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February 6, 2018 by Bob Nikkel, MSW

What Would a Truly Integrated System of Care Look Like?

Imagine that you were the director of a health insurance company and you had just agreed to provide health coverage to several hundred thousand people and you will have to fund health care including mental health and alcohol/drug care too.  This is called “integration.”

What it means financially is that you will lose a lot of money if you ignore the physical health needs of people with mental health problems.  In the parlance of insurance folks, you’re “at risk.”

Now, someone walks into your office and tells you that about a quarter to a third of the people you’ve just signed up to serve are being poisoned but no one really knows about it or recognizes it.  If it’s true, you stand to lose a lot of money unless you figure out what’s going on.  And what if they also tell you that the poisoning is not some form of environmental pollution like smoky air or unclean water but is actually being caused by the very providers of health and mental health that you’re about to be supporting?

Since you’ve been in the health insurance business for a while, you recognize that in western medicine, almost everything that’s provided is some form of mutilation, i.e. surgery, or poisoning, i.e. medications.  (Please note that if you’re a physician and reading this and taking some level of offense, the recognition I just pointed to was made by a physician, a well-respected one at that and he meant no offense, nor do I – just a simple way of thinking about things and the key question is whether the risks outweigh the benefits or vice versa.)

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January 11, 2018 by Sami Timimi, MD

The Scientism of Psychiatry

Psychiatry likes to portray itself as a scientific discipline, and indeed there is a lot of useful science to draw on when evaluating the evidence base connected to mental health problems, its causes and treatments. Sadly, most of the mainstream psychiatric literature of recent decades has shown a marked preference for rhetoric over scientific accuracy. Research and discourse in psychiatry are now dominated and infected by scientism — the promotion of a belief, sometimes intentionally, sometimes not, that because what you do and talk about sounds and looks like ‘science,’ it is ‘scientific’ — rather than a rational engagement with the nature and consequences of the actual scientific findings.

This scientism has sometimes scared critics from engagement with the actual science in preference of critiquing the suitability of using scientific reasoning to understand what we today define as ‘mental health.’ Opening the lid on both issues (the lack of engagement with the actual scientific findings and the suitability of using particular scientific methods for all knowledge generation) is important. We must endeavour to make transparent the grand deception that organisations such as the one I belong to (the British Royal College of Psychiatrists) are selling to the public about the nature of what we have come to call ‘mental illness,’ its causes, its treatments, and the way we should organise services to help those who become mentally unwell.

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January 1, 2018 by Gina Nikkel, PhD

Happy New Year!

Wishing you many blessings in 2018, the happiness you deserve, and challenges removed from your path! May we all approach 2018 with gratitude for what we have and the tenacity to improve the world we live in.

Here at The Foundation for Excellence in Mental Health Care we are most grateful for all the projects and research being funded by you, our donors. It is these very projects that are helping to improve the world we live in by affecting access to recovery-based programs and research knowledge to help people make more informed choices for their own mental health.

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December 11, 2017 by Bob Nikkel, MSW

How Would We Know If We Really Reformed the Mental Health System?

This post updated 12/28/2017

I have been wondering for some time how we would know if the mental health systems in the United States were really reformed.  It is true that there are “a thousand points of light,” many great new and older programs and initiatives out there with tremendous advocacy and efforts at radical change.  But when a system leaves so many without recovery-oriented supports, it is like swimming upstream against a powerful current.  Here are 25 indicators that if fully implemented would represent a complete system reform.

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November 16, 2017 by Berta Britz

Another Story

Acting like a “nice, compliant” individual has seriously harmed me for most of my 67 years.  Due to my economic privilege, I received the best medical and psychiatric treatment available and, for most of those years, I accepted the “official” narrative, the dominant explanation for my ongoing suffering.  That narrative is a limiting belief that harmed me and continues to damage all of us—not just we who have been diagnosed, but entire societies.

Many people identify the proliferation of psychiatric drugs as the root of our harm.  I see neuroleptic drug use not as the root but as the fruit of the destructive narrative upon which most of our industrialized, “developed,” societies depend.  And without deep transformative change, the damage from that dependence may be irreparable.

The people I depended on as an infant and young child did and said things that both helped and harmed me.  My early life felt confusing and terrifying, and it was my connection with animals that sustained me.  I lacked basic trust and hid my vulnerability. 

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November 13, 2017 by Sandra Steingard, MD

Duration of Untreated Psychosis Revisited: Response to the Goff Paper

Earlier this year, the American Journal of Psychiatry published a paper, “The Long-Term Effects of Antipsychotic Medications on Clinical Course in Schizophrenia.” This was a response to the concerns that have been raised that these drugs negatively impact long-term outcomes. The authors conclude, albeit in a somewhat lukewarm way, that overall, the “evidence for a negative long-term effect of initial or maintenance antipsychotic treatment is not compelling.” Robert Whitaker and Joanna Moncrieff, whose work was cited by the authors, have written critiques of this paper.

