On February 28, our good friend, the eminent Jeffrey Lieberman, MD, President of the APA, published Politics of Psychiatry and Mental Health Care on Psychiatric News, the APA’s online bulletin.
His co-author on this occasion is Patrick Kennedy, former Congressman from Rhode Island and co-sponsor of the Mental Health Parity and Addiction Equity Act.
The piece is fluff and cheerleading, which have become Dr. Lieberman’s areas of specialty.
He opens the article by telling us that psychiatrists are “…getting serious about the politics of mental health care.”
“After decades if not centuries of neglect, the bona fide health care disparity is receiving an unprecedented amount of attention.”
This increased attention to the desperate plight of psychiatry is prompted by several factors, including “…the rising number of people with mental illness involved in civilian massacres.”
He’s willing to exploit the victims of the mass murders and their families as a springboard to promote further expansion of the psychiatric juggernaut, but he’s not willing to call for an inquiry into the possible causal role that psychiatric drugs are playing in these incidents, and in suicides generally
He claims to want parity between psychiatry and physical medicine. But this is not the case. Real medicine stands or falls by its results. If a long-standing pulmonology treatment, for instance, is found on critical scrutiny to be doing more harm than good, then it will be scrapped. Medicare will stop paying for it; private insurers will stop paying for it. And customers will say no thank you.
Psychiatry, however, has built-in protections against this kind of functional self-scrutiny. Psychiatric research that establishes the efficacy and safety of its treatments has long since been hijacked by vested interests. Psychiatrists have not only acquiesced in this process, but have actually taken the leading role. They continue to offer electrically-induced convulsions as the treatment of choice for chronic, severe depression, even though there is no evidence of lasting benefit, and ample evidence of truly horrendous adverse effects. In addition, there is growing evidence that chronic, severe depression is actually an adverse effect of long-term ingestion of high doses of so-called antidepressants. The destruction wrought by neuroleptics is well known, and would simply not be considered acceptable in real medicine.
No, psychiatry doesn’t want real parity. Because real parity would also entail genuine medical quality accountability. What psychiatry and its eminent spokesperson Dr. Lieberman want is a government-enforced rule that enjoins Medicare, Medicaid, and private insurance carriers to reimburse psychiatrists at rates commensurate with those paid to real doctors, even though psychiatry is spurious and destructive.
“But true parity goes beyond monitoring and enforcement. It extends to the fundamentals of how we practice medicine. Integrated medical and behavioral health models, in which psychiatric physicians and mental health specialists work closely with patients’ primary care providers, can expand access, leveraging limited resources for truly comprehensive care that ensures more people are receiving quality health care, including mental health care.”
This last sentence takes some unraveling. But it really doesn’t matter. Dr. Lieberman’s essential style is to grab onto discrete print-bites and string them together with random bits of syntax. The print-bites in this case are: “…we practice medicine…”; …psychiatric physicians…”: “…work closely with primary care providers…”; “…expand access…”; …including mental health care…”
There’s an almost plaintive quality to Dr. Lieberman’s repetitive insistence that he and his colleagues are real doctors (honestly), and to his perennial plea for a place for psychiatry in primary care. He reminds me – and I say this in all kindness – of those little velveteen-covered mechanical toys that were popular in the 50’s and 60’s. You wound them up and let them go, and they would skitter around, clapping their hands, stomping their feet, moving their jaws up and down, etc… They were truly fun to watch, but had a very limited repertoire.
Anyway, back to the fluff-piece. Dr. Lieberman tells us, with perhaps more candor than he intended:
“Perhaps no piece of the puzzle is more complex than payment.”
What would we think of a surgeon or a nephrologist who told us that the most complex part of his job was getting his bills paid?!
With regards to Tim Murphy’s proposed legislation, Dr. Lieberman tells us:
“We support the bill’s intentions, but are also pleased with the opportunity it offers to work with members of Congress to educate them about the changes needed in mental health care. We must stay vigilant to ensure that the rights of people with mental illness are not being jeopardized and the services they need and deserve are secure.”
Now this, my dear and patient readers, is the very pinnacle of psychiatric spin. The Tim Murphy bill represents a major assault on the civil rights of people who have been ensnared in the psychiatric web. It would probably not be an exaggeration to say that if it ever became law, it would put the already-curtailed civil rights of these individuals back fifty years. But Dr. Lieberman tells us that psychiatry supports this bill, and in the same sentence assures us that psychiatry also strives to ensure that the rights of these people “…are not being jeopardized…”!
In closing the article, Dr. Lieberman tells us that psychiatry “…must always bear in mind our end goal.”
“We are working to create a society in which mental disorders and chronic addictions are recognized and understood to be what they are: illnesses that are real and treatable. To truly effect sustainable change, we must view these historic legislative initiatives as more than just laws, but as a means by which to shift the way we collectively think about mental health and integrate it into general health.”
Somewhat by way of an afterthought, he adds:
“We are working to ensure that people with mental illness receive the care they need when and where they need it and without bias in a true culture of parity.”
So, unlike real doctors, who see their role as treating illness, psychiatry has a different goal: to convince society that the problems psychiatry addresses are real illnesses. Their goal is “…to shift the way we collectively think about mental health…” So psychiatry’s end goal is more akin to marketing and PR than to real medicine. They’re going to change the way we think! We mental illness deniers will be persuaded as to the error of our ways. Survivors, who are coming out in their hundreds of thousands to protest the “treatment” they have received from psychiatry, will be mollified and returned to the fold of docile and unquestioning compliance, to which, given psychiatry’s proclivity for enforced “treatment,” could be added – “or else”!