has been going on for decades. Back in the 70s it looked as though the ‘user-survivor’ movement might make significant changes yet there is still a need for the sort of blogs and organisations you mention, Rxisk; Mad in America; David Healy etc. It is obvious by usually covered up these days that There is still an uderlying even overt contempt for people who are different, going through bad patches, behaving in ways others do not understand etc Adler useed to write about the urge to supeeriority – it’s not read much these days. People are often coralled into such as MIND or other massively funded organisations which are not speaking out power but protecting their own. Setting up cafes and art groups etc and conferences is useful for a while but keeps people quiet. I would bet that those who employed you will be very careful not to risk employing anybody who might have the confidence to do what you did. Some user-surviivors use ‘partnership’ positions as you know as a stepping stone back into employment – if there is another gap on the CV due to losing the job on top of having had a mental illness the future is grim.. Luckily, I hope being out of NZ will avoid that. The college of psychiatrists overall has 22 ‘users’ 22 ‘carers’ on different commitees..they are also asking for unpaid volunteers to work on Informatics – a skilled job which will be unpaid…can you hear the hollow laughter? The Welsh Division more farcically has 2 – each described as ‘user/carer’ as though there is no difference (although of course there may not be). The Royal Australian and New Zealand College of Psychiatrists by the way are holding a conference in Oct 2018 ‘History ,Philosophy and Ethics of Psychiatry in the 20 century – ‘The State of Play'(!!) If anybody cares to attend it will cost you 420-520 dollars (ex- cluding travel ,accomodation etc), Totally unnecessary waste of tax payers’ or anybodies’ money . I enjoy philisophical and ethical debates and can spend hours trying to understand the odious and abusive way people behave and are ‘treated’ but frankly there are times when a spade just needs to be called a spade – psychiatry on the whole – stinks.
Thanks for message,
On the whole I do think that psychiatry stinks as well due to its fraudulent ‘science’ and its striving for power by working with whoever helps them get there and then its abuse of power when it has achieved its status. Some psychiatrists may be unaware of the path they are on, some are brave enough to speak out while others have allowed their lust for status, money, greed and power to completely dominate them and these tend to then be the ones with the most influence. I think that psychiatry has done enough damage to its own reputation and has shown itself, overall, to be a force of coercion built on lies packaged as ‘scientific truths’ that I do not see how it can reform itself as if you examine it critically enough you realise that pretty much its whole foundation would have to be removed or reinvented.
It is sad to hear that my type of experience has been going on since at least the 1970’s but it doesn’t surprise me either. I suppose at this stage, mental health services and psychiatry, in particular, are trying to market themselves as if they have reformed. Hopefully by sharing my experience above and getting it out to people they will have to work extra hard at this marketing and co-option. And yes I do think that the service I work with will be extra careful about who they employ now and they will probably make sure that that person is more compliant and perhaps a fan of or ignorant of the current problems with psychotropic drugs. I thought about this and have considered if my actions have had some potentially negative consequences as well but hopefully overall they had a more positive effect and opened some people’s eyes or at least niggled at their conscience and that could be a start.
All the best
As a psychologist I can say that it’s very painful at times working in the mental health care system. I know first hand what it’s like for my whole life to have changed due to adverse drug reaction. And to be met with denial, blame, and minimization from what psychiatry. So going to work seeing it happen really is upsetting to me.
I’ve had a couple of recent situations w patients where I think there were serious adverse effects. I said something to the psychiatrists. My point of view is totally ignored. I am ignored. I fear being accused of practicing out of my scope of practice if I say anything more or being branding as a trouble-maker, disaplined in some way. The fact of the matter is I have no power in the system. Psychiatry and administration hold it all. I mentioned my concerns about lack of informed consent to my supervisor who is a psychologist and he wanted to be helpful but unfortunately has no idea what we are up against. I even feel fearful to write this post even though I am not using a personally identifiable name. I don’t think I am just a wimp. I think that it speaks to the power dynamics.
I am also fearful about my post because I don’t want to be accused of not doing enough to convey my concerns. I think I would also be angry too if someone said that to me. It’s not obvious how to work on this situation while keeping a job. I don’t think I’m just not willing to work up some level of courage. I think it would be reckless to just talk louder if nothing else changed in the system.
