Psychiatrists Wake Up to Criticisms of Their Industry and the Demands for Patients to be Protected from Psychiatric Abuse

Psychiatry is corruptible. Psychiatry causes tremendous harm. It needs an independent watchdog such as CCHR and ex-patient groups because the profession has failed to effectively police itself. – CCHR International

2022 started with a professional admission that scrutiny of psychiatry is necessary and dismissed only at its own peril. CCHR says its exposure of corruption and abuses in the mental health industry spurs much-needed debate about traumatized, disenchanted, and devastated” patients.

By CCHR International
The Mental Health Industry Watchdog
January 10, 2022

Dr. Awais Aftab, psychiatrist and clinical assistant professor of psychiatry at Case Western Reserve University, wrote an article published in Psychiatric Times (6 Jan. 2022) advising psychiatrists to stop being so defensive about criticism of psychiatry. Indeed, he questions whether psychiatry needs criticism in order to improve.[1] Aftab was candid: “Critiques of psychiatry are necessary and important, and will continue to be so, and psychiatry can only dismiss them at its own peril.”[2]

The Citizens Commission on Human Rights International, a 52-year mental health industry watchdog, said the criticisms are warranted and more psychiatrists and their membership associations should take heed. CCHR’s exposure of abuses in the industry is vital to ensure patient protections. It has taken groups like CCHR and psychiatric survivor groups agitating for change to see any semblance of human rights making its way into the mental health industry.

A United Nations (UN) Special Rapporteur report reinforces this: “The main task of CCHR has been to achieve reform in the field of mental health and the preservation of the rights of individuals under the Universal Declaration of Human Rights. CCHR has been responsible for many great reforms.” Laws throughout the world, “which would otherwise have inhibited even more the rights of patients or would have given psychiatry the power to commit minority groups and individuals against their will, have been defeated by the actions of CCHR.”[3]

That was in 1986 and it is even more relevant today with nearly 200 laws now enacted. The World Psychiatric Association (WPA) conceded in October 2020 that practices that constitute psychiatric coercion, include, “treatment without consent (or ‘compulsory treatment’), any form of treatment including the use of psychotropic medication; seclusion, locking or confining a person to a space or room alone; restraint actions aimed at controlling a person’s physical movement, including prolonged or unsafe holding by other person(s), the use of any physical devices (‘mechanical restraint’, chaining etc.) and the use of psychotropic drugs for the primary purpose of controlling movement (‘chemical restraint’).”[4] These are all violations CCHR has exposed for more than five decades.

Aftab notes: “There are understandable reasons psychiatry is scrutinized way more than other medical specialties. It, for instance, exercises social control over the lives of individuals under its care to a degree exercised by no other specialty; it is subject to more value disagreements,” while “the state of scientific development is still comparatively rudimentary.” For these and other reasons, he added, it can be assured that “psychiatry will be under the spotlight.” As such, “This additional scrutiny intersects with disorder within psychiatry’s own house, giving critics plenty of flammable material to work with.”[5]

There are too many “unhappy customers” when it comes to psychiatry, he said, who have been left “traumatized, disenchanted, even devastated by their experiences. There has been tendency within the profession to not take such individuals seriously, at least not without being forced to do so.”[6]

Aftab was also commenting on an earlier December 2021 article in Psychiatric Times by psychiatrist Daniel Morehead, M.D. titled, “It’s Time for Us to Stop Waffling About Psychiatry” wherein Morehead complained that “commonplace criticisms generate an image of psychiatry that is both wildly distorted and profoundly destructive.”

Yet his peer group, WPA, speaks sooth about such criticisms. It seems then to depend upon who the messenger is whether it is accepted.

Rather than look at his profession’s predatory and harmful history, Morehead ignores the fact that such criticism—despite the sources—is based on legitimate reasons and that psychiatry, itself, has ruined its own reputation and self-appointed honor. He appears aghast that even within his own ranks, there is dissention—something which CCHR explains in its official report, Why Psychiatry Sees Itself as a Dying Industry. 

Morehead further complained that: 

  • A Harvard historian’s book describes the history of psychiatry as a “series of failures.” The book received praise from inside and outside psychiatry, garnering attention in major periodicals such as The Atlantic and The New Yorker.[7]
  • A best-seller book makes a case that psychiatry is utterly corrupt, and that psychiatric diagnosis and treatment cannot be trusted. A quick internet search shows more than a dozen other recent books making the same argument.
  • Prominent psychiatrists assert that the profession should give up the idea that mental illness includes biological dysfunction, and either redefine mental illness or give up trying to define it altogether.
  • Numerous psychiatrists and commentators declare the field of psychiatry to be “in crisis,” and discuss psychiatry’s particular vulnerability to “institutional corruption.”
  • An opinion piece in the world’s most important medical journal, New England Journal of Medicine, stated that “something has gone wrong” in psychiatry, including the assertions that vast overprescribing and “trial and error ‘medication management’” have taken over the field.
  • Psychiatrists are labeled as pill-pushers and biological reductionists in psychiatric newspapers, general medical journals, and popular periodicals.[8]

In other words, Morehead, wake up and smell the roses. Listen to your critics and change things.

