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Harvard Expert Ties Mental Illness “Epidemic” to Big Pharma’s Agenda

Friday, July 29th, 2011

Minyanville
By Minyanville Staff
July 28, 2011

When the DSM-II was published in 1980, it became “the bible of psychiatry,” writes Angell, who adds, “but like the real Bible, it depended a lot on something akin to revelation. There are no citations of scientific studies to support its decisions.”

For any mental illness or passing mood swing that may trouble a person, the Diagnostic and Statistical Manual of Mental Disorders — better known as the DSM — has a label and a code. Recurring bad dreams? That may be a Nightmare Disorder, or 307.47. Narcolepsy uses the same digits in a different order: 347.00. Fancy feather ticklers? That sounds like Fetishism, or 302.81. Then there’s the ultimate catch-all for vague sadness or uneasiness, General Anxiety Disorder, or 300.02. That’s a label almost everyone can lay claim to.

These codes are used by doctors, psychologists, and regulators to maintain a mutual language; it’s a handy shorthand system for bureaucratic purposes. But over the past few decades, the staggering, ever-expanding influence of the ever-expanding DSM, which is published by the American Psychiatric Association, has also played a lead role in building wealth and off-label product uses for the major drug manufacturers. In an insightful essay in this week’s New York Review of Books, Marcia Angell, a senior lecturer in social medicine at Harvard Medical School and former Editor in Chief of The New England Journal of Medicine, explains how.

The medical director of the American Psychiatric Association (APA), Melvin Sabshin, declared in 1977 that “a vigorous effort to remedicalize psychiatry should be strongly supported."

Angell’s essay is based on a review of three current books examining the psychiatric industry: The Emperor’s New Drugs: Exploding the Antidepressant Myth, by Irving Kirsch; Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker, and Unhinged: The Trouble with Psychiatry–A Doctor’s Revelations About a Profession in Crisis, by Daniel Carlat. She also cites the DSM-IV, the most recent edition of the manual, while her review traces big pharma’s role in our current mental disorder epidemic to the DSM-III, published in 1980.

To begin, Angell describes the psychiatric profession’s backlash against a developing perception in the 1960s and 1970s that the practice was a “soft” almost pseudo science:

In the late 1970s, the psychiatric profession struck back–hard. As Robert Whitaker tells it in Anatomy of an Epidemic, the medical director of the American Psychiatric Association (APA), Melvin Sabshin, declared in 1977 that “a vigorous effort to remedicalize psychiatry should be strongly supported,” and he launched an all-out media and public relations campaign to do exactly that. Psychiatry had a powerful weapon that its competitors lacked. Since psychiatrists must qualify as MDs, they have the legal authority to write prescriptions. By fully embracing the biological model of mental illness and the use of psychoactive drugs to treat it, psychiatry was able to relegate other mental health care providers to ancillary positions and also to identify itself as a scientific discipline along with the rest of the medical profession. Most important, by emphasizing drug treatment, psychiatry became the darling of the pharmaceutical industry, which soon made its gratitude tangible.

Of the 170 contributors to the current version of the DSM (the DSM-IV-TR), ninety-five had financial ties to drug companies, including all of the contributors to the sections on mood disorders and schizophrenia.

These efforts to enhance the status of psychiatry were undertaken deliberately. The APA was then working on the third edition of the DSM, which provides diagnostic criteria for all mental disorders. The president of the APA had appointed Robert Spitzer, a much-admired professor of psychiatry at Columbia University, to head the task force overseeing the project. The first two editions, published in 1952 and 1968, reflected the Freudian view of mental illness and were little known outside the profession. Spitzer set out to make the DSM-III something quite different. He promised that it would be “a defense of the medical model as applied to psychiatric problems,” and the president of the APA in 1977, Jack Weinberg, said it would “clarify to anyone who may be in doubt that we regard psychiatry as a specialty of medicine.”

When the DSM-II was published in 1980, it became “the bible of psychiatry,” writes Angell, who adds, “but like the real Bible, it depended a lot on something akin to revelation. There are no citations of scientific studies to support its decisions.”

Despite its lack of citations, that DSM named 265 disorders doctors were meant to identify by matching (or mostly matching) a list of symptoms in the book with symptoms described by a patient. The drug companies were quick to see this radical shift in psychiatry as an opportunity. From the 1980s until now, as Angell demonstrates, the drug makers have supported the move away from talk therapy to the drug therapy, which also benefits practitioners, since doling out drugs and tweaking prescriptions earns a psychiatrist more money for less time spent with a patient.

Here Angell explains how companies influence the DSM itself. The bold typeface is ours.

Drug companies are particularly eager to win over faculty psychiatrists at prestigious academic medical centers. Called “key opinion leaders” (KOLs) by the industry, these are the people who through their writing and teaching influence how mental illness will be diagnosed and treated. They also publish much of the clinical research on drugs and, most importantly, largely determine the content of the DSM. In a sense, they are the best sales force the industry could have, and are worth every cent spent on them. Of the 170 contributors to the current version of the DSM (the DSM-IV-TR), almost all of whom would be described as KOLs, ninety-five had financial ties to drug companies, including all of the contributors to the sections on mood disorders and schizophrenia.

The drug industry, of course, supports other specialists and professional societies, too, but Carlat asks, “Why do psychiatrists consistently lead the pack of specialties when it comes to taking money from drug companies?” His answer: “Our diagnoses are subjective and expandable, and we have few rational reasons for choosing one treatment over another.” Unlike the conditions treated in most other branches of medicine, there are no objective signs or tests for mental illness—no lab data or MRI findings—and the boundaries between normal and abnormal are often unclear. That makes it possible to expand diagnostic boundaries or even create new diagnoses, in ways that would be impossible, say, in a field like cardiology. And drug companies have every interest in inducing psychiatrists to do just that.

Eli Lilly gave $551,000 to NAMI

In addition to the money spent on the psychiatric profession directly, drug companies heavily support many related patient advocacy groups and educational organizations. Whitaker writes that in the first quarter of 2009 alone, “Eli Lilly gave $551,000 to NAMI [National Alliance on Mental Illness] and its local chapters, $465,000 to the National Mental Health Association, $130,000 to CHADD (an ADHD [attention deficit/hyperactivity disorder] patient-advocacy group), and $69,250 to the American Foundation for Suicide Prevention.”

