A Diluted Murphy Bill Clears the House and Goes to the Senate

INTRODUCTION

On Wednesday, July 6, the US House of Representatives passed a watered down version of HB 2646, the so-called Helping Families in Mental Health Crisis Act.  The bill, which is now a House Resolution, is usually referred to as the Tim Murphy bill, after its principle author, Representative Tim Murphy, PhD, who is also a clinical psychologist.

The bill passed the house with a noteworthy tally of 422-2, with nine abstentions.

On July 6, the Wall Street Journal published a helpful summary of the issues:  House Passes Mental Health Bill, authored by Louise Radnofsky.  Here are some quotes, interspersed with my comments:

“The bill passed 422-2, overwhelming support that reflected a decision by sponsors to defer debates on some of its most controversial aspects. The bill would reorganize the federal agency overseeing mental health policy, direct funding to combat serious mental illness as opposed to general mental health programs, and change Medicaid reimbursements for treating patients with illnesses like schizophrenia.”

“…as opposed to general mental health programs…” is a reference to the federal Substance Abuse and Mental Health Services Administration (SAMHSA), which the eminent psychiatrist, Jeffrey Lieberman, MD, has described as “a proxy agency for the anti-psychiatry movement…” (here).  But here’s what Oryx Cohen wrote about the Murphy Bill and SAMHSA on November 6, 2015:

“The Murphy Bill threatens the recovery and community integration practices that current consumers of mental health services and survivors of coercive psychiatric interventions have worked so hard for over the last 40-plus years to create for those most in need. In particular, the bill would dismantle the federal Substance Abuse and Mental Health Administration (SAMHSA), which actively funds and supports important efforts to rebuild the community and family life of people dealing with mental health issues through non-medicalized institutions such as peer-run respites (short-term crisis centers managed by people living with mental health concerns and available to “self-referred” individuals seeking to avoid hospitalization through support from peers). SAMHSA also supports suicide prevention initiatives, trauma-informed practices, Emotional CPR (an educational program aimed at teaching people how to assist others through an emotional crisis), Wellness Recovery Action Planning and much more, all of which would suffer if SAMHSA were dismantled.”

And another quote from the same article:

“If the Murphy Bill is passed, psychiatric hospitals and pharmaceutical companies will reap huge financial benefits as a result of increased hospitalization and forced treatment. One way the bill will do this is by creating a financial incentive for states that implement ‘assisted outpatient treatment’: court-ordered treatment (including medication) for people whom a judge deems as living with ‘severe mental illness’ and unlikely to willingly take prescribed psychiatric medications.”

Oryx Cohen is a member of the National Coalition for Mental Health Recovery.

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Back to the WSJ article:

“The bill’s main author, Rep. Tim Murphy (R., Pa.) has for the past few years been blunt in his assessment of mental health care in the U.S., painting a picture of federal incompetence that diverted money to frivolous and unproven programs for general mental health. He said current practices impede treatment for serious mental illness by emphasizing patients’ civil liberties ahead of their treatment.”

“Mr. Murphy, a clinical psychologist, was tapped by House leaders to investigate mental health treatment in the U.S. in the wake of the Sandy Hook shooting in 2012. He and other advocates of changing the system have cited the obstacles family members faced in caring for people with serious mental illness, including privacy laws and provider shortages.”

This theme, that the proximate cause of the mass killings is the “mental illness” of the murderers, has become a staple response from psychiatry to the charge that psychiatric drugs, particularly SSRI’s, are the primary precipitators of these incidents.  In the Sandy Hook murders, for instance, there were reports that the killer, Adam Lanza, had been receiving psychiatric “treatment” and had  been taking psychiatric pills.  But the authorities refused to divulge the nature of the pills for fear that it would “… cause a lot of people to stop taking their medications.”

. . . . . . . . . . . . . . . .

Back to the WSJ article:

“Earlier iterations [of the bill] sought to change the privacy rules in the Health Insurance Portability and Accountability Act so that providers could share details of a patient’s diagnosis, prescriptions and appointments with a known caregiver. The earlier version would have also required states to pass laws compelling treatment for certain people as a condition of federal funding and restrict advocacy groups that receive federal health funding from helping patients bring legal challenges to their treatment.”

The bill’s sponsors have not given up on these matters, but as mentioned in the first WSJ quote above, have simply deferred them for later consideration.

The confidentiality issue is important, because client privacy has traditionally been one of the cornerstones of the mental health system.  The proposal to legitimize divulging sensitive information to a person’s family would essentially reduce the individual’s legal status to that of a child.  This is particularly critical, in that many of the individuals who would be affected by such legislation are in conflict with their families, and emphatically don’t want their confidentiality breached in this way.

Note also the proposed use of the federal purse-strings to increase the amount of forced “treatment”, and make it more difficult for “patients” to sue their psychiatrists.  Why shouldn’t an advocate help clients bring legal challenges to their “treatment”, if the “treatment” has been unhelpful and damaging?  Isn’t that what we’d expect an advocate to do?  Whose interests are being served by restricting an advocate’s activities in this way?  Certainly not the clients!  Psychiatry is extraordinarily resistant to criticism of any kind.

. . . . . . . . . . . . . . . .

Back to the WSJ article:

“Many of Mr. Murphy’s dropped measures had drawn opposition from patient advocates such as the Bazelon Center for Mental Health Law, an organization that focuses on protecting the human rights of people with mental disabilities. The center had said that it was alarmed by the attempts to reduce the privacy and civil rights of people with mental illness, as well as a shift toward compelled treatment, which the center doesn’t believe has been proven to be effective.”

The National Coalition for Mental Health Recovery has also come out against the bill.

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Back to the WSJ:

“The prospects for mental health legislation in the Senate are uncertain, given the compressed calendar in an election year and the fact that sponsors there have their own ideas for changes, including Bill Cassidy (R., La.) and Chris Murphy (D., Conn.) In a statement, the two senators pointed to the House’s overwhelming vote as ‘proof that there is broad, bipartisan support for fixing our broken mental health system.'”

