madbook ~

PSYCHIATRIC DRUGS
     "Paradoxical effects" | The language of obsfucation is always fascinating | BigPharma and Mental Illness Inc. sometimes use this term when referring to known negative effects | The researchers in the industry know this stuff, they just seem so averse to sharing it | I wonder why?:
Some recent observations

1- The latest issue of Mother Jones describes what happens when the Drug Lords manage the mental health system | Aliah Gleason was a direct victim of the Texas juvenile mental illness promoters | They took her from her family, pumped her full of a polypharma regimen, then kept her from her family |
     Seems that she was lucky | She survived | Some sources indicate that as many as 17,000 kids in Texas are subjected to forced psychiatric drugging |
     Rhetorical question time: Why is it that when the Soviets subjected their citizens to forced drugging it was recognized as torture but here in the USA it's just treatment as usual?

2- FDA Warns Antipsychotic Drugs Dangerous to Elderly The Food and Drug Administration (FDA) issued a public health advisory to alert health care providers, patients, and patient caregivers to new safety information concerning an unapproved (i.e., “off-label”) use of certain drugs called “atypical antipsychotic drugs.” These drugs are approved for the treatment of schizophrenia and mania, but clinical studies of these drugs to treat behavioral disorders in elderly patients with dementia have shown a higher death rate associated with their use compared to patients receiving a placebo (sugar pill).

3- How Bug Spray Works | This is here because of a search I did on "paradoxical effects" of psychiatric medications | The read is interesting and relevant since the article first talks about the brain's neurons communicate with one another, and how drugs affect that communication process |
     Read down and you'll find that a chemical known as Acetylcholine is used by the neurons that control your muscles, heart, and lungs | It is also used by many neurons in the brain that are involved in memory | Acetylcholine crosses the brain synapses and tells the muscles to extend by stimulating the receptor sites on the muscles |
     When nerve signals are terminated this is called “reuptake” | Acetylcholine is rapidly broken down by a chemical called acetylcholinesterase | Have you ever looked at the fine print on a bottle of Prozac, Paxil, or Zoloft? It says in there that the drug is a “selective serotonin reuptake inhibitor” (SSRI) |
     Now, read the fine print on a can of insecticide | For some of them, it says that the active ingredient is an “acetylcholinesterase inhibitor” | So, the same effect that we see with bug spray, can be facilitated by SSRIs | You do the math |
     As an FYI, nicotine directly stimulates acetylcholine receptors | Alzheimer’s disease results when these acetylcholine-using neurons in the brain die | [As an aside, does this new info about bug spray provide us any fresh insights on the actions of former insect exterminatior Tom DeLay?]

4- Consumers Union (publisher of Consumer Reports magazine) is working with Senators Grassley (R-IA) and Dodd (D-CT) in organizing a news conference to introduce their legislation that would create an Independent Office of Drug Safety. This media event may take place as early as tomorrow (Thursday, April 21st).
     They are looking for someone to speak at this news conference from their home states of Connecticut or Iowa that has suffered from, or has loved ones that have suffered from the side effects of prescription drugs, particularly those that have been given media attention lately (Vioxx, Bextra, Neurontin, and SSRIs, like Paxil).
     Information on the importance of this legislation is available here. Please contact Elizabeth Foley soon if you know of anyone that may be interested in working with this.

What got me started on this thread was my frustration with a community-based treatment team who accused one of their clients of "doing cocaine" when what changes they have seen with the guy are the result of the "paradoical effects" of jacking up his anti-depressant prescription | This has occured with him many times over the years, and they never seem to recognize it | Of course, if they didn't keep changing docs every couple of months...

