Mad in America: Rethinking Mental Health

In this podcast we discuss an educational program called Emotional CPR (eCPR), a form of peer support anyone can use to assist youth (or adults) in emotional crisis. Our guests are Oryx Cohen and Briza Gavidia of the National Empowerment Center, a Massachusetts-based nonprofit whose mission is to carry a message of recovery, empowerment, hope, and healing to people with lived experience with mental health issues, trauma, and/or extreme states. Oryx Cohen, M.P.A., is a leader in the international mental health consumer/survivor/ex-patient (c/s/x) or Mad Pride movement. Currently, Oryx is NEC's Chief Operating Officer. Among other responsibilities, he organizes the national Alternatives Conference every three years and assists states that have an underdeveloped consumer/survivor voice to find that voice and then work toward transforming their mental health systems to become peer-driven and recovery-oriented. Oryx is also a lead trainer for Emotional CPR, or eCPR, and has conducted over 50 eCPR trainings around the world. Prior to joining NEC, Oryx was Co-Director of the Western Massachusetts Recovery Learning Community. There, he helped to spearhead an innovative peer-run approach focusing on recovery, healing, and community. Oryx is also the co-founder of Freedom Center, the Pioneer Valley's only independent peer-run support/activist organization. Briza Gavidia is a certified Youth Emotional-CPR (eCPR) Educator. She is 21 years old and is a student at Fullerton College majoring in sociology. Briza is currently employed in a program assisting the elderly with daily activities. Her goal is to work in the mental health field so she can give young people real hope for a better future. She loves sharing her lived experiences with trauma and how she is tackling these challenges so she can become a stronger person.

Elisa Lacerda-Vandenborn, a professor at the Werklund School of Education, focuses on education and decolonization of mental health in Indigenous communities. She discusses the historical oppression faced by these peoples and critiques mainstream psychological practices for their lack of inclusivity. Lacerda-Vandenborn advocates for holistic, community-driven approaches like Family Group Conferencing, emphasizing the importance of cultural healing in child welfare. She underscores the need for ethical research methods that prioritize Indigenous voices and collective well-being.

On the Mad in America podcast this week, we hear from Renee Schuls-Jacobson. Renee was a teacher for two decades and she is now an author, artist, advocate and coach. In this interview, we discuss her book Psychiatrized: Waking up After a Decade of Bad Medicine which was released this year. The book is a beautifully written account of Renee's experiences being prescribed the benzodiazepine clonazepam (Klonopin) for seven years. It talks of her experiences taking the drug as prescribed but perhaps more importantly, also tells of what happened to Renee as she made attempts to withdraw.

In this podcast, we hear from the renowned clinician and researcher Dr. Giovanni Fava. Dr. Fava is a psychiatrist and professor of clinical psychology at the University of Bologna in Italy. He is also a clinical professor of psychiatry at the University at Buffalo School of Medicine and Biomedical Sciences. Since 1992, he has been the editor-in-chief of the peer-reviewed medical journal Psychotherapy and Psychosomatics. Dr. Fava has authored more than 500 scientific papers and is known for researching the adverse effects of antidepressant drugs. In a 1994 editorial, he argued that many of his fellow psychiatrists were too hesitant to question whether a given psychiatric treatment was more harmful than it was helpful. He recently released his latest book entitled "Discontinuing Antidepressant Medications" published by Oxford University Press. The book is designed to be a guide for clinicians who want to help patients withdraw from antidepressants. In this interview, we discuss the new book, approaches to antidepressant cessation and explore some of the concepts including novel psychotherapeutic approaches to withdrawal.

Hans Skott-Myhre is a Professor of Human Services at Kennesaw State University in Kennesaw, Georgia. Over the last 50 years, he has worked within a wide variety of human service settings, including residential homes, community health centers, inpatient psychiatric units, homeless youth shelters, transitional living programs, and prisons. About two decades ago, he transitioned into academia, where he now does research at the intersections of human services, psychology, cultural theory, and literature. His recently published book titled "Post-Capitalist Subjectivity in Literature and Anti-Psychiatry: Reconceptualizing the Self Beyond Capitalism" explored how we might be different types of people if we didn't live in a capitalist society. The book draws on Marxist and post-Marxist theory and presents a nuanced analysis of antipsychiatrists' professional writings, including Franco Basaglia and R. D. Laing, as well as the work of fiction writers, including Franz Kafka and Gabriel García Márquez. Through this analysis, Skott-Myhre identifies alternative conceptualizations of self and community that take us beyond capitalist subjectivity.

