Mad in America: Rethinking Mental Health

This week on MIA Radio we share what is something of an anniversary for us at MIA. This interview marks one hundred episodes since we launched our podcast in July 2017. And for this episode, we interview David Joslin. David is a retired army medic, having served in Iraq in 2003 and Afghanistan in 2008. David currently works as a senior healthcare administrator and he has co-founded Remedy Alpine, a veterans therapeutic recreation non-profit dedicated to providing wilderness therapy adventures in Alaska. David has also written for Mad in America, having published Broken is Not All I’ll Ever Be in August 2019 and he has recently launched a new podcast called Bullets to Beans, which is a military and veteran-centric podcast focused on current military and veteran topics, blended with discussions on mountain oriented recreational and adventure-based therapy programs. We discuss: How upon leaving the military, David felt that he had lost his identity, suddenly working in private healthcare and not being able to care directly for colleagues as he had as a combat medic. That to help deal with the change, David started going out into the backcountry wilderness to find peace and healing. How this interest led him to meet Eric Collier, a like-minded veteran interested in wilderness hiking. How David and Eric saw the benefits to be had in sharing wilderness adventure experiences and launched their first event for veterans in 2017 and when they got home, realising the amount of interest in and support for similar future events. David and Eric then took the time to establish themselves as a business during the Winter of 2018. During 2019, David and Eric led 49 veterans into the Alaska wilderness and connected with 150 veterans via outreach and community enrichment events. That David came to see that many veterans attending the wilderness therapy had struggled with multiple medications, prescribed during their service years. How David’s experiences within the military led to treatment for Post-traumatic Stress Disorder, resulting in being prescribed a drug cocktail. How the initial drugs were followed by others for insomnia, drugs for nightmares, blood pressure problems and for focus and concentration. How at the height of David’s ‘better living through chemistry’ he was on 13 different drugs. That through David’s pharmacological training he realised that one of the top ten side effects of many of the drugs he had been put on was suicidal thinking. How David came to take himself off all his drugs and strongly advises others never to do this themselves. That it was planning his own suicide that brought him to face that his life was unsustainable, accepting that he didn’t want to live as he had been. As he was planning it, he found that he didn’t want to suffer and came to realise that he did want to live, and realised that the suicidal thoughts were very likely as a result of treatment. That during his service years, David had assisted with at least three suicide interventions and that caused him to consider what might be driving veterans to consider suicide. How having confronted his suicidal thoughts and coming off his drugs, David then went on to find solace and comfort in wilderness adventures. That David still sometimes struggles with nightmares, hypervigilance and social anxiety but that he could deal with this without feeling numbed by the drugs and by being away from society but with trusted colleagues and friends in an environment conducive to healing. That Remedy Alpine is now starting to work as a government contractor to provide recreationally-based programs to the veteran community. How Remedy Alpine operates year-round and provides single-day hikes, single overnight camping events and multi-day hikes which can range from 26 to 30 miles through the Alaskan mountains. The recent launch of the Bullets 2 Beans podcast which focuses on post-military life challenges. That Remedy Alpine were attendees at the Nature’s Grace Conference, which focussed on America's veterans and the healing power of nature. How Remedy Alpine is now focussed on expanding the business side, applying for grants, developing their therapeutic programs and training veteran peer mentors. Relevant Links: Broken Is Not All I’ll Ever Be Remedy Alpine Bullets 2 Beans podcast Remedy Alpine on Facebook Nature’s Grace Conference

This week on MIA Radio we chat with Professor John Read of the University of East London. John worked for nearly 20 years as a Clinical Psychologist and manager of mental health services in the UK and the USA, before joining the University of Auckland, New Zealand, in 1994, where he worked until 2013. He has published over 140 papers in research journals, primarily on the relationship between adverse life events (e.g. child abuse/neglect, poverty, etc.) and psychosis. He also researches the negative effects of biogenetic causal explanations on prejudice, the opinions, and experiences of recipients of antipsychotic and antidepressant medication, and the role of the pharmaceutical industry in mental health research and practice. John joins us to discuss the UK licensing of esketamine nasal spray (Spravato) for so-called ‘Treatment Resistant Depression’. John led a group of 12 academics and professionals who wrote to the UK regulator expressing concerns about esketamine. We Discuss: Concerns about the basic concept of using derivatives of hallucinogenic, addictive street drugs to address complex human problems. The particular details of the clinical trials that raise concerns about treatment with esketamine. How the US Food and Drug Administration approved Spravato in January 2019 and the European Medicines Agency recommended that member states approve it on October 17, 2019, giving 67 days for member states to comment. That the Medicines and Healthcare products Regulatory Agency approved esketamine for UK use. That there have been no trials of the efficacy of esketamine in the medium or long term, with most trials being only four weeks duration. That only one of the trials found a benefit for esketamine over placebo, yet this was deemed sufficient for licensing by the USA’s FDA. That there were deaths and suicides recorded during the esketamine clinical trials. The relationship between the drug regulators and funding from the pharmaceutical manufacturers. How there was no response from the MHRA to the concerns raised by John’s group. In addition, no reply was made to concerns raised by Sir Oliver Letwin writing on behalf of the All Party Parliamentary Group on Prescribed Drug Dependence as well as letters from independent researchers from Kings College London and a group of service users. A recent response to the approval by the UK National Institute for Health and Care Excellence. A response to the NICE announcement from the Science Media Centre.

