tenetsummer04

the medicalization of what is labeled as "mental illness."
As we see it, the downside of the biomedical model of
treatment is:
A labeling process that does not allow for unlabeling
and hence, almost inevitably, produces marginalization
and discrimination
Institutionalization that disrupts family and social network
relationships and does little to help find meaningfulness
in relation to crises, further escalating anxiety and
perplexity in all those who care
The introduction of the current (but erroneous) biomedical
view of serious "mental illness" as being "incurable",
"chronic", and/or "deteriorating". Maintenance is
possible but-hope-so necessary for recovery, is nearly
impossible in this conceptualization
Medication, viewed by most as a required part of treatment,
may actually impede or prevent recovery by aborting
a potentially helpful psychological process that needs
to be related to and understood rather than suppressed.
It has, for example, been shown that the use of the antipsychotic
drugs, at least for what is called "schizophrenia",
has resulted in poorer long- term outcomes than
was the case prior to their use. In addition, suicide rates
have not been reduced as a result of the use of the antidepressant
medications
In violation of the Hippocratic dictum to "above all,
do no harm", excessive reliance on medications has produced
enormous rates of iatrogenic (doctor induced) diseases
such as tardive dyskinesia and dementia, neuroleptic
malignant syndrome, akathisia, suicidality, obesity,
reproductive difficulties, and addiction- to name but a
few. The model has induced a sense of powerlessness in
individuals, families and social networks because of its
ability to use coercion in the name of providing "medical
treatment.” Medicalization has produced a psychiatric/
drug company/hospital industrial complex that has such
power and control over theory and practice as to make a
change to a humanistic, psychosocial paradigm virtually
impossible.
Many mental health professionals -- especially psychiatrists
-- will attempt to invalidate and refute this argument
-- while defending the status quo -- by referring to
the "miraculous" effects of drug treatment. In addition
they will contend that clinical practice is actually based
on a "biopsychosocial model." It takes a very serious case
of denial not to see what is before your eyes: Mental health
treatment for the so-called "seriously mentally ill" is centered
on medication with lip service at best being given
to the "psychosocial" part of the model.
Consider these questions: How many adult mental
health consumers in the mental health systems you know
about are not being prescribed medications? What percentages
are receiving regular psychotherapy of any type?
How many are regularly able to access peer support
groups? Is client input into program planning and development
real -- or is it just tokenism? Are there client run
programs? Are the expressed needs of clients taken seriously?
We believe the alternative voice provided by Soteria
NARPA Rights Tenet: Summer 2004 page 22
Associates and other similar organizations that provide
accurate information (that is, with no conflict of interest)
and education about the realities of today's mental
health context -- via critical examination of current research
on mental illness -- is much needed. Without critical
dissident voices the real recovery oriented needs of
persons with complex and recalcitrant problems will never
be addressed.
There are many, many consumers and families coming
to the realization that today's treatment landscape is desolate
of any real understanding, help or hope for them.
Soteria Associates hears from these dissatisfied persons
daily by phone, email and regular mail. Among the many
issues they raise, the following are common themes:
They inquire whether there are any treatment centers
that do not use psychotropic drugs routinely -- at present
there are five in the entire country.
They ask to be withdrawn from psychotropic drugs
because of the terrifying and painful effects they have
experienced from them -- but there are no doctors or facilities
willing to take on the arduous task of withdrawing
these drugs. Many report that the drugs have not really
helped them -- only caused them problems. Many of
those who have tried to withdraw experienced very frightening
and unpleasant withdrawal reactions -- often of
sufficient magnitude to make them restart the medication.
They seek to understand and deal more effectively with
their experiences but can not find persons willing to join
with them in this difficult collaborative endeavor. Basically,
no one wants to hear them out. Psychiatric residents
(trainees) are taught that you "can't talk to disease"
(ie, "schizophrenia" and severe depression or mania).
They wonder why it is so difficult to find decent affordable
housing with interpersonal support, if needed,
in such an affluent country.
They seek almost any alternative way of dealing with
their problems but there are few professionals willing to
offer anything outside the current dogma. Even asking,
or questioning, may be viewed as non-compliance, further
damaging their reputations.
The list goes on, but these are representative examples
of what is wrong with the system. We find ourselves
empathizing with their powerlessness and hopelessness.
It would be delusional to believe that Soteria Associates,
a very small voice in a vast wilderness, can, by itself,
address these needs. What is required is the formation
of many communities of persons (and their friends)
who have been failed by biomedically focused mental
health treatment, the formation of groups demanding an
alternative: Interventions that are humane, focused on
understanding the meaningfulness of subjective experience,
and on filling legitimate needs is what we espouse.
Soteria Associates will be glad to be facilitators in so far
as our resources allow.
However, the system will not change without the mobilization
of many voices of angry, disaffected consumers
-- and those who care about them -- collectively directed
to changing the status quo and replacing those
perpetuating it.