Note the phrase “broken mental health system.”  This is actually an accurate description, in that the system is based on the spurious premise that all significant problems of thinking, feeling, and behaving are illnesses, and in practice, is destructive, disempowering, and stigmatizing.  But this is not what psychiatry proponents mean by the phrase.  Routinely in pro-psychiatry circles, the phrase is used to legitimize calls for more psychiatric “treatment”; more coercion; “early intervention” and routine integration of psychiatry’s spurious concepts and practices into schools, foster homes, nursing homes, group homes, GP’s offices, the armed services, prisons, juvenile detention centers, and, indeed, any setting where pills can be peddled.

PSYCHIATRY CAPITALIZING ON THE FEAR OF VIOLENCE

The notion that the public needs to be protected from “mentally ill” people is not new, but has enjoyed a marked revival after decades of decline.  Much of this revival can, in my view, be laid at the feet of the Treatment Advocacy Center (TAC).

J. Jaffe, a marketing executive, a founding member of TAC, and a former NAMI board member, gave an address to the Staten Island AMI in December 1994. The speech was titled “How to reduce both violence and stigma”, and was written up in the Staten Island AMI newsletter, December 1994. Here are some quotes:

“And recently adopted policies and laws won’t allow these individuals to be treated involuntarily until they become a ‘danger to self or others.'”

“We have to ‘head ’em off at the pass’.  Treat individuals with NBD [neurobiological disorders] before they become a ‘danger to self or others'”

Earlier in the address Mr. Jaffe had explained that he was using the term “NBD” as essentially synonymous with “mental illness”.

The critical point in this quote is that Mr. Jaffe is proposing that the laws be changed, so that individuals who have been given certain psychiatric labels can be committed to enforced “treatment” before there is any actual danger to self or others.  And he is absolutely clear that an individual’s refusal to take psychiatric drugs would be considered a valid reason to enforce “treatment”.

“For example, some individuals who become psychotic refuse treatment because they believe the medicines are poisons being administered by the CIA.  A ‘need for treatment’ standard would allow someone else to be assigned the right to decide on treatment for this individual until he/she regains the ability to reason.  The decision to administer medicines could be made before the individual becomes a danger to self or others, thus averting needless violence and another stigmatizing headline.”

Note the example Mr. Jaffe gives as to why a person might refuse psychiatric drugs:  that the drugs are being poisoned by the CIA.  But in fact most people who refuse psychiatric drugs do so for perfectly valid and rational reasons:  that they cause irreparable brain damage (e.g. tardive dyskinesia) and they produce extremely unpleasant effects (e.g. akathisia).  In 1974, forty-two years ago, Theodore Van Putten, MD, published Why Do Schizophrenic Patients Refuse to Take Theirs Drugs?  Here’s a quote:

“The reluctance to take antipsychotic medication was significantly associated with extrapyramidal symptoms—most notably a subtle akathisia.”

Mr. Jaffe outlines four proposals to promote the above agenda and then he adds:

“In addition, from a marketing perspective, it may be necessary to capitalize on the fear of violence to get the law passed.” [Bold face added]

In other words, it may be necessary to deceptively exploit isolated incidents of violence to secure the legal authority to forcibly drug many people who had never exhibited any violence, on the sole grounds that they were refusing to take neurotoxic drugs that have devastating adverse effects, including irreversible brain damage.

Mr. Jaffe continued this theme in an address he gave five years later at the 1999 NAMI Conference.  Here are some quotes:

“Laws change for a single reason, in reaction to highly publicized incidents of violence.  People care about public safety.  I am not saying it is right, I am saying this is the reality.”

“So, if you take nothing else away from what I’m saying, it’s gonna change in reaction to violence, and you gotta make this a public safety issue, and indeed it is a public safety issue.”

“We can talk to these people from their perspective, and then what we can say to them as family members, is, and this is also good for the individual.  It’s gonna prevent them from becoming homeless, psychotic, suicidal, uh, incarcerated.  We have found extraordinary…and I’m gonna show a poster in a minute…we have found extraordinary help, and again I gotta give credit to the Treatment Advocacy Center here, uh, of reaching out when there is an instance of violence.”

“We immediately call both the perpetrator and the victim.  And we say to them, ‘We understand what happened here when your sister was pushed in the subway by Andrew Goldstein.  It happened because he wasn’t getting treatment.”

“Uh, the family of Webdale, you may know Kendra Webdale was pushed in the subway, lost her life.  Somebody with untreated schizophrenia. Edgar Rivera was pushed in the subway.  He only lost his legs. But, uh…and he’s been a strong supporter.  And what happens is, the media goes and interviews these people, and because we’ve been to ’em first, they are telling our story.”

In other words, manipulate the media to inject into their reports of isolated violent incidents, the notion that people who haven’t been violent, and may never be violent, need to be forcibly drugged – just in case!  Elsewhere, Mr. Jaffe openly acknowledges that the majority of “mentally ill” people are not violent.  But he has no hesitation in infringing their rights to self-determination if they stop taking their neurotoxic pills, just in case.  In the criminal justice system this would be the equivalent of guilty unless proven innocent.  In fact, it would be worse than that.  It would be guilty, with no way to prove one’s innocence.

“Now what I’m gonna do is I’m just gonna show you very quickly, uh, the story of Kendra’s law in the media.  As I’ve said, change happens as a result of acts of violence.  And what, and so, when these acts of violence occur, the media goes out and writes stories about them, and then we start approaching the media.  We have in New York…it’s called Kendra’s Law…it’s a law we’re trying to pass.  It’s an outpatient treatment law…assisted outpatient treatment.  What a brilliant phrase.  It’s not involuntary commitment, it’s assisted outpatient treatment.  That was…came out of the Treatment Advocacy Center.”

What a “brilliant phrase”!  Almost as brilliant as “Helping Families in Mental Health Crisis”.

BACK TO THE TIM MURPHY BILL

In a House Energy and Commerce Committee press release (July 6, 2016), Fred Upton, committee chair, is quoted:

“We continue to hear tales of great loss where intervention was lacking or nonexistent.”

