Expansion of Psychiatric Turf

Last Saturday our local newspaper ran an article called “Mental Health Needs Reform.” It was written by a psychologist, and the main thrust of the piece was that if “serious mental health care reform” is not implemented, we will see more mass murders similar to those at Aurora and Newtown. The article contained several unwarranted assumptions, and recommended that mental hospitals “rebuild facilities for treating those patients.” My position, of course, is that there are no mental illnesses, and that cold-blooded killers are not sick in any meaningful sense of the term, but are, rather, individuals who have not internalized an age-appropriate respect for the lives and welfare of other human beings. ...

Prior to about 1994, childhood bipolar disorder was virtually unheard of. DSM-III-R (1987), in the section on manic episode, states, “…studies indicate that the mean age at onset is in the early 20s. However…a sizable number of new cases appear after age 50.”(p 216) Of course a mean age of onset in the early 20’s could include young children. The section on major depressive episode, however, contains the following: “The average age of onset is in the late 20s, but a major depressive episode may begin at any age, including infancy.” (p 220) ...

In the wake of the Connecticut mass murders of last month, a great deal of attention, official and otherwise, is being focused on the “mentally ill.” Politicians of all persuasions are proclaiming that we need more funding for the so-called mental health services, and predictably, the various practitioners and centers are lining up with their hands outstretched. The spurious logic, of course, is never identified, or if it is, it gets lost in the rhetoric. Mental illness is presented (and accepted) as the proximate cause of the violence. If one were to ask a mental health practitioner why an individual was so crazy and acted so brutally, the reply would be: Because he has a mental illness. But if one were to press the matter and ask: How do you know he has a mental illness? the only possible response is: Because he is so crazy and acted so brutally. The only evidence for the so-called illness is the very behavior it purports to explain. ...

There is an interesting article in last month’s issue of the British Journal of Psychiatry. The article, titled Psychiatry beyond the current paradigm, was authored by Pat Bracken, an Irish psychiatrist, and 28 other British and Irish psychiatrists. The gist of the piece is that the current psychiatric paradigm, which the authors describe as “applied neuroscience,” is not supported by the evidence and needs to be abandoned. Here are some quotes: ...

Earlier this year the World Health Assembly, the decision-making body of the World Health Organization, an agency of the UN, passed a resolution “to develop a comprehensive action plan covering services, policies, plans, strategies, programs and legislation to enable persons with mental disorders to live a full and productive life in the community.” The resolution recommends several strategies to promote mental health, including the integration of “…mental health into broader health policies and strategies…” and the promotion of “…mental health by targeting early childhood years, aging, prevention of domestic violence and abuse, workplace stress and suicide prevention programs.” ...