Mad in America: Rethinking Mental Health

This week on MIA Radio, we chat with Paula J. Caplan. Paula is a clinical and research psychologist, author of books and plays, playwright, actor, director, and activist. She was born and raised in Springfield, Missouri, attended Greenwood Laboratory School, received her A.B. with honors from Radcliffe College of Harvard University, and received her M.A. and Ph.D. in psychology from Duke University. Currently, she is an Associate at the Du Bois Institute, Hutchins Center for African and African American Research, Harvard University. She has been a Fellow at the Women and Public Policy Program of the Kennedy School of Government at Harvard; a Lecturer in Harvard's Program on Women, Gender, and Sexuality in the Psychology Department. She is former Full Professor of Applied Psychology and Head of the Centre for Women's Studies in Education at the Ontario Institute for Studies in Education, and former Lecturer in Women's Studies and Assistant Professor of Psychiatry at the University of Toronto. Paula is also a passionate and steadfast advocate for service members, veterans and their families. She has written: When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans and has founded the Listen to a Veteran! Project. In this interview, we discuss Paula's work to support service members, veterans and their families, and the role psychiatric drugs have played in harming these communities. We discuss: Paula's experiences that drove her towards working in mental health and advocating for veterans, which came from her father's service in World War II. This included combat in the Battle of the Bulge. After hearing her father's story that had been recorded as part of a history project, she learned her father had been a forward observer, and as result learned he had been on the front lines of the war. This led to her realizing that most American's don't understand military service and the only way of doing this, is through hearing veterans' stories. Prior to the invasion of Iraq, she became concerned about the care of service members of veterans and veterans upon their return from war, and more concerned of the "psychiatrization", diagnosing and prescribing psychiatric drugs to veterans. To get started in her efforts, she began by listening to a veteran share his experiences with her. The veteran talked for three hours, and Paula just listened. The next day, he called her and thanked her for listening, as he got a good night sleep for the first time in years. This led to her starting Listen to a Veteran, which was originally called "When Johnny and Jane Come Marching Home". As part of this initiative, a veteran of any era can meet with another person who has volunteered to listen to the veteran share any stories or experiences they're interested in sharing. Paula has faced barriers in getting this program expanded to the VA or throughout the "mainstream" mental health community because the system has been created to function based upon current "evidenced-based" best practices. How Paula is positive that we are currently causing harm to veterans and that alternative approaches need to immediately be implemented throughout the Department of Defense and Department of Veterans Affairs. How "therapy" needs to be dropped from the terms "art therapy", "music therapy" and the like, so we can stop pathologizing individual experiences, and instead support people in doing things that improve their overall well-being. Any veterans who want to be a listener as part of Paula's Listen to a Veteran initiative, or would like to have someone listen to them, they can go to listentoaveterans.org.

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. Medication-Free Treatment in Norway - A Private Hospital Takes Center Stage Written by Robert Whitaker, read by James Moore with thanks to Birgit Valla for pronunciation assistance, first published on Mad in America, December 8, 2019. The Hurdalsjøen Recovery Center, which is a private psychiatric hospital located about forty minutes north of Oslo, on the banks of stunning Lake Hurdal, was set up by its director, Ole Andreas Underland, to provide "medication-free" care for those who wanted such treatment or who wanted to taper from their psychiatric drugs. Norway's health minister was urging public mental hospitals to offer such treatment, and this private hospital stepped forward before any public hospital had taken the plunge. Hurdalsjøen opened on April 1, 2015. The first person to show up at its doors was 31-year-old Tonje Finsås, and she had a medical history that could fill volumes. She had developed an eating disorder when she was eight; she was put on antidepressants at age 11, which is when she started cutting herself; then came a prescription for a benzodiazepine; and soon she was cycling in and out of psychiatric wards with astonishing frequency. She arrived at Hurdalsjøen with prescriptions for 31 medicines, including three antipsychotics, and a record of 220 hospitalizations. She had spent most of the three previous years in isolation at a psychiatric hospital in Bergen, where she was watched over by two aides at all times, and was often restrained in a belt. "I tried to kill myself every day," she recalled. "I didn't want to live anymore. This was not a life. Even a dog in a cage has it better than what you have in there." Although Lake Hurdal provides a beautiful setting, the hospital is located in a 1970s building, one that was used to treat people suffering from nervous problems, and inside it has an institutional feeling: small rooms located off a long hallway, not all that different from what you might find in an older psychiatric hospital. When Finsås balked at staying there, Underland proposed a novel solution.

Ian Parker is one of the most important contemporary critics of the discipline of psychology. A prolific writer, with over 25 books to his name, he has a formidable reputation in the fields of critical psychology, Marxist psychology, and psychoanalytic theory. He is a fellow of the British psychological society, Emeritus Professor at the University of Leicester, and the managing editor of the Annual Review of Critical Psychology. Parker is also a practicing psychoanalyst analyst and a member of the Centre for Freudian Analysis and Research and the London Society of the New Lacanian School. His career reflects the principles he talks about – the importance of challenging powerful institutions and the need for collectively mobilizing against discrimination and exploitation. As the "Psy-disciplines" face increased scrutiny for involvement in past abuses, continued collusion with powerful and unjust institutions, and deep criticisms over current psychological research and practice, Parker's work has particular relevance. His criticisms of psychology and psychiatry started from his university days as a student. He observed that while other social sciences were critical of their received knowledge and open to contributions from the civil rights and women's movements, psychology continued to reinforce old power relations and pathologized these same social movements. Since then, Parker has become one of the most well-known critics of mainstream psychology, and his work repeatedly questions the role of ideology and power in the field. These contributions are evident throughout his writing, including his four-volume 'major work' Critical Psychology (2011) and a Handbook of Critical Psychology (2015). He is currently the editor of the 'Concepts for Critical Psychology' series for Routledge.