One can readily detect the manipulatively deceptive tones of D.J. Jaffe cited earlier.  Representative Upton made no mention of the many tales of great loss where psychiatric intervention and drugging had been present.  For instance:

Killers on psych drugs

Prior to about 1960, the status of people who were confined to mental “hospitals” for extended periods could accurately be described as pre-civil-rights.  Gradually, as the adverse effects of institutionalization and psychiatric “care” began to be exposed, their legal status improved.  The Murphy bill is, I believe, the first concerted attempt to roll back these protections.

CIVIL RIGHTS

Interestingly, Congressman Murphy was asked about this matter by CNN’s Jake Tapper in an interview on January 27, 2014.

The question came at 1:25 into the interview.

Jake Tapper:

“There was a period in the country when the civil rights and civil liberties of people with emotional and mental problems, and we obviously don’t want to stigmatize these people, however much even talking about it might do that.  But when those civil liberties became very, very important, and they had more rights, they were bestowed more rights.  Did we go too far as a society?  Did we not take into account society’s needs beyond the individual’s needs?”

This question could have produced a fruitful discussion on civil rights, but watch how Congressman Murphy neatly sidesteps the issue.

“I think we swapped the hospital bed for a jail bed, quite frankly.  Somewhere between forty and fifty percent of people in our county jails, our state prisons, our federal prisons, are mentally ill.  That is the ultimate removing of their rights.  It is…we segregate them there, we end up not treating them there.  And the same thing goes where we’ve tripled the homeless rate.  This is not the way we should be doing it.  We’re acting like a third world country quite frankly.  It is embarrassing, it is immoral, it is unethical what we have done, and so you have as one person so eloquently said, they end up dying with their rights on, because we say you have to consent to treatment.  But how do you get somebody to consent to treatment if they don’t even understand reality.  They can’t sign a contract, they can’t do anything else.  And what we need are other options.  Not just the option of you have to be adjudicated to say you must stay in a hospital, but also an outpatient treatment option like you just described the case where the guy stabbed his mom.  He could have been taking medication, he could have been doing much better.  And many of these other assaults that have taken place – Aurora, Colorado or Arizona, etc., the person later on realizes gee, if I was in treatment I wouldn’t have done this because I would not have heard those voices commanding me.”

In other words, the bill doesn’t really infringe on people’s rights, rather it protects their rights!  So we will forcibly inject large numbers of people with neurotoxic poisons to guard against the possibility that a few of them might otherwise end up in jail or prison.

The assertion that forty to fifty percent of the incarcerated population are mentally ill is routinely trotted out by psychiatrists and their adherents in these kinds of debates. But in fact this is an artifact of psychiatry’s spurious medicalization of virtually every significant problem, including criminal behavior.  According to psychiatry’s DSM, threatening or intimidating others, using weapons, being cruel to people and animals, stealing, robbing, raping, burglarizing, shoplifting etc., constitute a mental illness called conduct disorder (DSM-5, p 469).  Not surprisingly, a great number of these people end up in prison. And let us be clear, psychiatry’s contention here is not that people with other “mental illnesses” commit these crimes, but rather that the commission of these crimes, in and of itself, constitutes a “mental illness”.  So of course forty or fifty percent of the incarcerated population has a “mental illness”.  For psychiatrists, virtually all criminality is “mental illness.”

But even if we set that consideration aside, there is in fact no shortage of psychiatric “treatment” in prisons.  Here’s a quote from the Federal Bureau of Prisons Mental Health page:

“The Bureau provides a full range of mental health treatment through staff psychologists and psychiatrists. The Bureau also provides forensic services to the courts, including a range of evaluative mental health studies outlined in Federal statutes.”  [Emphasis added]

“Psychologists are available for formal counseling and treatment on an individual or group basis. In addition, staff in an inmate’s housing unit are available for informal counseling. Services available through the institution are enhanced by contract services from the community.”

And here’s a quote from California’s Department of Corrections Mental Health Program website:

“REFERRALS TO MENTAL HEALTH

Any inmate can be referred for mental health services at any time. Inmates who are not identified at Reception or upon arrival at an institution as needing mental health services, may develop such needs later. Any staff members that have concerns about an inmate’s mental stability are encouraged to refer that inmate for evaluation by a qualified mental health clinician (psychiatrist, psychologist, or clinical social worker). [Emphasis added]  Under certain circumstances, referral to mental health may be mandatory. A referral to mental health should be made whenever:

  • An inmate demonstrates possible symptoms of mental illness or a worsening of symptoms.
  • Upon return from court when an inmate has received bad news such as a new sentence that may extend their time.
  • An inmate has been identified as a possible victim per the Prison Rape Elimination Act.
  • An inmate demonstrates sexually inappropriate behavior as per the Exhibitionism policy.
  • An inmate who is written up for a disciplinary infraction was demonstrating bizarre, unusual, or uncharacteristic behavior when committing the infraction.
  • An inmate placed into Administrative Segregation indicates suicidal potential on the prescreening, or rates positive on the mental health screening, or gives staff any reason to be concerned about the inmate’s mental stability, such as displaying excessive anxiety.
  • Upon arrival to an institution when the inmate indicates prior mental health treatment and medications, especially if not previously documented.

Referrals to mental health may be made on an Emergent, Urgent, or Routine Basis. An inmate deemed to require an Emergent (immediate) referral shall be maintained under continuous staff observation until evaluated by a licensed mental health clinician. An Urgent referral is to be seen within 24 hours. A Routine referral should be seen within five working days.

Referrals are made on the CDCR-MH5, Mental Health Referral Chrono, and forwarded to the mental health office. Emergent and Urgent referrals should also be made by phone to facilitate a timely response. The referral chronos, when received at the mental health office, are logged, entered into the data tracking system, and scheduled for follow-up with the appropriate clinician.

Inmates may also self-refer for a clinical interview to discuss their mental health needs.  Inmate self-referrals shall be collected daily from each housing unit, and processed the same way as staff referrals.”

Similar programs and procedures are in place in prisons in other states, and in other countries.

