VANCOUVER, Monday, June 6, 2005
The Standing Senate Committee on Social Affairs, Science and Technology, met this day at 9 a.m. to examine issues concerning mental health and mental illness.
Senator Michael Kirby (Chairman) in the chair.
[English]
The Chairman: Senators, we are here to continue our discussion of issues related to mental health, mental illness and addiction.
We have three witnesses, Francesca Allan, Rob Wipond and Ruth Johnson. Colleagues, in front of you are statements that the witnesses would like to put forward.
We normally ask each of you to read out your statements then we have a dialogue and questions.
Mr. Rob Wipond, As an individual: Honourable senators, I have been a researcher/writer on social issues for 20 years, specializing in mental health.
Mental health care is in a sorry state and could easily be much better. Your reports show this committee has a strong bias guiding it and this suggests you will contribute to worsening the situation rather than improving it.
It is good the committee recognizes the importance of community supports but I worry about the encouragement for forced psychiatry and increased psychiatric treatments. Your reports are frequently factually misleading and omit crucial information, and I am referring to all three reports, by the way.
Your discussion of forced treatment in the first report says all legislation must comply with the Canadian Charter of Rights and Freedoms. In fact, most knowledgeable lawyers argue our Mental Health Acts do not comply with the Charter. As we speak, several legal teams are challenging the Mental Health Act of British Columbia.
An Ontario case recently went to the Supreme Court and the patient won. Why are these very important facts not discussed? Worse, the report attacks provinces that allow people to refuse treatment.
If psychiatric treatment were effective and relieved suffering, we would not have the crisis that we have in our health care system. People would love their meds. Forced psychiatry exists because many people often do not feel better, or loathe the drugs and their damaging side effects.
Even more prejudicially, the next paragraph links no problems to jurisdictions where people can never refuse treatment, yet the problems are obvious and epidemic. Just once, treat a patient against her will and if you do not alleviate suffering, you have lost that person's trust and intensified her fears forever. This is a vital issue for virtually all patients and ex-patients I have interviewed. Many are terrified of the mental health system. Why do we ignore this fact? Why are we not looking for solutions to this problem?
The report then highlights this quotation:
Compulsory treatment will usually restore someone's freedom of thought from a mind-controlling illness.
This is deeply biased Orwellian word twisting. This entire section is utterly dismissive of the real, extremely controversial issues surrounding relations of power in our mental health system.
In B.C., patients have virtually no rights and they seldom regard incarceration and drugging as liberating. Psychiatrists who do not want to relinquish any power obviously heavily influenced your report and it is a travesty that you apparently let them block serious questions in your third report.
Without rectifying that extreme, constantly threatening power imbalance, our entire system is thoroughly poisoned.
We endorse forced psychiatry based on an assumption that science can identify mental illness and treat it appropriately. This assumption is false. There is no established legal or scientific standard for what constitutes a psychiatric examination for a mental illness.
We hear this theory of biochemical imbalances and fantasize that psychiatrists in our hospitals examine people's brain chemistry. They do not. The U.S. Surgeon General admits:
There is no definitive lesion, laboratory test or abnormality in brain tissue that can identify mental illness.
The Diagnostic and Statistical Manual 'Normal' Disorders concedes the causes of mental illnesses remain unknown. Psychiatrists exam you any way they like. Mostly they talk with you and observe behaviour. That is it. The closest things we have to standardized examinations, which are sometimes used, are general psychological tests. These tests for depression have questions like:
Which statement best describes how you feel: I do not feel sad; I feel sad much of the time; I am so sad I can't stand it.
Now, if I ask you right now whether you are agitated or really agitated, we can call this exchange a lot of things but rigorously scientific is not one of them. Nevertheless, these types of utterly subjective error-prone dialogues and observations are the foundation of all diagnoses of mental illness in Canada and all forced treatment.
The absence of any discussion of this in your report has enormous ramifications, because if a diagnosis of mental illness is not based in science, what is it based in?
Let us watch it in action. Your report says:
The benefits of early intervention extend to numerous mental illnesses and to individuals of all age groups.
Scientific evidence does not support these fantastic claims. According to the definitive “Early Intervention for Psychosis (Cochrane Review)” for example, there were, “insufficient trials to draw any definitive conclusions.” The few conducted trials found “no difference between intervention and control groups.”
The benefit of early intervention is a controversial hypothesis, and how could we be conclusive when we are not even sure how to examine people for mental illness? Indeed, the CMHA did an early intervention study and found “nearly half of the participants received an incorrect diagnosis.”
Of course, if psychiatrists diagnose incorrectly 50 per cent of the time, the “corrections” are likely wrong 50 per cent of the time too. Therefore, this study actually suggested a 75 per cent error rate in early intervention, which does not beat dice throwing for accuracy.
Who guided those extraordinarily exaggerated claims into your report?
Consider how dangerous they are. Suppose we have a distracted, lethargic boy, and a focused, energetic boy. I say this distracted, lethargic boy has a biochemical brain imbalance; we must force him to drink twelve cups of coffee and pop some black beauties and smoke crack every day and he will be as successful as this other boy. You would laugh me out of here, would you not? Worse, you would say, first off, how do we decide if either lethargy or fervour is an illness? We are just holding these children up to arbitrary social standards. Furthermore, how could anyone seriously suggest that turning our children into drug addicts is a reasonable solution to any of their psychological problems? Consider the long-term damage of extended drug use.