posted by Will Brady @ 12:35 9 comments

SOCIAL JUSTICE | COMBATTING PREJUDICE
The discussion on activism and humam rights continues:
     Elizabeth (and the others who are reading the dialogue):
     Your response is, equally, heard, but it seems the points I try to make are missed. This time, then, I'll try to be more succinct.
     I get a sense that part of this discussion [from comments made both by E A Ricter and David B] that one of the ways to trash psyche survivor movement elder statesmen for the failure of society to listen to what we have been saying for decades | This may be an inaccurate supposition, perhaps, but it one that comes across when reading their comments nevertheless |
      You are quite accurate in identifying that the breadth and spread of influence of the medical model has expanded in those 30 or so year, rather than contracted |
     Yes, there are probably more kids on "Big Pharma cocktails" and the citizenry in general is more apt to run for the quick fix "cures" offered amd promoted by drug companies, social policy planners and the psychiatric industry | But none of these phenomena are the fault of long battling activists who are also psyche survivors [and their supporters] Indeed, some history lessons are in order here |
     Take time to read things like Leonard Roy Frank's books on the history of electroshock, Peter Breggin's books or Ken Kesey's "Cookoo's Nest" | Sit through films like the "Snake Pit" or "Titticut Follies" or meander through the small but growing number of websites that chronicle what life was like in abandoned asylums | If you can find copies, read the mimeographed and photocopied protest newsletters that abounded in the late 1970s and into the 1980s [Alice Earl's Peer Advocate for one] which documented CIA funded projects like MK Ultra and the McGill University sensory deprivation experiments of Ewan Cameron long before the mainstream publishing houses wanted to touch the stories | And take the time to look for more obscure tones like Edward Pinnell's The Witnesses [England 1940s] or Barbara O'Brien's "Operators and Things" | The latter two books witnessing abuse or ethical breaches written by people who were not connected with movements yet who spoke in hauntingly true tones of situations before drugs, and equally barbaric and morally corrupt |
     What I'm getting at here is that the social injustices that Elizabeth's "70%" have been exposed to has been going on for ~ not just decades, but centuries | I can assure you, once you read our history, you will walk away with the knowledge that there has NEVER been much of any
     >"... real attempt to identify the social and familial issues
     > underlying an emotional crisis, merely a superficial
     > focus on behavior..."
Perhaps the only difference between then and now is that adverse effects of
massive dosings of modern day psyche drugs are less visible than, say, insulin shock wards, camisoles, ice baths and body bags | Not much of a difference, really, I'm afraid to say |
     And I would be careful about being
     >"...far more concerned about these people whose lives are being destroyed
     > and mangled than I am about the minority who actually might be said to
     > have some differences that make it extremely difficult for them to
     > fit in socially..."
The other 30 % ~ that minority ~ also have feelings, experience pain and suffering and are just as ~ hell, even MORE susceptible to mistreatment, abuse and, yes, at times, torture, than the remaining majority | Perhaps, perversely, exposing that other 70% to the horrors of the coercive and destructive power of the psychiatric / mind control industry, is actually a good thing; if nothing else, those who survive it have gone away and been damned angry about what happened to them, and speak out |
     I'll caution the newbie psyche survivor activist, however, that for every one or two you meet who has been fighting this fight for decades, there are LEGION who start out as activists and once settled in and away from the immediacy of their ordeals, fade into the woodwork of the larger culture, and stop speaking out directly | I can't say I blame them | Life is much less complicated that way | Being an activist in this kind of movement takes a toll on you physically, spiritually and psychially | Friends and family who don't have like experiences seldom put up with our "obsessions" and are every bit as likely to dismiss or disparage our anger and ire as those who KNOW the message about psychiatric oppression is a true one, a valid one | And, I ask you, how many people honestly would remain dedicated to fighting a battle that is, at times, as elusive as the sources of unseen voices that some here but no one else recognizes |
     It is disappointing ~ disappointing and hurtful ~ to read someone who actually writes a statement that they are less concerned
     >"...about the minority who actually might be said to have some
     > differences that make it extremely difficult for them to fit in socially."
My point was not about having difficulty "fitting in" | My point was that we measure the quality of the entire society by how the society treats its most ignored, it's most reviled, it's most pitied |
     A little personal point here | I work as a human rights activist in a locale where ~ daily ~ I enter into a maximum security psychiatric facility | There are many folks there who, given the present political and social climate in the USA ~ even in a "blue state" are unlikely to ever be released from the place unless being transferred to one of a similar nature | Some are there simply for the "crime" of attempting suicide or who had too many brushes with the law concerning street drug activities | Some suffer from the social maladies of illiteracy or
life long institutionalization [and yet, still under the age of 35] The facility
where I spend a greater part of my time arguing for basic rights to be recognized
is but one of many | They are only the more restrictive end of the spectrum of
"services" provided to society by the mental illness industry | Do-gooders and
angry activists outside of these kinds of places, rarely, if ever, step into
them, much less ask about the goings on of such places |
     In context, when listening to others, relatively new in the movement for fighting for human rights in the psychiatric / mind control microcosm, I want to be clear that my earlier rant today was not just a "...concern about fragmentation of the movement..." | It's much broader than that, much broader | See, I've watched the folks come and go, earnest and angry, critical and disparaging and uncomfortable being seen with the "low functioning droolers" who hang outside psycho-social club houses or in hospital day rooms | And later on, they go away, perhaps having secured some position in a cushy non-profit who hires them on as their token crazy person staffer ~ serving as a gadfly and keeping the rest of the staff at
least minimally honest ...but they never got it | They never, ever saw that ~
once they were away from their "unnecessary suffering" ~ that their walking away
didn't eliminate the suffering machine | And without simultaneously creating real
alternatives for the folks who truly do suffer [yet who DO NOT LACK UNDERSTANDING
OF THIS FACT] while railing against the larger social injustices that allow that
suffering machine to remain in toto, then it will always be there, dark,
brooding, lurking in the background, ever ready to take you again, only the next
time, maybe to never spit you out like it did the last time |
     Dismissing the suffering of those who were suffering before they ever went into such a system, is as bad as thinking the plantation system was alright, because the fair skinned negroes got to read and write and stay in the big house | As long as the system exists, we are all low functioning individuals |
     Welcome to the real world of social justice activism in the 21st Century | Get used to it | We have a LOT of work to do, and it's possible we might not see it all done within our own lifetimes | I hope that we will, but we have to be prepared to pass the torch along to other valiant souls 30 years from now |

