Op-ed: Mental illness: Another point of view

The Connecticut Forum will soon host a panel of celebrities and professionals to take “An Honest Look at Mental Illness.”  The selected panelists’ consensus is that science has demonstrated that ‘mental illnesses’ are illnesses – biological diseases of bodily tissue… (and that pharmaceuticals are indispensable).

The problem: Prominent psychiatrists – the same people who promulgated this view – now admit that this isn’t demonstrated fact. Never has been.

The psychiatrist heading the National Institute of Mental Health criticized psychiatric “diagnoses” as lacking in both “validity” and any “objective laboratory measure.” His NIMH predecessor agreed: “psychiatric diagnoses seem arbitrary and lack objective tests; and there are no validated biomarkers…”.

Physician Marcia Angell, M.D., former editor-in-chief of the “New England Journal of Medicine,” concurs:  “Unlike the conditions treated in most other branches of medicine, there are no objective signs or tests for mental illness – no lab data or MRI findings…”  “I have spent most of my professional life evaluating the quality of clinical research, and I believe it is especially poor in psychiatry.”

A prominent psychiatrist admitted in the “Psychiatric Times” that the truism repeated to the public, about people’s problems being rooted in “chemical imbalances,” is an “urban legend” – “never a theory seriously propounded by well informed psychiatrists.”

But, isn’t this the very explanation most psychiatric professionals promote to the public? Based on past statements, there’s little evidence that this viewpoint, or the centrality of psychotropic medications, will be questioned by Forum panelists.

People who are upset, confused, overwhelmed are presumed “ill” – not emotionally distressed but medically sick.

For 20 years I served on the Institutional Review Board (IRB) of Hartford Hospital–Institute of Living, an ethics-in-research committee. IRBs ensure that potential research participants are told the truth about their medical or psychiatric conditions. “Informed Consent” is the medical ethics doctrine requiring that people be given accurate, understandable information; to make their own decisions based on honest assessments of their conditions, and the known risks/benefits of their options.

Researchers (whether funded by drug companies, government or others) are required to submit to IRBs their research designs, including comprehensive summaries of previous research. Buried in pages of background, these scientists repeatedly admit that the conditions we mislabel “psychiatric illnesses” are simply not documented to be diseases of the body – despite decades of attempts to verify biomarkers, specific lesions or physical/chemical malfunctions that might cause these “conditions.”

No reliable, reproducible research has ever demonstrated people’s sadness (“depression”) or a child’s rambunctiousness (“ADHD”) to be physically rooted in tissue abnormality; nor is there an identifiable brain disease called “schizophrenia.” Physical confirmation of “mental illness” is unavailable in research, hence absent in clinical practice.

Check any library. Medical pathology textbooks codify disease — verifiable physical/chemical abnormalities. “Psychopathology” lists theories – not established physical evidence. Markedly different rules of science, logic and culture apply in psychiatry compared to medical science. The proponents of biological theories, ascendant in psychiatry and pharmaceutical companies, downplay this illogicality.

Will Forum panelists tell you that the National Alliance on Mental Illness, the most media-quoted nonprofit source of “lay” information, was secretly majority-funded by the pharmaceutical industry, until a congressional inquiry forced NAMI to divulge their commercial backing?

Will panelists admit the non-specificity of psychoactive medications, their documented sedative, stimulant or placebo effects, and their often downplayed but expectable side-effects?

Will there be any mention of “Anatomy of an Epidemic,” which won the prestigious Investigative Reporters and Editors Prize for best book of 2010 (with judges’ comments, “an in-depth exploration of medical studies and science … [that] punches holes in the conventional wisdom of treatment of mental illness with drugs.”)?

Neglected, in the tunnel-vision search for the biological cause and nature of “mental illness” (and its misleading promotion as established fact) is human experience.

News outlets regularly publish stories of murder, sexual abuse, genocide, family conflict. We human beings, affected by overwhelming events, sometimes show our distress in complex, confusing ways. We may cope with painful, troubling personal difficulties and secrets, and usually work hard to keep those secrets — sometimes even deceiving ourselves.

We can and do help people with their private confusions, trauma, upset and conflict – without a “medical” paradigm that may interfere with their self-examination and improvement. A growing number of resources, including Greater Hartford’s Volunteers In Psychotherapy, help people by exploring and discussing people’s private lives under truly private conditions (with no reports to insurers).

You deserve a second opinion. An “Honest Look” must include the previously mentioned empirical findings… and must consider people’s troubling secrets, which often explain their initially inscrutable personal problems.

Richard Shulman, Ph.D., is a licensed psychologist and director of West Hartford-based Volunteers In Psychotherapy, which provides strictly private therapy to people in exchange for community volunteer work they provide, privately and independently, to the charity of their choice.