And that’s just one company in three months; one can imagine what the yearly total would be from all companies that make psychoactive drugs. These groups ostensibly exist to raise public awareness of psychiatric disorders, but they also have the effect of promoting the use of psychoactive drugs and influencing insurers to cover them. Whitaker summarizes the growth of industry influence after the publication of the DSM-III as follows:

“In short, a powerful quartet of voices came together during the 1980’s eager to inform the public that mental disorders were brain diseases. Pharmaceutical companies provided the financial muscle. The APA and psychiatrists at top medical schools conferred intellectual legitimacy upon the enterprise. The NIMH [National Institute of Mental Health] put the government’s stamp of approval on the story. NAMI provided a moral authority.”

And now here we are in 2011, with almost everyone we know taking two or three different mood disorder drugs. (This trend is not limited to mental disorder, mind you. See Disease Branding.)

Work started on the DSM-V in 1999, which is due out in 2013. It will contain many new disorders, such as “binge eating” and “restless leg disorder.” It will also expand existing categories by tacking on words like “spectrum” to the end of a known disorder, Angell reports. “It looks as though it will be harder and harder to be normal,” she writes.

But the curtain gets pulled back further still.

In her review of Daniel Carlat’s book, Angell calls attention to the “disillusioned insider’s” frank admission that when he prescribes a drug, his decision process is largely guesswork. Carlat’s view is that although any psychiatrist will acknowledge that he or she has had great success with mental disorder drugs for say, depression or anxiety, no doctor can say with certainty whether the drugs are working or if a placebo effect has taken effect.

[Carlat's] work consists of asking patients a series of questions about their symptoms to see whether they match up with any of the disorders in the DSM. This matching exercise, he writes, provides “the illusion that we understand our patients when all we are doing is assigning them labels.” Often patients meet criteria for more than one diagnosis, because there is overlap in symptoms. For example, difficulty concentrating is a criterion for more than one disorder. One of Carlat’s patients ended up with seven separate diagnoses. “We target discrete symptoms with treatments, and other drugs are piled on top to treat side effects.” A typical patient, he says, might be taking Celexa for depression, Ativan for anxiety, Ambien for insomnia, Provigil for fatigue (a side effect of Celexa), and Viagra for impotence (another side effect of Celexa).

As for the medications themselves, Carlat writes that “there are only a handful of umbrella categories of psychotropic drugs,” within which the drugs are not very different from one another. He doesn’t believe there is much basis for choosing among them. “To a remarkable degree, our choice of medications is subjective, even random. Perhaps your psychiatrist is in a Lexapro mood this morning, because he was just visited by an attractive Lexapro drug rep.”

Messy. And, of course, the whole system is now being exported to China and other countries where the middle class is growing and the mental health industry is still in a developing stage.

Angell’s latest book is The Truth About the Drug Companies: How They Deceive Us and What to Do About It.

Read the rest of her essay, which examines the controversial use of brain chemistry drugs to treat children, here.

http://www.minyanville.com/dailyfeed/2011/07/25/harvard-expert-links-our-mental/

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The Voices Inside Their Heads – Gail Hornstein’s Approach To Understanding Madness

Wednesday, July 20th, 2011
Note from CCHR:  This is a very interesting article, and reminds us of the movie A Beautiful Mind and the great disservice it did to Nobel prize winner John Nash, by completely altering the most remarkable element that led to his recovery— the fact he refused to continue taking psychiatric drugs, thereby changing the entire success of what Nash was able to accomplish—a drug free recovery. The film portrays Nash as taking “newer medications” at the time of winning his Nobel Prize, (which was false) thereby directly implying it was psychiatric drugs that cured him.  Nash, himself, says this is pure fiction; he hadn’t take psychiatric drugs for 24 years and stated that he willed his own recovery.   Why invent a fictitious pharma-friendly ending when the truth was so much more inspiring? The fact that the screenwriter’s mother was a psychiatrist may have had something to do with the film’s distortion, Nash said. The point is that psychiatry has long refused to admit psychiatric disorders are not medical conditions, and have vehemently suppressed workable non-drug treatments to overcome mental difficulties, even of the severity experienced by John Nash.  In the 1970′s, psychiatrist Loren Mosher, Chief of Schizophrenic Research for the National Institute of Mental Health, (who openly stated the diagnoses of schizophrenia had no medical merit), established a drug-free program — Soteria House — for patients diagnosed schizophrenic, “The idea was that schizophrenia can often be overcome with the help of meaningful relationships, rather than with drugs, and such treatment would eventually lead to unquestionable healthier lives,” Mosher said. Between 85 percent and 90 percent of the acute and long-term clients were able to return to the community without use of conventional hospital treatment.

But like “A Beautiful Mind,” this amazing accomplishment was buried and discredited. According to Mosher, “By 1980, I was removed from my post altogether. All of this occurred because of my strong stand against the overuse of medication and disregard for drug-free, psychological interventions to treat psychological disorders.”

There is no doubt that people suffer from a wide range of emotional, behavioral and mental difficulties.  But psychiatric diagnoses (disorders) are not medical conditions, evidenced by the fact there is not one proven medical test for any psychiatric disorder, including “schizophrenia.”  Falsely “medicalizing”  these problems benefits only two groups—the pharmaceutical industry and the psychiatric industry—not those seeking real help.  For more information: http://www.cchrint.org/psychiatric-disorders/

The Sun – July 19, 2011
by Tracy Frisch

The complete text of this selection is available in our print edition.

TRACY FRISCH lives in Washington County, New York, where she is a freelance journalist, homesteader, and grassroots organizer leading a “zero-waste” campaign. She derives much of her bodily and spiritual sustenance from her almost-year-round vegetable garden.

As a teenager Gail Hornstein developed a fascination with first-person accounts of mental illness, and in the decades since, she has collected more than seven hundred patient memoirs, autobiographies, and witness testimonies. She likens them to survivor accounts or slave narratives, with patients struggling against the psychiatric system to make their voices heard.

According to the National Institute of Mental Health, approximately one in four Americans suffers from a diagnosable mental disorder. Our society has gone further than any other in classifying unwanted behaviors and emotions as diseases demanding medical — and often pharmaceutical — treatment.

Hornstein, now a Mount Holyoke College professor of psychology, questions whether this labeling benefits those being labeled. She also rejects the idea that psychiatric patients, however severe their symptoms, have a physical disease. Even schizophrenia and other types of psychosis, Hornstein suggests, can result from trauma, abuse, and oppression. She offers a popular course for psychology majors in which they read only books by patients, and she urges a more open-minded inquiry into what causes mental illness and how people get better.

