New book changes the conversation on mental illness

Capital Times - Opinion

Have you ever wondered what is really involved in protecting you from taking an unsafe or ineffective medication? And, did you know that over 1100 adults and children with mental illness are placed on the government’s disability list each day ---250 of which are children!

There is a new book just out called Anatomy of an Epidemic by Robert Whitaker who brings some fresh light on this subject, and for the first time, looks beyond the drug approval and marketing process and looks squarely at the long-term follow-up effects of the drug industry’s impact on our mental health service system.

Whitaker examines the long-term outcome effectiveness studies of drug-based treatment and compares their effectiveness with non-medication psychosocial treatment, including family counseling, education and various forms of group treatment.

This literature review shows that psychiatric medications have proven their effectiveness for reducing certain serious psychotic symptoms such as anxiety, depression, hallucinations, paranoia and other thought disturbances especially for the serious mentally ill. While these drugs play a critical role in stabilizing patients in the community, Whitaker asks “why then is it that thousands more adults and children are added to the government’s disability rolls each year?”

In addition to the dramatic increase in our disabled population, the studies examined, used a variety of other long-term outcome measures such as length of treatment, and hospital discharge and relapse rates. Finally, drug-based treatment versus non-medication with psychosocial treatment methods, were also compared. Surprisingly, these non-drug therapies were found consistently to produce better long-term results and much less likely to cause chronicity or physical health related problems, than long-term drug-based treatment.

These results are very different than what the pharmaceutical industry and are public media would have us believe. Disability rates for mental illness in 1987 were 1.25 million people (1 in every 184 Americans) receiving disability payments, and by 2007 this figure more than doubled to 3.97 million (now 1 in every 76 Americans). In spite of Prozac and a host of other second generation “miracle” drugs, our serious mentally ill disabled population has soared.

As a former program evaluator for over 30 years and now a patient advocate I would like to recommend that our federal and/or state government mandate and conduct public funded long-term follow-up outcome mental health research studies every decade. This would assist state and local mental health planning groups to operate free from the drug marketers and better avoid the control and influence of special interests groups.

Meanwhile, until this happens, Robert Whitaker’s book, and the extensive long-term outcome study findings contained therein should be at the top of every mental health supporter’s priority reading list. This book will be this century’s definitive source whenever mental health researchers and other stakeholders gather to discuss, and compare, long-term outcome evaluation mental health findings.

Meanwhile planning councils like our own Wisconsin Council on Mental Health need to carefully consider these findings, and reconcile their own future planning and policy recommendation with these new research findings.

(Disclaimer – This writer strongly recommends that any questions that might arise from this article relating to your own particular medical situation be discussed between you and your physician.)

Benedict is a patient advocate.