There’s an interesting article on Mad in America dated September 17, 2013. It’s titled Psychiatry & Suicide Prevention: A 30-year Failed Experiment, and was written by Maria Bradshaw.
Maria Bradshaw is the founder of CASPER, an organization that rejects the medical model of suicide prevention in favor of a sociological model. Ms. Bradshaw founded CASPER after her son’s antidepressant-induced suicide.
Here’s the gist of Ms. Bradshaw article:
Roger Mulder, MD, is head of psychiatry at Otago University in New Zealand. For at least the last 15 years, he has supported the notion of psychiatric intervention as a suicide-prevention measure. For instance, here’s something he wrote in 2008 in an article published in Acta Psychiatrica Scandinavica:
“Suicide behaviours are common in depressed out-patients. Antidepressant treatment is associated with a rapid and significant reduction in suicidal behaviours. The rate of emergent suicidal behaviour was low and the risk benefit ratio for antidepressants appears to favour their use.”
However, at a conference in Auckland, New Zealand, two weeks ago, he stated that the psychiatric model of screening people for suicide risk was not effective. The conference was covered by Simon Collins of the New Zealand Herald. Here’s a quote from Dr. Mulder:
“‘We’ve had a 20- or 30-year experiment which hasn’t worked.'”
In her article, Ms. Bradshaw compliments Dr. Mulder on having the integrity to alter his stance in the light of the evidence. In his conference presentation, Dr. Mulder had pointed out that targeting groups deemed to be at high risk with psychological/pharmacological interventions has failed to impact actual suicide rates.
Ms. Bradshaw herself argues that not only has the psychiatric paradigm failed to lower suicide rates, it has actually caused them to increase.
In support of this position, she points out that the suicide rate for people who have used mental health services in the past year is 137.6 per 100,000, but only 7.6 per 100,000 for those who have not had a mental health contact. Ms. Bradshaw doesn’t cite a source for these figures, but the study is almost certainly not a randomized controlled trial. So to some extent, we may be comparing apples to oranges. But the numbers are sobering nonetheless, especially since the “life-saving” aspect of antidepressants is frequently touted by psychiatrists in response to various criticisms.
Another interesting statistic that Dr. Mulder reportedly mentioned at the conference is that “only 3 percent of those labeled as ‘high risk’ actually killed themselves, while 60 per cent of actual suicides had been categorized as ‘low risk.'” [Quoted from the Simon Collins article in the New Zealand Herald.]
DISCUSSION
It has long been recognized that a person’s risk for suicide increases in the first few weeks (months?) of taking an antidepressant. The psychiatric explanation of this was that the putative therapeutic action of the drug gave the individual sufficient motivation to do what he had been wanting to do previously – namely to take his own life.
I’ve never been impressed with this argument, and in my view, it’s becoming increasingly clear that the so-called antidepressants do in fact induce or strengthen suicidal urges in some people.
Maria Bradshaw’s article is well worth reading. CASPER, the organization she founded after her son’s suicide, is also worth watching. One of the ideas they are developing is the training of potential natural helpers in how to respond to people who mention suicide. The New Zealand Herald article describes how Ms. Bradshaw provided training in these matters to a group of hairdressers.
It’s too early to say how successful these kinds of endeavors will be, but the idea of natural helpers has, in my view, enormous potential, not only with regards to suicide prevention, but also in helping people cope with problems generally, and develop new skills.