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ON TO THE SENATE

The article in the Wall Street Journal states:

“The prospects for mental health legislation in the Senate are uncertain, given the compressed calendar in an election year and the fact that sponsors there have their own ideas for changes…”

But the various vested interests are already lobbying hard.  Here’s the text of a letter sent to the Honorable Mitch McConnell, Senate Majority Leader, and the Honorable Harry Reid, Minority Leader, by the APA and other groups on July 13, 2016:

“Dear Majority Leader McConnell and Minority Leader Reid:

On behalf of the undersigned organizations, we are writing to urge you to bring S. 2680, the Mental Health Reform Act of 2016, to the Senate floor for a vote as quickly as possible. Last week, the House of Representatives voted overwhelmingly to pass H.R. 2646, the Helping Families in Mental Health Crisis Act. It is now the Senate’s turn to act.

Mental illness is widely prevalent in the United States. Over 68 million Americans have experienced mental illness in the past year which is more than 20 percent of the total population of the United States. Lifetime rates are much higher with some estimates approaching 50 percent. More striking, in 2013, over 41,000 Americans died by suicide. Many individuals with mental illness or substance use conditions are unable to access or receive the appropriate services and supports for these illnesses, and they remain constantly challenged by mental health service delivery systems that are largely fragmented and uncoordinated across the country.

The Senate Health, Education, Labor, and Pensions Committee voted unanimously to advance S. 2680 in April. Notably, this bipartisan bill strengthens federal coordination of mental health resources, increases reporting on mental health parity, advances integrated service delivery, supports the mental health workforce, and increases early access to mental health services.

We now need your leadership to pass mental health reform and bring millions of Americans and their families help and hope.

Thank you for your consideration. We stand ready to work with you to ensure this critical first step in mental health reform can be sent to the President’s desk for signature this year.

Sincerely,

American Psychiatric Association
American Academy of Child and Adolescent Psychiatry
American Association on Health and Disability
American Congress of Obstetricians and Gynecologists
American Foundation for Suicide Prevention
American Nurses Association
American Orthopsychiatric Association
American Psychological Association
Anxiety and Depression Association of America
Association for Ambulatory Behavioral Healthcare
Children and Adults with Attention-Deficit Hyperactivity Disorder (CHADD)
Clinical Social Work Guild 49
Corporation for Supportive Housing
Depression and Bipolar Support Alliance
Eating Disorders Coalition
The Jewish Federations of North America
Mental Health America
National Alliance on Mental Illness
The National Association for Rural Mental Health
The National Association of County Behavioral Health and Developmental Disability Directors
National Association of Psychiatric Health Systems
National Association of Social Workers
National Association of State Directors of Special Education
National Council for Behavioral Health
National Health Care for the Homeless Council
National League for Nursing
National Register of Health Service Psychologists
NHMH – No Health without Mental Health
Sandy Hook Promise
The Trevor Project”

Note that the first signatory is the American Psychiatric Association.

It is sad that the list includes the National Association of Social Workers, who are squandering a rare opportunity to get on the right side of this debate and sever the shackles that bind them to the psychiatric hoax.

Note also the number of self-serving clichés that the APA have managed to work into this letter:

  1. wide prevalence of “mental illness”: 20% annually and 50% lifetime, but no mention of the fact that this includes every significant problem of thinking, feeling, and/or behaving, including childhood temper tantrums, habitual disobedience, habitual delinquency, shyness, adult temper tantrums, road rage, etc.
  1. “… over 41,000 Americans died by suicide”, but no mention of the fact that in 2010, 23.8% of suicide decedents tested positive for antidepressants post-mortem. (CDC Suicide: Facts at a Glance)   Nor is there any mention of the fact that the rate of antidepressant use in the US is increasing in step with the suicide rate.  The latter has been climbing steadily since 2000.  Here are the figures/100,000:

CDC Suicide rates

[Source:  CDC]

So the national suicide rate increased by 25% between 2000 and 2014.  Note also that the curve is steepening.  The increase from 2000 to 2005 was 4.8%, but from 2010 to 2014 it was 7.4%.

The CDC also reports that between the period 1994-2002 and 2005-2008, the rate of antidepressant use in the United States among all ages increased from 6.4% to 8.9% (a 39% increase).

Of course the fact that the increase in suicide rate coincided with the increase in antidepressant use doesn’t prove that the latter caused the former.  Many factors impact suicide rates.  But it certainly suggests that the matter warrants investigation.  Yet psychiatry, the primary promoters of the drugs, have persistently failed to take on this responsibility.  Brian at AntiDepAware has been single-handedly gathering information on this matter for years.  The sheer number of incidents he has logged is persuasive and compelling.

In addition, there have been numerous first-hand accounts of this phenomenon, including an article by Katinka Blackford Newman published on August 15 in the UK’s Independent.  Here’s a quote:

“On 13 March 2016, French investigators released a report on the case of Andreas Lubitz, the German wings pilot who locked himself into the cockpit of a plane and crashed the plane carrying 150 people into the Alps. When I opened it I felt sick; just nine days before the accident, he was put on exactly the same antidepressant medication that I had been on when I became psychotic and nearly killed my kids. It was clearly stated in the toxicology report – citalopram, mirtazapine and zopiclone sleeping tablets.”

Ms. Newman’s article is detailed and graphic.  Please take a look and pass it on.

JEFFREY LIEBERMAN, MD, SUPPORTS THE BILL

On June 16, 2015, the very eminent psychiatrist Jeffrey Lieberman, MD, presented testimony to the House Energy and Commerce Committee regarding the Tim Murphy bill.  Here are some quotes from his address:

“Our failure to take mental health care as an urgent public health need and national priority, has adversely affected our country in many ways, but there are several consequences which represent the tip of the iceberg of when it comes to our neglect of mental health care that are particularly disturbing. These begin with the seemingly recurrent incidents of mass violence in which the perpetrators are persons with untreated mental illness, and the shocking rates of suicide and PTSD in our military, but also includes domestic violence perpetrators and victims, the displaced mental patients who comprise 30% to 40% of the homeless and the growing rate of mentally ill prisoners. All of these would be limited or prevented by an effective mental health care system.”

Again, note the shameless regurgitation of the D. J. Jaffe marketing argument.  If you’re a Dr. Lieberman fan, as I am, do take a look at his full statement to the committee.  It’s classic Dr. Lieberman stuff, including:

. . . . . . . . . . . . . . . .