Aftab disagreed with Morehead’s characterization that the critiques of psychiatry are destructive and harmful.[9] He encouraged more debate and specified additional concerns to include:

  • Critiques of the Diagnostic & Statistical Manual of Mental Disorders (DSM), its limitation, and its misapplications
  • Links between psychiatric professionals and the pharmaceutical industry
  • Medicalization of everyday distress and the risks of psychotropic “medicines”
  • Psychiatric coercion
  • Evidence from harmed patients, individuals with experience, and the consumer/survivor/ex-patient movement.

In addition, Aftab wrote: “Psychiatry has been vulnerable to diagnostic fads. The profession has allowed itself to be exploited by pharmaceutical companies.”

Indeed, “many psychiatrists in positions of power and influence have often made grandiose claims—and at times have displayed stunning arrogance.” [10]

Former UN Special Rapporteur on health, Dainius Pūras, M.D., in a June 2021 Psychiatric Times interview with Aftab was “critical about the effects of totalitarian and authoritarian regimes on societal mental health and well-being.” According to Dr. Pūras, “…the problem of accountability in global mental health and psychiatry remains very serious.” Further: “The most worrying feature of psychiatry is that the leadership, under influence of hard-liners, tends to label those experts who blow the whistle and critically address the status quo as anti-psychiatrists… if influential psychiatrists continue to repeat that values are not a priority in mental healthcare, we should not be surprised that global mental health and global psychiatry is facing a crisis, which to a large extent is a moral crisis, or a crisis of values.”[11]

However, Morehead, argues: “These sorts of criticisms of our field are, in fact, commonplace—so much so that they rarely generate much protest or sense of outrage among psychiatrists and other medical professionals.”

Aftab cites John Sadler, M.D., writing in Values and Psychiatric Diagnosis, who stated: “Psychiatry, by the nature of its subject matter, is destined to be esteemed and loathed, scrutinized and dismissed, overlooked and debated. Psychiatry accepts many of the messy truths that almost everyone else would like to ignore or deny.”[12]

Both Morehead and Aftab apparently have a point of agreement in believing that too much truth about psychiatry’s ineffectiveness and abuse should be construed as egregious and misplaced. When such criticism occurs, it suddenly falls into a gray area dubbed “anti-psychiatry” in an attempt to minimize it. CCHR’s co-founder, the late eminent Dr. Thomas Szasz, a professor of psychiatry at the State University of New York’s Upstate Medical University in Syracuse, and others are cited as part of this group. But Aftab—like Dr. Pūras—admits that “many psychiatrists have been too trigger-happy with allegations of ‘anti-psychiatry’ and have lumped all sorts of critics under the same banner.”

Jeffrey Lieberman, a former American Psychiatric Association president, exemplifies this.[13] In his rush to blame others for psychiatry’s poor reputation, he laid all criticism at the feet of the “anti-psychiatry movement,” obfuscating the fact that the so-called movement was actually started by psychiatrists. The term “anti-psychiatry” was coined in the 1950s by South African-born psychiatrist David Cooper, who expounded the idea in his book Psychiatry and Anti-psychiatry in 1967.[14] This was two years before CCHR was formed.

In the early 1950s there were deep divisions between biological and psychoanalytic psychiatrists, according to a 2006 article entitled, “Evolution of the Antipsychiatry Movement into Mental Health Consumerism.” It reported: “An outcry was mounting against psychiatry’s practice of compulsory admission of mental patients to state institutions, where they were coerced into taking high doses of neuroleptic drugs and undergoing convulsive and psychosurgical procedures.”[15]

“Anti-psychiatry challenged the very foundations of psychiatry and its role in treating the mentally ill” and held psychiatry to account for abuses of human rights and “for the controlling force it played for society…. The modern use of the term ‘anti-psychiatry’ refers to an international movement which arose during the 1960’s and 70’s….”[16]

But Morehead conceives the movement’s criticisms as “one-sided and destructive depictions of psychiatry” which “need to come to an end,” rather than accepting them as a rational objection to legitimate psychiatric abuses. His comments are sometimes self-defeating when he concedes “the holy grail of central pathophysiology has not been located” to prove mental disorders are the same as physical illnesses; “just because we do not know everything about the biology of mental illness does not mean that we don’t know anything about the biology of mental illness.” Imagine a heart surgeon saying he did not know the biology of the heart before sticking a scalpel in it!