This week on MIA Radio, we interview Wendy Dolin founder of the MISSD foundation. MISSD stands for Medication-Induced Suicide Prevention and Education Foundation in Memory of Stewart Dolin. In 2010, Wendy’s husband Stewart Dolin was prescribed Paxil (paroxetine), a selective serotonin reuptake inhibitor ("SSRI") for mild situational anxiety. Within days, Stewart's anxiety became worse. He felt restless and had trouble sleeping. On July 15, 2010, just six days after beginning the medication, following a regular lunch with a business associate, Stewart left his office and walked to a nearby train station, despite not being a regular commuter. A registered nurse who was also on the platform later reported seeing Stewart pacing back and forth and looking very agitated. As a train approached, Stewart ended his life. Founded in 2011, MISSD is a unique non-profit organization dedicated to honoring the memory of Stewart and others by raising awareness and educating the public about the dangers of akathisia. MISSD aims to ensure that people suffering from akathisia's symptoms are accurately diagnosed so that needless deaths are prevented. Relevant Links: Medication-Induced Suicide Prevention and Education Foundation in Memory of Stewart Dolin MISSD on YouTube MISSD Handout MISSD Free one-hour Continuing Ed Course Akathisia Stories - MISSD Podcast (Apple Podcasts, Spotify) NYC Subway Ads Take Akathisia Out of the Darkness Wendy Dolin Takes on GlaxoSmithKline And Wins — For Now at Least Stewart Dolin’s Widow Loses $3 Million Verdict for Paxil Suicide on Appeal

Welcome to MIA Reports, showcasing our independent and original journalism devoted to rethinking psychiatry. We take selected MIA Reports and provide them as audio articles. Click here for the text version of this and all of our MIA reports. The Whistleblower and Penn: A Final Accounting of Study 352 Written by Peter Simons, read by James Moore, first published on Mad in America, December 29, 2019. Although the general story of ghostwriting in trials of psychiatric drugs is now pretty well known, the details of the corruption in specific trials are still emerging into the public record, often a decade or more after the original sin of fraudulent publication. The latest study to finally see the full light of day is GlaxoSmithKline’s study 352. Perhaps the most infamous ghostwritten study is GSK’s study 329, which, in a 2001 report published in the American Journal of Psychiatry, falsely touted paroxetine (Paxil) as an effective treatment for adolescent depression. The company paid over $3 billion in penalties for fraud. That same year, study 352 made its first appearance in the research literature. That was when Charles Nemeroff, who in the years ahead would become the public face of research misconduct, “authored” an article on the efficacy of paroxetine for bipolar disorder. It has taken 18 years for the full story of that corruption to become known, the final chapter recently emerging when a large cache of study 352 documents—emails, memos, and other internal correspondence between the key players—was made public. The documents reveal a web of corruption that went beyond the fraud of ghostwriting into the spinning of negative results into positive conclusions, and the abetting of that corruption by an editor of the scientific journal that published the article. The documents also reveal a whitewashing of the corruption by the University of Pennsylvania. However, it was the publication of these documents that provided Jay Amsterdam, an investigator in the trial who turned whistleblower after he smelled a rat, with a chance to say “case closed.” Amsterdam and Leemon McHenry have now published two articles that provide a step-by-step deconstruction of the study—the ghostwriting, the spinning of results, the betrayal of public trust. Here is the story of that whistleblowing. 

This week on MIA Radio, we interview Amanda Burrill. After a successful career as a Surface Warfare Officer and Rescue Swimmer in the United States Navy, Amanda was on track to continue her career as a professional triathlete and marathon runner, as she had already been competing internationally still while in uniform. Around the time of her discharge, she was prescribed a cocktail of psychiatric medications that caused physical injuries and leading to an early end to her rapidly accelerating career.  Amanda completed a Masters degree in Journalism from Columbia University, a culinary arts degree from Le Cordon Bleu in Paris, and continued her work as a travel and culinary journalist; all while surviving a cocktail of over a dozen psychiatric medications over eleven years.  While being treated for a traumatic brain injury (TBI) by specialists at New York University in 2018, Amanda’s doctors raised concerns about the selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, stimulants, sleeping medications and mood stabilizers concurrently prescribed to her by the Department of Veterans Affairs. Over the next 12 months, Amanda was successful in withdrawing from her cocktail of meds, which included the SSRI, Zoloft. She now sees it as her mission to ensure what happened to her does not happen to others.

