Bob Whitaker calls mental illness a hidden epidemic and questions why the number of people diagnosed has tripled in the past 20 years
January 19, 2011 -- Bob Whitaker, a journalist and well-regarded author of books about mental healthcare and illness in America is coming to Portland on Feb. 10 to discuss his new book, Anatomy of an Epidemic
, and how psychiatric medication is used to treat people with mental illness.
Whitaker will discuss his book with a panel of mental health advocates and providers, including Becki Child, director of Mental Health America of Oregon, Chris Gordon an assistant professor of psychiatry at Harvard Medical School, Will Hall, a Portland-based mental health therapist, and Gina Nikkel, director of the Oregon Association of Community Mental Health Programs.
Whitaker’s book calls into question why the number of people with mental illness has more than tripled in the past 20 years. “The epidemic has grown in size and scope over the past five decades, and now disables 850 adults and 250 children every day,” he writes, referring to mental illness as a “hidden epidemic.”
Doing a literature review of multiple studies investigating the effectiveness of psychiatric drugs, Whitaker finds that psychiatric drugs have little long-term benefit. The result, he writes, is that people are kept on psychiatric drugs for as long as the rest of their lives, are on disability because they are unable to work.
“That’s extraordinarily expensive,” Whitaker said in an interview with The Lund Report. “The truth of the matter is that we can't afford the current system. We need a system that really helps people achieve robust recovery. That will be cheaper in the long term.”
Whitaker’s book has already received a warm reception from people involved with mental healthcare in Oregon. “I can’t read a book like this, put it down, and not do anything,” said Nikkel.
Following the panel discussion will be a two-day conference to discuss how psychiatric medication is used, and how it can be improved.
There are alternatives. Child and Whitaker are proponents of “medication optimization,” which manages how medications are dispensed, when they are used, and for how long. Providing wrap-around services and services that consider all of a person’s needs can effectively treat mental illness, Nikkel said.
Whitaker advocates for an evidence-based model focused on long-term outcomes, “and looks at function outcomes,” he said, that include employment rates among people with mental illness, whether they are living at home, are socially engaged and in good physical health.
Child and Whitaker are supporters of the Open Dialog Project, a mental health treatment program in western Finland that de-emphasizes medication, helps people immediately after their first psychotic break, and develops a treatment plan within 24 hours. According a study evaluating effects of the program after five years, 83% of patients returned to their jobs and not on disability. Child called those outcomes “unbelievable.”
Whitaker is pessimistic the mental healthcare system will change rapidly any time soon because of the influence of drug companies as lobbying powers. “That’s a powerful force,” he said.
A medical-based model has been used to treat mental illness since the 1950s, when Thorazine, the first antipsychotic medication that noticeably resolved patients’ psychotic symptoms, was introduced.
The heavy use of medication have lead to a “broken brain” theory that mental illnesses are the result of chemical imbalances in a person’s brain, which can be properly treated by medication.
“That’s led to a lot of stigmatization,” Whitaker said, because it leads one to think that there’s something “wrong” with the mentally ill person.
“People don’t have hope,” said Child. “People are being told that they have to stop working, that they have to give up their hopes and dreams. It doesn’t help them get better. There’s a lot human capital that is being wasted.”
Nikkel said the current system is too expensive, doesn’t place people in the appropriate care settings to get the treatment they need, and makes them more susceptible to entering the criminal justice system. “The real tragedy is that a lot of this can be prevented.”
The panel discussion featuring Bob Whitaker takes place on Thursday, February 10, at the First Unitarian Church, 1011 SW 12th Ave. Portland, OR., 5-9pm, the panel discussion starts at 7pm.
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