David Healy and Robert Whitaker address suicide rate in New Zealand

I’m passing on this e-mail from Vince Boehm and video link that I received in my maibox today via ISEPP.

“Risk of suicide” was one of the many reasons given by my son’s psychiatrists for wanting to keep him on medications, not that he was suicidal, but because “statistics show that people with a diagnosis of schizophrenia have an increased risk for suicide during the first five years after diagnosis.”  I always felt that the specter of suicide was invoked often for the wrong reasons — not because patients were suicidal, but in order to keep them meds compliant. I was being made to feel irresponsible by continuing to inisist that my son was unlikely to commit suicide and I would prefer to work with him in non-drug interventions. The problem is, how do one ever really know that someone else is or is not suicidal?  That’s where I feel drug companies have gained the advantage. You don’t know, and nobody wants to assume the risk, so medications are prescribed as some sort of “insurance policy.”

People can and do commit suicide while on meds and when off meds, so it’s kind of murky to now whether the meds would have prevented it or caused it. On the other hand, there is valid scientific concern about the effect of antidepressants on suicide ideation in children and teenagers because antidepressants are being used off-label and little to no research had been done for this age group before this practice became widespread.

Here’s the e-mail from Vince Boehm about the video link:

CASPER (Community Action on Suicide Prevention Education & Research), the New Zealand organization organized by two mothers who lost children to suicide, invited two of our prominent list members to present at their conference this past month.   New Zealand has the highest rate of youth suicide in the OECD, twice the rate of the US and Australia and five times the rate of the UK. More young people in New Zealand die of suicide than all medical causes combined, with 10% of the deaths of New Zealand’s 10-14 year-olds being suicides.

David Healy is an Irish psychiatrist who is a professor in Psychological Medicine at Cardiff University School of Medicine, Wales.  He became the center of controversy concerning the influence of the pharmaceutical industry on medicine and academia. For most of his career Healy has held the view that Prozac and SSRIs (selective serotonin re-uptake inhibitors) can lead to suicide and has been critical of the amount of ghost writing in the current scientific literature.

In his segment of this compelling video, Healy delivers a powerful indictment of suicide and violence caused by psychiatric meds. Robert Whitaker is a friend and a former medical writer at the Albany Times Union newspaper.  In 1992, he was a Knight Science Journalism fellow at MIT.  Following that he became director of publications at Harvard Medical School. In 1994 he co-founded a publishing company, CenterWatch, that covered the pharmaceutical clinical trials industry. CenterWatch was acquired by Medical Economics, a division of The Thomson Corporation, in 1998. His articles on psychiatry and the pharmaceutical industry have won a George Polk Award for Medical Writing. and a National Association of Science Writers’ Award for best magazine article. In 1998, he co-wrote a series on abuses in psychiatric research that was a finalist for the Pulitzer Prize in Public Service. He is the author of four books. His most recent book is Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. His Mad in America has become a classic and belongs in your library.

These two books are destined to be mental health’s Silent Spring, the book that launched the environmental movement.

Once more a nerd

It was painful for me to see Chris reverse the gains he had made He was starting to look more and more peculiar, reverting to the nervous nerd look that had marked the first episode of his psychosis four years earlier. He buttoned his shirts up to the collar, and cinched his pants around his waist, leaving him looking like he was wearing high-water pants. His new red framed eyeglasses added a lab technician look to his already “odd-ball” appearance. Other people wondered what was happening to him, too. Instead of asking Chris what was going on, they spoke to me. “Oh, he’s just going through a rough patch, ” I tied to reassure them, not very convincingly. What looks like relapse may often be recovery I told myself every day or I might have completely given up hope. As the autumn progressed, Chris lost interest in going to choir practice and in continuing with his voice lessons. Ian and I insisted that he drop his two university courses before he failed them. Through all of this, we continued to work with Chris’s holistic psychiatrist to fine tune his supplements.

Then came an e-mail from Dr. Stern. While we all had agreed at our last family appointment that this was probably a necessary crisis for Chris and that with time and support he would emerge stronger, she was now suggesting strongly that he go back on both an antipsychotic and an antidepressant. She was worried that he was suicidal because he had told her in an indirect way that I thought he was suicidal. This was a miscommunication on his part about what we were discussing.

I pulled Chris aside. “Chris,” I hissed, “there are at least two things that you can tell a psychiatrist that are guaranteed to have them pulling out the prescription pad. One is to admit to hearing voices, the other is to mention suicide in any context.” Dr Stern was doing what any psychiatrist would do under the circumstances. She was protecting herself. I was very disappointed and somewhat angry with her. She knew we were against the medications because they had never worked for Chris. We engaged her specifically to help get him off them and now she wanted to throw all that away because she thought he might be suicidal.

Many people will side with Dr Stern here, because, after all, they will reason that you can’t be too careful when it comes to suicide, but I disagree. If you mention the word “suicide” to a psychiatrist, I suspect it doesn’t matter in what context you mention it, the fact is the “s” word has been said and psychiatrists have to consider their license and the very real possibility, in some countries at least, that they will be sued by the family if a tragedy does occur. I was not willing to have Chris’s recovery postponed and perhaps delayed forever by going back on medications. Dr. Stern saw Chris once a week. I saw him every day and I felt that my judgment as his mother trumped her judgment as his psychiatrist, even though I felt she was a very good psychiatrist in many other ways.

I sat Chris down. “What you decide to do about the medication is up to you,” I said. I deliberately avoided trotting out the reasons why I was against the medications. Chris knew them only too well. Chris confessed that, among other things, he was afraid that if he went back on medications, he would never be able to function at university. It was true he wasn’t functioning now at university, but the medications could make it worse, in my opinion. However, I said nothing. Chris sent an e-mail to Dr. Stern, copied to his holistic psychiatrist, Ian and me, saying that suicide was the last thing he had in mind and he was sorry if he misled her. He said he wasn’t against the medications, he just didn’t believe in them for himself.

“My feeling, he wrote,” “is that I am the cause of my own depression, but I hope that it will lift just as the clouds melt away after a summer thunderstorm.”