Dr. Anthony Ryan Hatch is a sociologist and associate professor of Science in Society, African American studies and Environmental Studies at Wesleyan University, who studies how medicine and technology impact social inequality and health. Professor Hatch is the author of two books. His first book, Blood Sugar: Racial Pharmacology and Food Justice in Black America, critiques how biomedical scientists, government researchers, and drug companies use the concepts of race and ethnicity to study and treat ‘metabolic syndrome,’ a biomedical construct that identifies people at high risk of heart disease, stroke, and diabetes. His second book, Silent Cells: The Secret Drugging of Captive America, examines how custodial institutions like prisons, nursing homes, and the U.S. military use psychotropic drugs to manage mass incarceration and captivity in the United States. His 2018 Wesleyan TedX talk is entitled “How Social Institutions Get Hooked on Drugs.”

Mary Watkins is a psychologist at Pacifica Graduate Institute who focuses on reorienting psychology toward social justice and liberatory ends. She has a foundation in the depth psychologies of Carl Jung and James Hillman, as well as holistic approaches to community healing such as indigenous, liberation, and eco-psychologies. She has worked in a variety of settings, such as immigration detention centers, prisons, and marginalized communities, with the aim of social transformation beyond the individual. Her research interests include a focus on the restorative power of dialogue, creative imagination, forced migration, adoption, and socioeconomic justice. In addition to numerous articles, she has published several books, such as Waking Dreams, Invisible Guests: The Development of Imaginal Dialogues, Toward Psychologies of Liberation with Dr. Helene Shulman, Up Against the Wall: Re-imagining the U.S.-Mexico Border with Dr. Edward Casey, and most recently, Mutual Accompaniment and the Creation of the Commons.  

Peter Mayfield is the founder and executive director of Gateway Mountain Center in California, an innovative program for helping youth learn, heal, and thrive As a teenager growing up in California, Peter became an accomplished rock climber, and developed into one of the world’s best mountain climbers, rising to become chief guide of the Yosemite Mountaineering School. Yosemite is known for being a rock climbing mecca, offering climbers some of the most difficult ascents anywhere in the world. He has enjoyed a 40-year career guiding people in mountain experiences and developing entrepreneurial enterprises. He is the founder of City Rock, the first full-service climbing gym in the world. Today, he is passionate about changing the system of care for youth suffering from serious emotional disturbances and complex trauma. Gateway’s program,  ‘Whole Hearts, Minds and Bodies’ is the first nature-based therapeutic program in California to achieve full-service partner contracts with County behavioral health departments and certification as a MediCal provider. This means that California has recognized his nature-based therapeutic programs as providing a medical benefit. In this interview, Peter speaks about his journey from mountaineering to his role as an educator and mentor, and how enabling children and adolescents to connect with nature has such a profound effect on their health and wellbeing. If you'd like to know more about the work of the Gateway Mountain Center, you can visit the website www.sierraexperience.org

