Under the guise of
combating the stigma of mental illness, the U.S. government will soon begin a
massive campaign of psychiatric indoctrination, designed to increase the
acceptance of psychiatric chemical imbalance theories and labeling, and to pave
the way for national psychiatric screening, driving more Americans into seeking
psychiatric drug treatment.
Regional meetings
in support of the National Anti-Stigma Campaign (NASC), a nationwide
television, radio and print public service advertising program funded by the
Substance Abuse and Mental Health Services Administration (SAMHSA), were held
this past summer in Los Angeles, Denver, Chicago and Washington, D.C. According
to a senior technical assistance specialist at the SAMHSA Resource Center to Address Discrimination and Stigma Associated
with Mental Illness (ADS Center), the ad campaign, which will target 18-25-year
olds, will be launched today. A campaign directed at older adults and ethnic
and racial minorities will follow.
On its surface, the campaign�s message may seem perfectly appropriate,
even compassionate. Its stated objective is to �encourage, educate and inspire
18-25-year olds to step up and support friends they know are experiencing a
mental health problem.� One ad, for example, shows a man with his hand over his
eyes. �Sometimes I find myself turning away from or just ignoring someone with
a mental illness, avoiding eye contact,� he says. �I know it is not their fault
but sometimes I don�t know how to communicate with them.�
But there can be no doubt about the real purpose of the campaign�s
emotional appeal: to create customers for the psychiatric/pharmaceutical
industry. This is clearly evident at SAMHSA�s website and in its literature. It
is no accident that 18-25-year olds were chosen as the first target. A SAMHSA
�Fact Sheet� states, �Among 18-25-year olds, the prevalence of serious mental
health conditions is high . . . yet this age group shows the lowest rate of help-seeking behaviors
[emphasis added].� �Help-seeking behavior� is, of course, a euphemism for being
psychiatrically diagnosed and drugged. The 18-25-year old demographic
represents a huge untapped market for psychiatric drugs and services. According
to SAMHSA�s website, the anti-stigma media blitz �has been designed to
establish a �new norm,� in which individuals, without hesitation, will seek out
the mental health services they need and deserve.�
The drug industry
seeds NASC
Further evidence of SAMHSA�s marketing agenda is found in the origins of
the National Anti-Stigma Campaign. The program was first recommended by a
federal commission that had extensive ties to the pharmaceutical industry. In
its 2003 report, Achieving the Promise:
Transforming Mental Health Care in America, the President�s New Freedom
Commission (NFC) on Mental Health called for the government to �undertake a
national campaign to reduce stigma.� The NFC proposed �national education
initiatives� to �shatter the misconceptions about mental illnesses, thus
helping more Americans understand the facts and making them more willing to seek help for mental health problems�
and advocated �actions of reducing stigma, increasing awareness, and encouraging treatment . . . (emphasis
added).�
Several members of the NFC had extensive ties to the pharmaceutical
industry, principally by way of an industry marketing scheme that was developed
in Texas in the 1990s. Known as the Texas Medication Algorithm Project, or
TMAP, it was designed to make the newest and most expensive psychiatric drugs
the first (and virtually only) treatment option for mental health care. The
project was nurtured at the University of Texas Southwestern Medical Center in
Dallas, a major research center that conducts drug trials for pharmaceutical
companies, with significant funding coming from the drug companies themselves. Pharmaceutical
company gifts to the Texas Department of State Health Services totaled $1.3
million from 1997 to 2004, with at least $834,000 earmarked for TMAP.
Backed by drug industry funding, TMAP was then exported to other states
via the National Association of State Mental Health Program Directors
(NASMHPD).
The chair of the NFC, Michael Hogan, was the Mental Health Program
Director in Ohio when the Ohio Medication Algorithm Project (OMAP), was adopted
there. A 2004 Janssen (makers of the atypical antispsychotic, Risperdal)
publication, �Mental Health Issues Today,� lists Hogan as a member of their
Advisory Board. In 2005, Eli Lilly (makers of the atypical
antipsychotic, Zyprexa and the antidepressant, Prozac) gave Hogan its Lifetime
Achievement Award. Hogan was president of the NASMHPD from 2003-2004 and
president of the NASMHPD Research Institute, which is heavily funded by the
pharmaceutical industry, from 1989-2000.
Another NFC member, Stephen Mayberg, was the California State Mental
Health Program Director when TMAP was adopted in that state. Mayberg is also a
past president of NASMHPD and the NASMHPD Research Institute.
NFC member Charles Curie, who recently stepped down as the administrator
of SAMHSA, was the Deputy Secretary for Mental Health and Substance Abuse
Services in Pennsylvania when PENNMAP was enacted. According Allen Jones, an
investigator in the Pennsylvania Office of Inspector General and a
whistleblower, Curie is reported to have set up a slush fund from which state
employees could solicit grants from the pharmaceutical industry.