Hi Katie B-T,
Thanks for your message and your insights into how difficult the situation is for you currently. You sound like someone who has their eyes opened to what is going on around you and do want to help in the most effective way you can without becoming a martyr to the cause either.
I do think that you have some power in the system, even though it is dominated by psychiatric and pharmaceutical interests. When you speak the truth about what you perceive is going on you have allowed the truth to work its magic in the world. Even if your viewpoint was ignored it was still heard and together with other voices who are speaking the truth it can have an effect eventually. Call me naive as maybe I haven’t been in this battle very long with my eyes open but I do think that truth, which I would also perceive as light, works wonders and while it might not be always cause revelatory I believe that it has its effect over time.
I hope that I didn’t imply those that don’t speak are ‘wimps’. I wanted to make the point that it is also a personal decision to speak up and it does take strength and conviction. However people find this strength, courage and conviction is a personal journey as well. I could have done more myself while working in the health fields and at times I acted like a coward. Other people are not in the same position as me to speak out like I did in NZ and on here. Fortunately I have never been in a position where I have had forced treatment or anything like this and I can imagine that after experience something like that I would be far more fearful about speaking out. Although sometimes these awful experiences (I think of Solzhenitsyn in the Gulags of Soviet Russia) can give people more strength and conviction to speak the truth. I do not know what makes the difference but for me, I think that there are some answers in spirituality and religion.
Katie, keep doing what you can and if you can be another vessel for the truth of what is going on that is fantastic. It sounds like you are already being brave at times in your conversations with psychiatrists. Kia kaha (‘Stay strong’ in Maori, one of the few Maori pharses I picked up in NZ :))
Hi Katie the ‘Critical Psychology Network’ may be of interest to you.
Martin, thank you for penning this exceptional blog post. Your experience sounds infuriating yet not at all surprising. Katie, as a fellow psychologist, I know just what you mean. Two common threads here are (1) much of what happens in the mental health system contradicts both solid science and basic ethical principles (e.g., nonmaleficence and beneficence), and (2) those who speak on behalf of their clients’ welfare, but who are not psychiatrists, have no power and are ignored and persecuted. I can certainly relate to both.
As a clinical psychologist practicing in Australia, I have sought guidance on these issues. Specifically, I have attempted to learn what, if anything, psychologists can say to their clients about medications. My insurance provider had no idea. The Australian Psychological Society had no idea. I contacted the Australian Health Practitioner Regulatory Agency, the agency with whom complaints about healthcare providers are filed. The advice I received is summarised in the following direct quote, which was explicitly endorsed by the expert with whom I spoke: “there is literally no scenario in which any psychologist can provide a client with any information about medication they have been prescribed by a medical doctor.”
I am continuing to investigate this topic because I care about the welfare of my clients and understand the science, outlined in sources such as Robert Whitaker’s Anatomy of an Epidemic, indicating standard mental health care often makes clients worse. I am very interested in connecting with other psychologists and non-psychiatrist professionals who are interested in this issue.
Thanks for your message and your kind feedback,
As you mentioned, it sounds like you have a similiar experience of Kathy’s above.
The insurance issue must be a worry especially after having trained and worked hard for so many years to be a psychologist. I wonder if you can direct people to books, websites, blogs, etc, or tell people about your skepticism about psychotropic drugs/the overmedicalisation of distress. This is not technically ‘medical advice’ but maybe could rather be referred to as ‘reading suggestions’ or ‘psychotherapeutic literature’ (although it might make the person pretty mad that they have been conned like they have to begin with but that’s also part of the journey). I know that this may be a fine line to thread at times but if the people you see trust you and sense your skepticism they could often do their digging into reliable information (if they are not too brain damaged by the drugs at that stage) and come to their own conclusions.
I think that once you are in a position such as a psychologist, you have may have more to lose in an economic sense and it may also affect the lifestyle that you have built for yourself and your potential loved ones and you don’t want to sacrifice all this. You may also have more to lose socially as if you speak out strongly you may lose the respect of some colleagues. But you will also gain allies and hopefully you can find other allies in the psychological field on here as you have suggested, who can then influence others.
I also think you may be the same Brett Deacon who I believe got some unnecessary stick over at Mad In America after defending an article by James Shroeder. Hope you can roll with that and dust it off and keep getting the truth out in whatever way you think is best for you, your loved ones and the people you work with.
