Dr. Elaine Schattner has Grand Rounds this week at Medical Lessons. Not only has she put together some very interesting reading, but a range of photos from around the world. In her call for submissions Dr. Schattner asked that bloggers submit a photo from their region, and she received some lovely images. Have a look.
The central theme of this blog is that there are no mental illnesses and that the spurious medicalization of problems of living represents a tragic wrong turn in human history.
In a comment on my last post, Nanu Grewal raised the question of a natural correction. In other words, does there come a point where the nonsense is so outrageous that some corrective force emerges which would undermine and even supplant the present illogical system. In my view this is an excellent question.
I used to think that the insurance companies might provide such a correction, by simply refusing to pay for this so-called treatment (as they did with inpatient substance abuse treatment in the early 1990’s.)
But this simply hasn’t happened. Indeed here in the U.S. we’ve recently enacted a parity law whereby insurance companies are required to cover the so-called mental illnesses on an equal footing with real illnesses. This makes it virtually impossible for insurance companies to start clamping down now.
I have sometimes wondered if the cost of the mental health system would become too great a burden on the public purse, and that some corrective measures would be undertaken. Most public support of healthcare in the U.S. is through Medicare and Medicaid, and it is widely reported that these programs are under a good deal of financial strain. Most of the suggestions in this regard, however, have been on the lines of requiring individuals to pay more than they already do, rather than eliminating, or even reducing, the mental illness services. So I see no great ray of hope in that area.
And of course over and above all of this is the fact that a great many people simply like to take drugs, and this is a powerful drive which tends to maintain the status quo.
Through the years there have been a number of individual writers who have seen through the nonsense and who have spoken out fearlessly. In recent years perhaps we’ve seen a little more of this, but it certainly hasn’t become a groundswell of protest. But perhaps that is the best natural correction that we can hope for – more and more individuals speaking out, exposing the spurious nature of the so-called mental illnesses and the tragic consequences of the drugs-for-every-problem philosophy.
Anyway, I can think of nothing else on the horizon. I’d be interested if any readers had any thoughts. Can you see any natural corrections in the works? Are there things we could be doing to promote natural corrections?
On June 23, the New York Review of Books, one of the most prestigious literary magazines in the country, published a piece by Marcia Angell. I’ve mentioned Dr. Angell before. She had been editor-in-chief of the New England Journal of Medicine and had come out strongly against the extent to which drug companies are controlling and directing medical research.
Well in this recent article she reviews three books:
The Emperor’s New Drugs: Exploding the Antidepressant Myth, by Irving Kirsch, PhD
Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, by Robert Whitaker
Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations About a Profession in Crisis, by Daniel Carlat, MD
Marcia does a very nice job of drawing the various threads from these three authors together into a coherent, stand-alone two-part article (which you will find here and here) that is well worth the read,. She has also written a book of her own:
The Truth About the Drug Companies: How They Deceive Us and What to Do About It. (Random, 2004)
It’s encouraging that this kind of material is appearing in mainstream publications. Disenchantment with psychiatry can no longer be dismissed as the crackpot ravings of a few disgruntled eccentrics.
Although I am encouraged by the work of Angell, Kirsch, Whitaker, and Carlat, in my view they all baulk at the final fundamental conclusion: that there are no mental illnesses. The concept of mental illness is intrinsically spurious. It’s not just that the concept is applied too liberally, or that drugs are misused, etc.. The critical point is that the APA defines mental illness as, essentially, any human problem – and then, voila! – discovers that lots and lots of people have these so-called mental illnesses.
Until this simple logical fallacy is recognized, progress is inevitably going to be slow and sporadic. But we’ll keep trying!