Jul 23, 2008 01:00 AM

American psychiatry has been rocked by Congress. Congressionalinvestigators first exposed the financial relationships betweenhigh-profile psychiatrists and drug companies. “But now the professionitself is under attack in Congress,” reported the New York Times on July 12, 2008.

Specifically under attack is psychiatry’s premier professional organization, the American Psychiatric Association. The New York Timesstated, “In 2006, the latest year for which numbers are available, thedrug industry accounted for about 30 percent of the association’s $62.5million in financing. About half of that money went to drugadvertisements in psychiatric journals and exhibits at the annualmeeting, and the other half to sponsor fellowships, conferences andindustry symposiums at the annual meeting.”

The American Psychiatric Association is, as the New York Times notes, “the voice of establishment psychiatry.” It publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM),which is the standard diagnostic manual. It also publishes influentialprofessional journals. And it is the primary lobbying organization forAmerican psychiatry.

The president-elect of the AmericanPsychiatric Association is Alan Schatzberg of Stanford University, andhis $4.8 million stock holdings in a drug development company raised ared flag for Congressional investigators. Sen. Charles Grassley,R-Iowa, informed the American Psychiatric Association, “I have come tounderstand that money from the pharmaceutical industry can shape thepractices of nonprofit organizations that purport to be independent intheir viewpoints and actions.”

One example of how psychiatrictreatment practices are corrupted by drug-company money was revealed ina 2007 analysis of Minnesota psychiatrists. The analysis showed thatpsychiatrists who received at least $5,000 from makers ofnewer-generation antipsychotic drugs wrote, on average, three times asmany prescriptions to children for these drugs as psychiatrists whoreceived less money or none.

The New York Times did trackdown one psychiatrist in private practice not on the take from drugcompanies, William Niederhut. Niederhut said that studies have shownthat researchers who are paid by drug companies are more likely toreport positive findings when evaluating that company’s drugs.Niederhut was upset that drug company influence has pushedpsychiatrists to prescribe expensive drugs rather than the off-patentinexpensive ones.

While the truly anti-psychiatry establishment psychiatrists were not quoted by the New York Times, reporters Benedict Carey and Gardiner Harris did provide an important service by using the term establishment psychiatry, which at least gives a clue that there are anti-establishment psychiatrists.Among this group of anti-establishment psychiatrists, two of the mostwell known are Peter Breggin and Grace Jackson, both of whom havetestified at Food and Drug Administration advisory meetings. Bregginand Jackson, for several years, have been reporting that the dangers ofpsychiatric drugs are downplayed or ignored by establishmentpsychiatry, that many blockbuster psychiatric drugs are no moreeffective than sugar pill placebos, and that the chemical imbalancetheories that sell these drugs are based on drug-company marketingrather than legitimate science.

Prior to exposing the AmericanPsychiatric Association’s financial dependency on Big Pharma,Congressional investigators had focused on individual establishmentpsychiatrists’ financial relationships with drug companies. Onehigh-profile example being Joseph Biedeman, about whom the New York Timesreported: “A world-renowned Harvard child psychiatrist whose work hashelped fuel an explosion in the use of powerful antipsychotic medicinesin children earned at least $1.6 million in consulting fees from drugmakers from 2000 to 2007.” Biederman and two of his colleagues in thepsychiatry department at Harvard Medical School (who received anadditional $2.6 million from drug companies from 2000 to 2007), byfailing to report income from drug companies while at the same timereceiving federal funds from the National Institutes of Health,violated rules designed to police conflicts of interest, according toSen. Grassley.

I can only hope that Congress and the mainstreammedia will get around to the most important issue of all: How BigPharma corruption of psychiatry has eliminated options for people withsevere emotional problems who have been failed by establishmentpsychiatric treatments. One such option that was eliminated is SoteriaHouse, the creation of psychiatrist Loren Mosher.

Loren Mosher(1933-2004) was chief of the National Institute of Mental Health’sCenter for the Study of Schizophrenia from 1968 to 1980. Mosher wantedto create an effective and more humane way to help psychiatry’s mostseriously troubled patients. Using National Institute of Mental Healthfunds, Mosher opened the first Soteria House in Santa Clara, Californiain 1971.

Mosher’s Soteria House experiment is detailed by former Boston Globe reporter Robert Whitaker in Mad in America.In Soteria House, newly diagnosed schizophrenic patients livedmedication-free with a young, nonprofessional staff trained to listento and understand them and provide companionship. Mosher tested hisidea that “schizophrenia can often be overcome with the help ofmeaningful relationships rather than with drugs, and that suchtreatment would eventually lead to unquestionably healthier lives.”

TheSoteria House experiment worked better than Mosher had expected. Overthe initial six weeks, patients recovered as quickly as those treatedwith medication in hospitals. Whitaker notes, “Even more striking, theSoteria patients were staying well longer. Relapse rates were lower forthe Soteria group at both one-year and two-year follow-ups. The Soteriapatients were also functioning better socially — better able to holdjobs and attend schools.”

Mosher’s success with nonprofessionalcaregivers and without drugs embarrassed establishment psychiatry. TheNational Institute of Mental Health choked off funding causing SoteriaHouse to close down. By 1998 Mosher was so disgusted with establishmentpsychiatry that he wrote a widely publicized letter of resignation fromthe American Psychiatric Association. Establishment psychiatry, whichin recent times usually ignores anti-establishment psychiatrists suchas Mosher, had to respond and did so by accusing Mosher of wanting toabolish drug treatments. However, abolishing the option of drugtreatment was never Mosher’s goal.

Loren Mosher remains a herofor many anti-establishment consumer- and patient-rights organizationssuch as MindFreedom. MindFreedom also does not advocate for abolishingthe option of drug treatment but instead advocates for truly informedchoice as well as for alternatives beyond establishment psychiatrictreatments — alternatives such as Soteria House. I recently spoke withtwo members of MindFreedom, a married couple. Both wife and husband hadbeen diagnosed in the past with schizophrenia. The wife chose to stayon psychiatric drugs, while the husband — who had especiallydebilitating adverse effects with his psychiatric drugs — chose to gowithout drugs. Their different paths initially created tension in themarriage but both ultimately quite graciously accepted each other’sdecision.

These are the true issues: Do Americans have mentalhealth treatment choices that are informed choices? Why, when BigPharma corruption has long been known, does it take Congressionalinvestigations for the mainstream media to inform Americans of thefinancial relationships that drug companies have with high-profilepsychiatrists and major psychiatry institutions? And most importantly,when will Americans get real choices when it comes to their mentalhealth?

A real choice is not a choice between Prozac or Zoloft,not between Zyprexa or Risperdal. One example of a real choice is thechoice between establishment psychiatry or Soteria House.

BruceE. Levine, Ph.D., is a clinical psychologist and author of SurvivingAmerica’s Depression Epidemic: How to Find Morale, Energy, andCommunity in a World Gone Crazy (Chelsea Green, 2007).