posted by Will Brady @ 22:36 7 comments

MAINTAINING IDEOLOGICAL PURITY
Some people, when involved in social movements, get unduly preoccupied with how "pure" their point of view has to be |
     The following blocked quote is my response to a writer in one of many groups I sit in on but don't generally make comment | It's a "mental health/psychiatric surviors" discussion group | He questioned which was more important, combatting the myth of mental illness -or- seeking an end to the stigma against mental illness by pursuing equality through "empowerment" tools | The questioner was quick to criticize one social / human rights activist in particular | A statement was made that "...the notion of “stigma” and the efforts to combat it operates from the assumption that mental illness is a real entity which sits in a biomedical view of the world." | Personally, I find this premise as absurd as saying that prejudice against racial minorities is an artificial construct [something I do not believe] So, for once, I was prodded to respond | Here's my rant:

Elizabeth has asked our thoughts of a member's point of view that contrasted empowerment/stigma busting with [to oversimplify] the premise that there is "no such thing as mental illness" |
     Without making contrast, I felt compelled to respond with commenter's line of discussion by asking my own questions:
          1- Are there proper degrees of ideological "purity" and
          2- is there no such thing as Prejudice?
     However well meant, David comments lead down the road that has marginalized those esposuing causes for social justice for the past 30 years.
     One can try to be "purer" than everybody else, only to find that no one hears what one has to say.
     I've been familiar with Mind Freedom [as Dendron] since the 1980s. I find that it's a bit of a stretch to classify D. Oaks and other human rights activists of his calibre (and integrity) as siding with those who placidly go with the "broken brain" psychobabble perspective.
     Going the route of find the "purest group" ideologically seems, [no disrespect meant] an exercise in idle navel-gazing and an unproductive one at that.
     Each and every person who is now fighting for Human Rights comes from a different starting point. The psyche survivor movement is but a part of that fight for human rights, albeit the seat from where those on this group come to the table from | But when fighting for justice, a narrow perspective doesn't run the show | Those varied perspectives must be taken into account |
     The ability to interact with people of varying viewpoints, and to find some common point at which to work, seems more important than sitting back and waiting for everyone to convert to any one particular point of view.
     Human history will, ultimately, decide who and what was right and accurate. Those of us living with a segment of that history in our face, if we are honest, lack the ability to determine those things. Working with one another to acheive commn goals against oppression, whatever one chooses to call it, is more important than holding out until one's personal philosophical slant is dominant.
     So others have some idea where I'm coming from ~ it's absurd to deny that individual human beings never personally live with cognitive, perceptual intellectual, spiritual or psychic realities that are so much at variance with others than they would not be deemed irregular from the mass of humanity | If one wants to call these kinds of variants "menal illnesses" well, they will call then so anyway, regardless of one's dislike of the concept | If a person is living with such variants and he or she can manage in life without society coming to lock-em away, so much the better |
     But there are some who find such variant ways of seeing the world so disturbing as to cause them, individually, to freeze and become unable to function even to care for basic food/clothing/shelter needs. And when this occurs, the rest of us must step up to assist and provide solace and support.
     Society around the world has differing responses to this when it occurs | Most categorize and, yes, sitgmatize, those who experience those troubling realities |
     It is just as troubling to me to have someone deny these experiences as it is for me to see people being forced medicated, electroshocked, denied housing, food, dignity and, yes, stimatized for living an interior life so apart from those around them that what most of us recognize as a common socialy reality is -essentially- something alien and strange and disturbing.
     A "no-mental illness"-style purist, [any, ideological purist for that matter] in my own experience, can be just as heartless and uncaring as the folk who rush too quickly, for the blister packs of Risperidone, Abilify, Haldol, the ECT switch or forced institutionalization |