Hi Martin. Thanks for your kind words and support. I’m still investigating this matter. I hope to ask some specific follow-up questions, in writing, to the Australian Health Practitioner Regulatory Agency. In discussing this matter previously with AHPRA, I was very clear to distinguish between a psychological providing medical advice (which I understand is beyond the scope of practice) versus accurate information (referral to a scientifically credible article or website). The response I received was that this distinction is irrelevant. As I note in a comment below, the overriding principle is this: if a prescribing physician could potentially be upset with what you say, don’t do it, because this could result in a complaint being filed that could lead to the determination you are practicing outside the scope of your profession by giving medication advice. This is all well and good provided that every prescribing physician provides full informed consent and engages in science-based practice. But of course, as well all know and as a large body of science demonstrates, this is far from the case.
My experience speaking out about these issues is that many colleagues in psychology and related non-psychiatric mental health professions are allies. But most feel unable to speak up, believe that doing so will be fruitless, or don’t believe they understand the relevant science well enough to argue it. I’d love it if this would change. And yes, that was me at Mad in America. All good, dusted off and still rolling! Many thanks and best wishes to you.
More ‘Whipping up a Storm’ …
More people should get pills to beat depression
Millions of sufferers would benefit, doctors told
More than a million extra people should be offered antidepressants after the largest study of its kind concluded that they worked, experts have said.
Patients and GPs must not be squeamish about treating mental health problems with drugs, according to scientists who found that every one of 21 common antidepressants was better than a placebo.
They criticised “ideological” resistance to antidepressants fuelled by a misguided belief that illness linked to social problems should not be treated with pills. They said that doctors should switch from the least effective antidepressants, including Prozac and citalopram, two of the most commonly prescribed in Britain, towards the best performing ones, which are up to twice as good as a placebo.
A global study led by researchers from Oxford University…
Psychiatry journal is urged to retract controversial Celexa study over newly disclosed details
By Ed Silverman @Pharmalot
February 21, 2018
A group of researchers wants the American Journal of Psychiatry to retract a study published in 2004 after newly unsealed documents suggest that Forest Laboratories, the company that sold the medicine that was the subject of the study, misled regulators about key details.
As reported previously, the documents indicate the drug maker obscured key data demonstrating its Celexa antidepressant was not effective in children. Instead, the company portrayed the results as positive in materials submitted to regulators in hopes of winning approval for pediatric use.
The citalopram CIT-MD-18 pediatric depression trial: Deconstruction of medical ghostwriting, data mischaracterisation and academic malfeasance
Authors: Jureidini, Jon N.a | Amsterdam, Jay D.b; * | McHenry, Leemon B.c
On September 1, 2017, Baum Hedlund sent a letter to Apotex, the current manufacturer of Paxil and paroxetine, putting the company on notice that the Paxil label is inadequate. We encourage you to read this letter.
Baum Hedlund Aristei & Goldman, a staunch prescription consumer drug safety advocate, wants Apotex to update the Paxil and paroxetine label to adequately warn about the risks of suicidal behavior beyond the age of 24.
The Times and Stat Plus have paywalls…hopefully somebody will provide full text for the ‘idealogical’ resistance, provided by The Times ..
Surprise, surprise ..
Science Media Centre
February 21, 2018
expert reaction to largest review of antidepressants
Scientists have published a systematic review and meta-analysis of antidepressant drugs, in The Lancet.
A briefing accompanied this roundup.
Prof Glyn Lewis, Professor of Psychiatric Epidemiology, UCL, said:
“This excellent and comprehensive study pulls together all the evidence for the effectiveness of antidepressant treatment and provides compelling evidence for their efficacy. Antidepressants often receive a ‘bad press’ but this paper shows they have a role in the management for people with depression.”
Prof Carmine Pariante, Institute of Psychiatry, Psychology and Neuroscience and spokesperson for the Royal College of Psychiatrists, said:
“This meta-analysis finally puts to bed the controversy on antidepressants, clearly showing that these drugs do work in lifting mood and helping most people with depression. Importantly, the paper analyses unpublished data held by pharmaceutical companies, and shows that the funding of studies by these companies does not influence the result, thus confirming that the clinical usefulness of these drugs is not affected by pharma-sponsored spin. Of course, these type of studies cannot look at individual differences, so cannot inform us about the specific personal characteristics that make an individual more likely to respond in general, or to respond to one medication rather than another one. Indeed, we still need to understand why some antidepressants work better than others, even within classes of drugs that supposedly have the same pharmacological actions. Also, this paper does not help us understand how best to help patients who have treatment-resistant depression and cannot improve on any of the 21 antidepressants tested here. Nevertheless, for the millions of individuals with depression who are taking antidepressants at present, or will need to take antidepressants in the future, it confirms that these drugs are safe and effective.”