Frisch: You express enormous empathy for those labeled “mentally ill,” yet you avoid romanticizing their lives. How do you walk this fine line?

Hornstein: I try to understand people as they understand themselves. If you ask them what their experience is or read their own accounts, you’ll find they can be articulate and psychologically sophisticated. Even people who lack formal education can offer highly nuanced descriptions of their emotional lives. I’ve adopted a phrase from my uk colleagues: “experts of their own experience.” This view helps me avoid either romanticizing their experience — seeing it in a more positive way than they do — or seeing it only as a tragedy with no redemptive qualities.

Emotional distress is highly individualized, and we shouldn’t come to any general conclusions about it. There are people who feel they’ve learned something profound from the experience of hearing voices, but there are plenty of others who are frightened and just want the voices to go away. One woman said to me, “If I could wake up tomorrow and not hear any voices, I would open up a bottle of champagne.” Yet she’d discovered the strength to get through it.

Frisch: Why do you feel so strongly about avoiding the phrase “mental illness”?

Hornstein: The term “mental illness” is heavily charged, politicized, and ambiguous. I prefer to talk about “anomalous experiences,” “extreme emotions,” and “emotional distress.” The main reason I don’t use medical language is that people who are suffering often don’t find it very helpful. No one experiences “schizophrenia” — that’s just a technical name for a lot of complicated feelings.

People who have been taught that “mental illnesses are brain diseases” see psychiatric patients as dangerous and unlikely to recover. And those in crisis are often understandably reluctant to consult mental-health professionals, because the stigma of mental illness is so severe: it’s possible to lose your job, your home, and your family as a consequence of being diagnosed with a mental illness. In cultures that take a social view of emotional distress, by contrast, people more readily seek help because they aren’t as likely to be ostracized and are assumed to be capable of full recovery.

The World Health Organization did an international study comparing outcomes for patients diagnosed with schizophrenia in “developed” countries — including the U.S., the United Kingdom, Denmark, and others — and in “developing” countries such as Colombia, Nigeria, and India. To their astonishment, they found that outcomes were much better in the developing countries. As often happens when a study produces unexpected results, the findings weren’t believed at first. So the study was repeated a few years later with a more stringent definition of what constituted improvement for the patients. The results were the same.

Two hypotheses have been put forward to explain these findings. One is that developing countries don’t use medications over the long term because they can’t afford it. Without long-term medication, patients don’t become chronically disabled. The other hypothesis is that people in developing countries are more likely to be cared for at home and be a part of their community, rather than being isolated or sent away to a hospital, and this helps them recover.

Frisch: How does what is commonly called “mental illness” differ from physical disease?

Hornstein: In psychiatry mental illness is a metaphor imposed on people’s behavior. There aren’t any physical methods of diagnosing a mental illness: There’s no blood test. There’s no mri. So-called mental illnesses are diagnosed on the basis of behavior. The “chemical-imbalance” theory was invented by the marketing departments of drug companies to try to convince doctors to prescribe their products. Some doctors say depression is just like diabetes: you have an imbalance of a neurotransmitter, the way a diabetic might need more or less insulin, and this drug will restore your balance. But with diabetes it’s possible to measure the amount of sugar and insulin in your blood. We know what a balanced level is. No doctor who has given anyone an antidepressant has ever measured the level of a neurotransmitter in the patient’s body. There is no independent means by which to tell if someone has a “chemical imbalance.”

Frisch: Do any mental illnesses have a known physiological basis?

Hornstein: The initial symptoms of Huntington’s disease resemble the symptoms of mental illness. When folk singer Woody Guthrie first manifested Huntington’s disease, he was sent to a psychiatric hospital. Similarly people in the early stages of brain cancer may behave in anomalous ways. If you don’t know they have cancer, you might think they’re having a psychiatric breakdown. But once they get a cat scan, you can see the brain tumor. You can’t see schizophrenia.

Frisch: I have always taken it for granted that only mystics or crazy people hear voices, but you suggest that it’s more common than we think.

Hornstein: Many people who hear voices never attract the attention of the psychiatric system. Estimates are that 4 percent of the uk population hears voices — approximately the same percent that has asthma. In Western society we most often associate hearing voices with illness. If we lived in a part of the world that was given to greater religiosity, unusual psychological experiences might be labeled as divine gifts. All the major religions of the world include figures who heard voices or had other anomalous psychological experiences. If the pastor in an Evangelical Christian church tells the congregation, “God spoke to me last night,” no one in that church thinks he has lost his mind.

Whether a phenomenon is considered “abnormal” or not depends on the circumstances, the person’s suffering, the reactions of others, and many more factors. One of the main goals of my book Agnes’s Jacket is to give readers the opportunity to learn about people who have unusual experiences and to encourage them to tolerate a wider range of behavior in themselves and others.

Read the rest of the article here: http://www.thesunmagazine.org/issues/427/the_voices_inside_their_heads

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Harvard Medical School Professor Among Five Psychiatrists Accused of Ghostwriting

Wednesday, July 13th, 2011

The Harvard Crimson – July 12, 2011

—Staff writer Naveen N. Srivatsa

Photo: Keri D Mabry

A complaint filed with the federal Office of Research Integrity alleged that a group of psychiatrists, including an associate professor at the Harvard Medical School, signed their names to an academic paper written by a communications firm hired by a major pharmaceutical company.

Gary Sachs, a researcher affiliated with Massachusetts General Hospital, is one of five doctors identified in the formal accusation filed July 8 by University of Pennsylvania professor Jay D. Amsterdam.

The psychiatrists allowed the medical communications company Scientific Therapeutics Information, hired by SmithKline Beecham, to draft a paper using their names, according to the complaint. The paper, according to Amsterdam, suggested that the antidepressant Paxil can help treat some cases of bipolar disorder.

SmithKline Beecham, which has since merged into the pharmaceutical company GlaxoSmithKline, manufactured Paxil.

The practice known as ghostwriting is widely condemned by scientific journals. The World Association of Medical Editors calls ghostwriting “dishonest and unacceptable.”

The complaint includes messages sent between those affiliated with the study, as well as their supervisors. The attached messages include professors saying that Scientific Therapeutics Information and SmithKline Beecham selected the first author of the paper and failed to provide the paper to all investigators before submission.

