Depression Screenings Not Recommended!

If you’re feeling down, don’t rush to your doctor just yet. Many instances of mild depression resolve without intervention. In fact, a new analysis published in the Canadian Medical Association Journal (CMAJ) concludes that routine screening for depression isn’t beneficial or efficient.

The United States and Canada recommend screening for depression by primary care providers, but the United Kingdom says no way! The UK does not recommend screening because of a lack of evidence and ineffective use of scarce health care resources.

In addition, The UK’s National Institute for Health and Clinical Excellence guidelines, cite concerns about high rates of false-positive results (in some cases more than 50 percent), lack of evidence, high costs and resources, and the diversion of resources away from people with serious depression.

Are Psychiatric Medications Making Us Sicker?

I first took a close look at treatments for mental illness 15 years ago while researching an article for Scientific American. At the time, sales of a new class of antidepressants, selective serotonin reuptake inhibitors, or SSRI’s, were booming. The first SSRI, Prozac, had quickly become the most widely prescribed drug in the world. Many psychiatrists, notably Peter D. Kramer, author of the best seller Listening to Prozac, touted SSRI’s as a revolutionary advance in the treatment of mental illness. Prozac, Kramer said in a phrase that I hope now haunts him, could make patients “better than well.”

Clinical trials told a different story. SSRI’s are no more effective than two older classes of antidepressants, tricyclics and monoamine oxidase inhibitors. What was even more surprising to me—given the rave reviews Prozac had received from Kramer and others—was that antidepressants as a whole were not more effective than so-called talking cures, whether cognitive behavioral therapy or even old-fashioned Freudian psychoanalysis. According to some investigators, treatments for depression and other common ailments work—if they do work—by harnessing the placebo effect, the tendency of a patient’s expectation of improvement to become self-fulfilling. I titled my article “Why Freud Isn’t Dead.” Far from defending psychoanalysis, my point was that psychiatry has made disturbingly little progress since the heyday of Freudian theory.

Mental health services have become increasingly dominated by psychiatry’s ”medical model”

Mental health services have become increasingly dominated by psychiatry’s ”medical model”, which claims that feeling depressed, anxious or paranoid is primarily caused by genetic predispositions and chemical imbalances.

This has led to alarming rises in chemical solutions to distress. In New Zealand, one in nine adults (and one in five women) is prescribed antidepressants every year.

The public, however, in every country studied, including Australia, believes that mental health problems are caused by issues such as stress, poverty and isolation. The public also prefers talking therapies to drugs and electroconvulsive therapy (ECT).

Research suggests the public is right. For example, the single best predictor of just about every mental health problem is poverty, followed by other social factors such as abuse, neglect and early loss of parents in childhood, and – once in adulthood – loneliness and a range of adverse events including losses and defeats of various kinds.

Politics and mental health a poor mix

Imagine a tribunal where the public could challenge clinical decisions by neurosurgeons or cardiologists. It would be ridiculous. But mental health is different. Unlike other medical specialties, it resembles law or politics: fields where subtle variations in the interpretation of a word can alter the entire trajectory of a patient’s treatment.

That’s why the right to appeal clinical decisions by mental health professionals through a tribunal, announced recently by the NSW government, met with public approval. Mental health possesses a built-in capacity for abuse that is greater than in other areas of medicine. A patient’s psychiatric diagnosis has enormous cultural power in many other fields, from the marketing of antidepressant medications, to general practice, disability claims and legal proceedings.

Miami couple faces lengthy sentence for Medicare fraud

Lawrence Duran was a Miami healthcare executive who regularly lobbied Congress in favor of legislation to boost government subsidies for his industry: community mental health centers. He visited with U.S. Rep. Ileana Ros-Lehtinen in Washington to drum up support. He, his girlfriend and other members of his lobbying organization threw a fundraiser for another Miami congressman, Rep. Kendrick Meek, when he ran for the U.S. Senate.

But Justice Department officials paint a far more sinister portrait of Duran and his girlfriend, Marianella Valera. They say the lobbying work was all a front to help them steal more money from the taxpayer-funded Medicare program.

Now Duran and Valera, who each pleaded guilty this year to Medicare fraud charges of running the biggest mental-health racket in the nation, face the prospect of spending the rest of their lives in prison for orchestrating the $205 million scam.