tear down the silos and reunify psychiatry and neurology!

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The first step in the evolution of ethics is a sense of solidarity with other human beings.

Albert Schweitzer 

Henry Nasrallah, MD, editor-in chief of Current Psychiatry ONLINE, claims that there have been "developments" that "are bringing neurology and psychiatry together again" in his latest editorial. 

The first development Nasrallah shares predictably is "The neuropharmacological revolution in psychiatry;" he neglects to mention the "revolution" relied upon deceit, i.e. misleading patients, the public, and other medical professionals about the symptoms and the etiology of symptoms; the subjective nature of a psychiatric diagnosis; the effectiveness of the available treatments; the dangerous risks endemic to using teratogenic, psychotropic drugs and/or electric shock machines that have never been safety tested...

via Current Psychiatry online:
Vol. 12, No. 08 / August 2013      
                                         

Featured alongside Dr. Nasrallah's editorial was this advertisement:

Henry A. Nasrallah, MD
Editor-in-Chief

Let’s tear down the silos and reunify psychiatry and neurology!

Psychiatry is as much anchored in the brain as its sister specialty neurology is

• The neuropharmacological revolution in psychiatry and the discovery of medications that control the symptoms of psychosis and of mood and anxiety disorders
• The explosive growth of neuroscience, which was catalyzed and enhanced by sophisticated investigational techniques
• The computerization revolution, which has facilitated development of myriad neuroimaging techniques that reveal, in vivo, the multiple neurological and neuropathological abnormalities associated with psychiatric disorders
• Breakthrough advances in molecular and cellular neurobiology, which are linking behavior, thought, affect, and cognition with specific signaling pathways. This has led to the scientific epiphany that psychiatric brain disorders cannot be localized (as neurologic brain disorders are) because they are caused by disrupted neural circuits and connectivity and are not localized in cortical or subcortical regions
• The molecular genetics revolution, which has revealed the complex genetics of psychiatric disorders, including risk genes, copy number variants, nonsense mutations, and epigenetics. With 50% of the 22,000 genes in the 23 pairs of human chromosomes involved in brain development, it isn’t surprising that the neurogenetics of mental illness are mainly aberrations in neurodevelopment genes—just as most non-genetic factors disrupt normal brain development during fetal life.
• The recognition, over the past 2 decades, that anomalies of neurochemistry and neuroplasticity are the underpinnings of psychiatric illness.

read the editorial here

Washington State Constitutional Rights of Psychiatric Patients Violated Under Color of Law

RCW  71.05.520  – Protection of rights.

“The department of social and health services shall have the responsibility to determine whether all rights of individuals recognized and guaranteed by the provisions of this chapter and the Constitutions of the state of Washington and the United States are in fact protected and effectively secured.

To this end, the department shall assign appropriate staff who shall from time to time as may be necessary have authority to examine records, inspect facilities, attend proceedings, and do whatever is necessary to monitor, evaluate, and assure adherence to such rights. Such persons shall also recommend such additional safeguards or procedures as may be appropriate to secure individual rights set forth in this chapter and as guaranteed by the state and federal Constitutions.”

[1973 1st ex.s. c 142 § 57.]

The State of Washington Department of Social and Health Services does not in fact have any appropriately trained investigators assigned to examine records or investigate complaints that criminal violations of any individual's rights, "recognized and guaranteed by the provisions of this chapter and the Constitutions of the state of Washington and the United States are in fact protected and effectively secured." There is no plan to change this.  David Reed works as an administrator for Washington State's the Department of Social and Health Services, Division of Behavioral Health and Recovery, and oversees the Involuntary Treatment program for DSHS. Mr. Reed is the individual who was appointed to investigate complaints of civil rights violations in Involuntary Commitment proceedings in 2008, by then-Governor, Christine Gregoire.  When I called Mr. Reed on the morning of July 8, 2011 to ask if he was aware of any complaints being filed that an individual's rights had been violated in  civil commitment proceedings, I already knew the answer to the question I was asking.  I was asking the question to see whether Mr. Reed would give a truthful answer. Mr. Reed has a poor memory, or he purposely lied to me in giving an answer. If one were to assume that Mr. Reed's memory failed one could further assume he forgot sending the following letters to the advocacy group, Crossroads for Change Campaign, and that he forgot being appointed by the governor to investigate the complaints of civil rights violations...