But the messages also seem to portray a feud between Amsterdam and University of Pennsylvania Associate Professor Laszlo Gyulai, one of the accused researchers. In one message, Amsterdam accuses him of stealing his research.

“As per your investigation there is little doubt that these data were misappropriated from me and used and published without my knowledge and without regard to the significant contribution that I made to this study,” Amsterdam wrote in an email to Gyulai’s supervisor.

The paper was published in June 2001, and the research was funded by grants from GlaxoSmithKline and the National Institute of Mental Health.

In an interview Wednesday morning, Sachs, an associate clinical professor of psychiatry at Massachusetts General Hospital, said that while the relationship between Amsterdam and Gyulai was antagonistic, the accusations of research misconduct should be investigated.

“There might be unhappiness between two faculty memebers, and they might escalate this. But the question is whether there is any basis to this assertion, and this is a very serious assertion,” he said. “So apart from whatever motivations there may be, they did raise assertions, and those assertions deserve to be investigated.”

Sachs said that he was involved in designing the study and that he saw the paper before it was submitted to the journal.

While he said he did not interact with anyone from Scientific Therapeutics International, he did come in contact with employees of the pharamceutical company.

“The idea that bipolar depression was important to study has been an essential part of my career. Encouraging studies in this field is obviously, as an academic, something I’d want to do,” he said. “I was very pleased that they were willing to put their drug to the test. I give them credit of actually having the trial for the drug. Interacting with them in the course of the design and execution of the study, that’d all be standard stuff to do.”

In a statement, GlaxoSmithKline said that employees were involved in the draft’s development and that the company financially supported the study. It said that the primary authors of a paper have final approval of the draft and that when its employees provide “substantive assistance” to a paper, it is disclosed.

“This article was written more than 10 years ago and we do not have details about the development of the manuscript,” a spokesperson said in the statement. “GSK is committed to complete transparency regarding clinical and case studies.”

A spokesperson for the hospital said that it is looking into the complaint.

“Massachusetts General Hospital takes allegations of research misconduct very seriously and will handle the matter in compliance with our policy to determine if there’s any validity to the complaint,” spokesperson Kristen Stanton said in an email.

Sachs said that since the filing of the complaint, he has discussed the matter with a hospital representative.

http://www.thecrimson.com/article/2011/7/12/complaint-amsterdam-sachs-glaxosmithkline/

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Doctors’ Conflicting Interests Can Cost Money and Lives, and Hinder Medical Discoveries

Monday, March 28th, 2011

ABC News – March 28, 2011

by Dr. Stefan P. Kruszewski, Psychiatrist

Psychiatrists who pimp for drug companies

The fact that doctors take money from pharmaceutical companies happens to be old news. But this time around, the docs in question come from Stanford University. Previous news stories reported that doctors receiving pharmaceutical funding hailed from Harvard, the University of Miami, the Medical College of Georgia and the University of Cincinnati College of Medicine.

More than a few of these doctors are psychiatrists who have received tax-supported, public National Institutes of Health and National Institute of Mental Health funding for clinical research, have participated in U.S. Food and Drug Administration advisory panels or have appeared on, or on behalf of, various not-for-profit psychiatric advocacy boards — some of which are heavily supported by the manufacturers of psychiatric medications.

In 2006, my colleagues and I wrote a brief letter to the editor to the Journal of the American Medical Association, one of America’s premier peer-reviewed medical journals. Our letter expressed concern about the lack of honest disclosure of conflicts by certain psychiatric authors in a previously published article.

Multiple authors had recommended specific antidepressant therapy but failed to reveal that they were being paid by multiple antidepressant manufacturers to speak, advocate and do research for the companies that sold the drugs.

During the review process, an associate editor at the journal asked the question (and inadvertently copied me on an email that had been sent to another associate editor), “What’s the big deal? What’s all this [expletive deleted] about conflicts of interest?”

Academic journals, heavily supported by advertising money, are biased and complicit in the conflict of interest fiasco.

Sometimes I wonder why I — or anyone else for that matter — should care about psychiatrists who pimp for drug companies. After all, physician spokespeople and drug manufacturers are capitalists, and capitalism is our economic cornerstone. Every day, any financial news consumer hears the refrain invoking the social advantages of free market capitalism. It is the mantra of a major financial television network. And even though I’m a psychiatrist, I’m also a capitalist, so why should I worry?

But I do worry, because drug promotion and clinical decision-making that are brokered on the backs of dollar bills have a greater chance of causing serious adverse outcomes, including illnesses and death. If a physician embellishes the effectiveness of a drug or minimizes its risk, that directly hurts you and me.

Physicians who are heavily supported by pharmaceutical companies and medical device makers are not forming independent, unbiased decisions. Instead, their brains have been lined with gifts, perks and money, which influences their rose-colored opinions.

My psychiatric colleagues are especially vulnerable here. The result is that your mother, your husband or my child can’t make a reliable decision about the risks and benefits of particular drugs. How could they? The prescribing doctors often don’t know the risks and benefits, so how could we be expected to learn what they don’t know?

Conflicts of interest promoted by pharmaceutical manufacturers negatively affect decisions about current and future medical care. That is tragic, because those half-baked recommendations come with a price that no amount of capitalism can justify. It’s simple and ugly: If you or your mom suddenly succumbs to an arrhythmia whose side effects were not appreciated by your doctor because your doctor was misinformed by another doctor serving as the manufacturer’s spokesperson, that is tragic.

I see it virtually every day in my clinical practice: in young men who have breast lesions and abnormal breast development from atypical antipsychotics; in sudden unexpected deaths, or “suds,” from psychiatric drugs in individuals who had no risk factors for sudden death; in tic and dyskinetic movement disorders in kids arbitrarily prescribed stimulants, and the huge weight gain and symptoms of type 2 diabetes in children and young adults who receive a sedative, such as quetiapine, for sleep.

The bad news doesn’t stop with current care. Conflicted clinical research — often done especially by and for a particular psychiatric pharmaceutical manufacturer — whose design and analysis are biased and whose summary and conclusions are misleadingly positive, fracture the backbone of scientific research.

The legacy of fraudulent research lingers for years before it is recognized and repudiated. That effort impedes real progress, wastes time, money and human resources that could be focused on finding real cures to help all of us. And that’s not good for anybody.