     We need to work together, not splinter into so many groups that our efforts are rendered ineffective | When that happens, then the Fuller Torreys, Sally Satels and Dr. Finks of the world have won | At least for the short term, in taking this rarefied stance, humanity continues to lose |
     As to minimizing combatting "Stigma" lets call it for what it is | Prejudice | Bigotry | Pure and simple | I challenge anyone who says that combatting stigma is just caving into the whims of the powerful | Replace the word Stigma with Prejudice or Bigotry and the comment becomes absurd | If one person focuses combatting prejudice rather than on promoting some other equally important point to address doesn't lessen the importance of the other point, it shows us what part of the larger battlefront that person is fighting on |
     And I must take issue with the statement that "...the human rights violations perpetrated by the psychiatric assault of labels and toxins is weakened - if not lost - when combined with consumer rights, ADA and pro-choice messages..."
     Take heed in the fact that the Amercians with Disabilities Act [for example] is NOT about accomodating to oppressors, but is a complex tool to force oppressive people to OBEY THE LAW about equal rights for all | And it was a set of laws gained by fighting for them, a fight that continues today | But...that a different discussion altogether |
     Hark back to my comments about personal cognitive or perceptual realities that some find disturbing. We all know people who haev been unjustly forced into "treatment" when nothing was wrong with them expect (perhaps) they lived in controlling oppressive families or groups, or that they were inarticulate in their discontent, but the experience of someone wrongefully incarcerated and forceby drugged, does NOT mean that the experiences of a man with a seizure disorder, or the troublesome and persistent psychic companionship of voices who drone on about a person's valuelessness or calling to disbelief everything around them, is something that the experiencer should just leave alone and try as best they can to ignore.
     Even if the premise for putting people on those drugs is not real [as the original author supposes] living with the long term and ongoing effect of being legally addicted to potent drugs that directly affect both the chemical and electrical operational components of the human brain is also real | Having one's cognitive, intellectual and physical abilities impaired by those drugs is real | The system, and psychiatry and society [by not questioning the practices] did this to people. Wishing this long history of oppression away because one doesn't like the fact that people are doing this does NOT help those now trapped in it |
     Each person's life experience is valid ~ and this includes troubling non-visible stimuli [something I suppose that the questioner has never experienced ...I hope he never has to] For any of us ~ using the premise of some vauge ideological purity based on one's own very personal and hence, limited [from a global sence] perspective as the sole rallying point of a movement is naive at best, and as arrogant as the war profiteers running the world these day at worst.
     To the poster, give it a rest | We all have to work together | Psychiatric labeling is real because it is with us | This doesn't make it valid; we continue to agree on this point, that writer and I | Prejudice, however, is also with us as are the lost opportunities, the discrimination in housing, employment and recognition as equal human beings | Even the fact that for some, the ability to travel to some places from the United States, IS A REALITY to some of those who have been labeled for years and who are still stuck in the system |
     When you walk away from the philosophical table or choose to ignore the DAY TO DAY DIRECT IMPACT of the actions of those in power on those long oppressed before become a latter day ideologiocal purist, you then commit yourself to the same blind path that Big Pharma and the powerful has committed itself to |
     Sorry. It's a messy package. But it's the whole thing that must be combatted and addressed. Not just the part that means sitting around tables full of books and meeting halls so you can look down from on high at the "deluded" who are merely fighting for their rights, which includes, the right to not be discriminated against because of deep seated prejudices and fears; fears that go far beyond the sphere of psychiatry and which permeate society in places that don't even realize or know about the profound influence of the social control freaks currently running the stage that is the world |