In a letter dated September 10, 2008, Mr. Reed responded to complaints that multiple individuals civil rights were violated; stating in part, “The documentation you have presented to the Mental Health Division is more than five years old and concerns a single RSN.  The practices you have identified were subsequently rectified and represented a small portion of the detentions in the state.  I have sent you a copy of DMHP Protocols in Appendix I § 6 is a list of Washington State Case Law.  By utilizing the website:  www.legalwa.org  you can review the listed legal decision of Washington State Courts that have previously affirmed the constitutionality of RCW 71.05’s due process provisions.  Other concerns you have addressed are addressed by statute and are monitored by MHD licensure staff.”  here

The law as written was affirmed to be Constitutional, only because the due process provisions the State of Washington and the U.S. constitutions require to be preserved and defended in civil commitment proceedings, are defined within the text of the Involuntary Commitment Statute. Obviously, if the law is not followed by the designated mental health professionals given the authority to implement the law, who detain individuals Under Color of Law, and the mental health professionals who subsequently petition the Court to civilly commit individuals Under Color of Law, an individual's rights will be violated.

In a letter dated January 7, 2009 Mr. Reed writes, "I have discussed your concerns with Mental Health Division management.  After review of the additional information you provided at our last meeting regarding an involuntary hospitalization from 2005, the Mental Health Division is unable to endorse your request for action and investigation.  The concerns you have presented are of concern and will be forwarded to our Licensure staff which is tasked with correcting WAC and RCW violations for detained consumers on the part of RSNs, Evaluation and Treatment Facilities and DMHPs.   I look forward to meeting with you again to continue our discussion the ITA process as it is currently implemented in Washington.” here

SPOKANE QUALITY REVIEW TEAM Investigation and Survey Results Regarding the Legal Representation by The Spokane Public Defender's Office for the Involuntary Treatment Act process

My son, who is now 25 years old, has been victimized by unethical mental health professionals who commenced illegal civil commitment proceedings against him twice as an adult in Washington State. Neither time were his civil rights preserved or defended.  

In 2010, my son was detained based entirely on perjured testimony and a fraudulent affidavit forged by Nancy Sherman, the Designated Mental Health Professional.  The same false tainted "evidence" was used by Jeffrey Jennings; a psychiatrist who relied upon Sherman's falsehoods because he had no "first-hand" information to offer in support of his petition for a Court Order for Involuntary Treatment since Jennings refused to speak to anyone who actually had first-hand information. 

The third hearing at which a Superior Court judge granted a six month out patient involuntary treatment order, lasted all of one minute and 26 seconds--my son was not at this or the two prior hearings; indeed, my son was not even aware that any legal proceedings had taken place. My son wasn't aware that the woman who had him sign papers and who informed the court he understood and waived his Constitutional right  to a jury trial, and that he agreed to follow Jeffrey Jennings' prescribed treatment recommendations was an attorney; much less, that the woman was his own Court Appointed attorney...  

The felony crimes of fraud and perjury were committed by mental health professionals in Yakima County Superior Court; a fraudulent affidavit and perjury were proffered as "evidence" used to detain and involuntarily treat my son. There was no criminal investigation of the crimes reported on my son's behalf, nor was there an investigation of the illegal shredding of Court records that was also reported. The CEO of Central Washington Comprehensive Mental Health, a current NAMI Washington Board member, Rick Weaver, claimed there is nothing wrong with shredding original Yakima County Superior Court records for Involuntary Commitment hearings, telling me,  "we do it all the time."  How is it that the illegal shredding of original Superior Court documents used to detain and Court Order people targeted for Involuntary Treatment allegedly because they are incapable of making treatment decisions, is not referred to Law Enforcement for criminal investigation?

the second time my son was committed in 2011, the attorney appointed by the court to represent my son had an obvious conflict of interest., the attorney also did legal work for the psychiatric facility that sought the Benton County Superior Court's order to treat him involuntarily! The attorney's obvious conflict of interest was never disclosed to my son, or to any of the three people who are designated representatives authorized to protect his interests when he is unable to do so himself. All three of us were present and conferred with the attorney and the psychiatrist.  I discovered that my son's attorney also does legal work for the facility when I conducted an internet search seeking the attorney's contact information. The attorney had failed to provide any of his contact information to my son. no phone number, no e-mail address; no way to contact him at all... 

Sails Blithely: a short film about Charles Nemeroff and Transparency

This film questions only one matter: TRANSPARENCY

Sails Blithely

from omphalos on Vimeo.