In this podcast, which comes on the heels of reports linking social media use to reduced self-esteem in teen girls, eating-disorders therapist Shira Collings discusses person-centered, socio-culturally aware approaches to dealing with disordered eating and other food-related challenges in youth (and adults). Shira Collings, M.S., N.C.C., is Mad in America's Assistant Editor for MIA Continuing Education and the Youth Coordinator for the National Empowerment Center. She received her B.A. in Communication from the University of Pennsylvania and an M.S. in Counseling and Psychology from Troy University. As a person with lived experience of recovery from diet culture, disordered eating, and trauma, Shira is passionate about supporting others in finding freedom with food, body acceptance, and the ability to be their full, authentic selves and live according to their values. She is an advocate for trauma-informed, person-centered approaches to mental health care.

Helena Hanson is professor and chair of translational social science and health equity and associate director for the center for social medicine at UCLA. As a psychiatrist and anthropologist, she has spent much of her career researching how race, class, gender, and social determinants of health affect psychiatric diagnosis and treatment. Growing up in 1970's Oakland and Berkeley, California, Hansen witnessed the consequences of deinstitutionalization and mass incarceration policies firsthand. Losing family members to both the prison and mental health systems gave her a personal understanding of the social and structural failures she interrogates in her work today. She also draws on the principles she learned as a participant in AIDS-related activism to mobilize community organizations and champion mutual aid groups in combatting our current mental health crises. In this interview, Hansen discusses how race and class affect psychiatric diagnoses and subsequent treatment, the moral implications of psychiatric diagnosis, structural competency, and more.

Schizophrenia is a psychiatric diagnosis that carries a heavy social stigma. However, experts have also questioned the validity and utility of the label. In response, some experts and service-user groups have called for different conceptualizations and terms for those experiencing psychotic symptoms. Doctors Matcheri Keshavan and Raquelle Mesholam-Gately are currently tackling this issue. They recently completed a project in collaboration with the Consumer Advisory Board of Beth Israel Deaconess Medical Center in Boston, MA, examining the benefits and drawbacks of renaming schizophrenia. Matcheri Keshavan, M.D. is the Stanley Cobb Professor of Psychiatry at Harvard Medical School and Academic Head of Psychiatry and Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center. Raquelle Mesholam-Gately, Ph.D., is an Assistant Professor of Psychology in the Department of Psychiatry at Harvard Medical School. She is also the director of the Consumer Advisory Board and conducts neuropsychology research in the Psychosis Research Program at the Massachusetts Mental Health Center. In this interview, they discuss what they learned about the issues surrounding the renaming of schizophrenia in their research with consumers and service users. In particular, they reflect on how this psychiatric diagnosis can impact the therapeutic alliance necessary for effective treatment and the overall quality of life of people diagnosed.

This week we talk with Professor Jim van Os and Doctor Peter Groot about their latest study which looks at the effectiveness of tapering strips to help people get off antidepressant drugs. Jim van Os is Professor of Psychiatric Epidemiology and Public Mental Health at Utrecht University Medical Centre, the Netherlands and Peter Groot works with the User Research Centre of UMC Utrecht. They both are involved with the development and study of tapering strips which are pre-packaged, gradually reducing dosage tablets that facilitate tapered withdrawal from psychiatric drugs. In this interview, we discuss their latest research paper which examines tapering strips in real-world use. *** Download Mad in America's new mobile app here. Available for Apple or Android mobile devices, keep up to date as we publish new audio interviews or browse our archive.

Ursula Read is a research fellow and associate at King's College London. She holds a Ph.D. in anthropology from University College London, where she studied family experiences of mental illness and help-seeking and Ghana. Currently, her research addresses Global Mental Health, and she utilizes participatory research methods to explore the relationship between mental illness and social exclusion internationally. Her recent work focuses on mental health care in Ghana, drawing attention to the need for rights-based approaches to mental health care. In doing so, she questions the movement for Global Mental Health: asking what this movement is doing currently and imagining what it could become. Her research brings to light how those in the Global North and high-income countries can overlook what rights-based approaches to mental health care may actually look like when incorporated into Global Mental Health and enacted on the ground. She also is deeply concerned with the structural and social determinants of health and mental health and their interconnection with community resources, places of worship, faith, and overall health promotion.