This week on MIA Radio, we chat with Beatrice Birch who is the initiator of the residential healing community Inner Fire. For over 35 years, Beatrice worked as a Hauschka artistic therapist in integrative clinics and inspiring initiatives in England, Holland and the USA where the whole human being of body, soul and spirit was recognized and appreciated in the healing process. She has lectured and taught as far afield as Taiwan. Her passionate belief in both the creative spirit within everyone and the importance of choice, along with her love and interest in the human being has taken her also into prisons where she has volunteered for many years offering soul support through Alternatives to Violence work and watercolor painting. In this interview, we discuss how Inner Fire works to help the people that attend, and how a core principle of their healing work is that 'human being are creators, not victims'. We discuss: Beatrice's background and experiences as someone providing alternative help and support for mental and emotional challenges, including her time in the UK National Health Service (NHS) utilizing Hauschka artistic therapy and other artistic therapies alongside improving nutrition and connection to new skills. How she came to be interested in the resilience of the human spirit, wanting to understand why some people cope and others do not. That Beatrice worked for many years in prison settings, working with Alternatives to Violence (AVP) and providing artistic therapies to inmates before founding Inner Fire, based in Vermont. Inner Fire is a proactive healing community officially recognised by the state of Vermont as a Therapeutic Community Residence (TCR) that has been operating as a 501(c)(3) non-profit for almost 6 years. How Inner Fire provides a medication-free approach to recovery from debilitating or traumatic life experiences, helping people to reclaim their lives. That Beatrice believes in the importance of allowing people to connect with their divine, creative selves and this leads to a core principle of Inner Fire which is that 'human being are creators, not victims'. Inner Fire doesn't influence a person's choice to stay on or come off psychotropic drugs, but they will work with people who want to gradually taper either to a comfortable level or off completely. Beatrice presented a paper to ISPS Rotterdam entitled: Suppose 'Mental Health' is a Reductionist Term for 'Soul Health'… How Beatrice describes those that come for help as 'seekers' and those from Inner Fire that support them as 'guides'. That the focus of Inner Fire is participation, connection and community achieved by learning new skills in a group environment, getting people out of their heads and into their limbs. The importance of rhythm when following the Inner Fire programme and how it is key to the healing process. Inner Fire has a staff psychiatrist who has an appreciation of the spiritual dimensions of our lives, allowing spiritual and biological aspects to coexist. How Beatrice's experience is that while medications can be helpful for some for a time, typically one drug will lead to another and then another and ultimately to hospitalisation. Where tapering is concerned, the seeker and the psychiatrist together decide on the tapering approach but that it is recognised that tapering must be slow and must adapt to the experience of the person trying to reduce. That Beatrice wants to raise enough money to provide a space where people can freely express the emotion that often arises as they come off their psychotropic drugs. Inner Fire is currently private pay and that people donating can therefore help seekers who want to attend but don't have the financial resources. How Inner Fire is not a profit-motivated enterprise because the focus is on the individual's healing journey. Bob Whitaker helped open the east wing of the Inner Fire home. Love is for the world what the Sun is for outer life No soul could live if love departed from the world It is the moral Sun of the world To spread love over the Earth to the greatest degree possible To promote love That alone is wisdom - Rudolph Steiner, Love and its Mission in the World More Information: Inner Fire Application Process Become a Supporter Beatrice on the Peter Breggin Hour podcast

This week on MIA Radio, we interview Laysha Ostrow. Laysha is the founder and CEO of Live & Learn, a research and consulting company that specializes in the inclusion of people with lived experience of the mental health system. She researches community-driven interventions that present safe and effective pathways to independence and empowerment. Ostrow earned her PhD from the Johns Hopkins School of Public Health and holds a master's degree in public policy from Brandeis. Ostrow is passionate about improving the experience of mental health service users, partially due to her personal experience with mental health systems. She has discussed some of her previous research on Mad in America.

Peter Stastny is a New York-based psychiatrist, documentary filmmaker, and a co-founder of the International Network toward Alternatives and Recovery (INTAR). He has been working on the development of services that obviate traditional psychiatric intervention and offer autonomous paths towards recovery and full integration. Stastny has frequently collaborated with psychiatric survivors in conducting research and writing projects, including the book and major exhibit at the New York State Museum, The Lives They Left Behind: Suitcases from a State Hospital Attic(together with Darby Penney) and the edited volume Alternatives Beyond Psychiatry (with Peter Lehmann). He has directed several documentary films.

Psychiatric diagnosis has come under increased scrutiny in recent years following the release of the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-5) in 2013. Two organizations that played a prominent role in challenging the Bible of psychiatry prior to 2013, the British Psychological Society and the Society for Humanistic Psychology (American Psychological Association - Division 32) subsequently joined to form the Task Force for Diagnostic Alternatives (TFDA). Today, February 12th, 2020, the TFDA released a new Open Letter regarding the reform and revision of diagnostic systems. MIA spoke with two leaders of the Task Force, Sarah Kamens, and Peter Kinderman about this effort. Sarah Kamens is an Assistant Professor of Psychology, at the State University of New York (SUNY) College at Old Westbury and co-chair of the Task Force for Diagnostic Alternatives for the Society for Humanistic Psychology. Her research examines the intersections between extreme emotional distress and structural marginalization. More specifically, she studies the ways in which lived experiences of psychosis and trauma are entangled with social conditions in the world. Peter Kinderman is past president of the British Psychological Society (BPS) and a Professor of Clinical Psychology at the University of Liverpool. He is also a past guest on the Mad in America podcast and the author of A Manifesto for Mental Health, Why We Need a Revolution in Mental Health Care (2019) and A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing (2013).

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