Prof Anthony Cleare, Professor of Psychopharmacology & Affective Disorders, King’s College London and Consultant Psychiatrist, Maudsley Hospital, London, said:
“This is the most up to date summary of all the data we have on how well antidepressants work, and whether people are able to tolerate a full course of treatment without stopping medication early. Whilst no single study is perfect or able to provide all the answers, putting all the studies together as the authors of this work have done allows us the best chance of seeing the overall big picture.
“It is an important piece of work. It puts to bed the idea that antidepressants don’t work – all 21 antidepressants were more effective than placebo at treating depression.
“It also challenges the often-held view that all antidepressants are more or less equally effective. Several treatments do seem work better than others.
“In terms of tolerability, it is interesting that for almost all antidepressants, patients are no more likely to stop treatment early when taking an antidepressant than when taking a placebo. Some treatments were even better tolerated than placebo. This suggests that, overall, patients judge that the greater effect of antidepressants in relieving depression counterbalances any side effects.
“The decision to prescribe an antidepressant should always be a joint one between patients and clinicians, individualised to the person’s specific needs. By clarifying which antidepressants are most effective, and which ones patients find easiest to take, this new work will greatly help clinicians and patients in those decisions.”
Prof Allan Young, Director of the Centre for Affective Disorders, King’s College London’s Institute of Psychiatry, Psychology & Neuroscience, said:
“This is good quality research and the conclusions are backed up by solid data.
“However, we should be aware that these findings only apply to major depressive disorder and are calculated from group data so individual patients may differ significantly in their responses. A range of treatment choices should therefore be maintained. Also a lot of “antidepressants” are used for other disorders (such as anxiety or OCD) or off-label (where the drug is prescribed for something other than the original condition for which it was officially approved) and this evidence does not apply in these instances.
“However, the top line is that these findings should be considered good news as they confirm existing evidence that antidepressants do work and, for most people, the side-effects are worth it.”
Prof David Taylor, Professor of Psychopharmacology, King’s College London, said:
“This analysis of a huge number of studies of antidepressants confirms that they are much more effective than placebo – itself a powerful treatment in depression. Differences between antidepressants are smaller, although newer drugs tend to be better tolerated. However, the most effective drug was amitriptyline – an antidepressant discovered in the 1950s. Overall this analysis of over 500 published and unpublished studies of antidepressants proves that they do indeed work.”
Dr James Warner, Reader in Psychiatry, Imperial College London, said:
“This rigorous study confirms that antidepressants have an important place in the treatment of depression. Depression causes misery to countless thousands every year and this study adds to the existing evidence that effective treatments are available. This study also adds clarity about how effective and how well tolerated all the common antidepressants are, and should help clinicians and patients in treatment choices.”
* ‘Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis’ by Cipriani et al. published in The Lancet on Wednesday 21st February.
The SMC also produced a Factsheet on antidepressants which is attached and available here:
It’s official: antidepressants are not snake oil or a conspiracy
The drugs do work: antidepressants are effective, study shows
Doctors hope study will put to rest doubts about the medicine, and help to address global under-treatment of depression
Sarah Boseley Health editor
Wed 21 Feb 2018 23.30 GMT
Needless to say, they are all over it like a rash ..
Simon Wessely Retweeted
Dr Jay Watts @Shrink_at_Large 2h
The drugs do work: antidepressants are effective, massive review shows https://tinyurl.com/yawe2mat SSRIs not coming up on top in regard to efficacy. Wonder if this will lead to different prescribing patterns.
RC of Psychiatrists @rcpsych 4m
Antidepressants are effective, study shows
https://www.theguardian.com/science/2018/feb/21/the-drugs-do-work-antidepressants-are-effective-study-shows?CMP=share_btn_tw … Professor Carmine Pariante said the analysis “finally puts to bed the controversy on antidepressants, clearly showing that these drugs do work in lifting mood and helping most people with depression.”
