Current Trends in Mental Healthcare
Robert Whitaker (above) is an award-winning journalist, most well-known for his impeccably referenced, breakthrough book, Anatomy of an Epidemic. In it he describes the harm of taking psychiatric medications long term, something that you would not see in ads from Big Pharma that proliferate the media. John Horgan recently published an interview he had with Whitaker in “Scientific American” in October, 2020. Following are excerpts from that published interview.
When asked about current trends in mental health Whitaker summarizes the negatives:
More and more research tells of how the conventional narrative, in all its particulars, has failed to pan out. … the narrative that was told to us starting in the 1980s [that most mental illness is caused by chemical imbalance in the brain that can be rectified by chemistry] has collapsed…
The diagnoses in the Diagnostic and Statistical Manual (DSM) have not been validated as discrete illnesses; the genetics of mental disorders remain in doubt; MRI scans have not proven to be useful; long-term outcomes are poor; and the notion that psychiatric drugs fix chemical imbalances has been abandoned. Ronald Pies, the former editor in chief of Psychiatric Times, has even sought to distance psychiatry, as an institution, from ever having made such a claim.
Whitaker also points to new initiatives in current trends that hold great promise:
You have the spread of Hearing Voices networks, which are composed of people who hear voices and offer support for learning to live with voices as opposed to squashing them, which is what the drugs are supposed to do. These networks are up and running in the U.S., and in many countries worldwide.
You have Open Dialogue approaches, which were pioneered in northern Finland and proved successful there, being adopted in the United States and many European countries (and beyond.) This practice puts much less emphasis on treatment with antipsychotics, and much greater emphasis on helping people re-integrate into family and community.
You have many alternative programs springing up, even at the governmental level. Norway, for instance, ordered its hospital districts to offer “medication free” treatment for those who want it, and there is now a private hospital in Norway that is devoted to helping chronic patients taper down from their psychiatric medications. In Israel, you have Soteria houses that have sprung up (sometimes they are called stabilizing houses), where use of antipsychotics is optional, and the environment—a supportive residential environment—is seen as the principal “therapy.”
You have the U.N. Special Rapporteur for Health, Dainius Puras, calling for a “revolution” in mental health, one that would supplant today’s biological paradigm of care with a paradigm that paid more attention to social justice factors—poverty, inequality, etc.—as a source of mental distress.
Current Trends Re the Causes of Mental Disturbances
Whitaker sees progress in understanding the causes of mental illness and the foundation of mental health:
… researchers are returning to investigations of how we are impacted by what has “happened to us.”
The Adverse Childhood Experiences (ACE) study provides compelling evidence of how traumas in childhood—divorce, poverty, abuse, bullying and so forth—exact a long-term toll on physical and mental health. Interview any group of women diagnosed with a serious mental disorder, and you’ll regularly find accounts of sexual abuse. Racism exacts a toll. So too poverty, oppressive working conditions, and so forth. You can go on and on, but all of this is a reminder that we humans are designed to respond to our environment, and it is quite clear that mental distress, in large part, arises from difficult environments and threatening experiences, past and present.
… what do we all need to be mentally well? Shelter, good food, meaning in life, someone to love and so forth—if you look at it from this perspective, you can see why, when those supporting elements begin to disappear, psychiatric difficulties appear.
I am not discounting that there may be biological factors that cause “mental illness.” While biological markers that tell of a particular disorder have not been discovered, we are biological creatures, and we do know, for instance, that there are physical illnesses and toxins that can produce psychotic episodes.
However, the progress that is being made at the moment is a moving away from the robotic “it’s all about brain chemistry” toward a rediscovery of the importance of our social lives and our experiences.
Dainius Puras, the psychiatrist mentioned above who is the UN Special Rapporteur for Health, believes the answer lies here:
If we want to have better mental health, we need to look at what is happening in families, schools, workplaces, communities, and our society. Are we being tolerant? Are we protecting human rights principles? If yes, we can expect good mental health. Then we should apply the same standards to mental health settings. If we follow these principles, there is the way out of this crisis of mental health care, this crisis of psychiatry.
Integrative Mental Health for You, IMHU.org
IMHU offers 35 courses and presentations, mainly online, that direct people towards these new trends in mental healthcare–curated by experts so you don’t have to do the research. The catalog of offering is HERE.
Of particular interest to readers of the article above:
- The New Psychiatry: Moving Beyond Psychiatric Medications
- Integrative Psychiatry with Lila Massoumi, MD
- New Models of Residential Treatment and Collaborative Care