Sorry for the length of the rant | Hope my point has been made |

posted by Will Brady @ 14:33 1 comments

SOCIAL MENTAL ILLNESS
Although the State of Connecticut, under chief thief John Rowland, was capable of shoving through a $229 million dollar gift to ENRON weeks before it went bankrupt, it appears that same state is unable or unwilling to pay state pharmacies on time to ensure that clients on Title 19 get their medications as prescribed |
     I try not to burden my state legislators with case-by-case problems of clients but one that came to light this morning is particularly disturbing. Moreover, it sounds as if it might have much larger ramifications |
     This morning -at home- I got a phone call from a man on the other side of the state, distraught after being told by his Assertive Community Treatment [ACT]^* team nurse that he didn't have any medications for the weekend | After a couple of phone calls I learned that the pharmacy owner was refusing to provide any meds to clients whose pharmachy bills the state has gotten behind in paying the pharmacy bills | In this man's situation the bill amounts to some $2,000 (approximately). I've no idea how many other clients are so adversely impacted |
     While on the pharmacist's part, I can understand his frustration at not being paid, it seems inconscionable to deprive people of prescribed medications, I also know this problem [i.e.pharmacies not getting paid] is not a new one. I'm not certain which is the culprit, but just because Connecticut's Department of Administrative Services [or the Office of Policy + Management] can't get it's act together to pay vendors in a timely manner doesn't mean the state's most fragile should be punished |
     In this specific situation, I'm trying to work out with the pharmacist, by phone, so the man to get his weekend's work of medications and hope that this could get resolved on Monday | And just for the record I also took the time to raise the question to one of the legislators on the Public Health Committee |

posted by Will Brady @ 11:35 5 comments

HOSPITAL LIFE
My first visit to see someone in the mental hospital, in 1982, was difficult | I'd gone to visit a friend who'd only recently been admitted | I didn't have any idea what to expect |
     To make matters worse, I'd worked third shift, had been up most of the day running errands and chores, and was tired | I still had to go home to at least take a nap before starting the work cycle all over again |
     Visiting hours were very unstructured | All visits took place in a large common room where people were aimlessly shuffling about, others reading, someone else was on the pay phone | A group of four men sat at a table rolling cigarettes from loose tobacco with a large rolling device that sat on the table | A visitor could, if he wished, stay all day | Just make sure you don't lose that visitor's badge, a flimsy piece of stick-on paper upon which you'd written your name | When you tired of visiting, you'd just get up and ask one of the staff to let you back downstairs |
     It was not a good visit | I'd brought him what he'd asked for but he was off, upset, angry and not focused | I stayed until my friend got up and walked off, and just didn't return to where we were sitting | So I got up and asked to leave |
     Ward staff let me out the door by the elevators | While the door to the elevator was wide open, staff neglected to tell me I'd need to be "keyed" to get down and out the building | I waited about 10 minutes before anyone came by | Finally, a gruff, gnarled sour-faced man came down the hall, got into the elevator car, turned the key in the slot, and we headed down | The car started on it's very slow trajectory down four floors to the lobby |
     I must have sighed audibly, or made some other sound, for the man turned to me and said "Rough day, huh?" | I acknowledged that it was | Then, without so much as a scintilla of further discussion he said [or thought] aloud, "Yeah, that's the problem with this place" |
Curious, I asked, "What's that?" |
     This time he sighed. "They don't let us put them in restraints as much any more" |
     "Ahh!" I responded, almost grunting | There were three more flights to descend | I didn't know this man from Adam, but it was clear he wanted me to know with what degree of seriousness he took his job | I didn't know it at the time, because I was wondering what he'd do if I paniced while alone in the slow moving car with him, but that chance encounter started me on the career path I continue to follow today |
     Fighting for patients' rights |

posted by Will Brady @ 02:31 0 comments

BE PREPARED
Ideas for checking in the hospital: | Last week Ian found himself in a horrible state | He's doing somewhat better now | During the process he wrote this collection of sage suggestions |

