Mad in America: Rethinking Mental Health

Lucas Richert is the George Urdang Chair in the History of Pharmacy at the University of Wisconsin, Madison, and historical director for the American Institute of the History of Pharmacy. His work explores prescription and illicit drugs, the American counterculture, and the influence of various power structures within and beyond psychiatry. As a scholar of the pharmaceutical industry, Richert encountered a trove of historical documents that talked about the self-described radicals in mental health from the 1970s. "They cared about relevant issues, things that we talk about right now: racism, the environment, militarism, and political division. It really grabbed hold of me when I got these documents, they were a catalyst." This project turned into his 3rd book, Break on Through: Radical psychiatry and the American counterculture in which he examines the tumultuous 1970s in America with a focus "not just on the elite doctors and people in positions of power, but also wider societal trends." In addition to Break on Through, Richert has published A Prescription for Scandal: Conservatism, consumer choice, and the food and drug administration during the Reagan era and Strange Trips: Science culture, and the regulation of drugs. His fourth book, Cannabis: Global Histories, will be available later this year (2021). In this interview, we will discuss the radical landscape of American psychiatry in the 1970s, "therapeutic" and "non-therapeutic" drugs and how they are classified as such, and feminist critiques of psychiatric institutions.

This week we are sharing the audio taken from our recent psychiatric drug withdrawal town hall held on January 15th 2021. This was our initial, scene-setting discussion and the panelists are Adele Framer, also known as Alto Strata founder of surviving antidepressants, Luke Montagu, co-founder of the Council for Evidence-based Psychiatry, Swapnil Gupta, a psychiatrists with a specila interest in deprescribing and John Read, Professor of psychology and Chair of the International Institute for Psychiatric Drug Withdrawal. This series aims to explore what we do and don't know about safe withdrawal from antidepressants, antipsychotics, benzodiazepines and stimulants. We will seek to present and explore new understandings that are emerging from the professional and lived-experience communities. We will discuss the knowledge, skills and experience necessary to support those who may be having difficulty getting off psychiatric drugs. We will address questions of interest to both prescribers and patients alike. Our next even in the series will be held on March 12th 2021 and registration details will be available on Mad in America in early February.

Mad in America, in partnership with the Council for Evidence Based Psychiatry and the International Institute for Psychiatric Drug withdrawal is arranging a series of free to attend online town hall discussions on psychiatric drug withdrawal. We aim to explore what we do and don't know about safe withdrawal from antidepressants, antipsychotics, benzodiazepines and stimulants. We will discuss the knowledge, skills and experience necessary to support those who may be having difficulty getting off psychiatric drugs. By doing this we hope to stimulate further discussion between service users and prescribers. Our first discussion will be held on Friday January 15th at 10 AM Pacific time, 1 PM Eastern time and 6 PM GMT. The panellists for the first discussion are Adele Framer, founder of Surviving Antidepressants; Swapnil Gupta, a Board Member of the International Institute for Psychiatric Drug Withdrawal and a psychiatrist with a special interest in deprescribing; John Read, Professor of Psychology and Chair of the International Institute for Psychiatric Drug Withdrawal; and Luke Montagu, co-founder of the Council for Evidence-based Psychiatry and member of the NICE guideline committee for safe prescribing and withdrawal. To register for the first discussion, visit madinamerica.com and use the link at the bottom of the home page or click here: https://bit.ly/psych-drug-withdrawal We hope that these discussions will add to an increasingly detailed collection of knowledge and experiences that can inform prescribers when providing informed consent and when implementing gradual tapering regimes. We very much hope you can join us.