Dr. Stefan Kruszewski is an addiction psychiatrist and CEO of Kruszewski & Associates, a Harrisburg, Pa., company that focuses on health care and financial fraud.

Read the article and watch the ABC News video here:  http://abcnews.go.com/Health/medical-conflicts-interest-disaster-patients/story?id=13060973

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Confronting Bigots Intolerant of Alternative Mental Health Treatment

Wednesday, October 6th, 2010

Huffington Post, October 6, 2010

by Bruce E. Levine

“Webster’s Dictionary” defines bigot as “a person who is utterly intolerant of any differing creed, belief, or opinion.” Despite the success of alternative mental health treatments for many people, there still exists bigotry against these approaches.

For many self-defined “ex-mental health patients,” “mental health treatment consumers,” and “psychiatric survivors” who attended Alternatives 2010 Conference (September 29 through October 3 in Anaheim, California), D.J. Jaffe’s September 30, 2010 The Huffington Post piece, “People with Mental Illness Shunned by Alternatives 2010 Conference in Anaheim” was insulting. Mr. Jaffe writes of the Alternatives 2010 Conference:

By failing to include ‘people with mental illness’ in the list of ‘consumers’ and ‘survivors’ who are invited, they are sending a not-so-subtle message: mentally ill not welcome.

Mr. Jaffe’s statement can most politely be described as disingenuous. Mr. Jaffe knows full well that the Alternatives Conferences are attended by many people who have been in fact diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder, and other serious mental illnesses, but who have found that neither their diagnoses nor their standard treatments have been helpful. In other words, not only does the Alternative Conference welcome people who have been labeled as mentally ill, the conference celebrates them, and provides them an arena and a platform.

Why is there a need for alternatives to standard drug treatments? A long-term outcome study of schizophrenic patients who were treated with and without psychiatric drugs was published in 2007 in the Journal of Nervous and Mental Disorders. Funded by the National Institute of Mental Health, research psychologist Martin Harrow, at the University of Illinois College of Medicine, discovered that after 4.5 years, 39 percent of the non-medicated group were “in recovery” and 60 percent had jobs. In contrast, during that same time period, the condition of the medicated patients worsened, with only six percent in recovery and few holding jobs. At the fifteen-year follow-up, among the non-drug group, only 28 percent suffered from any psychotic symptoms; in contrast, among the medicated group, 64 were actively psychotic.

Read the rest of the article here: http://www.huffingtonpost.com/bruce-e-levine/confronting-bigots-intole_b_749836.html

For more information on the success of treating patients diagnosed “schizophrenic” without the use of psychiatric drugs,  read about the work of psychiatrist Loren Mosher, former Chief of Schizophrenic Research for the National Institute of Mental Health (NIMH) and founder of Soteria House http://www.moshersoteria.com/about.htm

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The Los Angeles Examiner: Psychiatric Overdiagnosis Means “Normal” Could Become Obsolete

Tuesday, July 20th, 2010

Examiner.com
By jenny Westberg
July 13, 2010

An intolerance of individual differences, according to some, has led to overdiagnosis.

Are you normal? Are you sure?

A growing number of behaviors and moods are being relabeled as mental disorders, according to two recent articles. Sadness, shyness, personality quirks and the ups and downs of everyday life may qualify almost anyone for a psychiatric diagnosis, effectively pathologizing normality.

Allen Francis, MD writes in the Psychiatric Times that almost everyone meets the criteria for one or another of the conditions listed in the Diagnostic and Statistical Manual of Mental Disorders, the book psychiatrists use to determine whether you have a mental illness. The fifth edition of the manual (DSM-5), due in 2013, will relax these criteria even further, giving psychiatric labels to even more people.

According to 2010 figures from the National Institute of Mental Health (NIMH), more than 25 percent of the adult population has a diagnosable mental disorder. That’s approximately 60 million people. A prospective study found that, by age 32, half of U.S. adults could be diagnosed with anxiety; 40 percent with depression; and 30 percent with alcohol abuse or dependence.

With criteria proposed for the DSM-5, psychiatrists could diagnose “Nicotine Use Disorder” or “Caffeine-Induced Sleep Disorder.” If your child has temper tantrums, that’s one of the signs of “Temper Dysregulation Disorder with Dysphoria.” Bad dreams? It could be a case of “Nightmare Disorder.”

Why is this a problem? Mental illness carries a stigma. A diagnostic label can follow you for the rest of your life. It is shared with your insurance company. Your family and friends might make certain assumptions about you. Your doctor may insist you need psychiatric drugs.

More and more behaviors, however, are being stamped as “mental illnesses.”

Francis writes that individual differences that were once accepted as normal have become medicalized. Our society, he says, has become perfectionistic and intolerant of even short-term distress.

Read entire article:  http://www.examiner.com/x-31400-Portland-Mental-Health-Examiner~y2010m7d13-Psychiatric-overdiagnosis-means-normal-could-become-obsolete

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The Huffington Post—Life is Not a Mental Disorder

Tuesday, July 13th, 2010

The Huffington Post
By Ronald Ricker
July 13, 2010

The Bible (or really any religious text) can be made to say and mean anything the author wishes.

The “Bible” of psychiatry, that fabled and hoary text, the DSM-IV-TR (Diagnostic Statistical Manual of Mental Disorders written by the American Psychiatric Association), is no different. Conceived as an instrument to identify and help heal disorders of the mind, it has morphed as to both form and function. Too often, psychiatrists wield the DSM-IV-TR like a blunt instrument, desperate in their drive to assign names to supposed “mental conditions” and thus to be able to assign numbers to these “conditions.” Discover a new widely inclusive “condition,” give it a name and number and you have a winner: One more brick in the wall of sicknesses.

DSM-IV-TR is very large book. We have lots of diagnoses, the number rapidly growing. We need lots of page room. Aside from blank pages, Chapter Heading Pages, and long lists of Contributors, etc., DSM-IV-TR is chuck full of diagnoses, with detailed descriptions and code numbers for each diagnosis. This book is 952 pages long. It weighs 4.8 pounds.

There is an odd situation in DSM-IV-TR. Really odd. In its entirety, all 952 pages, there is no “No Disorder” option. Therefore, everyone is seen by DSM-IV-TR as sick, the only question being from which sickness(es) they suffer. The annual physical checkup many of us get, usually, unless there is something wrong, ends with “everything is fine.” This, apparently, doesn’t exist in mental health.