NFC member psychiatrist Rodolfo Arredondo served on the board of the
Texas Department of Mental Health and Mental Retardation during TMAP�s
development, while another NFC commissioner, Robert Postlethwait, has had a long career with Eli Lilly and
Company.
According to Jones, at least 14 of the 22 NFC members have drug industry
ties. Not surprisingly, the NFC selected TMAP as a model program and stated
that the �biggest challenge� was to ensure that TMAP was �implemented in other
states and localities.�
The psychiatric industry is well on its way to meeting that challenge --
with disastrous results for our youth. A similar pattern emerges in states
which have adopted TMAP. In Texas, 19,404 teenagers were prescribed an
antipsychotic in July or August of 2004. Ninety-eight percent received the
newer atypical antipsychotics. In April of 2004, the Texas Comptroller, Carole
Strayhorn, released a report, Forgotten Children, that was highly
critical of the psychiatric drugging of foster children in Texas.
In 2005, the Columbus (Ohio) Dispatch ran a two-part story, �Drugged
Into Submission,� on the psychiatric drugging of children, including 700 babies
and toddlers, under state care. Part one was titled, �Forced Medication
Straitjackets Kids.�
In 1998, the Los Angeles Times reported, �Children under state
protection in California group and foster homes are being drugged with potent,
dangerous psychiatric medications, at times just to keep them obedient and
docile for their overburdened caretakers.�
In Pennsylvania, Dr. Stephan Kruszewski, a Harvard trained psychiatrist
working for the Pennsylvania�s Department of Public Welfare, complained that
children were being heavily drugged with antipsychotics and anticonvulsants
(mainly Neurontin). He was fired.
In Washington State, atypical antipsychotics ranked 1, 3, and 5 on the
Medical Assistance Administration�s list of top 100 drugs by money paid in
2004, with nearly $78 million spent on those three drugs: Zyprexa ($36
million), Risperdal ($21 million), Seroquel ($20.8 million). Neurontin was #4,
at $20.8 million. Antidepressants Zoloft, Effexor and Paxil came in at #7, #11
and #12, with nearly $31 million spent on those three drugs. A 1997 Seattle
Post-Intelligencer series charged that an �unmonitored stream of mood drugs
imperils children entrusted to state.�
Additional confirmation of the drug industry�s control of SAMHSA comes
in the form of an email sent to me by the previously mentioned senior technical
assistance specialist at SAMHSA. The
email was a response to my inquiry about the anti-stigma campaign. The
assistance specialist sent a copy of her response and my original inquiry, to
the NASC liaison at NAMI. NAMI, of course, is the National Alliance for the
Mentally Ill, a well-known front group for the pharmaceutical industry. SAMHSA
is obviously working hand in hand with NAMI -- even forwarding private
communication from the public to NAMI�s offices. In 1999, Mother Jones magazine reported that 18 drug firms gave NAMI a total
of $11.72 million between 1996 and 1999. NAMI continually promotes psychiatric
chemical imbalance theories, minimizes the damaging effects of psychiatric
drugs, and advocates for forced psychiatric drugging programs.
On May 28, 2006, the Philadelphia Inquirer reported that NAMI �did not
disclose that Lilly [Eli Lilly, makers of Zyprexa and Prozac] marketing manager
Gerald Radke briefly ran its entire operation. Radke began in 1999 as a
Lilly-paid �management consultant,� then left Lilly and served as NAMI's paid
�interim executive director� until mid-2001. The group acknowledged this only
after being shown Radke's resume listing the job.�
According to the Inquirer, Lilly gave NAMI $3 million between 2003 and
2005 and �called its executive loans mutually beneficial.� NAMI�s former
executive director for 16 years was Laurie Flynn. Flynn is now the Director of
Teenscreen, a psychiatric screening program developed by Columbia University�s
Child Psychiatry Research Department and, not surprisingly, recommended by the
NFC. TeenScreen�s goal is to screen all teenagers in the U.S. for psychiatric
disorders.
NASC and
screening: Educating Americans to be good customers
Since psychiatric drugging must, in most cases, be preceded by the
assignment of a psychiatric label, psychiatric screening is an essential step
in the industry�s plans to expand its market. That�s where the anti-stigma
campaign and national psychiatric screening -- both recommended by the NFC --
come into play.