Morehead continues that psychiatry is facing an “intellectual culture that has habituated the public to think of psychiatry as flawed, failed, corrupted, and lost. The stereotypical picture of our field focuses relentlessly on the influence of drug companies, the weaknesses of the DSM-5, and the dangers of overprescribing.”

All true. He doesn’t discuss the high propensity of criminality that is also within psychiatry’s ranks. For example, in 2021, the Supreme Court of Spain upheld the decision of a lower court which sentenced psychiatrist Antonio Asin Cabrera to seven years in prison and 20,000 euros ($22,570) in restitution for sexually abusing a patient for nine years, under the guise of “therapy.” The victim had had been prescribed a cornucopia of psychiatric drugs that, according to the Court, directly affected her decision-making capacity.[17] Cabrera is one of thousands of psychiatrists and psychologists that CCHR has documented to have sexually abused their patients.

Another Spanish psychiatrist, Emilio González Fernández, who was also convicted of patient sexual abuse, was expelled by the country’s medical association in 2021. The board of directors of the Official College of Doctors of A Coruña unanimously approved the expulsion, noting the psychiatrist’s prominence, including his being the clinical head of the psychiatric sanatorium of Conxo, in Santiago and founder of the Psychosocial Centre of Ferrol, among other things. González was denounced by a patient and brought to light ten other almost identical cases that also wanted to take him to court. The women were to testify as victim-witnesses in the trial that was to be held in June that year but before the date of the hearing arrived, the psychiatrist reached an agreement with the prosecution whereby he admitted the facts and accepted a sentence of one year and nine months in prison and the payment of a compensation of 6,000 euros (U.S. 6813) to the victim.[18]

It is ironic that it was in Madrid in 1996 that the WPA formalized its “Madrid Declaration on Ethical Standards for Psychiatric Practice” which says that under no circumstance “should a psychiatrist get involved with a patient in any form of sexual behavior, irrespective of whether this behavior is initiated by the patient or the therapist.”[19]

Yet the practice continues to be rife. At least 10% of psychiatrists admit to sexually abusing their patients. In 2019, Melbourne, Australia psychiatrist, Prabakar Rajan Thomas was sentenced to two years in jail for sexually assaulting a female patient.[20] That same year in Connecticut, U.S. psychiatrist, Paul Fox was sentenced to seven years in jail for the sexual assault of an 18-year-old female patient.[21]

The WPA also condemns psychiatric coercion because it carries “the risk of harmful consequences, including trauma” and that an individual subject to “physical coercion is susceptible to harms that include physical pain, injury and death.”[22]

In 2016, U.S. psychiatrist H. Steven Moffic wrote an article about “The Worst Psychiatrist in History” published in Psychiatric Times, in which he nominated examples of really bad psychiatrists, including those who participated in the hospitalization of political dissidents in the Soviet Union and more recently, China; Aubrey Levin, known as “Dr. Shock,” who tortured gay soldiers in South Africa during apartheid and sexually abused patients after he fled to Canada; and “psychiatrists who cooperated with the Nazis in the murder of psychiatric patients and others during World War II.” But the “winner” for the worst psychiatrist at that time was Serbian psychiatrist, Radovan Karadzic, accused of killing thousands of Muslim men and boys as part of a so-called ethnic cleansing campaign in wartime Sarajevo.[23]

In 2016, Karadzic was convicted of genocide, war crimes and crimes against humanity by a UN war crimes tribunal and sentenced to 40 years in prison.[24]

CCHR has reported on all of the above psychiatrists for decades.  When CCHR France investigated Karazdik in the 1990s and provided evidence to the war crimes tribunal and European authorities, it was commended by the Council of Europe, which signed a Resolution that recognized psychiatrists as the architects of the ethnic cleansing campaign. The Resolution encouraged Council members to “study the material that has been put together and researched by the French chapter of the Citizens Commission on Human Rights….” [25]

Robert Kaplan from the Graduate School of Medicine, Wollongong University, Australia, writing in The Sydney Morning Herald, confirmed what CCHR’s research had found. He went further to say that Karadzik used his psychiatric training “to plan terror tactics for ethnic cleansing” and “as a genocidal murderer, Karadzik is an extreme but not uncommon example of clinicide—the phenomenon of doctors who kill.”[26]

What is clear is that when anyone other than the courts, media or psychiatrists themselves report on psychiatric atrocities, psychiatrists like Morehead and/or their membership associations will dismiss the allegations as dishonoring the profession or being “anti-psychiatry.”