I have always felt that I was a crummy writer, starting from college and thereafter (including medical school, internship, National Institute of Mental Health, Psychiatric Residency). However, in writing this poorly written piece, while trudging through DSM-IV-TR, I found 315.2 – “Disorder of Written Expression.” It was an AH-HA moment. I may be a crummy writer, but it’s because I have a disease. Criteria, according to DSM-IV-TR, for this disease (315.2) are 3:

  • a) Writing skills below those expected given the person’s chronological age, measured intelligence and age appropriate education;
  • b) The disturbance in criterion A significantly interferes with academic achievement or activities of daily living that require the composition of written texts (e.g, writing grammatically correct sentences and organized paragraphs);
  • c) If a sensory deficit is present, the difficulties in writing skills are in excesses of those usually associated with it.

Read entire article:  http://www.huffingtonpost.com/ronald-ricker/life-is-not-a-mental-diso_b_644606.html

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Hidden Facts About Ritalin; Side Effects include brain damage, psychosis, severe dependence, paranoia

Monday, July 5th, 2010

New With Views
By Jon Rappoport
July 5, 2010

In 1986, The International Journal of the Addictions published a very important literature review by Richard Scarnati. It was called “An Outline of Hazardous Side Effects of Ritalin (Methylphenidate)” [v.21(7), pp. 837-841].

Scarnati listed a large number of adverse affects of Ritalin and cited published journal articles which reported each of these symptoms.

For every one of the following Ritalin effects, there is at least one confirming source in the medical literature:

• Paranoid delusions
• Paranoid psychosis
• Hypomanic and manic symptoms, amphetamine-like psychosis
• Activation of psychotic symptoms
• Toxic psychosis
• Visual hallucinations
• Auditory hallucinations
• Can surpass LSD in producing bizarre experiences
• Effects pathological thought processes
• Extreme withdrawal
• Terrified affect
• Started screaming
• Aggressiveness
• Insomnia
• Since Ritalin is considered an amphetamine-type drug, expect amphetamine-like effects
• Psychic dependence
• High-abuse potential DEA Schedule II Drug
• Decreased REM sleep
• When used with antidepressants one may see dangerous reactions including hypertension, seizures and hypothermia
• Convulsions
• Brain damage may be seen with amphetamine abuse.

Many parents around the country have discovered that Ritalin has become a condition for their children continuing in school. There are even reports, by parents, of threats from social agencies: “If you don’t allow us to prescribe Ritalin for your ADHD child, we may decide that you are an unfit parent. We may decide to take your child away.”

This mind-boggling state of affairs is fueled by teachers, principals, and school counselors, none of whom have medical training. Yet even if they did…

The very existence of the “illnesses” for which Ritalin would be prescribed is unproven. It is merely assumed.

In commenting on Dr. Lawrence Diller’s book, Running on Ritalin, Dr. William Carey, Director of Behavioral Pediatrics, Children’s Hospital of Philadelphia, has written, “Dr. Diller has correctly described… the disturbing trend of blaming children’s social, behavioral, and academic performance problems entirely on an unproven brain deficit…”

On November 16-18, 1998, the National Institute of Mental Health held the prestigious “NIH Consensus Development Conference on Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder [ADHD].” The conference was explicitly aimed at ending all debate about the diagnoses of ADD, ADHD, and about the prescription of Ritalin. It was hoped that at the highest levels of medical research and bureaucracy, a clear position would be taken: this is what ADHD is, this is where it comes from, and these are the drugs it should be treated with. That didn’t happen, amazingly. Instead, the official panel responsible for drawing conclusions from the conference threw cold water on the whole attempt to reach a comfortable consensus.

Read entire article:  http://www.newswithviews.com/Rappoport/jon101.htm

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Australian Psychiatrist Patrick McGorry Wants His Pre-Drugging Agenda to Go Global

Wednesday, June 16th, 2010


“Australia is a place that can actually change the world in mental health, provided we get the right government support to do so.” — Patrick McGorry

By CCHR International
June 16, 2010

A Public Service Announcement on Australian TV features Australian of the Year, psychiatrist  Patrick McGorry,  claiming that nearly half the population will experience mental ill-health during their lifetime. Considering that after World War II, psychiatrists claimed that one in 20 people had a mental disorder, and now it’s every second one of us, that’s a damning 1000 percent failure rate for psychiatrists in reducing “mental illness.” Let’s get real; the reason psychiatrists claim more people are mentally ill is because they can keep  inventing new ways to label them mentally ill—but the press and governments are  starting to catch on, evidenced by all the controversy surrounding psychiatry’s upcoming edition of their Diagnostic and Statistical Manual of Mental Disorders (DSM)—better known as psychiatry’s billing bible. Yet of all the proposed “mental disorders” ranging from overeating to kids throwing tantrums, no proposed model of mental disorder is more  insidious and dangerous than that of Patrick McGorry, who promotes diagnosing people before they develop a so-called mental disorder—drugging them before they become “mentally ill.” Yet the Australian government has bought into it hook, line and sinker—despite the fact McGorry’s plan is so outrageous, even his peers, such as psychiatrist Allen Frances, former Chair of the DSM task force, have called it ”the most ill-conceived and potentially harmful.”

Make no mistake, the pre-drugging agenda is Patrick McGorry’s baby—his dream for a new paradigm in mental health, one that has the power to diagnose and drug people before they become mentally ill—welcome to the Brave New World of Patrick McGorry. And he isn’t stopping with Australia; his plan is to go global. As he recently stated, “Australia is a place that can actually change the world in mental health, provided we get the right government support to do so.”[1]

The fact that McGorry’s agenda is so controversial—it even has other psychiatrists protesting it—has not deterred the Australian government from funding this “ill-conceived” plan. A recent letter to Citizens Commission on Human Rights states, “The Australian Government is providing $25.5 million over four years from 2010-2011 to expand Early Psychosis Prevention and Intervention Centre (EPPIC) model,” developed by McGorry who founded EPPIC and the Orygen Youth Health in Victoria, Australia.

