The Failing Stigma and Treatment of Mental Illness

The author maintains it’s time to rethink and change the laws, rules and regulations of HIPAA.

OPINION -- Unless we are all missing something, it seems that the stigma of being declared mentally ill or mentally incompetent is rapidly turning into a nightmare. The most recent evidence, German wings flight 9525’s copilot’s ravenous and murderous behavior. Reports indicate he had torn up doctor reports that he was unfit to fly based on a psychosomatic illness concerning his eyes. His mental wellness is contingent on taking prescribed medications for depression prescribed by his doctor.

We’ve got to ask ourselves, what is wrong in the world when we’ve seen so much violence and lives lost as a result of untreated and avoided mental wellness issues? What is the stigma people look to avoid that turns into untreated symptoms that result in mass chaos and destruction?

People suffering from mental health symptoms are often deemed as outcasts, following their reported and diagnosed symptoms to the extreme, while looking to persecute the people in the environment who they believe would not understand or scoff at the pain and suffering they are going through. And then there are the pills or medications that turn their minds into zombies.

Psychiatry has become a religion of sorts, providing the answer to all of our problems in a nice little pill with side effects so long it takes a speed talker speaking at a billion words a minute to list them all in one commercial. Who would want to take such a pill? And of course the irony of medication sets in as well, over time the patient begins to feel better so they come off their medication, but the main reason they felt better was because of the medication. At the same time, going on and off medication sends the neurochemicals into a frenzy and the patient and doctor have to begin all over again, adjusting and readjusting pills and dosages until the desired effect has taken place. Six months later, the process begins again. Getting the right dosage and pills for any particular person is a crap shoot; you’d have better luck hitting a bull’s eye with a blind fold on.

Of course I’m not necessarily talking about the average person who is prescribed Lexapro for stress or mild depression by their primary care physician. That’s the equivalent of taking a vitamin for your brain. I’m talking about the severe mentally ill, whose industry has been accepted and guided by the American Psychological Association (APA) and the insurance company you’re paying a hefty monthly premium to TELL YOU HOW TO LIVE YOUR LIFE. The APA has got a book on this subject, it’s called the DSM, now in its fifth edition and used by doctors and psychiatrists the country over to label patients for the muddled up, messed up and screwed up way for which they think while offering no understanding of treatment other than a jagged little pill for the rest of their lives, confining patients to a prison of the mind. Our mental wellness as a person and as a society have got to come up with something that’s a whole ton better than these so called experts of the trade. Unfortunately, it appears the power of original and creative thought has gone by the way side as a result of scientific research performed on rats in captivity.

So it seems we’ve come to a crossroad and are questioning what is truly the best way to treat matters of mental wellness. Let’s try this on for size; acceptance, understanding, and empathy. Most of my patients say the same thing day in and day out, it’s not the voices they hear that they are afraid of, it’s the stigma associated with the people around them that terrifies them the most. People suffering from severe mental illness want to be accepted, not ousted by society. They want to lead normal and productive lives just like the rest of us and they require a supportive environment to do so.

I’m not saying to allow potential psychopaths to run amok in the streets while we sit around and coddle them to sleep every night, not at all. If a patient reports suicidal or homicidal thoughts, that person needs to be committed for prolonged care, or if a schizophrenic client hears voices that are telling them to hurt themselves or others, yes that person should be placed on medication, there are always exceptions. However, the majority of people suffering from severe mental illness do not exhibit such extreme hallucinations or delusions. It would be unfair to poke and prod at such people just because of the stigma associated with hearing voices or because it’s become the standard of care handed down by insurance and pharmaceutical companies as the best practice to treat any such symptomology.

On another note, practitioners need to be held to a higher standard, specifically related to the greater good of society. Should a doctor, therapist or psychiatrist treat a person who they deem is unfit to carry on their job duties, it should be their responsibility to disclose such information on their own and not wait for the patient to self-disclose. Seriously, the doctor has a patient in their office they feel is unfit to work, who is a pilot in control of the care and safety of hundreds of people, and he/she leaves it up to the patent to disclose this information.

