Presentation to the Wisconsin Council Mental Health’s Legislative and Policy Committee

January 13, 2011

First, a brief update re my letter to the Secretary of the Department of Health

First, let me begin by saying how pleased I was to learn that your Committee was chosen to consider my recommendation and to report back your findings to the Council. I thank you and I am so pleased to be here this afternoon.

On July 23, 2010 I wrote a letter to the Secretary of the Wisconsin Department Health, Ms. Karen E. Timberlake. In this letter I briefly shared my professional qualifications and experience relating to evidenced-based, long-term mental health outcome studies. I noted that in spite of this professional training and some thirty years of experience, Robert Whitaker’s latest book, Anatomy of An Epidemic, shocked and surprised me (For the full text of the letter, including my recommendation for action, to the Secretary, please see my blog: Danecountyalmanac.blogspot.com).

In this book, for the first time, Whitaker brings into public view over fifty evidenced-based and scientific long-term mental health outcome studies about what actually occurs to those treated for mental illness in the United States. This story is quite different than what the public media has given us until now. This story is framed from dozens of archival scientific mental health research studies beginning in the 1950s to the present. They are cogently summarized and documented (See Chapter 6: A Paradox Revealed).

Because Whitaker tells his story through the prism of evidenced based scientific long-term mental health outcome results, this Legislative and Policy Committee can draw its own conclusions about these studies, including your recommendations regarding their implication for Wisconsin’s mental health program. Based upon these scientific studies Whitaker asked and chose to write about some of the following questions:

“During the past fifty years when investigators looked at how psychiatric drugs affected long-term outcomes, what did they find? Did they discover that the drugs help people stay well? Function better? Enjoy good physical health? And, are long-term recovery rates higher for medicated or un-medicated patients with serious mental health disorders?

I am convinced that Robert Whitaker’s book will be this century’s definitive
evidenced-based repository and source when people gather to discuss long-term outcome evaluation studies.

I believe that with your help, that hereafter mental health researchers and other stakeholders will use and refer to this text whenever they turn their attention to the latest scientific findings having to do with long-term mental health outcome study findings. Hereafter when ever questions of long-term treatment efficacy are raised in mental health care, researchers and administrators, and all stakeholders, the world over, will turn to Whitaker’s book. Certainly most of us are aware that Wisconsin has led the country in timely patient-centered mental health reform in the past.

Because I feel so strongly about this, I have requested that Wisconsin’s Council on Mental Health become informed of this long-term evidenced-based information and reconcile them with existing practice and funding policies and with their future long-range planning for this state’s mental health system.

To continue as usual in the face of the overwhelming evidenced contained in these scientific long-term outcome studies would be ethically and professionally irresponsible. These evidenced-based outcome study findings demand that all mental health stakeholders, but especially this citizen council, our Governor’s oversight body, carefully consider these findings and document their own findings and recommendations in response to their own study of these study findings.

Most of all, each day that mental health stakeholders delay in informing themselves regarding these latest scientific findings is another day wasted before we reexamine our present care and treatment practices and funding policies against these latest research findings.

As a patient advocate what also concerns me most is that we can no longer continue to follow treatment practices as usual if we find this evidence to be compelling and actionable.

Finally what are we going to say to our youngest mentally ill patients, when and if, they discover down the road that this long-term information existed, and that we should have acted on it on their behalf but failed to do so, way back in year 2011?

What are we going to tell patients and suffering families with mental illness who depend on us and trust us to be aware, informed, honest, upfront and transparent about these latest scientific long-term research findings, if they later prove to be fundamentally true?

I am optimistic however that here in Wisconsin, we will not be too busy, too proud or complacent or too invested in the status quo to consider alternatives, if in deed, we find these long-term evidence-based findings should point in that direction.

Thank you again so much for allowing me to talk with you today. I hope we still have a few minutes for your questions or comments.

Respectfully, William R. Benedict

(For more about this presenter’s evaluation work, see “Goal Attainment Scaling: Applications, Theory, and Measurement”, Mental Health and Social Service Applications, p. 81-104 which was edited by Thomas M. Kiresuk, Aaron Smith and Joseph E. Cardillo.)

To access all the documents to date regarding this mental health reform project,
see this writer’s blog: danecountyalmanac.blogspot.com