“Stigma of mental illness is pervasive in American society and is actively perpetuated by a virulent Anti-Psychiatry Movement. Psychiatry has the dubious distinction of being the only medical specialty with a movement dedicated to its eradication.”

Of course there are very good reasons why psychiatry has this “dubious distinction”.  I’ve listed and discussed these in an earlier post.

. . . . . . . . . . . . . . . .

“In fact I would go so far as to consider SAMHSA a proxy agency for the anti-psychiatry movement, which is to say that the agency has resisted the scientifically driven evidenced based approach to mental health care that psychiatric medicine has embraced since its scientific revolution began in the 1970’s.”

This is the “scientific revolution” that was based on the blatantly deceptive -­ and now widely debunked – premise that virtually every significant problem of thinking, feeling or behaving is caused by a chemical imbalance in the brain; a chemical imbalance which is correctible by taking psychiatric drugs, often for life.  So if that’s the revolution that SAMHSA is resisting, I’d say:  good for SAMHSA!

. . . . . . . . . . . . . . . .

“So many painful and dispiriting elements and incidents in our society would be ameliorated by the advent of a comprehensive effective public mental health system and have a dramatically uplifting effect on public morale and quality of life.”

A dramatically uplifting effect on public morale and quality of life!  Is there just a hint of grandiosity here?

The prescribing of antidepressants and neuroleptic drugs has been increasing markedly in recent years.  We have even reached a point in the US where detectable levels of antidepressants are being found in the drinking water in many areas.  If these trends continue, perhaps “public morale” and “quality of life” will be off the charts.  Perhaps we’ll all be dancing joyously in the streets, and rival gangs will be holding choral concerts in the spill of the streetlights.  Oh Happy Day!

. . . . . . . . . . . . . . . .

“Let me state at the outset that by mental illness I am referring to what are traditionally considered mental illnesses (e.g. schizophrenia, bipolar disorder, depression), addiction (e.g. substance use disorders) and intellectual disabilities (e.g. autism, Fragile X syndrome). The distinctions between these are arbitrary as they all are conditions affecting the same real estate in the brain and manifest by disturbances in common mental functions.”

So, the distinctions between the psychiatric labels schizophrenia, bipolar disorder, depression, addiction, autism, fragile X syndrome, etc., are arbitrary!  I’m not sure what point Dr. Lieberman is making here.  My Random House Webster’s College Dictionary (1992) defines “arbitrary” as:

“1. subject to individual will or judgment without restriction; contingent solely upon one’s discretion; an arbitrary decision2.  decided by a judge or arbiter rather than by a law or statute.  3.  having unlimited power; uncontrolled or unrestricted by law; despotic; an arbitrary government. 4.  Capricious; unreasonable; unsupported; an arbitrary demand for payment.  5.  Math undetermined; not assigned a specific value:  an arbitrary constant

So the distinction, for instance, between “schizophrenia” and “depression” is subject to individual (presumably a psychiatrist’s) will or judgment without restriction.  This sounds like there’s no essential distinction between these so-called illnesses.  Perhaps Dr. Lieberman is coming over to the anti-psychiatry side.  I’ve always said he was our greatest ally.  Or perhaps he just got a little confused in his choice of words.  Maybe he’s tired.  Laboring assiduously against “a virulent Anti-Psychiatry Movement” must take a dreadful toll.

A DISSENTING PSYCHIATRIST

Dinah Miller, MD, a psychiatrist/instructor at Johns Hopkins, pointed out on February 4, 2015, that the APA endorsed an earlier version of the bill before the full text had been published!  Here’s a quote from Dr. Miller’s post:

“Still, I heard the news and was terribly disappointed in the APA. The decision to support this sweeping legislation was made without a vote by the Assembly, with the knowledge that some of these issues are quite polarizing. In addition to the HIPAA disqualification, the issue of outpatient civil commitment, in particular, is controversial. Although proponents are quick to point to research that show its benefits – the research has been done specifically on Kendra’s Law in New York, where $125 million was placed into that state’s mental health system to shore up services – we don’t have the research to know if what helps is providing more services or strong-armed coercion. The text of the bill will be released in the coming weeks. At the very least, couldn’t the APA have waited to see exactly what it is we endorsed?”

THE LINK BETWEEN PSYCHIATRIC DRUGS AND MURDER/SUICIDE

There is an abundance of anecdotal information linking psychiatric drugs (especially neuroleptics and antidepressants) to violence, including murder, and suicide.  There are also several formal papers, most by psychiatrists, going back to at least 1978, which confirm these reports.  For instance:

Neuroleptics: Violence as a Manifestation of Akathisia, W Keckich, MD, Journal of the American Medical Association, 1978

Suicide Associated with Akathisia and Depot Fluphenazine Treatment, K Shear, MD, A Frances, MD, P Weiden, MD, Journal of Clinical Psychopharmacology, 1983

Homicide and Suicide Associated with Akathisia and Haloperidol, JL Schulte, MD, American Journal of Forensic Psychiatry, 1985

Behavioral toxicity of antipsychotic drugs, T Van Putten, MD, SR Marder, MD, Journal of Clinical Psychiatry, 1987

Fluoxetine, Akathisia, and Suicidality: Is There a Causal Connection?, W Wirshing, MD,  T. Van Putten, MD, J Rosenberg, MD, et al, Archives of General Psychiatry, 1992

Akathisia, suicidality, and fluoxetine,  MS Hamilton, MD, LA Opler, MD, Journal of Clinical Psychiatry, 1992

Akathisia as Violence, I Galynker, MD, D Nazarian, MD, Journal of Clinical Psychiatry, 1997

Causality and collateral estoppel: process and content of recent SSRI litigation,  PD Whitehead, MD, Journal of the American Academy of Psychiatry and the Law, 2003

Antidepressant-induced akathisia-related homicides associated with diminishing mutations in metabolizing genes of the CYP450 family. Y Lucire, MD, C Crotty, MD, Pharmacogenomics and Personalized Medicine, 2011

The relevance of cytochrome P450 polymorphism in forensic medicine and akathisia-related violence and suicide, SJ Eikelenboom-Schieveld, Y Lucire, MD,  JC Fogleman, PhD, Journal of Forensic Legal Medicine, 2016