Ritalin is a damaging, addictive amphetamine, not unlike cocaine or black beauties, and that is why it is now a common street drug too. Four months ago, Health Canada banned the attention deficit amphetamine Adderall, after it killed 14 children.
Many studies have shown that more exposure to psychiatrists means more diagnosis of psychiatric illnesses. The Diagnostic and Statistical Manual of Mental Disorders, DSM calls love sickness and computer addiction mental illnesses. This is what you are setting our children up for when you advocate early intervention: Stigma, drug addiction, brain damage and potentially, death. You had better be sure your science is solid, and it is not.
Your reports broadly support increasing access to psychiatric treatments without reviewing the most common treatments. Doing so provides crucial insights into why our mental health care system is in crisis. Psychiatrists prefer descriptives like “antipsychotics” and “mood stabilizers”. In lay terms, the most common drug treatments are tranquilizers, highly addictive sedatives, amphetamines and a variety of drugs with clinical pharmacologies that state “the mechanism of action is unknown.” Most can be extremely damaging.
Studies on these drugs have been on small groups of people for short periods. More people drop out than experience meaningful improvement in their condition. Even then, most receive funding from the biased drug manufacturers. The leading medical journals have spent several years trying to establish new regulations to make these studies more honest and reliable.
The other common treatment is electroconvulsive therapy; electric shocks to the brain. In the early literature, psychiatrists stated that its therapeutic action was brain damage; patients forgot their problems. Nowadays, psychiatrists say the therapeutic action of ECT is unknown but there are side-effects of memory loss.
When you advocate forced treatment and support earlier and more psychiatric interventions, you set people up for sedative and amphetamine addictions, electrical shocks to the brain and poorly understood brain chemistry experiments.
The Senate committee, like much of the public, has developed a distorted sense of the efficacy and safety of psychiatric treatments. We have given psychiatrists supreme authority. Our faith is woven from wishful thinking, conflicts of interest, and a focus on behaviour control over genuine healing.
Consider that the B.C. government recently dismissed environmental concerns and expanded fish farming. Suppose, hypothetically, every provincial politician worked in the fish farming industry and also took personal gifts from fish farming companies. Would you say “unimportant,” “we can still trust our politicians to make a balanced scientific decision about expanding fish farming.” That is exactly the situation we are in with psychiatrists and the drug industry.
Meanwhile, independent World Health Organization studies have consistently shown that outcomes for people diagnosed with mental illnesses are significantly better in India, Nigeria and other much poorer countries than they are in wealthier nations where drugs are the widely available first line of treatment. One study concluded:
Being in a developed country was a strong predictor of not attaining a complete remission from mental illness.
Your report ignores this and exhibits other cultural biases. It laments, “Aboriginal communities suffer significantly higher rates of mental illness.”
The Aboriginal liaison for Victoria's psychiatric hospital put that differently in an interview with me,
Are there Aboriginal people who have a cultural viewpoint of the world that makes them more susceptible to a mental health diagnosis?
That question is not in your report. Ample research has shown that culture, lifestyle and spiritual difference are crucial factors in diagnoses and forced treatment. If you start seeing gods and demons and believe you are approaching a mystical breakthrough, it is not at all likely that a psychiatrist is going to support your exploration. He is going to call you “delusional,” probably “schizophrenic” and tranquilize you.
Your report laments that Canada has only four Aboriginal psychiatrists but shows no concern for the lack of traditional Aboriginal healers in our psychiatric hospitals. That was a major concern of our Aboriginal liaison and this same issue extends further. Where are the Jungian psychologists, the transpersonal psychotherapists, the Hindu yoga gurus, the Buddhist meditation teachers?
If this makes you roll your eyes, or want to, as it does many psychiatrists that I have interviewed, you exemplify the severe prejudice in our mental health system.
This is a major issue of belief differences which your report rarely addresses and it is a primary aspect of the crisis in our mental health system for many patients.
Your report notes “there is a significant lack of accountability mechanisms”. Doctors police themselves. I believe only one modern Canadian psychiatric hospital has ever undergone a comprehensive independent investigation. That one investigation found “systemic” abuse of patients' rights, although few of its recommendations have been implemented.
What proof do the people who hold the power in our mental health care system have that anything they are doing is truly helping our society?
What large-scale statistical evidence do they provide of improved mental health in Canada? What large-scale statistical evidence do they provide of improved mental health in Canada?
In fact, all the evidence shows everything is getting worse. Meanwhile, every time things do get worse psychiatrists say they need tougher mental health laws, earlier interventions, more public outreach, community treatment orders and on and on. They are putting infants on antidepressants. As many as one in five kids are on drugs. Five per cent of our population is addicted to prescription sedatives. Electroshock is increasing. Lobotomies are performed right here in Vancouver.
Where will it stop and when will we say that maybe we need to develop a model of mental health care that is not oriented around drugs and forced treatment.
The Chairman: Thank you very much.
MORE:
psychrights.org/index.htm