Ducktors Nemeroff and Insel quacks can't be Kosher

Poor Judgment and Academic Misconduct Qualify Psychiatrists to Lead Ethics Reform and to be "Scientific Advisers"

Drug Company Toady Charles Nemeroff Cons British via Lunatic Fringe

Does the AACAP have an ethical, medical rationale for prescribing neuroleptics to kids? No, it does not.

It appears that prescribing neuroleptic drugs for children and youth with emotional and behavioral issues has proceeded without evidence the drugs even treat emotional and behavioral problems in the pediatric population. Worse than this, prescribing psychoactive drugs off label has become a "standard clinical practice" without any evidence the drugs are safe or effective for children and teen-agers. What is truly frightening: the wider medical community use these wholly unethical standards of "care." While off label prescriptions are not unusual in medicine, off label use of drugs requires sufficient evidence of safety and effectiveness to be considered an ethical standard of medical care! It is apparent that prescribing children and teen-aged youth neuroleptics and other psychotropic drugs has proceeded without even minimal evidence, forget definitive evidence, to support or validate the practice. Why are we using what are dangerous, teratogenic drugs to treat kids' emotional and behavioral symptoms?

Medical treatment in which drugs are used in ways that are not FDA approved, and not supported with definitive evidence of the drugs' effectiveness or safety is accurately described as "experimental use" of the drugs; not something that should be considered a "standard clinical practice!" Atypical antipsychotics or "Second Generation Antipsychotics," are neuroleptic drugs which alter many physiological processes. Although some of this class of psychotropic drugs have been FDA approved for pediatric use, for specific psychiatric diagnoses and/or behavioral symptoms, the approval was not based on what a reasonable person would consider to be robust data of safety or efficacy, much less effectiveness. The fact is, in real world practice, neuroleptics are prescribed to kids much more off label than they are prescribed for FDA approved conditions or symptoms. In effect, experimental use of teratogenic drugs on children and youth, i.e. human experimentation, is now a "standard practice" in psychiatry.

When children and youth are prescribed psychotropic drugs off label, particularly neuroleptics, what protection do they have from harm? In effect, they have little to none; using a "standard of care" is an affirmative defense against a malpractice claim for damages, whether it is an ethical standard or not...It is unconscionable that most of the prescriptions for neuroleptic drugs are for off label use; why is this ethically questionable standard of care casually accepted by the wider medical community? Drugs that have not been tested and clinically demonstrated to be safe and effective for children and youth, should not be widely prescribed in standard practice! Nonetheless, off label prescriptions for neuroleptic drugs continue to account for the largest percentage of prescriptions for neuroleptics in the pediatric population. Neuroleptic drugs cause a wide variety of adverse cognitive effects, i.e. brain damage, neurological impairments and metabolic dysfunction; they cause diseases---these are direct, adverse effects of neuroleptic drugs, it is how they "work." This "standard practice" has been investigated by the U.S. Senate at least three times in my memory, each investigation has quantified an increase in the numbers of children being prescribed teratogenic drugs and fraudulent Medicaid claims being paid. What is not quantified is the number of children who are disabled and killed. Using poor children on Medicaid who have behavioral and emotional problems as unwitting guinea pigs is now considered an ethical standard of care...

The standards of care, treatment algorithms, and practice parameters were developed by consensus, a quasi-democratic political process, not derived from clinical research data.  Psychiatric professionals who are members of the American Academy of Child and Adolescent Psychiatry, and the American Psychiatric Association, then disseminated these unethical standards in their professional literature, in symposiums and continuing medical education programs.  Psychiatrists in the AACAP really would like the NIMH to fund research to hopefully gather the supporting evidence that will validate the standards of care in widespread use (thanks to the AACAP).  These are the standards of care that the AACAP is simultaneously vehemently defending as "necessary medical treatment;" implying it is ethical evidence-based treatment...

The AACAP is acknowledging that the evidence for the ethical medical prescription of teratogenic drugs off label to children and youth is STILL needed---decades after the AACAP started using neuroleptic and other psychotropic drugs off label to "treat" the emotional and behavioral problems children have---decades after it became a "standard prectice." The AACAP implemented a standard of care absent the evidence required to validate it as a standard. It is not ethically possible to implement the use of psychiatric drugs "off label," i.e. experimentally, as a standard treatment without definitive evidence of safety and effectiveness. Obviously, this standard was implemented  precipitously; without regard for patient safety. It is a standard of care that is not based on sound scientific principles, or actual evidence; it is absent the use of ethical medical judgement altogether...