Antidepressant use and violent crimes among young people: a longitudinal examination of the Finnish 1987 birth cohort., E. Hemminki, MD, M Merikukka, PhD, M Gissler, PhD, et al, Journal of Epidemiology Community Health, 2016

BRILLIANT PHRASES

Congressman Murphy is as attuned to the power of catchy slogans as D.J. Jaffe.  Here are some “brilliant phrases” that Dr. Murphy has used in an article and in speeches promoting his bill:

Mental illness is a medical emergency
Treatment before tragedy Minute 9:02
Delayed treatment is denied treatment Minute 1:22
Where there is no help, there is no hope Minute 1:26
Little has been done to get those who need help the help they need Minute 0:22

AND INCIDENTALLY

Here’s some information on the sources of Tim Murphy’s campaign finances for the past four election cycles:

Tim Murphy Campaign Finance Sources

[The source of the financial information listed above is Open Secrets.org, a “nonpartisan guide to money’s influence on US elections and public policy.”]

To put these numbers in perspective, Rep. Murphy’s total campaign expenditures, again, according to Open Secrets, for the years in question were:

Tim Murphy Campaign Expenditures

So the contributions detailed above represent a sizable portion of Rep. Murphy’s campaign expenditures.

DECEPTIONS AND SLOGANS

And so, my dear and patient readers, there it is:  D.J. Jaffe’s tawdry marketing tactics and slogans from the 90’s, adopted today by an ambitious, pharma-psychiatry funded politician, and shamelessly embraced by organized psychiatry.

There are truly no depths of venality and deception to which psychiatry will not stoop to draw attention away from the link between psychiatric drugs and murder/suicide.

And to save their so-called profession, they are even willing to pass the blame for the murder-suicides onto their own clients, for whom they profess such care and concern.

Organized psychiatry, committed irrevocably and wholeheartedly to drug pushing and to their corrupt and corrupting relationship with pharma, simply will not countenance the fact that their primary product is fundamentally flawed and destructive.  So they hire a PR company; they fund and lobby politicians; they parrot slogans; and they encourage one another to ever-increasing heights of self-congratulation.  But they will not commission a definitive study to clarify and assess the scale of this problem once and for all.  And the reason for this inaction is because they know that it would be bad for business.  It would “cause a lot of people to stop taking their medications”.  So the pharma-psychiatry cartel thrives, and the dance of death goes on.

FINALLY

If you live in the US, please write to your Senators and ask them not so support this legislation.

  • S Randolph Kretchmar

    Phil, I am with you as a HUGE fan of Jeffrey Lieberman! I propose that we start an official fan club… We can exchange pictures of him, and quotes from all of his amazing speeches, among adoring club members (and I bet there will be thousands).

  • Mark

    Marvelous piece, Dr. Hickey.

    You wrote,

    In the criminal justice system this would be the equivalent of guilty unless proven innocent. In fact, it would be worse than that. It would be guilty, with no way to prove one’s innocence.

    I think this is a really valuable metaphor and I want to expand on it a little bit. Too often, the debate around the Murphy bill talks about the rights of “the mentally ill”, but in fact we’re discussing the rights of people diagnosed with “mental illness”. Since anyone is potentially subject to psychiatric labeling, they’re actually the rights of everyone. Consider the difference between talking about Miranda rights as “the rights of criminals to remain silent” vs. “the rights of criminal suspects to remain silent”. By framing debates on the Murphy bill around the rights of “the mentally ill” we imply that “mental illness” is a natural and objective category, and reinforce the us-them distinction between “sane” and “insane” that allows psychiatrists and the courts to do an end-run around constitutional due process. These are the rights of people accused of “mental illness”, and whenever we talk about the rights of “the mentally ill”, we’ve prematurely conceded a significant philosophical and rhetorical point to the druggers. As long as the public thinks the right to refuse medication is only for “crazy people,” they’re likely to think it’s not very important.

  • S Randolph Kretchmar

    In May, 2015, I took a class at the American Psychiatric Association’s annual meeting in Toronto entitled, “Evaluation and Treatment of Behavioral Emergencies.” Despite the fact that the largest amount of time was spent discussing the details of drugs new and old, there was also a prevailing opinion that the magic factor in emergency psychiatry is “de-escalation”. There was a great deal of common sense in this, and some fascinating statistics. Apparently the statistics prove that psychiatry works far better with the least possible amount of coercion. All five of the class faculty agreed with that principle.

    The problem of course, is that so-called “treatment of behavioral emergencies” remains nothing more than a euphemism for police action. There’s no way to fundamentally separate it from coercion. An explicit point was mentioned that chemical restraint, defined as treatment with drugs not to ameliorate any medical condition but only to control a person’s movement, violates civil and human rights. This was considered a sobering thought, perhaps because all present knew on some level that every slightest difficulty in human thought, emotion and behavior is not traditionally considered to be a medical condition. The public just isn’t quite with them on this yet, and psychiatric “treatment” cannot really be distinguished from chemical restraint.

    Again, this was at the APA’s annual meeting. It’s not as though these guys don’t know better than the Murphy bill.

  • all too eay

    People believed Hitler’s manifest too.
    To avoid the truth so carefully, so thoroughly, with such precision, is a skill some develop with astonishing devotion. For these beloved, poor, desperate souls 2 + 2 equals 22, 4.02, 5, 0, cheese cake or nicotine, even as they fix their hatred on the very people who have dedicated their energy, their resources, their entire lives to helping those who are so terribly sick and damaged, as they are. That’s a big, “Thank you,” indeed.

  • Phil_Hickey

    Mark,

    Thanks for your support.

    I agree about the importance of words. That’s why I always put words like “schizophrenia”, “mental illness” “diagnosed” inside quotations marks: to indicate that these are not real entities. See my post The Power of Words to Shape Attitudes.

    Best wishes.

  • Phil_Hickey

    Randolph,

    Good point. I believe that at some fundamental level, the great majority of them realize that it’s all a hoax, but it’s always easier to change our thoughts than to change our behaviors. So they perform whatever mental gymnastics they need in order to keep practicing.

