Commentary: “The Illusions of Psychiatry” by Marcia Angell

There are many grains of truth in this New York Review of Books article by Marcia Angell discussing three recent publications exploring the sad state of the profession of psychiatry and its “Diagnostic and Statistical Manual of Mental Disorders (DSM)”. Among those grains:

• We accept as fact that MANY mental disorders exist just because they are published in the DSM when many of these diagnoses are poorly  supported, if at all, by well-designed research. Mental health cannot fit into the codification and classification that has so benefitted other medical specialties.
• The medical model of mental illness, rapidly becoming the neurobiological model of mental illness, misleads the public to think that pills are THE answer to mental distress, and this misconception feeds proliferation of and profiteering in the drug industry.
• In the medical specialty of psychiatry, the close connection between universities and drug companies has been a disaster.
• Too many children are being diagnosed at too young an age with “mental disorders” and prescribed medications that have NEVER been tested or approved for use in those with fragile, developing neurological systems.
• Diagnosing tiny children with severe mental disorders has also become a way to qualify them for Supplemental Security Income (SSI) Disability payments to their  parents, prompting an MIT economics professor to call this, “the new welfare.”

On balance, there are other realities:

• Most psychiatrists wish from the bottom of their hearts to help their patients, but their medical education never included introduction to promising new understandings of MENTAL HEALTH nor have they received encouragement from mentors to be receptive. In fact, many are punished for looking outside of neurobiological understandings. As they leave medical school and get caught in the grinding reality of “managed mental health” and a crippled mental health system, they lose hope and stop looking for new answers.
• Some drugs have been life-saving for people with certain symptoms. Any mental health clinician will tell you stories about small numbers of patients who found new leases on life via drugs prescribed for certain disorders — schizophrenia and adult ADHD, for example.
• Like the authors of the books Angell profiles, many, many mental health professionals have become disillusioned with the medical model of mental illness. Many are searching for nonmedical, spiritually-situated ways to understand the human experiences of mental well-being and distress.  Many are looking for a way to understand the “logic” of the “psyche” (SOUL) and find a true science of psychology.

The fact that books like those Angell reviews are proliferating is a good sign.  It reflects growing discontent among mental health practitioners, mental health consumers and the general public.  This rumbling awareness that all is not right in the world of mental health is a WONDERFUL opportunity for those of us who have seen another way to gather our courage, speak out and stand for what we know — the true answer to mental distress will always be spiritual.  Even when the brain is not functioning well (damaged, diseased, etc.) mental health (love, understanding, joy) is always accessible, because it lies within the essence of every human being, no matter what!  Who has not seen a so-called severely developmentally disabled person light up a room with a bright, pure expression of joy?

“You can’t possibly find the secret to human behavior without walking on the spiritual side of life,” — Sydney Banks, The Enlightened Gardener Revisited