Friday, August 29, 2003

No proof mental illness rooted in biology

By KEITH HOELLER
GUEST COLUMNIST

What is "the mental health movement?" Its proponents claim that millions of Americans are afflicted with a mental illness, which is a disease "just like any other" and that the mentally ill suffer from a chemical imbalance in the brain that is corrected by psychiatric drugs.

Mental illness is said to be the cause of many of our society's social ills, such as suicide, murder, divorce, child abuse, sex offenses, depression and various addictions. If only mental illness could be cured, mental health supporters say, all of these ills could be prevented.

Because the mentally ill often are unaware of their disease, treatment must be forced on the mentally ill. All 50 states have laws that allow involuntary treatment if professionals deem they are a danger to self and others.

Psychiatrists, we are told, can now accurately diagnose mental illness and have safe and effective treatments. Psychiatry is considered a valid medical specialty, like cardiology, and the claims of the movement are based on scientific research.

The largest lay group is the National Alliance for the Mentally Ill (NAMI). The media routinely refer to NAMI as advocates for the mentally ill, although its membership consists almost entirely of family members and not the mentally ill themselves. NAMI ascribes to the "biological basis of mental illness," and endorses forced treatment of the mentally ill.

The movement's major source of funding is the highly profitable pharmaceutical industry, which funds the drug research; which funds psychiatric journals, and even the American Psychiatric Association itself; which funds advertising to doctors and the public; and even funds lay groups such as NAMI (at least $11 million) and Children and Adults with Attention Deficit Disorder (at least $1 million).

Yet many professionals claim that the mental health movement is not a legitimate medical or scientific endeavor, let alone a civil rights movement, but a political ideology of intolerance and inhumanity. Numerous psychiatrists and psychologists have examined the psychiatric research literature and found it to range from smoke and mirrors to quackery.

Psychiatrists have yet to conclusively prove that a single mental illness has a biological or physical cause, or a genetic origin. Psychiatry has yet to develop a single physical test that can determine that an individual actually has a particular mental illness. Indeed, The Diagnostic and Statistical Manual of Mental Disorders uses behavior, not physical symptoms, to diagnose mental illness, and it lacks both scientific reliability and validity.

On Aug. 16, eight members of MindFreedom (www.mindfreedom.org), an umbrella organization of mental patients who call themselves "psychiatric survivors," began a Fast for Freedom "to press for human rights and choice in psychiatry" and to "demand that the mental health industry produce even one study proving the common industry claim that 'mental illness is biologically-based.' "

Dr. James Scully of the American Psychiatric Association responded to the hunger strikers by claiming the evidence was so vast one need only look at "Mental Health: A Report of the Surgeon General" (1999) or a recent psychiatry textbook.

An expert panel for the strikers, made up of members (like myself) of the International Center for the Study of Psychiatry and Psychology (www.icspp.org), quickly responded by pointing out that neither of these works contains any such conclusive proof. Actually, the surgeon general's report on mental health states that "the precise causes (etiology) of mental disorders are not known" and "there is no definitive lesion, laboratory test, or abnormality in brain tissue that can identify (a mental) illness." The Textbook of Clinical Psychiatry (1999) states: " ... Validation of the diagnostic categories as specific entities has not been established."

In its reply to the fasters, the National Alliance for the Mentally Ill did not cite any scientific evidence at all.

In 1784, a similar debate raged in Paris about the scientific validity of the latest psychiatric nostrum (hypnotism) and its inventor, Dr. Franz Anton Mesmer, who claimed to have discovered a physical mechanism he called animal magnetism. The Academy of Sciences formed a panel, including American scientist Benjamin Franklin and French chemist Antoine Lavoisier, to assess the movement sweeping the city, and concluded that Mesmer's "cures" had no scientific basis. They were due entirely to the power of suggestion, now called the placebo effect. The Royal Society of Medicine issued a report with similar findings on Aug. 16, 1784.

Let us hope the Fast for Freedom has a positive outcome for all involved.

If not, let us insist that the American Medical Association (or similar body) form a panel of objective, non-psychiatric scientists, without any ties to drug companies, to examine whether psychiatry should continue as a medical specialty or if it should join the historical ranks of alchemy, astrology and phrenology as a pseudoscience.

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