The NFC report recommended �early detection of mental health problems in
children and adults -- through routine and comprehensive testing and screening
. . ." and while NFC chair Hogan has denied that the NFC intended
universal screening, in a January 20, 2005 story in the Christian Science
Monitor, Hogan said that the commission decided that recommending universal screening
would be "a little premature and probably
controversial, even though we thought, in the long run, it probably might be
the right thing to do.�
In other words, the only barrier to screening everyone in America, as
the NFC sees it, is the controversy it would generate. It�s �premature.� Americans
have to be prepared to accept mass psychiatric interventions. SAMHSA�s
NFC-recommended NASC program is their answer -- a three-year, �long run�
program to prepare the population for universal screening, followed, of course,
by psychiatric labeling and drugging.
The NASC campaign will advertise that mental illness has reached
epidemic levels in the population -- a theme that has been repeated in
psychiatric marketing campaigns dating back to the 1940s. The psychiatric
industry wants Americans to see mental illness everywhere -- to associate any
problem in life with a possible psychiatric disorder that can be treated with a
psychiatric drug.
A PowerPoint presentation available at the NASC website warns that �22% of Americans have a diagnosable mental
health problem� but �the majority . . . do not seek help.� SAMHSA has produced
three brochures that focus on the workplace (Mental Health: It�s Part of Our Lives at Work), the elderly
(Mental Health: It�s Part of Aging)
and college students (Mental Health: It�s Part of College Life). All state that one in five adults in the
U.S. experience a mental illness each year. All stress that not enough people
are seeking treatment due to stigma.
At the same time SAMHSA�s Eliminating Barriers Initiative (EBI) is
currently being pushed into secondary schools via school administrators'
associations. EBI is being piloted in eight states, (Mass., Ohio, Fla., NC,
Calif., Texas, Wisc. Pa.). EBI training presentations promoting psychiatric
chemical imbalance theories, stating, �Mental illnesses are brain disorders.�
In Massachusetts, the commissioner of Mental Health was brought to one
conference and read a student�s suicide note to the assembled school
administrators. Suicide is a favorite theme, even though 1) child suicides are
extremely rare (4.6 per 100,000 in 2001, according to the Center for Disease Control)
and declining; 2) In 2004, the U.S. Preventive Services Task Force (USPSTF)
found �no evidence that screening for suicide risk reduces suicide attempts or
mortality� and "insufficient evidence that treatment of those at high risk reduces
suicide attempts or mortality;� and 3) psychiatric drug treatment
has been found to increase suicidal thinking and behavior in children under 18.
The goal of such programs is clear. SAMHSA, acting as a tool
of the psychiatric and drug industries, wants Americans to view the world
through psychiatric lenses -- to find mental illness in their children, their
colleagues, their family and friends. The purpose of the NASC campaign is not
to educate Americans about psychiatric theories and treatments but to instill
acceptance of psychiatric dogma and psychiatric labeling and thus prepare the
way for psychiatric screening and drugging. Always the appeal is heavily weighted to the
emotions. The elderly brochure, for example, advises, �If you feel shame
because you have a mental illness remember: You are not alone.� SAMHSA will
tell us that fear of the mentally ill is part of the stigma, while, at the same
time, they will be sowing a subliminal fear that mental illness is lurking
around every corner.
The NASC campaign will spread the gospel of chemical imbalances and
suggest that the stigma of mental illness is the result of public ignorance and
fear. This is a key element of NASC. Americans must be taught to locate the
source of the stigma in their own personal failure, not the rampant disease
mongering and fear tactics of the psychiatric industry.
The real source of
the stigma
The real source of the stigma of mental illness lies in the definition
of stigma itself. The dictionary says a stigma is �A mark or token of infamy,
disgrace or reproach. A small mark; a scar or birthmark.� The word derives from
the ancient word for the mark or tattoo that was carved or burned into the flesh
of a slave or prisoner to inform everyone of their shameful status.
The definition of stigma suggests at once the source of the stigma --
psychiatric �marking� -- and how it could be eliminated: Don�t place the mark.
The most direct way to end the stigmatization of the mentally ill would be to
stop calling them mentally ill and labeling them with specious disorders. After
all, there�s no proof they�re ill. There is no lab test that can verify the
presence of any psychiatric disorder. We could just get rid of the Attention
Deficits, the Major Depressives, the Social Anxieties, the Bipolars and the 370
other labels psychiatrists have invented to alienate and marginalize those who
are suffering and convince those who are well that they are ill. We could tell
the psychiatric prisoners that their diagnostic cells are a thin illusion, that
their experience is part of the infinite variety of human experience. We could
tell them they are not other than us, they are not sick, they don�t have bad
brains. Life is tough, for a thousand different reasons, and most of us
struggle.
If we just put an end to psychiatry�s fraudulent pathologizing of life,
the stigma of mental illness would disappear.