    I’m often reminded of the Wall Street hustlers, many of whom in the run-up to the 2008 crash, had expressed the hope that the bubble would last long enough for them to reach retirement!

    Best wishes.

  • all too easy

    ONCE AGAIN, AS USUAL, PHIL DOES NOT CITE ONE STUDY IN WHICH PROOF IS OFFERED THAT MEDS CREATED DAMAGE TO THE BRAIN.

    NO ONE CAN ESTABLISH THAT PAIN IS REAL.

  • Circa

    ATE, there are studies which confirm that antipsychotics shrink the brain and shorten life span. I can’t remember the name of the researcher (might be Andreason) but you can google and find out. And if you can stand some advice from me, please don’t post in all caps; it’s the equivalent of shouting.

  • all too easy

    Not a speck of evidence, my friend; not in any peer reviewed, scientifically validated literature.

    Have u noticed how you and your dearly beloved cohorts never, ever, not even once, mention that fact? Hmm?

    Don’t forget pain, sweetie. Doesn’t exist. Tis a hoax. That’s what you believe. Come on Robbie, u can do better.

  • Circa

    You are simply incorrect but I think you should research it yourself. Who is Robbie? Seriously, a psychiatrist would probably diagnose you with borderline personality disorder. Are you like this in real life or are you just obnoxious anonymously on the internet? Get some help.

  • all too easy

    Robbie is God-like in his mind and in his presentation of himself with lowly, unenlightened pukes. He has experienced everything and therefore realizes from experience and his vast knowledge of all things, that he understands exactly what human beings need: HIM. His diagnostic skills cover all human ailments, even from a vast distance. Just tell him what troubles you and no matter what it is, he knows what you should do to find relief: Be like him. For you see Robbie has achieved a special and preeminent place among us. He only has peace and health to accompany him as he preaches his greatness among regular folk. He has all the answers. We love Robbie- Stevie, and plead with you to follow his path, for your own sake

  • doppelganger

    Circa – Although psychiatric diagnoses are nothing but pejorative labels, I concur with your assessment of “borderline” for ATE. ha ha ha ha ha ha Good one! This site’s resident troll has indeed sought help from the psychiatric trade, but his preferred “diagnosis” is ADHD because that gets him easy access to amphetamines from his drug pusher.

  • Circa

    Ah, well that would explain his stellar typing – the guy is on speed. 🙂

  • all too easy

    Don’t take any thing to manage the pain from severe burns, dislocated joints, compound fractures, sprains, knife and bullet wounds or any other made up bologna the drug companies push on the unsuspecting, duped, uninformed, morons out there like little Stevie who think pain is real. Not one scientific, biologically based test proves pain exists. Not a one. HOAX

  • all too easy

    WATCH OUT FOR FELLATING THE MASS PHALLUS. SHE’S OFF HER MEDS

  • doppelganger

    Did you know that the FDA has approved methamphetamine for the “treatment” of ADHD?! Yeah the stuff is called “Desoxyn.” ATE seems to be suffering from some adverse drug effects such as:

    * new or worse behavior and thought problems
    * new or worse bipolar illness
    * new or worse aggressive behavior or hostility
    * new psychotic symptoms (such as hearing voices, believing things that are not true, are suspicious) or new manic
    symptoms

    You can read about the side effects of prescription methamphetamine here:
    http://www.fda.gov/downloads/Drugs/DrugSafety/ucm088582.pdf

  • Rob

    I guess that means speed corrects neurological imbalances?

  • doppelganger

    No. It means if you can mimic the fake “symptoms” of a fake psychiatric “illness,” then you can get access to otherwise illegal drugs (even methamphetamine!) via a fake “doctor,” i.e. a psychiatrist.

  • Cledwyn Gallows Buffoon

    All is useless.

    People would have a better chance of success concentrating their reformist energies on some other degenerate mob of apes, not so far fallen from some pristine, prelapsarian, mythical condition that they torture and torment purely for the fun of it, for their hit of schadenfreude, and who, unlike the rest of our simian brethren, have added to their repertoire of vilenesses the infliction of psychological violence – be it perpetrated for existential gain, or simply to distract man, the bored ape, from the senseless drift of non-events that constitutes his depressing existence – for so much more refined are the torments we inflict upon each other, wheresoever we are fated to fall into such bad company as our own kind affords, we are able to inflict wounds that never heal, but that cannot be seen, so that the (in)justice system and morality may never trace the countless acts of psychological violence that men inflict in the course of their lives, when putting certain of their sensory organs to corrupt usage, be it in the perpetration of our crimes, or as an accessory before and after the fact (as with our lying tongues and fingers).

    Yet easily drowned out are the voices striking such a stray note of dissent amidst the general chorus of self-congratulation orchestrated under the baton of contemporary academics, trumpeting the triumph of the “better angels of our nature”, sowing seeds of blindness, and bringing in the sheaves (converts to the religion of “humanity”); or under the baton of the mountebanks and phony philanthropes trading on our trust in every age.

    “What a piece of work is man!”

    Hamlet

    The effort expended in trying to reform human society (even when it is more than a veiled attempt to recast others, of such supposedly inferior construction, in our own mold, for there being not enough mirrors in the world to gratify the bottomless amour-propre of some men, they try to remake others in their own image, so that everywhere they may happen upon their own reflection, which madness they then dignify, identifying it with a cause so lofty as the reformation of humanity) is just an ongoing attempt to evade acknowledgement of the fact that a truly just society is inconceivable outside of a graveyard, to say nothing of its manifest impossibility.

  • Cledwyn

    Instead of wasting our time on that incorrigible ape known as man, we should draft a proposal for the speedy reformation of the hamadryas baboon. Perhaps something can be done with him…

    So much wasted energy…

  • Circa

    Sorry, Phil, for posting this in the wrong place but I made a comment on your post about depression and I can no longer find your piece so I don’t know if you responded. I was asking for your position on the life and death of David Foster Wallace. I would really appreciate your pointing me to your reply as I would be interested to know what you have to say on the matter.