Psychiatry is corruptible. Psychiatry causes tremendous harm. It needs an independent watchdog such as CCHR and ex-patient/survivor groups because the profession has failed to effectively police itself. In June 2021, the World Health Organization (WHO) was also clear that coercive psychiatric practices remain “pervasive.” WHO points to a series of UN guidelines and Human Rights Council resolutions that have called on countries to tackle the “unlawful or arbitrary institutionalization, overmedication and treatment practices [seen in the field of mental health] that fail to respect… autonomy, will and preferences.” People who are subjected to coercive practices report feelings of dehumanization, disempowerment and being disrespected, WHO further stated. [27]

And as Aftab states: “In my opinion, psychiatry cannot wriggle its way out of this dilemma by rhetorical appeals, tone-policing of criticisms, and becoming self-assigned arbiter of what sort of critiques are allowed from inside or outside the profession.”

“By blocking and dismissing criticisms aimed at psychiatric institutions (for instance, criticisms from the UN and the WHO), it may very well be standing in the way of those who are actually trying to change it. With respect, psychiatry as a profession should join the effort or get out of the way.”[28]

CCHR’s comments and criticisms stem from either patients traumatized and stigmatized by psychiatric labeling and treatment, patient families, or quoting extensively from psychiatric or other mental health profession studies and reports. It agrees with Dr. Aftab: if psychiatrists cannot face their own criticism, their patients’ allegations of abuse and media or law enforcement reports of coercion, corruption and failures, they should get out of the way—permanently.

References:

[1] Awais Aftab, MD, “It’s Time for Us to Stop Being So Defensive About Criticisms of Psychiatry: Does psychiatry need criticism in order to improve?” Psychiatric Times, 6 Jan. 2022, https://www.psychiatrictimes.com/view/its-time-for-us-to-stop-being-so-defensive-about-criticisms-of-psychiatry

[2] Ibid.

[3] Erica-Irene Daes, Special Rapporteur to the UN Human Rights Commission, Principles, Guidelines and Guarantees for the Protection of Persons Detained on Grounds of Mental Ill-Health or Suffering from Mental Disorder, 1986

[4] https://www.cchrint.org/2021/06/07/un-special-rapporteur-dainius-puras-addresses-psychiatrys-global-coercion-crisis/ citing: https://www.wpanet.org/alternatives-to-coercion

[5] Op. cit., Awais Aftab, MD, Psychiatric Times, 6 Jan. 2022

[6] Ibid.

[7] Daniel Morehead, MD, “It’s Time for Us to Stop Waffling About Psychiatry,” Psychiatric Times, Vol 38, Issue 12, 2 Dec. 2021, https://www.psychiatrictimes.com/view/its-time-for-us-to-stop-waffling-about-psychiatry, Citing: Harrington A. Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness. W.W. Norton & Co; 2019; Greenberg G. Psychiatry’s incurable hubris. The Atlantic. 2019:30-32; Szalai J. Mental illness is all in your brain – or is it? New York Times. April 24, 2019. Accessed September 22, 2021. https://www.nytimes.com/2019/04/24/books/review-mind-fixers-psychiatry-biology-mental-illness-anne-harrington.html

[8] Ibid., Citing: Aftab A. The impoverishment of psychiatric knowledge. Psychiatric Times. March 30, 2020. Accessed September 22, 2021. https://www.psychiatrictimes.com/view/impoverishment-psychiatric-knowledge; Aftab A. Institutional corruption and social justice in psychiatry. Psychiatric Times. 9 Mar. 2020. Accessed 22 Sept, 2021. https://www.psychiatrictimes.com/view/institutional-corruption-and-social-justice-psychiatry

[9] Op. cit., Awais Aftab, MD, Psychiatric Times, 6 Jan. 2022

[10] Ibid.

[11] https://www.cchrint.org/2021/06/07/un-special-rapporteur-dainius-puras-addresses-psychiatrys-global-coercion-crisis/ citing: Awais Aftab, MD, “Global Psychiatry’s Crisis of Values: Dainius Pūras, MD,” Psychiatric Times, 3 June 2021, https://www.psychiatrictimes.com/view/global-psychiatry-crisis-values

[12] Op. cit., Awais Aftab, MD, Psychiatric Times, 6 Jan. 2022

[13] Jeffrey A. Lieberman, “DSM-5: Caught between Mental Illness Stigma and Anti-Psychiatry Prejudice,” Scientific American, 30 May 2013, https://blogs.scientificamerican.com/mind-guest-blog/dsm-5-caught-between-mental-illness-stigma-and-anti-psychiatry-prejudice/