Thomas Teo is a Professor of Psychology in the Historical, Theoretical, and Critical Studies of Psychology Program at York University, Toronto, Canada. He has spent his 20+ year career challenging the status quo in academic psychology. His unique approach to research has been described as both critical and meta-psychological. He often takes the discipline of psychology itself, including its methods and assumptions, as the target of his analysis. He is currently the co-editor of the Review of General Psychology (Sage), editor of the Palgrave Studies in the Theory and History of Psychology, and co-editor of the Palgrave Studies in Indigenous Psychology. He is the former president of the International Society for Theoretical Psychology, of the American Psychological Association's Society of Theoretical and Philosophical Psychology (Division 24), and former chair of the History and Philosophy of Psychology Section of the Canadian Psychological Association. He has a research record with more than 200 academic publications and refereed conference presentations. In this interview, Teo expounds upon concepts covered in a recent Science News Article and explains what it means for him to be a critical psychologist. He outlines how, as he became disappointed with the general state of psychology in Western Europe and the Americas, he sought alternative approaches that could better account for how culture, society, and economics are entangled with psychology. This led him to look more closely at historical examples of fascism, as well as postcolonial authors, to better understand how the psychosocial dimensions of social power operate in the world today. As he explains, this has important implications for how we think about psychiatry, mental health, and disability. Teo concludes the interview by foreshadowing some of his future work, which will further build on his concept of subhumanism to examine how subjectivity is shaped by the premium placed on certain lives. In contrast, others are constructed as less-than-human under neoliberal capitalism.

Piers Gooding is a Mozilla Foundation fellow (2020) and researcher at the Melbourne Social Equity Institute at the University of Melbourne Law School. His main interests are disability law and policy, international human rights law, the law and politics of mental health, and empirical legal research. Gooding describes his scholarship as an interdisciplinary undertaking that blends theoretical inquiry with applied qualitative research at the local, national, and international levels. He has collaborated with the UN Special Rapporteur for the Rights of Persons with Disabilities and the World Psychiatric Association on recommendations for alternatives to coercion in mental health. He blogs at https://pgooding.substack.com/ and tweets at @p_gooding. In this interview, he discusses his journey pursuing a human rights agenda in mental health. We focus on his efforts to marry international human rights law and the work of disability rights committees to ensure that people with psychosocial disabilities are not left out. He then talks about his longstanding work to prevent coercion in mental health and its connection to the digital, data-driven direction taken by the field as a whole. He elaborates the regulatory and ethical issues he has uncovered in his research at the intersection of mental health services and data-driven technologies and gestures at emerging methods of "algorithmic accountability" for addressing some of these issues.

Jennifer White is one of the founders of the Critical Suicidology Network, a growing international network of scholars interested in exploring alternatives to biomedical approaches to suicide prevention. Critical suicidology brings together persons with lived experience, mental health professionals, researchers, and activists "to rethink what it means to study suicide and enact practices of suicide prevention in more diverse and creative, less psycho-centric and less depoliticized, ways." She is a Professor in the School of Child and Youth Care at the University of Victoria in British Columbia, Canada. She has practiced as a counselor, educator, researcher, and advocate. White served for seven years as the Director of the Suicide Prevention Center in the Department of Psychiatry at the University of British Columbia. She has written numerous articles and book chapters on suicide and self-harm and has co-authored two books: Child and youth care: Critical perspectives on pedagogy, practice and policy (2011), and Critical suicidology: Transforming suicide research and prevention for the 21st century (2016). Her current research focus centers itself around the contemporary discourse of youth suicide prevention, seeking alternatives to one-size-fits-all approaches. She is currently leading a Wise Practices for Life Promotion project funded by the First Nations and Inuit Health Branch (FNIHB) of Health Canada. This project seeks to curate a series of wise practices for promoting life based on what is already working and/or showing promise in First Nations communities across the country. She is also conducting a study with family counselors to learn more about the challenges and opportunities they face with youth suicide prevention and the organizational conditions that support them to be most effective in their work.

Tanya Luhrmann is a Watkins University Professor in the Anthropology Department at Stanford. Her work explores how cultural contexts shape the experience of mental distress, particularly voice-hearing and the symptoms associated with psychosis. She also turns the lens on the practice of Western psychiatry itself, investigating how the field represents the mind and how these representations influence our collective understanding of reality. Luhrmann's book When God Talks Back was New York Times' Notable Book of the Year, and she has written numerous articles on psychosis, medical anthropology, and spiritual experiences. Recently, Our Most Troubling Madness: Schizophrenia and Culture was published by the University of California Press. Her newest book, How God Becomes Real: Kindling the Presence of Invisible Others, was published by Princeton in 2020. Luhrmann describes herself as someone who is interested in different types of "realnesses." Given that she grew up surrounded by different worldviews, it is not surprising that her work reflects this diversity of interests. It spreads across academic fields and geographical terrain – from anthropology to psychiatry on one side and Chicago to Chennai on the other. Throughout these writings, she has challenged many assertions of mainstream psychiatry, often to the annoyance of leading figures in the field. In this interview, she talks about the damaging effects of a diagnostic identity and the often-unseen challenges that peer counselors can face. She also takes on big questions: What does it mean when a person with high scores on psychosis scales is functional in one culture but not in another? Are auditory hallucinations shaped by cultural experiences? Are they always a source of distress?