  • Cledwyn’s Pus Poetry

    Continuing, some might point to our capacity for compassion, for fairness, and so forth, all of which seem unique to our species, but these carry no great weight in the affairs and motives of men at large, greatly overborne as they are by man’s peerless propensity for cruelty, in which he often takes a depraved satisfaction, in contrast to the indifferent cruelty of other creatures, who do not inflict humiliation and suffering purely for the powerful stimulus it affords to their feelings.

    Feelings such as our vanity, the gratification of which is at bottom of so much of the obscene vileness of men who, for the rich harvest of pleasurable feelings it affords ( purchased at the expense of the misery of others), draw such invidious distinctions between each other, and who blame and shame those who have had a bad hand in the rigged game of life all so that they may take take credit for their luck, so that they may strut about the winner’s enclosure like peacocks, whilst sitting in judgment or laughing at all the “losers”, the “deadbeats”, the “bums”, the “failures”, setting about them with our labels and reproaches like wolves a wounded prey.

    In human society, as in the rest of nature, the law is devour or be devoured; but whereas in the rest of nature, flesh feeds on flesh, in human society, egos feed upon egos; and no man is found to be left standing, who isn’t by the lifeblood of another empowered.

    Nah, the attempt to better humanity is a lost cause.

  • Cledwyn

    People like Steven Pinker, Raymond Tallis, and the rest of the secular priesthood for this new religion of Humanity, worship at the altar of a god just as cruel and unjust as the one who in religious mythology hatched him; and just as many believers in the latter, toadying to this abominable tyrant in the sky, have sacrificed, and continue to sacrifice, the victims to whose detriment their god designed the world, blaming them for their evil, misery, failure, and misfortune; likewise, those who prostrate themselves at the feet of this new deity, this many-headed monster (Humanity), under the influence of the same belief in free will – that cruelest of treacheries perpetrated by the fortunate against the unfortunate – are just as often found to make propitiatory offerings of victims to their god, in order, likewise, to absolve it, when in truth it is to it, and not to the victims themselves, that their misery, evil, failure, and misfortune are owing.

  • Cledwyn

    In his writing, Senator Murphy has made some important points the critics urgently need to address, such as that embodied in expressions of his humanitarian concern that the what should be the patient’s inalienable “right to be well” is being infringed.

    This is a very good point. In this connection, maybe we could institute legal proceedings against Nature, or that other human rights abusing bastard, God, for visiting so many seeming millions of diseases on our heads, not to mention misfortunes on our bottoms.

    And while we’re at it, let’s arraign before a human right’s tribunal that other scoundrel, Fate.

    And surely some of the responsibility must be borne on the shoulders of healthcare professionals, for these most despicable infringements of perhaps our most basic right, “the right to be well”, in failing to cure us of the many ailments with which we are mercilessly persecuted from the commencement of our wretched existence to its conclusion.

    I can only assume that terminally-ill cancer patients, bearing their disease silently and without protest, haven’t been fully apprised of their rights. To think that my dead mother might be here today, if only she had been told of her right to be well and had pursued the relevant avenues of redress that would surely be open to every man, woman and child, were the legal system so constituted as to ensure justice for those subjected to these vile human rights abuses.

    The problem is, in treating illnesses, the basis for which is entirely presumptive, psychiatry creates states of ill-health for which evidence is readily forthcoming, therefore it could be argued, perhaps only by unreasonable people, that the eminent Senator Murphy – at whose feet I would gladly fling myself – is hoisting himself with his own petard.

    Nevertheless, I commend Mr Murphy for drawing attention to the shameful state of affairs wherein a man’s INDEFEASIBLE right to be well is by the criminals aforementioned being ridden roughshod over.

    By drawing attention to this, and laying bare this vast network of criminal activity, you give hope to many billions of people, and hold out to all humanity the prospect of a world in which men need not suffer from the interminable array of ailments that lay siege to and persecute them night and day, a world in which the right to be well will be as taken for granted as is now the right to be happy, to be beautiful, and to be immortal.

  • Rob

    Go to “Home” tab on the Disqus web site. Click on your “Profile” avatar (upper right corner) and you’ll see all of your posts and their respective threads.

  • Phil_Hickey

    Circa,

    I’ve just posted a reply under your original comment.

  • Cledwyn’s Pus Poetry

    “…how do you get someone to consent to treatment if they don’t even understand reality.”

    And how do you stop people from imposing their nominal treatments on others when they don’t even understand reality, when their minds are ineluctably lost in the labyrinth of logic into which the human heart leads, without the Ariadne’s thread of reason to find their way out?

  • Phil_Hickey

    Cledwyn,

    Nice!

  • Cledwyn’s Suicidal reveries

    “Many factors impact suicide rates.”

    We should be celebrating this epidemic of lucidity.

    There comes a point at which it becomes obscene to go on living, and we all reach it the moment we pop out of the womb.

    “No-one ever lacks a good reason for suicide.”

    Cesare Pavese

    People say that suicide is a tragic waste of life, but it is life that is a tragic waste of suicide.

    All the reasons conventionally adduced for why such-and-such a person ought not have killed himself only serve to vindicate him, and attest to the soundness of his judgement. “He had his life ahead of him!”. Exactly. “He had a family!”. Every man has his cross to bear. “He was such a kind and loving person!”. I rest my case.

    Life is like much theater. Crap scenery, dreadful dialogue, full of unsympathetic characters, meaningless, and the audience applauds the villains of the piece, and just as when the curtain is drawn, audiences are known to cry encore, hoping to return another night, so we cry encore at the curtain close, knowing the play of life to be shite. What madness!

  • Cled’s Melancholy Pus poetry

    Some try to cast off the roles to which they are allotted by fate and society, but at least for some, it is no use; they are “typecast in every move” (Mark Eitzel).

    Hence it transpires that some exit the stage all together, despairing of escaping the role they are expected to play out to the end, be it the clown, the leper, the hobo, the freak, the madman, the slave, or some such other part in the depressing tragi-farce of human existence.

    We all of us know that there is sometimes nothing that can be done to change the individual’s role, given the invidious distinctions fate and society alike draws between individuals, yet we cruelly force people to go on playing out their roles.

    We even tell such people that they freely choose their roles, adding shame to their burden of misery and adversity. What a piece of work is man!

  • all too easy

    LOL