Needless to say, this is not the kind of campaign SAMHSA has planned. There�s
too much money at stake. For several decades now psychiatrists have been
manufacturing stigmas at a ridiculous rate. Psychiatry�s book of stigmas, the Diagnostic and Statistical Manual of Mental
Disorders, has expanded from 112 stigmas in 1952 to its current 374, under
the guiding hand, the New York Times
and others recently (April 20) reported, of �experts� with financial ties to
drug companies.
According to the Times, a
study in the journal Psychotherapy and Psychosomatics found that �56 percent of
170 experts who worked on the 1994 edition of the manual, called the Diagnostic
and Statistical Manual, or D.S.M, had at least one monetary relationship with a
drug maker in the years from 1989 to 2004.� A report on the study in the Chicago Tribune noted that, �100 percent of the experts on DSM-IV panels overseeing
mood disorders and schizophrenia/psychotic disorders were financially involved
with the drug industry. These are the largest categories of psychiatric drugs
in the world, racking up 2004 sales of $20.3 billion and $14.4 billion,
respectively. Depression is the leading mood disorder.�
It�s a particularly profitable symbiosis. Psychiatrists invent the
diseases; the pharmaceutical industry makes the snake oil to treat them. And as
we have seen, the purpose of the NASC campaign is to help the experts and drug
companies cash in on their cozy relationship, to ensure that Americans accept
psychiatric branding and become good customers for the
psychiatric/pharmaceutical complex.
The last thing the psychiatric industry wants is for people to have the
facts about psychiatry�s invented illnesses and ineffective, damaging drugs. SAMHSA�s
campaign will follow a different script, one with more of a �slaves are people
too� theme, one which ensures that psychiatric branding is broadly accepted.
A brochure from the ADS center asks that we �remember� that people with
mental illnesses �do recover and lead productive lives,� they have the �same
needs as everyone else,� they �make valuable contributions to society,� and
discrimination �keeps them from seeking help� and �violates their rights.�
In other words, we will be educated about how people become slaves
(mentally ill); that it�s not their fault (it�s genetic); that slavery touches
all of us, and that, while slaves are different, they should be treated with
dignity. Slaves can lead productive lives, they have the same needs as
everyone, they make valuable contributions, and you shouldn�t discriminate
against them. We�ll be told that psychiatric prisoners are fortunate to have
kind wardens who treat them with respect and though the whip is occasionally
needed, it�s all in their best interests. Just don�t start thinking that they
are normal human beings -- they are slaves, i.e., mentally disordered with
damaged brains.
SAMHSA�s campaign
will justify and expand the stigmatization that supports the current mental
health system, while chiding us to be nice to those who are thereby victimized.
It won�t tell us how psychiatrists invent their diagnoses. It won�t tell that
psychiatry�s own diagnostic manual admits that psychiatry can�t distinguish one
disorder from another or mental illness from mental health. It won�t tell us
that psychiatric diagnostic reliability is low. We won�t be informed that, as
Harvard psychiatrist Joseph Glenmullen wrote in Prozac Backlash, �We do not yet have proof either of the cause or
the physiology for any psychiatric diagnosis. . . . In recent decades, we have
had no shortage of alleged biochemical imbalances for psychiatric conditions. Diligent
though these attempts have been, not one has been proven.�
The ineffectiveness of psychiatric drugs won�t be mentioned -- nor the
stream of warnings that have issued from the FDA and international agencies
over the past several years concerning the dangerous and often lethal side
effects of antidepressants, antipsychotics and stimulants.
We won�t hear about
last year�s study of antipsychotics, published in the New England Journal of Medicine, which found the newer
antipsychotics to be no more effective than the older drugs. In the study 74
percent of patients quit the drugs and
�[T]he majority of patients in each group discontinued their assigned treatment
owing to inefficacy or intolerable side effects or for other reasons.� (Note:
They didn�t quit because they �decompensated,� �lacked insight,� or were �in
denial.� The drugs were ineffective and intolerable.)
Instead, our government will tell us of the terrible consequence of
failing to seek treatment. We�ll be told to get branded -- and encourage our
friends and family to do the same - as soon as possible. We�ll be assured that
life on the pill plantation is a wonderful thing.
The pitch will touching and benevolent, the unspoken message crystal
clear: psychiatric stigmatization is a good thing. Only the ignorant and
uncaring fail to embrace it. You�ll be hearing a lot about the stigma of mental
illness in the coming months and with good reason. A trillion dollar industry
depends on it.
For
the past 20 years, Richard A. Warner has been the president of the Citizens
Commission on Human Rights of Seattle. He's written several pieces for the
Seattle Times and Seattle Post-Intelligencer over the years, been a guest on
dozens of local and national radio shows, and testifies regularly at the
Washington State capital in Olympia on issues related to mental health. His
recent paper on shock treatment can be found at ect.org.