The Australian Government has already been criticized for massive expenditure on psychotropic drugs increasing more than 660 percent during the last decade—with a whopping 3,100 percent increase on antipsychotic drugs (with at least 15 Australian deaths in the under 19 year olds as a tragic consequence of this).  This can only get worse when under McGorry’s plan, with an enormous client base that can be prescribed drugs despite the fact they are not yet  “mentally ill.” It’s called prodrome (prodromos meaning the forerunner of an event)—referring to “a period of prepsychotic disturbance” that may or may not develop into psychosis or “schizophrenia”[2]—in other words, the crystal ball theory.

Australia Meets the US in Pre-Drug Scam

McGorry’s plan for Australia to “lead the change” in world mental health is happening—to the detriment of those who may be forced to undergo drug treatment based on a psychiatrist’s hunch that they might, one day, become ill. In the U.S., on May 13, 2009, the Department of Health and Human Services convened a Technical Expert Panel (TEP) discussed “emerging evidence around psychopharmacological interventions for first episode schizophrenia” citing the research efforts of McGorry and others.[3]

The push for pre-diagnosing and pre-drugging has even those within the psychiatric profession calling foul; Dr. Richard Warner, professor of psychiatry at the University of Colorado, counters the idea that science drives McGorry’s pre-disorder assessment, stating, “Given the expected number of false positives, the potential for harm is significant.”[4]

However, as Anthony Pelosi, honorary professor, Department of Psychiatry, Hairmyres Hospital, wrote in a counter to McGorry in the British Medical Journal last year, “this has not stopped their skillful lobbying of politicians, journalists, patients, and carers with upbeat messages about the prevention.”

“Skillful lobbying” is right.

In 2006 McGorry and other researchers, including psychiatrist Michael Berk, Karen Hallam, Craig McNeil, Linda Kaler and psychologist Melissa Hasty reported in the Medical Journal of Australia, “Evidence increasingly indicates that earlier identification may allow for appropriate pharmacological and psychosocial treatments….”[5]

Could they have a Pharma incentive behind this agenda? Berk is financially linked to AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen-Cilag, Lundbeck, Organon, Novartis, Mayne Pharma, Servier, Sanofi-Synthelabo, Solvay, and Wyeth and Pfizer.[6] Hallam disclosed received speaker fees from Janssen-Cilag; McNeil received consultancy fees, speaker fees and travel assistance from Eli Lilly, Janssen-Cilag and Sanofi-Aventis; and Hasty and Linda received financial assistance to attend conferences from or Janssen-Cilag, maker of the antipsychotic Risperdal (resperidone).[7]

McGorry has received grant support from Eli Lilly, Janssen-Cilag, Bristol Myers Squibb, Astra-Zeneca, Pfizer, and Novartis.[8] He is a paid consultant for, and has received speaker’s fees from all or most of these companies.[9] Studies published in the British Medical Journal in 2005 and 2008 declared McGorry’s “early intervention studies have received partial support in the form of investigator-initiated unrestricted research grants from Janssen-Cilag.”[10]

The U.S. has already begun adopting the “early intervention” fad, which looks more like a trade in children’s lives and a business opportunity for increased pharmaceutical sales. In March 2010, the Department of Health & Human Services Substance Abuse & Mental Health Service Administration Center for Mental Health Services announced $16.5 million in funding for “Mental Health Transformation Grants,” including the “Early Detection and Intervention for the Prevention of Psychosis Program (EDIPPP).”[11]

EDIPP is the American sister of McGorry’s EPPIC.  It was originally bankrolled by a $14.4 million grant from the Robert Wood Johnson Foundation. According to investigative journalist Evelyn Pringle, “The founder of RWJF, Robert Wood Johnson, was chairman of Johnson & Johnson for over 30 years, from 1932 to 1963, as a member of the drug maker’s founding family. Throughout the years, the majority of the Foundation’s money has come from investments in J&J stock.”

In an article in Behavioral Healthcare, in 2008, the Mid-Valley Behavioral Care Network (MVBCN), an intergovernmental Medicaid government insurance-managed healthcare organization situated in Oregon, was recommended to study EPPIC used at Orygen and EDIPPP.

Based on EDIPP and EPPIC, the MVBCN developed the Early Assessment and Support Team (EAST) in 2001.  In 2003, the Oregon state legislature allocated $4.3 million to disseminate early psychosis intervention statewide.  By March the following year, new programs had begun in 12 counties.[12]

EDIPPP also replicates the “Portland Identification and Early Referral,” or “PIER,” a treatment research program at the Main Medical Center, in Portland, Maine.[13] People typically are referred to PIER by high school guidance counselors, pediatricians, or other clinicians who attended presentations about PIER’s work, says Pringle. “Virtually every person entering the PIER program is prescribed antipsychotics, such as Risperdal or Invega, marketed by Johnson & Johnson,” she added.

Both PIER and EDIPPP are promoted in McGorry’s 2002 book, Implementing Early Intervention in Psychosis: A Guide to Establishing Early Psychosis Services.”[14] The book’s foreword is written by Dr. Jeffrey Lieberman, Professor of Psychiatry, Chairman Department of Psychiatry, Columbia University College of Physicians and Surgeons.[15] Lieberman has taken consulting fees and research grant support from AstraZeneca, Bristol-Myers Squibb, Upjohn Pharmacia, Novartis, Eli Lilly, Janssen, Pfizer, Hoechst AG, & AstraZeneca. He’s on the Speakers Bureaus for Astra Zeneca, Janssen, Eli Lilly and Pfizer.[16]

Lieberman is also the Vice President (North America) of the McGorry instigated group International Early Psychosis Association (IEPA), which was officially incorporated in Victoria in 1998.[17] McGorry is currently Treasurer of the Association.[18] Lieberman is a member of the psychiatric-pharmaceutical company front groups, National Alliance for the Mentally Ill (NAMI) and National Alliance for Research on Schizophrenia and Depression (NARSAD).

Between 1999 and 2003 IEPA received unrestricted education grants from Janssen-Cilag and AstraZeneca.[19] EIPA’s conferences are supported by Janssen-Cilag, AstraZeneca, Eli Lilly, and Bristol-Myers Squibb.[20]

The IEPA lists the “who’s who” of Pre-Psychosis Risk Syndrome (the official label given pre-psychotic symptoms) and many of its board or members disclose manufacturers of antipsychotics as companies they’ve received financing from.