dele Framer, also known by her online handle Altostrata, is the founder of SurvivingAntidepressants.org, a critical and comprehensive peer-support website that features several thousand case histories of psychiatric drug withdrawal. The site is a hub of information on the topic, highlighting methods of safe drug tapering and recovery and underscoring the humanity of those in the grips of withdrawal. Framer arrived at her expertise through personal experience. In 2004, after three years on 10 mg of paroxetine, she went off under medical supervision and suffered symptoms of withdrawal that her doctor discounted as relapse. She then went on to visit more than 50 psychiatrists, trying and failing to find someone knowledgeable in antidepressant withdrawal. Her own research into the topic, including close readings of journals and FDA recommendations, led her to the creation of SurvivingAntidepressants.org in 2011. Registered members now stand at roughly 14,000, with around 56,000 visitors per month. The site features 6,000 case histories and contains more than 60 topics covering tips on the gradual tapering off of specific drugs. All of the site's information is pulled from scientific papers, governmental advisories, and package inserts, and much of it has been shared across Facebook and other platforms on the web. The site has received mentions in scientific journals and mainstream outlets such as Psychiatric Times and Psychology Today. Framer, who grew up in New York, has lived in San Francisco for more than 40 years. She's now retired from a career in software user design.

Natalie Campo, MD, is an integrative psychiatrist practicing in Nashville, TN. She became interested in holistic treatment modalities in her first year of medical school at the University of Texas. In that same year, she was awarded an NIH grant to study infectious encephalitis in the Amazon Jungle. Upon her return, she sought out a physician whose primary care practice included holistic modalities, nutrition, and acupuncture. During medical school, on an externship, she started studying mindfulness and began using it with patients. After medical school, Campo trained in psychiatry at Yale and in medical acupuncture at Harvard. She obtained certifications from the American Board of Psychiatry and Neurology and the American Board of Integrative and Holistic Medicine. For many years, she taught alternative, holistic, and natural treatment options for anxiety and PTSD as a Yale faculty member. Campo currently resides in Nashville, where she serves as a Clinical Assistant Professor at Vanderbilt and provides consultation to the Osher Center of Integrative Medicine. In May of 2017, she participated in the World's First Congress of Integrative Medicine in Berlin, Germany. She started her practice in Nashville called Mindful Medicine in 2011 to bring safe, effective treatments to people seeking relief from anxiety, depression, addiction, and the stress of a hectic lifestyle.

Kirk Schneider is currently running for President of the American Psychological Association (APA). He is a licensed psychologist and adjunct faculty at Saybrook University and Teachers College, Columbia University. He is well-known as the leading spokesperson for integrative, existential, and humanistic approaches to psychology, which emphasize the therapeutic relationship and the importance of confronting the deep paradoxes of being human, and the conflicts that arise from them, in psychotherapy. He has authored or co-authored thirteen books, including the Wiley World Handbook of Existential Therapy, The Spirituality of Awe: Challenges to the Robotic Revolution, The Polarized Mind: Why It's Killing Us and What We Can Do About It, and, most recently, The Depolarizing of America: A Guidebook for Social Healing. Many trainees in counseling and clinical psychology will recognize Schneider from the APA Psychotherapy Training video series featuring his therapy work. Schneider is campaigning to serve as President of APA to "to address the existential crises that are now flaring all about us." As he puts it: "We are in crisis racially, politically, and environmentally. We are in crisis with gender and sexual injustices, and we are in crisis with mental and physical health. In short, America is poised on the precipice, and if our profession fails to grasp this problem, we are in danger of inflaming it. In this interview, Schneider discusses his path into psychology, including his own struggles and growth, his approach to psychotherapy, and his scholarship on the psychology of awe and the polarized mind. Then we turn to his vision for psychology; a "whole-person" approach to healthcare, a "Psychologist General" of the United States, and the development of dialogue groups that address polarization and division.