Why We Need Different Approaches
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It is fairly universally accepted that America's mental health system is a failure.  At great public expense, our current mental health system's ubiquitous deployment of psychiatric drugs, including forcing them into unwilling patients, dramatically worsens outcomes and suffering. 

Since the introduction of the so-called miracle drug Thorazine in the mid-1950's the disability rate of people diagnosed with serious mental illness has increased more than six-fold.[1]

 [2]

We now see a recovery rate of only 5% for those people who are maintained on neuroleptics.[3]

This is far worse than anything seen before the advent of the neuroleptics in the mid-1950's.

It has been shown, however, that if we try to avoid the use of neuroleptics when people experience their first break from consensus reality a nearly 80% recovery rate can be achieved.  The below chart shows results from the "Open Dialogue" program in Northern Finland in which they avoid the use of neuroleptics if possible.

Similar results were achieved during the Soteria-House study in the 1970's conducted by Loren Mosher, MD, who was Chief of Schizophrenia Research at the National Institute of Mental Health (NIMH) at the time.

Soteria-House Study

First-episode schizophrenia patients treated conventionally in a hospital setting with drugs versus treatment in the Soteria House.

Results:

At end of six weeks, psychopathology reduced comparably in both groups.

At end of two years:

·         Soteria patients had better psychopathology scores

·         Soteria patients had fewer hospital readmissions

·         Soteria patients had higher occupational levels

·         Soteria patients were more often living independently or with peers

Antipsychotic Use in Soteria Patients:

·         76% did not use antipsychotic drugs during first six weeks

·         42% did not use any antipsychotic during two-year study

·         Only 19 % regularly maintained on drugs during follow-up period

 

J Nerv Ment Dis 1999; 187:142-149

J Nerv Ment Dis 2003; 191: 219-229

 

What we find is the recovery rate of people who get off of neuroleptics after they have been on them for a while goes from 5% to 40%.

While this is 8 times better than staying on them (40% vs. 5%), it is half of what can be achieved by avoiding the use of neuroleptics in the first place as established by the Open Dialogue and Soteria House studies, both of which achieved close to an 80% recovery rate.[4]  This demonstrates the importance of avoiding the use of neuroleptics if at all possible.  In addition to their lives being so much better, allowing 16 times more people to recover not only saves a tremendous amount of treatment expense, it converts people who would otherwise be receiving life-long publicly paid services and transfer payments into productive, taxpaying citizens. [5] 

In addition to dramatically reducing the recovery rate, the ubiquitous use of psychiatric drugs reduce the lifespan of people diagnosed with serious mental illness in the public mental illness system by 20-25 years.[6]  We should and can do better.



[1] The charts are from talks given by award winning journalist, Robert Whitaker, author of Anatomy of an Epidemic and Mad in America, including his July 16, 2021, talk to the Soteria Network in the UK, "Soteria Past, Present, and Future: The Evidence For This Model of Care," available on YouTube at  https://youtu.be/UXe2dgBF70w.  This one hour talk is highly recommended.

[2] It is likely at least some of the increase after 1987 was because people were thrown off welfare under the “welfare to work” legislation passed in 1996,  and had to be certified as disabled to continue to receive financial assistance.  The decrease since 2013 is in large part due to the government making it harder to qualify for such disability payments. 

[3] Marketed as "antipsychotics" even though they don't have anti-psychotic effects for most.

[4] While there might not be a 100% overlap between the 80% who recovered and the 80% who were not taking the neuroleptics long term, clearly minimizing the use of the neuroleptics produce dramatically better outcomes.

[5] The best book to understand the impact of psychiatric drugs in general, not just the neuroleptics, is Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, by Robert Whitaker, from whose work the foregoing is largely drawn.

[6] See, various studies at http://psychrights.org/Research/Digest/NLPs/neuroleptics.htm and Morbidity and Mortality in People with Serious Mental Illness, by the National Association of State Mental Health Program Directors, October 2006.