Even if one accepts the paper’s conclusions at face value, there is little argument regarding some serious long-term risks such as movement disorders and weight gain. One of the most compelling reasons why these authors support long-term care is related to the relapse data: when one is started on these drugs, the relapse rate is higher when they are stopped than when they are continued (at least over the first two years). However, there is general consensus that there are some individuals who will recover and not need medications long-term. In fact, there is even consensus that some can recover without drugs; the dispute is over numbers.

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October 30, 2017 by Bonnie Kaplan, PhD

Are We Treating Mental Disorders or Suboptimal Nutrition?

Lecture to the May 2017 Nutrition and Health Conference at the University of Arizona’s Center for Integrative Medicine

NutritionFundVideo

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October 7, 2017 by Bob Nikkel, MSW

The Continuing Education Course on Withdrawal from Psychiatric Drugs is Here!

At the beginning of September, I wrote about the next stage of the Mad in America Continuing Education project—the development of webinar formats and I announced the planning for a “course” on withdrawal from psychiatric medications.  At that time, I was able to provide only introductory information but now I can provide a full picture of the 7 webinars that comprise the course and update a few other developments.

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October 4, 2017 by Lauren Spiro

Finding our way back again, the cure for isolation and its ills

Massive doses of human connection are needed to counter the alienating influence of technology, disruption of the village and a growing culture of isolation.

I remind myself often how wonderful it is to notice the wealth of resource and intelligence that is all around us. I just left the gym where I watch CNN (while on the treadmill) and I go from the devastation of Puerto Rico to the massacre in Las Vegas and then read an entrepreneurial magazine in the lobby.

Club Business International’s October 2017 publication stated, “When I [the editor of CBI] asked the U.S. Surgeon General Vivek Murphy what was the biggest disease in America today, without hesitation, he answered, ‘It’s not cancer, It’s not heart disease, It’s isolation.’”

One of the results of the incessant technological assault, observes Murphy, “is the pronounced isolation that so many people are experiencing that is the great pathology of our lives today.” The Editors note continues, “International Health, Racquet & Sportsclub Associate Chairperson Derek Gallup counsels, ‘Certainly, continue your search for technological solutions, but, as you do so, remain constantly focused on the all-important human element. In the final analysis, your members, and how they feel about them selves and the team members- those are the critical factors that, ultimately, will determine whether your business grows and thrives… or doesn’t.’”

The Editorial also points out that Thomas L. Friedman, Pulitzer prize-winning author and journalist with The New York Times, states “How ironic, we are the most technologically connected generation in human history- and yet more people feel more isolated than ever. The connections that matter most and that are most in short supply today are the human-to-human ones.”

Personally, I am hopeful. More and more people globally are waking up and re-connecting with our shared humanity and a shared vision of a peaceful and collaborative world. Currently in the U.S. however, a great divide appears to be growing, where we see an acceleration of the breakdown of our social structure and our community infrastructure.

Unsustainable systems are collapsing and something new, hopeful, empowering and global is in the process of emerging. It seems that we need to collectively burn through some darkness before we collectively see the light. Lately, there seems to be a growing isolation and war-like posturing. Let’s shift gears and focus on a hopeful antidote that everyone can apply.

 

World peace begins with me
Human beings have been making war for a long time in many cultures, meaning in many minds, because the culture is a reflection of the mind.

I am coming to a clearer understanding that when I am not at peace in my own mind, I am waging an internal war and that war is projected onto others whether I am aware of it or not.

The war in my head can be framed around a variety of battles – it can be framed around the ancient and false belief that I am not good enough or smart enough, or if that other person would do something well or if this condition or that condition were met – then all would be worked out and peaceful. I have constructed a story that tints the lens through which I see myself, others, our relationships, and the world.

If I remain unaware of how I have tinted the lens, and I remain stuck in the story, the conditions for peace will not be met. Peace is revealed in the absence of war – in the absence of isolation, separation, judgments, and conditions.

If we take another step deeper, we can see that the source of this war comes from the belief that we are some thing that is separate from others. This early learning, this sense of separation and human disconnection, is so pervasive and integrated into the threads of our culture that it makes it hard to see.

This experience of human disconnection, a separation of self from self and self from others, is a fundamental concept in both trauma-informed practice and in Emotional CPR (eCPR), www.emotional-cpr.org. The impact of trauma and human disconnection played out in my own early childhood, for example, by my experiencing such a profound lack of safety that it resulted in my clinging to anyone who offered safety and anything that could numb the pain.