Off label prescription drugs that are unsupported by evidence that the treatment is safe and effective, is experimental by definition. Medicaid, in theory, functions like insurance for the poor.  Why are fraudulent claims for non-covered, non-approved off label prescriptions drug costs paid? It is only psychiatric drugs that are ALWAYS paid for without question, by the Medicaid program.

Billions of taxpayer dollars have been defrauded from the American people since the vast majority of off label psychotropic drugs prescribed are written for poor children on Medicaid. We pay for it even though it is not ethical, even though it is fraudulent, even though it disables and kills children.

A few months ago, the AACAP applauded the AMA for seeking guidance from the NIMH about the off label use of neuroleptics for children and youth with emotional and behavioral problems.

via the AACAP:
The American Academy of Child and Adolescent Psychiatry (AACAP) applauds the American Medical Association (AMA) for adopting a report recommending the National Institute of Mental Health (NIMH) assist in developing guidance for physicians on the use of atypical antipsychotic medications in pediatric patients, and encouraging ongoing federally funded studies on long-term efficacy and safety.

AACAP delegate to the AMA and member of the AMA Council on Science and Public Health, Louis Kraus, M.D., testified that the report discusses the complex issues surrounding the clinical use of these drugs and evaluates the data currently available.

There has been an increased use in atypical antipsychotic medications which when used appropriately can be an effective part of a comprehensive treatment plan for children with schizophrenia and bipolar disorder. However, these medications are increasingly being used "off label" when treating children and adolescents with other psychiatric disorders.

"Physicians and parents need more information about both the safety and efficacy of these medications, especially when they are used over an extended period of time," testified David Fassler, M.D., AACAP alternate delegate to the AMA.

Most research on the use of atypical antipsychotic medications on the pediatric population focuses on short term use, yet in clinical practice an increasing number of pediatric patients take these medications for many months or years.

"AACAP is pleased that the AMA is encouraging NIMH to conduct additional studies on these medications. We need to better understand both the short term and long term effects on our patients," said AACAP President, Martin J. Drell, M.D.

The AMA report is supported by the American Psychiatric Association, American Academy of Psychiatry and the Law and the American Pediatric Association. here

Does the AACAP have an ethical, medical rationale 

for prescribing neuroleptics to kids off label?
No, it does not.  

via REPORT OF THE COUNCIL ON SCIENCE AND PUBLIC HEALTH CSAPH Report 1-I-12:
 a couple excerpts:

"The proportional use of atypical antipsychotics was 16% of treatment visits in 1995, but such use had surged to 93% of treatment visits by 2008. In two-thirds of these visits, the prescription was for an off-label use.5

"Antipsychotic treatment rates among privately insured youth ages 6 to 17 increased steadily from 1996 (0.21%) to 2006 (0.90%) with higher rates among those ages 13 to 17.7 The annualized rate of use in such patients ages 2 to 5 more than doubled between 1999 and 2007 to 0.16%, most commonly to help manage pervasive developmental disorder or mental retardation.8

"More than 4% of Medicaid youth ages 6 to 17 filled at least one prescription for an antipsychotic in 2004, with 75% of these being for off-label uses.7 A number of children under 6 years of age enrolled in Medicaid programs receive ongoing treatment with antipsychotic medications.9,10" (page 3)

Discussion
Although certain atypical antipsychotic drugs are FDA-approved for specific uses in pediatric patients, the majority of prescribing (70 to 75%) is off-label for these drugs. Head-to-head comparisons of atypical antipsychotic drugs for off-label uses are few, and evidence from placebo-controlled trials for off-label use suggests that efficacy differs between drugs. Accordingly, one cannot anticipate that a “class effect” exists for atypical antipsychotics with respect to any specific clinical use or indication.  here

from a letter from Citizens for Responsible Care & Research, Inc. to The Presidential Commission for the Study of Bioethical Issues Public Comment in Response to: Federal Register 76:41 (March 2, 2011) pp. 11482-11483:

a couple of excerpts:
"Part 1: Suggestions To Consider
As suggested in the Federal Register notice, in order assist the Commission in developing a thorough  understanding of the adequacy of current U.S. and international standards for protecting the health and well-being of human subjects in scientific studies supported by the federal government, we refer the Commission to the public comment of CIRCARE vice president Gerald Schatz, J.D., in which he describes international law, requirements of which the bioethics community is apparently oblivious. For your convenience we reproduce the relevant portion of his comment:
                “There is the International Covenant on Civil and Political Rights the United States
                ratified in 1992 and it makes informed consent an absolute requirement, no exceptions,
                not even in emergencies, subject to those normal legal fictions of consenting for the
                incapacitated patient to medical care and so forth. Additionally, the Geneva Conventions
                and Additional Protocols to the Geneva Conventions make research very, very difficult
                or prohibited altogether for those individuals who are caught up in the war and armed
                conflicts.” (2)

