Book Sparks Mental Health Movement
A group of psychiatrists and mental health experts kicked off a national effort in Portland last month to improve the use of mental health drugs
March 15, 2011 – Gina Nikkel said she couldn’t read a book like Robert Whitaker’s Anatomy of an Epidemic and not “do something about it,” she told a crowd at the First Unitarian Church of Portland last month.
Whitaker – sitting a few feet away onstage – grinned proudly. His book looks at the outcomes of mental health patients over the past century, concluding in part that long-term use of mental health drugs could be making patients worse.
What Nikkel, the executive director of the Association of Oregon Community Mental Health Programs, along with Whitaker did about it was help create the Foundation for Excellence in Mental Health, which plans to raise several million dollars toward non-biased research into the use of psychiatric medication.
“The whole thought is to empower our docs and our psychiatrists to use medication in the manner that it’s supposed to be used,” Nikkel said. “A lot of the research we have now is funded by different entities that have a stake in the outcome of that research. We want to make sure there is research focused on medications and focused on recovery and what are the best protocols for recovery.”
The Foundation already has significant funding for a series of symposium’s beginning with one in Portland last month that brought together more than 50 psychiatrists and mental health experts. In October, the Foundation plans a symposium on child psychiatry in Boston.
Nikkel said the Foundation was inspired by stories of physicians who say they face pressure from the public for a “magic pill.” Others have seen that medication isn’t always the best answer. Meanwhile, doctors are getting other messages that certain mental health conditions could require lifelong medication.
In Whitaker’s book, he describes patients that successfully recovered from mental illnesses by perhaps using medications periodical while relying on community support and other therapies.
“In some ways this is not a new way to think about things,” said Dr. Maggie Bennington-Davis, chief medical officer of Cascadia Behavioral Healthcare, who attended the two-day conference. “In some ways we’re going back to what community mental health was always meant to be when first envisioned in the 60s.”
She blames decades of reduced funding that have led payers to require that doctors invoice for specific practice codes. Patients end up in certain categories they may not belong, which can easily lead down the path of medication, Bennington-Davis said.
“It’s like shopping for a menu. If what you need isn’t on there, you’re out of luck,” she said.
Cascadia is the largest mental health provider in the state with most of its services located in and around Portland. It treats roughly 13,000 people with anything from therapy to secure residential housing. The organization itself has weathered perennial reductions in government funding, pushing the non-profit in recent years near bankruptcy.
“For Cascadia it’s a reminder that we’re here to help people to recover by whatever that looks like for each person,” Bennington-Davis said. “That may or may not include medication. It certainly doesn’t automatically require medication.”
The Oregon Psychiatric Association held a two-day conference in Portland earlier this month around the strengths and limitations of evidence-based medicine in terms of various therapies as well as medications, said John McCulley, executive director.
“I don’t think there is ever any question that psychiatrists want to improve their education and skills in the area of medications,” McCulley said. “It’s so very complex and so individually patient determined. There needs to be continual research in all these areas.”
Dr. Chris Gordon, assistant professor of psychiatry at Harvard University, told the crowd at the Unitarian Church last month that the causes of mental illness are still unknown.
“I have the greatest respect for the profound suffering that whatever this is that we call mental illness actually is,” Gordon said. “I do acknowledge that many people have suffered grievous harm at the hands of psychiatrists, and my profession has unfortunately greatly compounded the suffering of many people. We have grossly under-appreciated the possibility for recovery.”
To Learn More
For more about the first symposium in Portland click here.
Mar 15 2011