RC of Psychiatrists @rcpsych 42m
Tune in to @talkRADIO now to hear @ParianteSPILab talking about today’s Lancet study into the effectiveness of antidepressants.
Wendy Burn @wendyburn 2h
Wendy Burn Retweeted Nick Hodgson
Yes they work. Not for everyone but for many they are literally a life-saver. And its a scandal that people are shamed for being unwell and needing them.
Nick Hodgson @nickchodgson
Antidepressants work, study on patients with severe depression confirm. We at @rcpsych been banging the drum on this a while! @BBCBreakfast
Picking up the SENSE about Science ..
Noel Davy @noel_davy 1h
Replying to @rachelburden @bbc5live
Was this study funded by the pharmaceutical industry? If 5 million people in the UK alone are on these pills then it is massive business for the industry and GP’s. Nowhere near enough being done to identify the role these drugs play in 87% of suicides. We are treated as lemmings.
David Healy @DrDavidHealy 43m
The Cipriani paper discussed today is junk. It is based on ghostwritten papers with no access to the data. No one – not MHRA or FDA have had access – none of the notional authors of these papers have had access – none can let an independent expert see what the data shows
David Healy @DrDavidHealy 21m
Re Cipriani et al: Dr Cipriani and SMC opinion leaders know the articles behind this are junk. This paper contributes to a misleading of doctors and patients. All concerned would be doing a more important and noble job if they were to tell doctors and patients this.
David Healy @DrDavidHealy 32m
Re Cipriani et al: Lots of doctors in UK, Canada, etc use sertraline today based on a similar paper some yrs ago by Dr C which made sertraline out to be the best SSRI – but when the unpublished sertraline trials are taken into account it may be the worst
David Healy @DrDavidHealy 32m
Re Cipriani et al: an earlier paper by this group looking at pediatric trials concluded Prozac works – when the FDA reviews of the trials for this drug in children show it is negative for the primary outcomes.
David Healy @DrDavidHealy 35m
Re Cipriani: In the case of at least one of these drugs – paroxetine – there have been fraud charges for overhyping the benefits and hiding the harms – we have to assume the same holds true for pretty well every paper that is part of this review
The issue they have concentrated on in public announcements is that the controversy was focussed on the claim that placebo is as effective as drugs. There is very little mention of adverse effects and these are played down by suggesting a different anti depressant will ‘work’ if one does not ,or that one or some drugs are ‘not tolerated’ and need to be changed to another. There has been no mention in the massive publicity given to the ‘research’ which came out yesterday and last night on World News throughout the night , of the horrors of withdrawal or addiction. So this study is being fed to people world wide – It shows that such a publicity bomb has been found necessary to counteract the growing anger about the massive increase in psychiatric prescription drugs. Has there been a deal with the Health Dept. perhaps – doctors have 10mins appointments – they cannot deal with psychological problems in this time, they have not all had enough training to diagnose or treat properly , there are not enough psychological therapies available , there are not enough psychiatrists per population, ‘people in deprived areas are already massively over prescribed – pop a pill my dear was the advice given to women decades ago and ruined so many lives ..Now there are Shades of Aldous Huxley’s Island where the whole population was given a drug called ‘soma’ by ‘the authorities to keep them quiescent. R5 just made a mention of the ‘research’ – only one response from the public was allowed -castigating psychiatrists and others who undermine those who take them. There aren’t many who support doing away with them altogether – the publicity is being cleverly managed
The open publication of the paper was paid for by the Department of Health whether this is in the name of transparency or more likely because it supports the policy, but obviously it gets a bit thick when the Royal College of Psychiatrists announce that this should end all controversy – they are really nailing there trousers to the mast. If you are harmed they don’t want to know about it, and this paper doesn’t tell you anything about it, so it is a really great paper. Are they for real?
PS to Wedy Burns – who exactly is ‘SHAMING people who take them’ ??
The usual straw man game…
Hello Brett Deacon, is it not safe to refer patients to pharmacists’ drug leaflets? I was astonished recently to see that in the leaflet of Leponex (clozapin) there is detailed guidance how to withdraw it: time and dose. I wonder if this info was in the leaflets few years ago? Checked some other psychotropics – no such detailed instructions for other, stating only that ”patient should refer to his prescriber who will advice for slow withdrawal”.