Over the past several years the International Compilation of Human Subjects Protections posted on the OHRP website has been significantly strengthened by additions of the International Covenant on Civil and Political Rights, the Geneva Conventions and Additional Protocols to the Geneva Conventions. (3) A persistent problem, however, has been a lack of OHRP guidance on the significance and applicability of this law. An additional difficulty seems to be that not only is there failure to acknowledge this law and its applicability inside and outside the U.S., it is almost surely the case that neither OHRP nor FDA are adequately resourced to implementation of this law.(sic) Consequently we urge the Commission to recommend information about this law be distributed to appropriate U.S. agencies, research partner governments, research institutions, commercial research sponsors, and appropriate NGOs. Links to the Michigan State University faculty response as drafted by Gerald Schatz to the 2005 OHRP request for comment on equivalent protections as described above, two legal articles, and electronic versions of the law in question are provided in the references at the end of this document. (3)"

"CIRCARE holds FDA and OHRP in high regard and commends staff for their accomplishments. Practically speaking, our post hoc system means that failures of protections occasion the bulk of regulatory oversight of institutions or individuals. The opening paragraph of a typical FDA warning letter refers to an inspection conducted many months earlier and addresses objectionable conduct in one or more clinical investigations which ended years previously. (4) The definition of the verb “to protect” is “to cover or shield from exposure, injury, damage, or destruction; (to) defend.” (5) We challenge the Commission to consider if is it reasonable to believe post hoc action provides meaningful protection of human subjects in research."

"A typical FDA warning letter offers two challenging paradoxes the Commission should to consider. Prior to 2007 boiler-plate language informed warning letter recipients that FDA inspections are conducted under a program, one aspect of which is to ensure the integrity of data submitted in drug or medical device marketing applications, the other aspect of which is to ensure that human subjects are protected from undue hazard or risk in clinical investigations. More recently this language has been revised to state that inspections are conducted pursuant to FDA’s Bioresearch Monitoring Program to evaluate the conduct, i.e. data integrity, and to ensure that the rights, safety, and welfare of human subjects have been protected. (op sit, p.1) The past tense of the copulative verb “have been” illustrates the paradox of a post hoc system in which the regulator proposes to protect the welfare of human subjects by inspection and enforcement after the fact." here

photo credit
4-16-2013

Why are different lower "legal" standards used in Involuntary Commitment proceedings?

"If the physician presumes to take into consideration in his work whether a life has value or not, the consequences are boundless and the physician becomes the most dangerous man in the state. -DR. CURISTOPH HUPELAND (1762-1836)

I have not been myself since the summer of 2010. More accurately, I have been changed by the events which happened when my son had a crisis. I more fully realized that many things are just not at all how they should be, and that many people do not seem to care that they are not. Crimes were committed in the summer of 2010 which violated my son's civil rights, and when I filed complaints with the appropriate authorities on his behalf no appropriate action was taken. My son was traumatized yet again by unethical "mental health professionals" who are not going to be held legally accounable for committing crimes which caused harm to a person they owe an ethical legal duty to. It is standard for no one to be held accountable when victimizing people with a psychiatric diagnosis. Crimes are not even investigated, at least crimes in which my son was the victim never have been...

Although involuntary treatment commitment proceedings are considered, “civil” as opposed to “criminal,” one should have no doubt that a loss of one’s liberty, the loss of legal and political status without being afforded equal protection under the law, is a violation of one’s Human Rights. The consequences are as detrimental, if not more so, than the consequences for a misdemeanor criminal conviction. For one thing the Court Order can be in effect for the remainder of one’s life. The individual rights protections the law allows a person in a civil commitment proceeding are less than those people charged with crimes can count on. Not unlike a misdemeanor criminal conviction, a Court Order for involuntary treatment alters a person’s legal status and temporarily deprives them of their Liberty. However, in civil commitment proceedings, the person’s lowered status often becomes a permanent legal distinction, and the deprivation of Liberty can also become permanent, through either in- or out-patient commitment.

This begs the question, “Why are different lower "legal" standards used in Involuntary Commitment proceedings?” The Involuntary Treatment statutes deprive people of individual rights protection people charged with felony crimes can take for granted.  

1. The “evidence” required to obtain a Court Order to detain, and/or commit a person can consist of nothing more than hearsay, speculation, gossip and innuendo, it is not required to comply with the Rules of Evidence.  

