Saturday 17 August 2019

Mind Fixers

The Spinoff has a superb piece by Danyl McLauchlan reviewing Anne Harrington's Mind Fixers. Thomas Szasz makes an appearance. A snippet:
In January of 1973 the psychologist David Rosenhan published an article in Science, one of the world’s most influential academic journals, titled ‘On Being Sane in Insane Places’. He’d conducted an experiment in which eight people (including himself) presented to twelve different psychiatric hospitals across the US, complaining of audible hallucinations: the words they claimed to hear were specifically chosen because they didn’t correspond to anything in the published literature linking them to psychotic symptoms. They were all diagnosed with either schizophrenia or ‘manic depressive psychosis’ and committed. Upon admission they started behaving normally and taking notes about the environment, in such an overt manner that their fellow patients accused them of being professors or journalists checking up on the hospital. At no point did any medical staff suspect they were not mentally ill. Eventually they were all discharged with a diagnosis of ‘schizophrenia in remission.’

Rosenham’s article ended with a story about a well regarded teaching and research hospital that had heard of his study and challenged him to send pseudo-patients to them, confident that they could detect such imposters. Over a period of several weeks they identified 41 individuals whom they diagnosed as sane but pretending to be mad. Rosenham had not actually recruited anyone for this study: these were genuine patients, 41 false negatives. Another critic of psychiatry, Thomas Szasz, made the point that none of this looked remotely like medicine. What psychiatrists seemed to do was identify people who behaved in unusual, socially unorthodox ways and declare that they were ‘sick’, and therefore in need of confinement and treatment, which they applied whether the patient wanted to be treated or not. Psychiatrists seemed to be violating the basic civil rights of their patients on an astonishingly vast scale.
I hadn't known about that study. Danyl concludes:
Two of the final quotes in the book come from high ranking members of the psychiatric priesthood, summing up the current state of the science. This first is Thomas Insel, a former director of the US National Institute of Mental Health for 13 years, who wrote:

“I spent 13 years at NIMH really pushing on the neuroscience and genetics of mental disorders, and when I look back on that I realize that while I succeeded at getting lots of really cool papers published by cool scientists at fairly large costs – I think $20 billion – I don’t think we moved the needle in reducing suicide, reducing hospitalizations or improving recovery for the tens of millions of people who have mental illness.”

And in 2016 the psychiatrist Shekhar Saxena, director of the World Health Organisation’s mental health unit, remarked that if he was diagnosed with schizophrenia he’d prefer to live in Addis Ababa in Ethiopia, or Colombo in Sri Lanka, where he could live as a productive if eccentric member of the community, as opposed to New York or London, where he’d be stigmatised and relegated to the margins of society.
And there are some well-deserved slaps along the way for journos who are a bit too credulous when they head out on attack against Pharmac. Read the whole thing. 

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