On July 29-30, the First international Youth Mental Health Conference is being held in Melbourne, with keynote speakers, including McGorry. The conference is described by one advocate as an “important and innovative event, attracting the best in the business/industry to discuss the emerging issues of youth mental health.”[21]

It couldn’t have been more adequately stated: business and industry. Herein you see McGorry’s pitch again that Australia is a global leader in this latest psychiatric fad. His invitation online states, “This is an important event for Australia and the mental health field. We expect this to be the first of many similar conferences, bringing together innovators, practitioners, researchers, young people and families to showcase the best of youth mental health innovation from around the globe.”[22] [Emphasis added]

There’s no doubt that this conference, like his Australian award, will be used to demand more funding to increase the business stakes and drive more income into psychiatry’s pre-drugging efforts.  Despite the government already allocating $103 million to McGorry, including the $25 million to further research EPPIC, he continues to call for another $800 million in funding for programs for youth mental health over the next four years.[23]

McGorry recently stated, “You have to be able to give something of yourself to people, if you are going to help them.”[24] McGorry’s brand of “helping” entails stigmatizing children with psychiatric labels that have no basis in science or medicine and then drugging them. That does not qualify as “help.” It’s betrayal. If this agenda to pre-diagnose, and pre-drug is allowed to take hold, we will truly have entered a Brave New World; Patrick McGorry’s.

[1] http://sydney.edu.au/medicine/museum/mwmuseum/index.php/McGorry,_Patrick

[2] http://www.mentalhealth.com/mag1/scz/sb-prod.html

[3] U.S. Department of Health and Human Services, “ASPE Technical Expert Panel on Earlier Intervention for Serious Mental Illness: Summary of Major Themes,” The Lewin Group, 13 May, 2009.

[4] Richard Warner, MB, DPM, is director of Colorado Recovery in Boulder, Colorado, and professor of psychiatry at the University of Colorado, “Early intervention in psychosis: Future or fad?” Centre for Addiction and Mental Health website, http://www.camh.net/Publications/Cross_Currents/Winter_2007-08/futureorfad_crcuwinter0708.html.

[5] http://www.mja.com.au/public/issues/187_07_011007/ber10341_fm.pdf

[6] http://www.mja.com.au/public/issues/187_07_011007/ber10341_fm.pdf

[7] http://www.mja.com.au/public/issues/187_07_011007/ber10341_fm.pdf

[8] http://www.mhanet.ca/documents/2008/Research-Colloquium/0920%20-%20Keynote%20MCGORRY.pdf

[9] http://www.bmj.com/cgi/content/full/337/aug04_1/a695

[10] http://bjp.rcpsych.org/cgi/content/full/187/48/s108; http://www.bmj.com/cgi/content/full/337/aug04_1/a695

[11] http://www.opednews.com/articles/Tracking-the-American-Epid-by-Evelyn-Pringle-100602-668.html

[12] http://www.behavioral.net/ME2/dirmod.asp?sid=9B6FFC446FF7486981EA3C0C3CCE4943&nm=Archives&type=Publishing&mod=Publications%3A%3AArticle&mid=64D490AC6A7D4FE1AEB453627F1A4A32&id=BFCD36BFD75E447CA63F662A633F41FB&tier=4

[13] http://www.opednews.com/articles/Tracking-the-American-Epid-by-Evelyn-Pringle-100602-668.html

[14] http://books.google.com.au/books?id=lyLfMPsnvJ0C&pg=PA136&lpg=PA136&dq=Portland+Identification+and+Early+Referral+McGorry&source=bl&ots=lEp9tdT8ZV&sig=_zlnHeFk8oqxTHSjbvLf0XQmlY4&hl=en&ei=lP0RTKThLMWPcMnSzNAH&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBQQ6AEwAA#v=onepage&q&f=false

[15] http://69.5.18.33/ahrp/cms/index2.php?option=com_content&do_pdf=1&id=345

[16] http://69.5.18.33/ahrp/cms/index2.php?option=com_content&do_pdf=1&id=345

[17] http://www.iepa.org.au/ContentPage.aspx?pageID=10

[18] http://www.headspace.org.au/about/headspace-board/

[19] http://www.iepa.org.au/ContentPage.aspx?pageID=59

[20] http://www.iepa.org.au/ContentPage.aspx?pageID=59

[21] http://www.iymhconference.com.au/why-attend/

[22] http://www.iymhconference.com.au/

[23] Mental Health Update, GetUp! Action for Australia, 21 Apr. 2010, http://www.getup.org.au/blogs/view.php?id=1936&dc=1086,21560,1

[24] http://sydney.edu.au/medicine/museum/mwmuseum/index.php/McGorry,_Patrick

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The Psychopharmaceutical Industrial Complex—creating epidemic of mental illness through psychiatry’s chemical imbalance hoax

Tuesday, June 8th, 2010

Dissident Voice
By Evelyn Pringle
June 8, 2010

For the past two decades, the Psychopharmaceutical Industrial Complex has been the driving force behind the epidemic of mental illness in the United States with the promotion of biological psychiatry and a bogus “chemical imbalance” in the brain theory.

The Psychopharmaceutical Industrial Complex (PPIC) is a symbiotic system composed of the American Psychiatric Association, the pharmaceutical industry, public relations and advertising firms, patient support organizations, the National Institute of Mental Health, managed care organizations, and the flow of resources and money among these groups, according to an October 1, 2009 paper in the Journal of Mental Health Counseling, by Dr Thomas Murray, director of Counseling and Disability Services at the University of North Caroline School of Art.

Murray’s paper draws parallels between cult indoctrination and PPIC techniques and notes the similarities between cult members and mental health consumers who are vulnerable to losing their identities to the PPIC.

The PPIC and “its adherence to the disease model pervades mainstream culture and greatly impacts psychotherapy,” he says. “Consequently, the effects of the PPIC may have resulted in some psychiatric consumers adopting disease-model messages in ways similar to cult indoctrination.”

“Consumer adoption of the disease model can create obstacles to treatment when hope is fundamental,” he advises.

Murray says his most difficult cases “involve clients who have in essence been drawn into the PPIC and have become resigned to the disease model with little sense of empowerment to overcome their emotional problems.”

“These are the consumers who have little self-efficacy and little hope that they have options other than to suffer,” he reports.

“Insurance companies rely on pharmaceuticals to contain costs (and limit psychotherapy sessions), and reimbursement depends on a diagnosis of a diseased brain,” Murray notes.

Read entire article:  http://dissidentvoice.org/2010/06/tracking-the-american-epidemic-of-mental-illness-part-iii/

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