This week on MIA Radio, we interview Drs. Peter Breggin and Michael Cornwall their new initiative, Stop the Psychiatric Abuse of Children (SPAC!). Peter Breggin, MD is a Harvard-trained psychiatrist and a former consultant at the National Institute of Mental Health who has been called "The Conscience of Psychiatry." For decades, he has made successful efforts to reform the field, including bringing a stop to lobotomy and psychosurgery. He has testified before the FDA and Congress, been an expert witness in many court cases involving the pharmaceutical industry and has appeared on Oprah and 60 Minutes, among other programs. Dr. Breggin continues to criticize psychiatric drugs and “electroconvulsive therapy,” and promotes more caring, empathic and effective therapies. To that end, with his wife Ginger, he founded the Center for the Study of Empathic Therapy, Education and Living.  He is the author of more than 20 books, most recently Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions. Dr. Breggin maintains a private practice in Ithaca, New York where he treats adults, couples, and families with children. Michael Cornwall, PhD has done therapy with children, teens and families since 1980 as well as specializing in therapy with people of all ages experiencing extreme states. He completed doctoral research on medication-free treatment of extreme states and is the editor of a two-volume special edition of the Journal of Humanistic Psychologyon extreme states. Dr. Cornwall has been a prolific MIA blogger since 2012 and a frequent Esalen Institute workshop leader on alternative approaches to extreme states. He is the director of the SPAC! project for Dr. Breggin’s Center for Empathic Therapy. (audio) We discuss: How SPAC was started in response to the introduction of the Monarch eTNS, an electric stimulation device worn on a child’s forehead at night that is touted as an alternative to ADHD medication, which was fast-tracked by FDA with little testing The extensive, downplayed adverse reactions found in testing the Monarch on children How the device is purported to work to target brain activity in certain areas, but likely affects other important neural areas and how this is likely to disrupt a child’s normal brain function Problems with the design of the studies on the Monarch and how deliberate intrusions into brain function make an individual child more docile but also more apathetic The potential widespread adoption of the Monarch device due to a partnership between the manufacturer and a pharmacy chain, the many uses for which it is being marketed, and anticipated psychiatric prescribing of the treatment by primary care doctors The nature and risks of ECT, another form of psychiatric “treatment” that targets the brain with electricity, intentionally causing a seizure and short- and long-term traumatic brain injury, and where to find ECT resources on Dr. Breggin’s website Reframing “ADHD” behavior as a sign of deficiencies in the teacher, classroom, or parenting approach rather than an illness in the child. What might cause inattentiveness in a young student and how doctors typically medicate the problem as a brain disorder Alternatives to high-tech interventions and drugs for helping inattentive or severely troubled youth alike, including modifications at school and entering family therapy. The importance of parents’ expressing love and discipline to change problematic behaviors, with examples from Breggin’s private practice How the medical model of psychiatry discourages identifying unmet human needs in young patients and their families, and the benefits of offering trauma-informed support and connection, with examples from Cornwall’s work in the public mental health system The importance of engaging children to identify what they need from adults in their lives, arming parents with new attitudes and communication tools for relating to their children, and the success they have had with such approaches How listeners can learn more about SPAC! and get involved with advocacy against conventional psychiatric treatment for children and for more compassionate and commonsense alternatives. The groundswell of interest they have received from parents and a variety of online resources available on these topics The right of parents to say no to dangerous drugs or devices doctors want to prescribe, and the importance of understanding the risks of resisting a medical professional’s authority or challenging a child’s school Reasons for parents and teachers be optimistic that even seemingly incorrigible children can be reached. Relevant Links SPAC! webpage, part of Dr. Peter Breggin’s Children’s Resource Center ECT Resource Center Center for the Study of Empathic Therapy, Education, and Living MIA blogs Monarch eTNS Inspires “Stop the Psychiatric Abuse of Children!” (SPAC!) FDA Approves Using Electricity All Night Long on Children’s Brains

This week on MIA Radio we turn our attention to support for those who are struggling to withdraw from psychiatric drugs. Recently in the UK, this issue has become headline news with more and more attention being given to the work of groups such as the Council for Evidence Based Psychiatry and peer-led initiatives such as the Bristol Tranquilliser Project.  December 4 2019, marks the release of guidance which has been specifically written to support psychological therapists and their clients in having discussions about taking and withdrawing from psychiatric drugs. The comprehensive guidance is a collaboration between psychologists, peer support specialists and psychiatrists and aims to provide important context and evidence-based support to psychological therapists, whatever their particular modality. In this interview, we chat with psychotherapist  and project lead Dr. Anne Guy, Peer Support Specialist Paul Sams and Professor of Psychology John Read. We Discuss: How the project to create guidance for psychological therapists got started. The need to address a significant gap in knowledge and experience, particularly given the numbers of clients who work with psychological therapists and are already taking or thinking of coming off psychiatric drugs. That therapeutic training previously hasn’t addressed the intersection of psychiatric drugs and the practice of therapy. How a recent survey showed that 96% of all therapists are seeing at least one client who is taking psychiatric drugs. That the guidance is not prescriptive but provides an opportunity for a therapist to respond to drug issues that other professionals may not have time available to address. The important distinction made between giving medical information and giving medical advice. How the guidance will be launched in Westminster, London on December 4 2019, and that people can read the guidance and view a Q&A here. That next year will see some Continuing Professional Development activities. How lived experience and peer support knowledge has been applied in developing the guidance. How the guidance opens up the conversation such that no go areas are addressed as part of the overall therapeutic discussion. That the approach is one of empowerment and supporting conversation rather than defining or being prescriptive. How the evidence-based part of the guidance came together and that there was a fairly consistent finding that around 50% of people coming off psychiatric drugs will experience some sort of withdrawal with around half of those describing the withdrawal effects as severe. That the guidance has provided the chance for psychologists, counsellors and psychotherapists to work together. Relevant Links: Read or download the guidance here. View the guidance Q&A here. © Mad in America 2019