The regulation of HIPAA laws, which define patient confidentiality and the rights of both patient and doctor to disclose or even more, NOT to disclose personal information to anyone outside the doctor’s office, has placed society at risk for a hostile takeover. Our infamous co-pilot of flight 9525 was told to self-disclose his illness to his employer. As we all know that did not happen, assuming that this was due to the doctor’s inability to disclose this information as a result of “patient confidentiality,” designated by HIPPA, so the task came upon the co-pilot (I’m not mentioning his name for a reason), to do so.

I believe it’s time to rethink and change up laws, rules and regulations of HIPAA. Perhaps 150 people would still be with us. What do you think?

P.D. Alleva, MSW, is the founding owner of Lifescape Solutions and Evolve Mental Health which he opened in December of 2011, based on a new model of healing and psychotherapy called Spiritual Growth Therapy.

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Comments

I find it unfortunate to use the Germanwings disaster as an effort to argue for destigmatization of mental illness diagnoses. In fact, using this example actually INCREASES stigma because people will be encouraged to believe that this man engaged in these violent acts simply because he was suffering from depression and was not receiving treatment. The facts suggest that he WAS receiving treatment, and that his violent acts stemmed from his own building frustration and feeling his life was out of control. Additionally, the antidepressant he was taking, Celexa, is of a type that can cause manic episodes, especially in someone who is already prone to that kind of behavior. Reports from his former girlfriend suggest that he could be grandiose and paranoid, and it is more than possible that treatment with an SSRI antidepressant exacerbated these symptoms and pushed him over the edge. 

Depression is not generally associated with extreme violence, whatever the level of treatment. Moreover, this person was in treatment and taking antidepressants, and it did not prevent and may have contributed to his violent behavior. We do people suffering from depression a grave disservice by suggesting that this kind of extreme behavior is associated with major depression or any particular mental disorder diagnosis. These events are rare and often bizarre, they are not predictable nor necessarily responsive to any particular treatment. To associate an intentional suicide/mass murder with having chronic depression sends exactly the opposite message that you intend and encourages the already entrenched social tendency to view the "mentally ill" as alien and dangerous, rather than encouraging empathy and compassion as I believe you are intending.

--- Steve McCrea

I have little doubt many people believe as P.D. Alleva, MSW, does. To maintain his cert, he no doubt has to speak as he has.

Nonetheless, Peter Gotzche, a founder of the Cochrane group and an out-there proponent of getting All The Data out of company-run trials, represents the wave of exposures coming out in which data was hidden, as was collateral damage.

I once proposed that maybe Europe had better care because of socialized medicine. I stood corrected. There can be even more incentive to drug 'em and move 'em out of the office there, I was told.

Later this month, there will be a convocation in Michigan featuring prominent professionals who are speaking out. Peter and Ginger Breggin are organizing it. Those who are interested will be able to find the details on the net. Peter Breggin has appeared in many public forums and has testified in front of congress regarding the epidemic of suicides in the military.

I am a participant with Re-Thinking Psychiatry, which is now meeting monthly at the National College of Natural Medicine. I know Steve McCrea from there, and I appreciate his response here.

Mary Saunders

 

 

 


 

While I don't disagree with the author's premise that mental health care is insufficient and that the DSM V is flawed (PhRMA loves psychiatry!), I think any conclusions we make about mandatory reporting will take us down a very slippery slope. What jobs will merit that kind of mandatory reporting? One could argue we should expect that of all the CEOs who are sociopathic in their lust for money, privatizing profit and socializing risk. (Hey! That may already be a screen done by corporations to make sure that they get a sociopath at the helm...)

What triggers a person to take his/her life? That is a mystery. All the more so when a person has no access to mental health services.

The mainstream media cannot judge the appropriateness of the therapist's judgment of this young man's suicidal (which cannot be equated to "murderous" behavior) ideations. We may find that all settings will require monitoring. For example, PPS now has a "suicide screening form" that is supposed to be in a student's cumulative file. Does it make sense to profile these students at risk for suicide throughout their education career? Does this information get uploaded to other databases? Who has access to this data? http://www.pps.k12.or.us/files/student-services/Suicide_Screen_fillable.pdf

Therapists try to evaluate as best as possible the intent to commit suicide. That means getting specifics of what they intend to do. But patients may not be truly forthcoming. So what then? Red flag all symptoms of depression for pilots and report to the employer?

Should we stop at pilots? Maybe we should do that for bus drivers? Physicians? Why not food handlers?

Kris Alman