A Behavioral Approach to Mental Disorders

I have recently read De-Medicalizing Misery [palgrave macmillan, 2011]. It’s a comprehensive collection of articles, edited by Mark Rapley, Joanna Moncrieff, and Jacqui Dillon. The table of contents provides a sense of the book’s scope. Table of Contents Carving Nature at its Joints? DSM and the Medicalization of Everyday Life, Mark Rapley, Joanna Moncrieff, and Jacqui Dillon Dualisms and the Myth of Mental Illness, Philip Thomas and Patrick Bracken Making the World Go Away, and How Psychology and Psychiatry Benefit, Mary Boyle Cultural Diversity and Racism: An Historical Perspective, Suman Fernando The Social Context of Paranoia, David J. Harper From Bad Character to BPD: The Medicalization of 'Personality Disorder', James Bourne Medicalizing Masculinity, Sami Timimi Can Traumatic Events Traumatize People? Trauma, Madness, and Psychosis, Lucy Johnstone Children Who Witness Violence at Home, Arlene Vetere Discourses of Acceptance and Resistance: Speaking Out about Psychiatry, Ewen Speed The Personal is The Political, Jacqui Dillon 'I'm Just, You Know, Joe Bloggs': The Management of Parental Responsibility for First-episode Psychosis, Carlton Coulter and Mark Rapley The Myth of the Antidepressant: An Historical Analysis, Joanna Moncrieff Antidepressants and the Placebo Response, Irving Kirsch Why Were Doctors So Slow to Recognize Antidepressant Discontinuation Problems? Duncan Double Toxic Psychology, Craig Newnes Psychotherapy: Illusion with No Future? David Smail The Psychologization of Torture, Nimisha Patel What Is to Be Done? Joanna Moncrieff, Jacqui Dillon, and Mark Rapley Each author brings to the general topic his or her unique perspectives, and the result is persuasive and inspiring. Here’s a quote from the final chapter: ...

On Monday, October 7, 2013, The Sun, a British tabloid newspaper ran the following headline: 1,200 Killed By Mental Patients. Shock 10-year toll exposes care crisis. It took up almost all of the front page. The headline precipitated a great deal of protest from politicians, advocacy groups, mental health professionals, and others. The general points in most of these protests were that the headline was sensationalistic, misleading, and would serve to increase the stigma associated with “mental illness.” ...

I recently came across an APA article titled Change, Challenge, and Opportunity: Psychiatry in the Age of Health Care Reform. It was co-authored by Jeffrey Lieberman, MD, and Howard Goldman, MD, PhD, and dated October 3. The article discusses the implications of the Affordable Care Act (Obamacare) for psychiatry, and also reviews progress of the 2008 Mental Health Parity Act. The latter mandated that insurance coverage for “mental illnesses” be essentially on a par with coverage for general medical problems, but the act has not yet been implemented in its entirety. The authors also point out that there are provisions in the ACA that focus on reform of the actual health care services, as well as the reform of health care insurance. ...

I’ve been reading another great book: Deadly Medicines and Organised Crime: How big pharma has corrupted healthcare, by Peter C. Gotzsche [Radcliffe Publishing, 2013]. The book is an exposé of pharma’s fraudulent research and marketing. The author is a Danish physician who has been involved in clinical trials of drugs, and in drug regulatory matters. He is a professor at the University of Copenhagen. He has published more than 50 papers, including papers in the BMJ, Lancet, JAMA, Annals of Internal Medicine, and the New England Journal of Medicine. ...

On September 30, the Wisconsin State Journal posted an article online. It’s called County Executive Joe Parisi proposes new mental health program for county school district, and was written by Andrea Anderson. [Thanks to S. Randolph Kretchmar on Twitter for the link.] The gist of the article is that Joe Parisi, the County Executive of Dane County, Wisconsin, is proposing to allocate $90,000 each to two school districts “…to treat student mental health…” ...

There’s an interesting article on Harvard Law Petrie-Flom Center’s blog titled Daubert as a Problem for Psychiatrists. It was written by Alex Stein and is dated September 19. [Thanks to Dustin Salzedo for drawing my attention to this in a comment on an earlier post.] The article deals with the legal rules governing the admission of expert testimony. Apparently there are two different sets of rules in this area, known respectively as Frye and Daubert. ...

On September 27, the New York Times published an article called Lacking Rules, Insurers Balk at Paying for Intensive Psychiatric Care. The author is Reed Abelson. Thanks to S. Randolph Kretchmar on Twitter for the link. The article describes the kinds of conflicts that can occur between people with “mental illnesses” wanting “treatment,” and insurance companies who sometimes are reluctant to pay for this “treatment.” The article is fairly balanced. It presents a number of actual cases of people who were experiencing difficulty. But it also tries to do justice to the insurance company’s position: ...

There’s an interesting exposé in the London Daily Mail, September 29, titled Critics claim antidepressants are being handed out like sweets… Thanks to Leonie and Antidepaware on Twitter for the link. To find out how easily people could get prescriptions for antidepressants, the Mail sent "…three women of differing ages — all of whom had no current mental health issues — to their doctors, reporting fictional symptoms of mild depression which had lasted for three to six weeks." ...

On September 25, PsychCentral ran an article on this topic. The article was a commentary on a 2013 meta-analysis conducted by Katharine Barnard, PhD, et al of the University of Southamptom, UK. The meta-analysis examined three systemic reviews and 22 studies. RESULTS "There was evidence that antidepressant use is associated with type 2 diabetes. Causality is not established, but rather, the picture is confused, with some antidepressants linked to worsening glucose control, particularly with higher doses and longer duration, others linked with improved control, and yet more with mixed results. The more recent, larger studies, however, suggest a modest effect." ...

Jeffrey Lieberman, MD, President of the APA, has written a guest post, In the Wake of the Navy Yard Shooting: A Way Forward, on EverydayHealth. Everyday Health Inc. is a media company which operates for-profit websites on health and related matters. It’s been confirmed that the Navy Yard shooter had been taking trazadone, an antidepressant of the serotonin antagonist and reuptake inhibitor (SARI) class, and the House Committee on Veterans’ Affairs has indicated that it plans to investigate to what extent the drug might have been a causative factor. ...