Hi Lina. I was told by the Australian government representative the answer to your question is no. It is not acceptable for a psychologist to provide clients with any information about medications, period, regardless of how scientifically uncontroversial it is. The relevant principle is this: if a prescribing physician could potentially be upset with what you say, don’t do it, because this could result in a complaint being filed that could lead to the determination you are practicing outside the scope of your profession by giving medication advice. So in my case, this advice apparently means I can author published articles on antidepressants (e.g., http://www.illawarraanxietyclinic.com.au/uploads/7/6/0/4/7604142/are_antidepressants_overrated_deacon___spielmans_2017.pdf), I just can’t show them to my clients. This whole situation is bizarre because surely the most relevant consideration should be the best interests of the client.
ben goldacre, MBE LOL @bengoldacre 7h
This new antidepressant paper is good, a great sensible metaanalysis by a solid team. I have one rather niche quibble on communicating the results which I’ll write a short letter on when back at work tomorrow. http://www.thelancet.com/journals/lance
I guess we’ll look forward to Goldacre’s niche quibble like our niche quibble on GSK featuring in Alltrial promos ..
Ben writes to Scott ..
RxISK @RxISK 20m
RxISK Retweeted David Healy
This is the key point on that much-hyped paper showing antidepressants “work.” A meta-analysis tries to consolidate the findings of prior studies. So it’s only as good as those prior studies. Most of them are highly biased junk–and almost none have shared the raw results.
David Nutt @ProfDavidNutt
BBC News – Anti-depressants: Major study finds they work http://www.bbc.co.uk/news/health-43143889 …. Wow thought we knew this in the 1960s!
BBC News ..
Shelley Jofre @ShelleyJofre
I’m going back to my roots. Delighted to join the excellent BBC Scotland Investigations team as Editor. My time as Health and Social Care Correspondent has been amazing but this was too exciting an opportunity to pass up.
Soooo well deserved, Shelley and Panorama put Seroxat on the Map ..
Some good news – Caroline Jones (UKIP politician) made a very honest and tough contribution to the Health and Social services debate 14 feb (which I referred to on Rxisk blog – and thanks to Annie for putting up the link) – She was the only one as I recall who made reference to the massive increase in antidepressant prescribing and suicide. Sent her a copy of the Welsh Petition (see previous blog on rxisk)- she gave a quick response to say she is going to support it . I am not a supporter of any political party – no self interest – but her response is so different from that of Sarah W. Chair of the English Health Cttee who has done exactly nothing to raise concerns on ‘her’ committee.
So what’s the truth about depression pills? A study says antidepressants DO work and a million more should use them.
JOHN NAISH profoundly disagrees
So why is the announcement such a big deal now, prompting some leading psychiatrists to whoop and holler in applause?
The answer, of course, is that we are not talking about ordinary drugs here. We are talking about antidepressants.
Katinka Newman descended into psychosis
Calling the Oxford study ‘highly misleading’ she added: ‘Many of the five million people prescribed antidepressants in the UK are not acutely depressed, they are reacting to an adverse life event such as divorce or stress at work.
Psychiatrists aren’t warning people they can be impossibly difficult to get off, and the side-effects can last even after you come off them.’
Erick Turner @eturnermd1 13h
Here’s 1 recent story. Lead author @And_Cipriani & co-author Ioannids make fairly nuanced comments. Then a non-author excitedly says it “puts to bed” any Q re efficacy, then @CBCHealth headlines that as study conclusion @HealthNewsRevu @robinson_erik http://www.cbc.ca/news/health/antidepressants-meta-analysis-1.4546709 …
Why not interview the ‘Expert’ on antidepressants …
Simon Wessely @WesselyS 16h
Quick heads up – doing @LBC Daily Debrief with @RichSuchet around 17.00 today. Topic? Antidepressants again.
Truthman30 @Truthman30 6h
Another pharma whore willing to sell vulnerable people down the river for his pieces of silver… manslaughter charges should be brought against all of these pharma-whore psychiatrists who are complicit in this fraud and abuse of vulnerable people…
Antidepressants ‘again’ ..