     DISTRIBUTE FREELY DO NOT ALTER

     1)  If ya gotta go now, then go!  But, if ya don't, then here are some things to think about:
     2)  Try to wrap things up.  Things like, bills, pets, mail, etc. What you can't do before you leave, you may be able to do by phone.  A cell phone is helpful here. So is a friend.  Wards also usually have payphones (see #3 and #4 and remember to bring change). You may want to ask a friend to be your point of contact, a sort of filter between you and the outside world.  Try to select a person you can trust with the more personal aspects of your life for you never know what you may need from them.  If you need to and you are able, designate different people to handle the aspects of your life for which they are best suited.
     3)  Pack smart.  Number 1 item: shower shoes.  (You’ll thank me later).  Bring at least 24 hours worth of meds along with a complete list of all of the meds you take (dosage, # times/day & time of day). Pack things like toiletries, comfortable clothes, undies & socks (shower shoes can be used as slippers) and your cell phone w/charger (the phone is usually left with the staff, so turn it off and use it when you want to get your messages or call out).  Include a list of important phone numbers as well as money (no more than $20 and keep it in small bills w/some change as well), writing material, stamps & envelopes, books, etc.  Don't take anything you're not willing to lose. A "ready bag" can be packed in advance (this list is coming soon).
     4)  Make sure you have access to a phone.  This is your contact with the outside world, your voice.  It is important to stay in touch with your therapist (if you have one, otherwise, read the last half of idea #5, "it's never too late") and friends (idea #2).  Most wards have a phone but you may needs lots of change or a prepaid calling card, there are usually limits on time and important messages are often not received.  A cell phone w/charger is your best bet (idea #3).
     5)  Use your Therapist.  Clue them in to your status, THEY WORK FOR YOU.  Discuss what hospitals or programs are available, and have them use their connections and familiarity with the system to find the best place for you.  If you don't have a therapist, it's never too late.  Here's what I do:  get out the Yellow Pages, dial the therapists that appeal to me, listen to their message and decide from there (You can tell a lot from a message).  Most will negotiate fees and nearly all will help when you really need it.
     6)  The day of the week is important.  Staff is not usually on duty on weekends and holidays.  These are "sit and wait" days.  Even on days when staff is present there's still lots of free time, and then there are the nights.  Plan to occupy yourself (see #3).
     7) CALL AHEAD. Have a therapist or doctor (even a medical doctor, social worker or, in a pinch, a friend you trust to speak for you) call psych staff to lay the ground work for your arrival (see #5).  This is like instant credibility with the staff - you are "represented".  This is also a good opportunity for your doctor to explain your situation to the staff, saving you time and precious effort and laying the foundation for a more productive stay.
     8)  Never go in high or drunk if at all possible.  Your words will be discounted and thus you will lose your ability to negotiate (see #9).  Find a part of the day when you are usually straight (first thing after waking) and go then.  Coordinate with a professional.  (See # 7 and #5).     9)  Negotiate.  Think about the things that would make your stay more comfortable and productive and ask for them.  Discuss this with your therapist beforehand (Important: see #7 and #5).  A calm voice and some eye contact are helpful.  Remember, breathe and take your time.
     10)  If you have a hard time expressing yourself, write down the things you want to negotiate for and take the paper with you.  This is a good place to record your needs and goals, triggers and fears, and what are the best ways (and worst) to communicate and work with you.  This can guide staff in your treatment and prevent them from inadvertently hurting you.  Most of this can often be written in advance and kept in your "ready bag" (see #3).
     11)  Rules of engagement.  Don't swear if you can help it.  Staff need to know if you are potentially violent and swearing is one of the first signs of escalation (Remember, they need to feel safe too and protect the rest of the people on the ward.).  Pay attention to your posture and speech.  Even though you may be afraid, resist the temptation to look and act tough.  This can be perceived as potentially violent.  If you fear you are feeling violent, tell the staff and negotiate for your safety (#’s 9, 7 and 8).
     12)  You have rights.  For instance, you have the right to refuse visitors and phone calls (If this is a potential issue, notify staff as early as possible).  You also have the right to refuse medication (Try to use good judgment, meds can help you). IF YOU BRING YOUR OWN MEDS DON'T be surprised if they try to take away your meds and re-prescribe you their own. It may be reasonably argued that they are bound to do this by law or regulation. Look for posters and bulletin boards, they will inform you of your rights and give you the names and phone numbers of people to contact if you have questions or problems (Again, judgment is crucial here.  These folks are often overwhelmed with petty complaints. Pick your battles wisely.).  See # 4.
     Gods bless all of you brave, intrepid souls who take that terrifying leap. They know not of your courage or inner strength.
     JRG © 2004 comments/suggestions twoshadows@verizon.net

posted by Will Brady @ 08:10 4 comments

DRUG WARS || MENTAL HEALTH
The cozy bed of politics and medicine | I hand over this entry to Stefan Kruszewski:

     Medicine and politics are obligatory companions, as inseparable as tea and biscuits. Although academic reactionaries and purists may argue that medicine should not be tainted by political agendas, rarely has this been, or is it, reality. (1)
     Medicine--as practiced in times and regions as diverse as pre- Christian Hippocrates, Freud’s Vienna or Massachusetts’s Back Bay--invokes relationships, all of them illustrating a political connectedness to governing authorities.
     When I hear fellow Pennsylvania physicians speak of politics in medicine, the substance often reflects those controversies that attract media scrutiny and hefty emotional responses: Fee-for-service vs. managed care reimbursements, Darwinian evolution vs. creationism, stem cell research vs. right-to-life arguments, clean needles for IV drug users vs. moral objections, and/or financial support for AIDS prevention and treatment vs. financial resources allocated elsewhere. However riveting are those arguments, it is the day-to-day interrelationship of politics and medicine---those that border on the mundane—that cement the relationship. The existence of that bond makes the case, at least for me, that our relationships to, and with, governing bodies are fundamental to medicine and therefore critical to medical reporting. (2)
     In psychiatric medicine, the evolution of this interrelationship, particularly as it pertains to 19th and 20th century U.S. federal and state policies, is highlighted by involuntary commitment, deinstitutionalization, Federal, State and private sector funding sources, psychiatric epidemiology and pharmacoepidemiology(3).
     As is true of both psychiatric and non-psychiatric medicine, our profession in Pennsylvania is licensed by authorization of the Department of State. The Secretary of State is an official appointment of the elected Governor. The regulatory oversight and management of conduct for practitioners of the healing arts (including medicine, dentistry, veterinary, podiatry, nursing, etc) is defined by Pennsylvania Code (applicable laws of Pennsylvania) as well as federal and local/community standards. Similar laws and standards define the compensation for our services from federal programs (Medicare), federally-subsidized state programs (Medicaid) and from private insurers who are under State and Federal licensing and regulation.
     Medical practitioners prescribe within the directives and guidelines of the Federal Drug Enforcement Agency (DEA) and, where applicable, individual state agencies that monitor controlled substances. (Not all US states have separate registries for controlled substances; Pennsylvania is one that does not.)
Like its counterparts in the UK(MHRA, NPSA; others), our pharmaceutical and therapeutic prescribing habits have Federal watchdogs, including the U.S. Food and Drug Administration, multiple collateral advisory committees and Federally-funded programs that assist the process of research and information dissemination (National Institute of Health/National Institute of Mental Health/Substance Abuse and Mental Health Services Administration: NIH/NIMH/SAMHSA; others.)
     The American Psychiatric Association (APA) and its collaborative organizations devote a prodigious effort to legislative and political agenda. The current APA website’s Homepage highlights three “front and center” advocacy items: Endorsement of recent Congressional passage of an $83 million dollar ‘Suicide Prevention Bill’, and two subsequent links to the APA Advocacy Action Center and APAPAC, both sites that promote lobbying efforts on behalf of APA’s constituency. (4)
     Oversight regulation, advocacy and legislative agendas, investigatory and legal mandates underscore medicine’s inseparable coexistence with politics. With issues of medical record confidentiality, academic research freedoms, parity, tort reform, the involuntary commitment of individuals, the duty to warn, the continued evolution of Lyndon Johnson’s Community Mental Health Act of 1965 or George W. Bush’s New Freedom Commission’s recommendation to screen American’s youth for psychiatric disease, psychiatry is as much about legal and political agendas as it is about mental illness and mental health.
     Whether the issues pertain to psychiatry or non-psychiatric medicine, it is crucial for journals to discuss political trends and counter-trends in medicine---just as it is expected that they deliberate the epidemiology and pathophysiology of heart disease, cancer or schizophrenia. Medical journals and physicians would be well served, I believe, by confronting-- not denying--the issues and the political forces that shape them.

[published : 10 nov 2004 as "The Inseparability of Medicine and Politics"; British Medical Journal | My readers might also want to look at the article that calls for greater scrutiny of the use of psychiatric medications to determine their adverse "side effects"]

posted by Will Brady @ 08:34 1 comments