freakoutcrazy

Blog des AK Psychiatriekritik der NFJ Berlin

Monat: Februar, 2014

The Story of Legal Capacity: Specificity and Intersections

In this article I explore legal capacity as it has impacted my life, through the lens of a negative experience and a positive one.  As many of you know, legal capacity is an important right guaranteed in the Convention on the Rights of Persons with Disabilities (CRPD).  It is also guaranteed in the Convention on the Elimination of all forms of Discrimination Against Women (CEDAW), and in a broader sense is incorporated in the Universal Declaration of Human Rights (UDHR) and the International Covenant on Civil and Political Rights (ICCPR).   My aim is to encourage people to be aware that legal capacity is a social construct, it is not an inevitable fact of life and can be changed – indeed we are seeing it change before our eyes with respect to the particular act of marriage.  Legal capacity is being similarly reshaped from a disability standpoint, in a much more comprehensive way.  Please see CRPD Article 12, the draft General Comment on Article 12 by the Committee on the Rights of Persons with Disabilities, the IDA CRPD Forum Principles for Implementation of CRPD Article 12, and my article Norms and Implementation of CRPD Article 12, for more information.

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Psychiatry Has its Head in the Sand: Royal College of Psychiatrists Rejects Discussion of Crucial Research on Antipsychotics

Two pieces of research have been published over the last two years that should prompt a major reorientation of the treatment of schizophrenia and psychosis, and a fundamental reappraisal of the use of antipsychotic drugs in general.  Put together, these studies suggest that the standard approach to treating serious mental health problems may cause more harm than good. Long-term treatment with antipsychotic drugs has adverse effects on the brain, and may impair rather than improve chances of recovery for some. Many people ask me how the psychiatric profession has responded to this data. Surely, they think, it must have stimulated a major debate within the profession, and some critical reflection about why it took so long to recognise these worrying effects? Sadly, this does not appear to be happening.

I have described both of these studies in detail in previous blogs. Briefly, in 2012 the research group led by Nancy Andreasen, the former editor of the American Journal of Psychiatry, published results of a brain scanning study of people diagnosed with schizophrenia or psychosis. The study found that people’s brains shrank over time in proportion to the amount of antipsychotic drugs they had been exposed to. The report concluded that  ‘antipsychotics have a subtle but measurable influence on brain tissue loss over time‘(1, p 128).  The study confirmed that the brain shrinkage observed in animals(2) also occurs in humans.

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Homelessness, Hospitalization and “Compliance”

As most of you know, E. Fuller Torrey is a psychiatrist, one of the strongest proponents of involuntary treatment, and a supporter of outpatient commitment — the process of mandating that individuals take psychiatric drugs for extended periods of time after being released from a hospital setting.  In the quote above, he accuses Robert Whitaker of ignoring the plight of the homeless “mentally ill” who he believes would be better served by the modern mental health system and forced psychiatric drug treatment.

But before getting to Torrey’s argument, let’s first take a look at how those who are poor and homeless and suffering severe emotional distress are generally treated in the community.  Often those who are suffering distress will be brought to a hospital setting by police or community members, or come in of their own accord voluntarily.  Once hospitalized, they are almost invariably prescribed psychiatric drugs and often are prescribed antipsychotics.

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CAFÉ Study: Real Science or Marketing Exercise?

Any discussion of CAFÉ must begin with a review of CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness).

CATIE was a randomized trial funded by the US government (NIMH).  It was written up in three phases:  Phase 1 (Lieberman J et al, 2005); Phase 2 Part a (McEvoy JP et al, 2006) and Phase 2 Part b (Stroup TS et al, 2006);  and CATIE Phase 3 (Stroup TS et al, 2009).  CATIE’s purpose was to compare old neuroleptics with new neuroleptics.  There was no placebo.  This reflected the belief/assumption that the efficacy of neuroleptics generally had already been established.  The researchers compared the old drug perphenazine with the second generation neuroleptics olanzapine, quetiapine, risperidone, and ziprasidone.  The conclusion:

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10 Ways Mental Health Professionals Increase Misery in Suffering People

Decreasing suffering often means “comforting the afflicted, and afflicting the comfortable.” However, AlterNet’s recently republished Psychotherapy Networker article, “The 14 Habits of Highly Miserable People,” authored by psychotherapist Cloe Madanes, instead appears to have afflicted many of the afflicted. Perhaps Madanes was attempting to afflict those comfortable enough to afford her and her professional partner Tony Robbins, but that comfortable group excludes many readers.

While some of the article’s voluminous reader comments were positive, concurring that many unhappy people have chosen to make themselves miserable, the majority vilified Madanes, calling her: “condescending,” “shaming,” “asinine,” “insensitive,” “pompous, “judgmental,” “violent,” “a narcissistic, manipulative, abuser,” and a long list of even nastier invectives.

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