There have been a few comments by Simon W and others which seem to show they are treating all this like a game. He is adept at putting on the often abused ‘charm’ people have commented on which can give more credibility to a message -which may be the reason he is ither the self or psych appointed spokesperson so often when they are in a jam. His attitude is worrying when he is incapable or refuses to acknowlege the distress he and others are causing and when he seems unable to properly understand the limits of the study. What diagnosis (as well as the label Truthman has designated) would be given to others with these traits especially when they are in positions of power
Doctors say antidepressants study saying more should be given out is misleading patients by ignoring the dangers and side-effects
But last night experts hit back at the findings published in The Lancet medical journal, claiming they were misleading patients and doctors.+3
David Healy has criticised the study for failing to address the risks of long-term anti-depressant use
David Healy, Professor of Psychiatry at Bangor University, accused the authors of ‘hyping the benefits but hiding the harms’.
Antidepressants carry a risk of side-effects ranging from loss of libido to disabling anxiety and agitation. Other studies have shown that in rare cases they can trigger suicidal and homicidal thoughts.
Professor Healy said the short-term nature of the study, which looked at how patients responded after eight weeks, does not provide an accurate reflection of how most people take the drugs. ‘
‘You could put alcohol through these trials and show it is an antidepressant,’ he told The Mail. ‘But it wouldn’t be a good idea to have 10 per cent of the population taking alcohol.’
He criticised the study, which looked at 120,000 patients from more than 500 trials — some of which had been funded by pharmaceutical companies — for failing to address the risks of long-term use.
While not officially classed as addictive, Professor Healy said the side effects of withdrawal were so severe, many patients end up taking them for long periods.
‘The problem is more that what a lot of people are going to be hearing from this is that the drugs work really well, when they don’t, and there are no harms being talked about.
People assume they are safe, but they can be extremely risky.
‘About 80 per cent of people who get put on these pills by a GP will be on them for over a year and that will be because they can’t get off them.’
Professor Carmine Pariante, of the Royal College of Psychiatrists, said the prescription of antidepressants would never be ‘black and white’ but maintained the research was beneficial.
He said the review showed there was no difference in findings, whether the research was funded through charities, a public body or pharmaceutical company.
‘I think this should reassure patients and clinicians that we’re using them because they work — not because of the spin from people who might make money out of it.
‘I don’t think anyone is looking to push antidepressants to those who don’t need them. The guidance is very clear on who should be prescribed them and I am confident that clinicians are sticking to this.’
Adam Jhugroo @Adam_Jhugroo Feb 22
Replying to @And_Cipriani @TheLancet
Could I ask…How would you respond to the comments on your work from @DrDavidHealy?
Nancy99 February 23, 2018 at 8:24 pm
Yes – it is a very sad situation that even a prestigious journal like Lancet publishes these types of articles. However, I think there appears to be a small increase in mainstream news articles that correctly report information on psychiatric drugs – I came across the following BBC article today:
But that’s what happened ..
BBC Wales James Moore – David Healy -Dr. Shetty-
But Dr David Healy, professor of psychiatry at Bangor University, said patients were often not told of the risks of dependency as doctors had not been told themselves.
“They haven’t been told, for instance, that you can get hooked to these drugs and it may be close to impossible to come off them,” he said.
“Back in the late 80s when the drugs came on, first the expectation was you’d be on them for three, maybe six months. The idea they’d be on them for a year, or five years or 10 years was inconceivable back then. But that’s what happened,” he added.
Antidepressants are effective, right?
Caldicot, United Kingdom
If you live in the UK, no doubt you will have seen some of the extraordinary media reporting about antidepressants. If the headlines are to be believed, then the latest Lancet study into antidepressants should permanently end any doubt about their efficacy.
The Lancet study certainly made headlines, but as usual, the devil is in the detail.
There will be far more elegant critiques posted in response to the study, but there is one fact that the media doesn’t seem so keen to report on, which may change how we view this much-heralded study.
The study itself is not new work but reviews the outcomes of 522 placebo-controlled trials conducted over the last six years. In many of the studies reviewed, results (outcomes) were obtained at 8 weeks and no further.
This study may indicate that antidepressants have a beneficial, short-term effect, but we can’t tell anything about the benefit versus the risk over the longer term.
In the UK as a whole, we tend not to prescribe short courses of antidepressants, people are on them for many months, years, sometimes decades. The Royal College of General Practitioners recommends that antidepressant therapy is continued for at least six months. This study, unfortunately, tells us nothing that will be of benefit to prescribers or to patients given the way that we prescribe drugs for mental health.
