Why mental health is a 'disability' issue / 10 December 2012
I've been mulling over the range of comments that were entered in last weeks online debate as posted in DAOs editorial. In response I have to say, first off, that we have stop thinking of disability as a physical attribute. Disability is a state of inequality brought about as a result of oppression within society. This is often to do with physical barriers and lack of physical access, but it is also because of attitudinal barriers.
What I would like to emphasise to those who would trivialise mental health issues and deny them as being a disability issue, is that what they have to take on board is that we have been living in a war of attrition with psychiatry ever since chlorpromazine was announced as the wonder drug in 1955. At that point in time the so-called pharmacological revolution introduced the concept of mental illness resulting from a chemical imbalance in the brain, with glib ideas about how the brain works, used as if 'chemical imbalance' were a known pathology.
Over the past 57 years anti-psychotic medication has caused unwritten, untold damage as the power relationships maintained by the medical model of psychiatry remain underpinned by the large pharmaceutical companies, who continue to dole out the idea that their drugs can and do 'cure'. The arguments the psychiatric profession proffer correlate with the kind of arguments enforced by witch-finders in the 300 years or so of the state persecution of witches.
Once submitted to the ducking stool, it was proof of your guilt and allegiance to evil if you rose to the top of the water; and of your innocence if you drowned. Similarly, under the rules of psychiatric intervention if you admit to being ill and take your medication, then you are getting 'better'. If you refuse and deny the professionals' reflection on how you 'present', then you are ill and therefore need further medication. No-matter that psychiatric medication itself has been proven to cause chemical imbalance and to shrink the actual size of the brain. The terrible thing is that like many, addictive illicit drugs which alter the brains chemistry, the impact of neuroleptics is devastating if, once introduced, they are not taken away over time and with careful consideration. What we are living in is a state of institutional abuse at a national level in which millions of individuals in the west are being systematically poisoned in the belief that this is somehow for the greater good.
I went to the Open Paradigm conference last Friday. US Journalist Robert Whitaker (author of Mad in America) talked through psychiatry's own statistics on how dangerous and ineffective psychiatric medication is. He discussed the statistics for how neuroleptic drugs intervene with brain chemistry; how preventing the brains production of dopamine is like driving a car with the brakes on. He discussed the rates of low age expectancy for individuals on neuroleptics long-term, the long-term brain damage through brain shrinkage, tardive dyskinesia and akithisa, which are a physical manifestation of a brain trying to produce dopamine naturally, when the transmitters are being blocked by the 'medication'. He also discussed the financial costs of disabling people through making them incapable of functioning in any capacity for work or study. He discussed the statistics produced by NIMH and all the research into neuroleptic drugs from the introduction of chlorpromazine in 1955 to statistics around the current 'wonder drug' clozapine. He was passionate and took on board how very upsetting the information he has gleaned would be for the 120 or so people in the room, many of us whom were survivors.
In a constructive response psychotherapist Nick Putman talked about his experience of the Finnish Open Dialogue psychiatric model which was introduced as the method of treatment in the mid-1990s. West Lapland has gone from being the country with the highest incidence of 'schizophrenia' in Europe per capita to the country with the least incidence. Why? Because the Open Dialogue method advocates medication as the very last resort. It advocates looking at psychosis as a breakdown in communication between people, rather than a breakdown 'in' people. It advocates setting aside the traditional power relations between doctor and patient through a process of mirroring.
Open Dialogue is in accord with other developments in psychiatric care, such as the Soteria project developed by Loren Mosher in Canada. Now there have been moves to establish a Soteria house in Brighton, East Sussex. The root meaning of psychiatry is care of the soul. Yet the medical model approach defines us by our symptoms of anxiety, depression or psychosis. It puts us in the control of the professionals and the government puts itself in the position of protecting the public from the ‘mentally ill.’
The beauty of the Soteria and the Open Dialogue approaches are that they offer potential for a paradigm of care which takes the notion of the individual being in a state of 'division'; of having a divided self; and looks at unravelling how that person has entered into a state of division from other people.
I don't know how we move forward to creating a fairer society, one which breaks down the barriers which disable us? But to say that "the mainstreaming of mental illness is a greater problem than the genuine problems that need support and assistance" is to ignore hundreds of years of persecution and to lay a foundation for an argument that will lead us straight back to the gas chamber.