ablechild/contact us

Submitted for publication in Seattle Post-Intelligencer

Dear editor:

This psychiatrist since 1947, who continues to publish in the field, would like to add his comments on the recent "psychiatric survivors'" Fast for Freedom.. I write also as an ex-mental patient, having been voluntarily hospitalized for three months in 1963 for paranoid schizophrenia,

I welcome the Fast as an effort to call public attention to the immense harm psychiatry has been causing the mentally disabled it is charged with helping. For the disabled patients needing hospitalization, treatment results today are far worse than they were fifty years ago - I did one of the earliest statistical studies. The overall damage psychiatry currently inflicts is vividly depicted in Robert Whitaker's meticulously-documented book, Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Menally Ill.

In 1948, before the drug era, over half of the 2,941 schizophrenic patients admitted for the first time five years earlier to the New York State Hospital system had returned to the community - receiving no governmental benefits. The state then had 14 million people. Recently, with a state population of 18 million, the New York Times discovered some 15,000 mentally crippled hospital dischargees locked away in the back wards of nursing homes - and supported by the government. The half century increase in chronicity, from 1,470 (the half of the 2,941 who remained in hospital) to the 15,000 post-hospital cripples, illutrates some of the harm the system causes.

A similar picture of useless, if not harmful, treatment exists today in Seattle, one of the very few places in America honestly studying the effects of its services. Taxpayer-funded outpatient benefits or residential services are being provided to nearly 7,000 people, most of them on medication. Of this group, 573 improved from "dependent" to "less dependent" status during 2002, 561 went from "less dependent" to "dependent," and five (5!) recovered.

The new mind-impairing psychiatric drugs, and excessive reliance upon them, are the major reasons for these worsening results. The specialty's most effective therapeutic tool, the psychiatrist-patient relationship, has not only been replaced by the drugs, but limiting the psychiatrist's role to the prescribing of drugs has actually destroyed that relationship. The psychotherapy/counseling which patients need most is now provided, if at all, by lower status non-medical professionals who are also charged with ensuring that patients continue taking the drugs which many of them object to. And psychiatrists who don't know the patients retain final word on - and legal responsiblity for - their treatment as a whole. The entire crazy process has been called schizotherapy.

Clear-cut brain changes do occur in Alzheimer's and Parkinson's diseases but not in most of the "disorders" in the American Psychiatric Association's Diagnostic and Statistical Manual. The claim that such brain changes nevertheless occur in most "mental illness" is relatively new - about 30 years old; despite the A.P.A.'s Dr. James Scully, its wide acceptance is due to frequent repetition rather than scientific proof.

The "brain disease" hypothesis of mental illness, against which the hunger strikers were protesting, is, however, of more than academic interest. It fosters the demoralizing belief that these "disorders" are essentially incurable and can, at best, be ameliorated - by drugs. Belief in permanent stigma, and hopelessness, then follow.

While we have long known that a trusted, competent psychiatrist, who remains with the patient from the start of his illness in hospital thru its finish in clinic, may be the best way to help the mentally disabled recover, the provision of public mental health care by a multitude of agencies usually prevents this. How care should be set up is described in my attached, just-published paper, "The Rational Organization of Care for Disabling Psychosis - 'If I Were Commisioner.'" The paper also points out the beneficiaries of today's harmful care system, such as the drug manufacturers, and the opposition which can be expected from them, and from groups such as NAMI which they fund, to setting up care effectively.

If the hunger-strikers succeed in opening widespread public discussion of what today's psychiatry is really doing - which Whitaker describes - the entire country will be in their debt.

Nathaniel S. Lehrman, M.D., 10 Nob Hill Gate, Roslyn NY 11576; 516/626-0238; former Clinical Director, Kingsboro Psychiatric Center, Brooklyn N

<BACK

'01

Web Hosting, Web Marketing, and E-Commerce by Outflow Technologies