By Andy Alt

May 23, 2010

Many people, including myself, complain about the present state of mental health care. Problems exist in the area of psychotherapy and psychopharmacology — two primary aspects in the field of mental health care.

Without giving up the desire for improvement and demanding transparency — as it relates to side effects and adverse reactions — there must be an acknowledgment that mental health care has a history of improving, and presently is better than at any time in the past.

Chemical lobotomies and chemical straitjackets are terrible things. However, pharmaceutical drugs can at times be better than nothing at all. Especially if administered and prescribed responsibly with an adequate amount of monitoring, they can help give people struggling with — or strangled by — mental illness the opportunity to improve their quality of life and decrease their suffering. A person bound in a literal straitjacket or who’s undergone a literal, physical lobotomy has far less of a chance, far less hope, and far less freedom. It’s still sad and unfortunate that potentially dangerous psychiatric drugs manufactured by companies that have been charged multiple times with lawsuits are the best — and sometimes only — hope. The drugs do, however, mark progress.

A poor representation of humanity and society is when progress and proper care come about only after investigations, lawsuits or “getting caught in the act.” In a perfect world, people would do right by other people because they consider the Golden Rule, “Do unto others as you would have done unto you.” (Jesus Christ, ca. 32 A.D.) Other reasons to be ethical include the desire not to be evil, not to hurt other people, to help people if it’s within one’s power, and trying one’s best to not allow greed to morally corrupt his actions or eternal soul.

For purposes of example, everyone should know of Nellie Bly, and what she accomplished in 1887:

Nellie’s Madhouse Memoir

It started as a dare. “New York World” managing editor John Cockerill suggested an outlandish stunt designed to attract readers, while testing the journalistic mettle of the intrepid Nellie Bly. Bly would pose as an insane woman and allow herself to be committed to Blackwell’s Island — New York City’s notorious asylum. What resulted was a searing exposé that got the attention of reformers and readers alike[...]

From March 4, 2009:
Supreme Court Allows Lawsuits against Pharmaceutical Companies to Move Forward

[...]Case involved preemption doctrine

JEFFREY BROWN: So she sued Wyeth in state court and won $6.7 million. Her argument was that the label did not correctly…

MARCIA COYLE: It wasn’t adequate.

JEFFREY BROWN: … wasn’t adequate for how it should be administered.

MARCIA COYLE: That’s right. It warned that there could be gangrene if the drug went into the artery, but she claims that it didn’t tell clinicians that they should use the I.V. drip instead of the higher-risk I.V. push. She won, as you said, the Vermont Supreme Court affirmed, and Wyeth was the party that brought the case to the Supreme Court[...]

From 2008:
WGBH American Experience – The Lobotomist – Online Forum

[...]Finally, one should beware the tendency to rely on an individual piece of anecdotal evidence (or even a handful of such examples) when assessing whether a treatment “works.” Lobotomy was a mutilating and irreversible operation that possessed little or no scientific warrant, and was used in remarkably careless ways on patients who either had no say in the matter, or who were gulled by ruthless enthusiasts like Walter Freeman, who fed them grossly inaccurate information about what was being done to them. Many operations were done on people whose problems were relatively minor and transient, and these less disturbed individuals undoubtedly provided the majority of Freeman’s successes[...]

[...]After years of denial, and suppression of the relevant clinical trial data, drug companies have finally been forced to acknowledge that certain antidepressants carry with them an increased risk of suicide among children and adolescents. Antipsychotic drugs often dull the mental faculties, and they carry risks of serious iatrogenic consequences, many of which are masked as long as the patient remains on the pills, but then surface and are essentially untreatable. For twenty years after the introduction of Thorazine, psychiatry denied that its use was associated with the risk of permanent disabling and stigmatizing tics and grimaces — a disorder called tardive dyskinesia. This is now a recognized risk of using these drugs. It almost certainly reflects neurological damage attributable to the drugs, and it remains something we cannot reverse and very often cannot effectively mitigate. On another level, treating what are often behavioral and maturational issues through drugs is a terrible evasion of the underlying issues, and illegitimately redefines what are often as much social and psychological problems as biological — among other things, a dreadful lesson to teach our children.[...]

Psychotherapy is an area I’d have trouble providing citable, concrete examples. Personally, I’ve had therapists with whom I’ve been satisfied and some who I’d now encourage to stick their degree back into its cracker jack box and look for another line of work.

Trying to solve the problems associated with mental illness and effectively, humanely treating people who have it is a monumental challenge. A good start to that end would be treating them, us, like people — not like experimental subjects or as the means to make a house or boat payment.

Advancements can’t be made without honesty and integrity. Capitalism without a conscience will continue as long as human nature dictates that power corrupts. It’s just so very sad that that the punishment from “getting caught” is what motivates people to change their behavior. After a good spanking — apparently when free will exits the scene — is the time when influential members of society act for the common good.

Paul McCartney once sang, “I’ve got to admit it’s getting better (Better)
A little better all the time (It can’t get more worse)…”

Mental health care is getting better all the time, albeit slowly; and from a historical perspective, it could be a lot worse.

Tags: Mental_Health Health_Care History

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