Ron Unger LCSW

 “Stormy search for self” as a young man ◦ Sometimes “mad” but it was also a positive emotional and spiritual journey  Multiple family members pulled into mental health system due to similar crisis  Became an activist for change in the mental health system  Then became a professional ◦ To develop alternatives  Then became an educator ◦ To increase availability of alternatives  See my blog

 People in mental health crisis are frequently dangerous to self, sometimes to others ◦ “Too much” respect for their rights has been criticized as possibly leading to people “dying with their rights on”  But too little respect for the human rights of people in crisis can lead to very serious problems that are too often ignored ◦ By looking at both sides of the issue in a balanced way, we can find better solutions

 Between 44 and 51% were found to have PTSD induced by psychiatric admission and treatment  (Priebe, Broker, & Gunkel, 1998; Morrison, Bowe, Larkin, & Northard, 1999)  Forced drugging, restraint, and seclusion have been identified as inducing fear, victimization and helplessness ◦ Also a factor: Loss of control over identity as one is forced into the role of a “mental patient”

 Damaging person’s relationship with mental health system ◦ Creating either  Too much rebellion & disengagement, or  Too much compliance  Possibly imposing a treatment which is actually more harmful than helpful ◦ Because of failure to listen to feedback from person receiving treatment  In General, unjustified infringements on liberty

 Often mental health goals can be accomplished without coercion ◦ Seclusion & Restraint can usually be mostly eliminated by facilities which make that a goal ◦ Research shows making voluntary treatment easily available works as well as involuntary outpatient commitment in reducing mental health problems ◦ Greater appreciation of the damage done by coercive treatment, and appreciation for the very limited ability of psychiatrists etc. to predict violence, could lead to much less use of coercion  And ending it sooner, when it is used at all

 Mental Health system has pretended to know that there exist “real illnesses” like “schizophrenia” that are definitely not understandable reactions to difficult events  Despite large amounts of evidence to the contrary ◦ Has a “bible” (the DSM) of ever expanding “disorders” invented by committees  Human distress and confusion is real ◦ and sometimes overwhelming or even deadly  But is not adequately addressed by applying labels and then treating the person just based on that label

 Much of the public is convinced that mental health problems are due to “biochemical imbalances” that can be corrected by medications ◦ Despite the fact that no one has provided good evidence of anything that simple! ◦ And despite the fact that psychiatric drugs create abnormal biochemical states in the brain  In 2003, MindFreedom did a hunger strike to challenge the APA to provide evidence of a biochemical imbalance ◦ More recently, psychiatry is backing off from any such claims

 This book documents a large body of evidence suggesting that while psychiatric drugs often appear to help in the short term,  The long term effect on average is to make the problems worse

GD = Guided Discontinuation MT = Maintenance Therapy See Wunderink, L., Nieboer, R. M., Wiersma, D., Sytema, S., & Nienhuis, F. J. (2013). Recovery in Remitted First-Episode Psychosis at 7 Years of Follow-up of an Early Dose Reduction/Discontinuation or Maintenance Treatment Strategy: Long-term Follow-up of a 2-Year Randomized Clinical Trial. JAMA Psychiatry, 70(9), doi: /jamapsychiatry

 The drug will not simply correct a specific “biochemical imbalance”  It will create what could be called a “drugged state” ◦ and then either this drugged state or the placebo effect may be give some relief in the short term  In the long term, there is substantial risk that use of the drug will interfere with resolving the issue ◦ And there is risk of various side effects,  including possibly permanent neurological changes, and dependency problems.

 There is no adequate “informed choice” when people are given only one treatment option  Options that should exist: ◦ Psychological approaches that address trauma and life stresses  Even for “serious disorders” ◦ Holistic options that integrate mind, body, and spirit ◦ Social causes of mental health issues should be appreciated as a public health issue  Like inequality

 “In order to recover,  I had to believe the opposite of what the mental health system told me to believe,  and I had to do the opposite of what it told me to do.”

 We all have an ethical obligation to speak out when human rights of people receiving treatment are being disrespected ◦ And when treatment guided by narrow ideology and/or profit seeking is leading to more harm than good  Joining an advocacy group like MindFreedom is one way to help make sure these issues get addressed!