[14] “The ‘Anti-Psychiatry Movement,’ CCHR and Other Advocates Against Psychiatric Pseudoscience, Coercion and Abuse,” CCHR International, https://www.cchrint.org/about-us/the-anti-psychiatry-movement/, citing: Oliver Josef Dumolo Ralley, “Anti-psychiatry,” Priory.com, (Priory Lodge Education Ltd.) Nov. 2012, https://www.priory.com/history_of_medicine/Anti-Psychiatry.htm; Oliver Josef Dumolo Ralley, Priory.com; David J. Rissmiller, D.O. and Joshua H. Rissmiller, “Evolution of the Antipsychiatry Movement Into Mental Health Consumerism,” Psychiatric Services published by American Psychiatric Association, 1 Jun. 2006, https://mindfreedom.org/campaign/apa-essay-on-movement/

[15] Ibid., David J. Rissmiller, D.O. and Joshua H. Rissmiller

[16] Op. cit ., Oliver Josef Dumolo Ralley, Priory.com

[17]Tenerife psychiatrist gets seven years for sexually abusing patient,” Euro Weekly, 3 Dec. 2021, https://www.euroweeklynews.com/2021/12/03/tenerife-psychiatrist-gets-seven-years-for-sexually-abusing-patient/

[18] “Spanish psychiatrist convicted of sexual abuse expelled by medical association,” The European Times, 4 June 2021, https://www.europeantimes.news/2021/06/spanish-psychiatrist-convicted-of-sexual-abuse-expelled-by-medical-association/?fbclid=IwAR3VhJtOjDH12QPSdcSZMECHA9w6smkjwijgkzNKUnWTeQ6ZcVdO523xAss

[19] “Madrid Declaration on Ethical Standards for Psychiatric Practice,” WPA, https://www.wpanet.org/current-madrid-declaration

[20] https://www.cchrint.org/2020/07/13/psychiatric-sexual-assault-other-crimes-cause-harm-in-australia/#_edn51 citing: Benjamin Ansell, “Psychiatrist jailed for assaulting vulnerable, long-term patient,” Channel 9 News, 29 Mar. 2019, https://www.theage.com.au/national/victoria/sleazy-psychiatrist-gets-14-months-for-sex-assault-on-female-patient-20190329-p518wc.html

[21] https://www.cchrint.org/2019/07/11/connecticut-jails-psychiatrist-paul-fox/ citing: Criminal case file of Paul Fox, Case NO. DBD CR16-0153169-S, Connecticut Superior Court Judicial District of Danbury

[22] https://www.wpanet.org/alternatives-to-coercion

[23] H. Steven Moffic, “The Worst Psychiatrist in History,” Psychiatric Times, 6 Oct. 2016, https://www.psychiatrictimes.com/view/worst-psychiatrist-history

[24] https://www.cchrint.org/2016/03/25/cchr-praises-conviction-of-radovan-karadzic/ citing: “PHR Welcomes Guilty Verdict Against Radovan Karadzic, Key Figure in Bosnia’s Genocide,” Physicians for Human Rights, 24 Mar. 2016, http://physiciansforhumanrights.org/press/press-releases/phr-welcomes-guilty-verdict-against-radovan-karadzic-key-figure-in-bosnias-genocide.html.

[25] https://www.cchrint.org/2016/03/25/cchr-praises-conviction-of-radovan-karadzic/#_edn1 citing: “Human suffering and degradation Following Ethnic Cleansing,” Council of Europe Parliamentary Assembly, doc 8493 rev. 1 Sept. 1999, http://www.assembly.coe.int/nw/xml/XRef/X2H-Xref-ViewHTML.asp?FileID=8785&lang=EN

[26] https://www.cchrint.org/2016/03/25/cchr-praises-conviction-of-radovan-karadzic/ citing: Robert Kaplan, MD, “When saving lives morphs into torture and killing,” The Sydney Morning Herald, 24 July 2014, http://www.smh.com.au/news/opinion/when-saving-lives-morphs-into-torture-and-killing/2008/07/23/1216492536680.html?page=fullpage

[27] https://www.cchrint.org/2021/06/11/world-health-organization-new-guidelines-are-vital-to-end-coercive-psychiatric-practices-abuse/ citing: “Guidance on Community Mental Health Services: Promoting Person-Centered and Rights-Based Approaches,” World Health Organization, 10 June 2021, pp. 5 & 8, https://www.who.int/publications/i/item/9789240025707 (to download report)

[28] Op. cit., Awais Aftab, MD, Psychiatric Times, 6 Jan. 2022