Another result of the belief that we are some thing and this thing is separate from each other is that we get focused on protecting this thing. Whatever the thing is – our territory, our home, our family – we protect it and hold on to fear, and anger and revenge, and we wait for someone else to do something differently so that we think we can find peace.

Our tinted lens reinforces the idea that that other person is different – separate from me. And this separation perpetuates conflict and war. It perpetuates the war in my head which perpetuates the war I wage with others. The inner war creates global war.

When I am practicing eCPR or human connecting I am cleaning the lens. By that I mean, I intentionally focus on letting go of my own judgments and labels; there is nothing to protect. I focus on perceiving the other person in their full humanity. The distress the person is expressing is a particular patterned way that this person’s internal war has escalated.

As a supporter or listener or fellow human being I focus on being with her and assisting her in finding peace. I do this by seeing the genuine person underneath her lens, underneath the social conditioning, underneath her story. And when I do this, I am perceiving or ‘being’ underneath my own lens. From this place, where peace is revealed in the deep connection of two people, I mirror back the best I see in her, my great hope for her, my belief in her, my knowing that together, in this moment, we will move through this.

For more on this process, see “When the war in our mind ends, peace emerges” (http://www.mentalhealthexcellence.org/war-mind-ends-peace-emerges/)

 

Connection as a preventative of violence
Shortly after Congresswoman Gabby Giffords and 17 others were assaulted with a firearm in Tucson, Arizona in 2011 and six people died from their wounds, the mayor of Tucson, Arizona asked for a meeting with the Administrator of the Federal Substance Abuse and Mental Health Services Administration (SAMHSA).

I recall being hopeful that some federal action step might be taken to move forward in a collective and positive direction after this tragedy. About 45 of us from around the country met at SAMHSA in Rockville, Maryland, the Tucson mayor and his wife joined us via phone.

There was much talk around what some communities have done in response to similar attacks, how we might be able to prevent such attacks and where we go from here, such as community dialogues, town meetings, etc.

I listened for a long while and then spoke and I would say the same thing today: People don’t act out in desperate acts of rage – be it homicide, massacre or suicide – when they know they are connected and belong to something bigger than themselves – be it family, community or some entity that gives their life meaning and purpose. I don’t believe this behavior occurs when people know that they belong in community, that they have a safety net, a place where they are being well thought of, cared about.

If people have somewhere safe to go when they feel big feelings, whatever those feelings are – anger, rage, isolation, anxiety, sadness, etc., they would not act out so desperately, at least they would be less likely to. The invitation is to think creatively and strategize about how we rebuild our communities so they everyone knows they belong, everyone is valued and has a place.

We can and must do a better job of connecting to our own hearts and to the hearts, minds and spirits of others.

I end with two simple and eloquent quotes from Albert Einstein, “We can not solve our problems with the same thinking we used when we created them” and “The ideals that have lighted my way, and time after time have given me new courage to face life cheerfully, have been Kindness, Beauty, and Truth.


Lauren_SpiroLauren Spiro’s vision of social justice and mental health liberation fuels her work of community building, developing our individual and collective capacity for feeling deeply connected, appreciating the vast creative intelligence of the human mind and creating pathways so everyone may come home. Diagnosed and institutionalized with chronic schizophrenia as a teenager, she has emerged as a visionary thinker, artist, and consultant dedicated to embodying inner peace to create global peace. She has an M.A. in Clinical/Community Psychology, has been featured on national media, co-founded Emotional CPR and two non-profit mental health corporations, is the former director of the National Coalition for Mental Health Recovery (www.ncmhr.org) and author of a recently published memoir, Living for Two:  A Daughter’s Journey from Grief and Madness to Forgiveness and Peace. Join her at www.laurenspiro.wordpress.com or email Laurenspiro1@gmail.com

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September 27, 2017 by Lise Zumwalt

Many people have asked me why I made this film called CRAZY.

And the answer is I got hooked. After decades working in television, I was looking for stories that aren’t being told. I came across an article about a group of people diagnosed with mental disorders that were going to weekly meetings, 12 step style. I researched the mental rights movement and I started wondering why we weren’t talking more about the issues they were raising. I called David Oaks and when I got off the phone, my hands were shaking. I met a guy, diagnosed bi polar who told me, “all I have to do to get committed is make 2 doctors nervous…do you know how easy that is?” And then he described how devastating it was to be told that you cannot trust yourself anymore. Your mind, your mission control will have to be run by someone else.

Hmmm. Who decides that? And how?

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