Finally, as for the wild extrapolation that “up to a million more may benefit from the drugs” as widely reported, the data in the Lancet study does not back that conclusion up in any way.
Whatever the study reports, or the debate that goes on around it, none of that diminishes the power of your own experiences with these drugs. Whether you felt they helped or harmed you, you are the expert in your own experience.
Thank you, as always, for your support and your signatures, it means a great deal.
‘The study published today in no way helps anyone make an informed choice, results are based on 8 weeks treatment, totally out of step with the way these drugs are prescribed. Long term outcome data is needed, until we have it, this study advances our understanding not one bit.’
This is almost the same wording Alistair Benbow used when defending Seroxat ..
Wendy Burn @wendyburn 19h
I’m really sorry for anyone who experiences withdrawal but most people can stop then without problems as long as it’s done slowly. This is about long term
Lancet. 2003 Feb 22;361(9358):653-61.
James Moore @jf_moore 18h
Replying to @wendyburn @dropthedisorder and 2 others
I’m sorry I have to take issue with this, firstly, your own survey on the @rcpsych website shows that 63% reported withdrawal symptoms (82% for Venlafaxine) secondly, how does one ‘withdraw slowly’? Do they cut pills, do they crush them, where is the official guidance?
The Royal College of Psychiatrists are leading calls and subsequently there has been a large throwback from the twittersphere ..
Wendy Burn is completely out of her depth quoting articles from Feb 22, 2003 in The Lancet
Her ‘Previous’ whatever his morals and ethics might once have been, is now enjoying the fruits of his Establishment Career, meeting the Royalty, Giving out Garlands, Media Guru, the GO TO man of the moment.
So, what are we to make of all this
Come in Wendy Dolin and talk some more sense
GSK Has Duty To Warn About Generics, Widow Tells 7th Circ. Via @Law360
Leonie @leoniefen 1h
Irish psychiatrist suspended over death of teen in UK. The tribunal found that Dr Murphy “failed to explain the benefits, risks and side effects” of Risperidone.
https://www.rte.ie/news/health/2018/0221/942510-irish-psychiatrist-suspended-over-death-of-teen-in-uk/ … via @rte
Sparrow, at least, got some sort of Justice – a suspension
Would that we Could ..
We were told last week that researchers had ‘the final answer to the long-lasting controversy about whether antidepressants work for major depression’. I very much doubt it. Not only did the study (of old research, much of it paid for by the drug companies themselves) show very limited success for these pills. We are only just beginning to scrape the surface of what I suspect may be one of the biggest drug scandals of all time. If anyone insists to you that all is well, ask them this: have they had access to the drug companies’ own full testing records?
Last week ..
Peter Hitchens @ClarkeMicah
On serotonin theory , please read http://bit.ly/1iU0Ow7 and http://bit.ly/1rUu1fN
These are the source of my unfashionable position on SSRIs. Also influenced by the work of the great David Healy.
Peter Hitchens @ClarkeMicah
And they may also be a huge unexposed scandal, about which people will one day ask ‘Why didn’t we see that earlier?’. In which case I won’t be one of those wishing he’d done something and didn’t.
Thanks Martin and Brett for your kind and helpful comments. Brett, that’s useful for me to know after you did some digging the conclusion you got re talking to clients about medications. Crazy world we live in.
There is a woman in the San Francisco bay area who took some significant flak as a peer support staffer as a result of her work with the Hearing Voices Network.
Tears are running from my eyes while I read his article…Cause I`m a health journalist and, paraphrasing you, health journalism doesn`t seem to be something for me anymore. I decided to be a health journalist 20 years ago just because I had my own experience and I wanted to write about mental health and warn people about the importance of treating our mental diseases. But I am exactly right now in the same “process” that you have described – reading Dr. David Healey and Peter Gotzsche’s books, Mad in America, The Withdrawal Project, MISSD. And I just can`t work anymore. I can hardly sleep at night because of this. In my country (Brazil) there`s no such a thing as advocacy groups, at least not related to medicine, because people don`t even know how to name the side effects that they have. So I don`t know if I should open a blog or just start to work as a dog sitter or something like this. I am more prone to choose the latter.