2. It is alleged or implied in the proceedings that the person has a “brain disease” or genetic defect which will be corrected, or “medically treated.” No evidence is offered; nor is any evidence to support the claim stated or implied even asked for.

3. Standard Court Procedures are not followed.

4. A person may be appointed an attorney, however, this does not mean that Effective Assistance of Counsel is provided. Not only are the legal, social and political consequences of a Court Order for Involuntary Treatment  profound; the medical consequences can be lethal.

The obvious detrimental social, political and legal consequences to the person court ordered to Involuntary Treatment really demands that individuals have equal protection under the law. It is ethically, legally and morally indefensible they are allowed much less. It is a civil rights violation. It is a social policy that has “legalized” discrimination against an entire class of people Under Color of Law. It is inhumane to deprive vulnerable people of equal protection under the law. The attempts to justify this social policy by claiming it is in a victim’s “best interest;” or that it is done “for their own good” are juvenile; all things considered, justifying any of this as beneficent or charitable is incomprehensible; truly despicable really.

Medical professionals in theory, police themselves...Doctors (and perhaps, all professions that "police" themselves) seem to do so very ineffectively. While this is a rather broad generalization, I believe there is more than a grain of truth in it...
Part of learning in life and in medicine requires learning from one's own and one another's mistakes; in effect, bearing one another's burdens as well---this reliance upon one another may inhibit one’s ability or willingness to learn how and when one should act in defense of a vulnerable person, and perhaps play a role in having a person held accountable for an error that caused harm to a vulnerable person. The intent and the purpose of accountability is to ensure people are treated with respect and have ethical medical care to protect patients from quackery and unethical practitioners. Performing the ethical duty of policing one’s colleagues more effectively and consistently, would restore and help to effectively preserve the ethical integrity of the evidence base, and the reputation of the medical profession.  

One of the things that I have come to realize, (I have yet to accept it with any grace) is with rare exceptions, basically good people, who were otherwise competent professionals made errors in judgement or behaved in a reckless, abusive or negligent manner when interacting with my son.  For the most part, basically decent people harmed my son. Even more looked the other way; failing their ethical duty to my son. It is of no comfort to me to realise it wasn’t malice or ill intent which motivated their actions; truthfully, the fact that it was simply carelessness or ignorance, has  caused me no small amount of additional sorrow...

I’m at a loss as how to reconcile what I believed and thought was true about people in general, and mental health professionals in particular, with our experiences. The manner in which we were treated, has made it impossible to reconcile how we were treated with the ethical guidelines for medicine, or the principles of social justice. Societal norms of civility and human decency I believed at one time to be "how things are done;" were nowhere to be found in our trek through the mental illness system.  I have spent countless hours doing research looking for answers which could possibly explain any of what happened; and I came across the chapter of a book several weeks ago that offered an explanation of sorts, but is of no comfort at all. I am nonetheless thankful to have found it.  

There is no reason for what we experienced. Reason has nothing to do with good people being wilfully blind; in effect, choosing silent complicity. There is no good reason for continuing to employ people who fail to perform required tasks clearly stated in their job description, when their failure is a crime. The system isn't broken---it's the people who are employed in spite of failing to perform a critical part of their jobs as Paid Public Servants. The fact that is, it's a crime for state employees or contracted providers to not refer complaints to Law Enforcement for investigation when required by law to do so; this seems to be conveniently overlooked; rarely (if ever) prosecuted. Probably because the state is ultimately liable for damages.


I am grateful that I was there to bear witness to how my son was used and abused; more grateful that he survived. I am painfully aware others don't survive; then there are the survivors who have no one to validate their pain, some have no one who listens to them at all. No one should have to bear such burdens alone; no one should be without someone who loves them, validates them, believes them and has confidence in them. Someone who will bear witness for them, should they be too traumatized to tell their own story. My son has been silenced by fear and trauma (de)Voiced by his lived experience; he will be 25 day after tomorrow, silenced by fear.  

I have no understanding for why a psychiatric diagnosis is used as a justification for treating people as if the diagnosis means they are less than human; less than worthy of their Human Rights being preserved or even defended. In truth, it seems to me that if a person is not as able to protect their legal interests temporarily or permanently for any reason, the person would need special consideration to preserve and defend their fundamental Human Rights. Involuntary Treatment statutes lower the standards and allow a much lower standard with less protection for an individual's Human Rights to be used. How is that even ethically or morally justifiable? I know it isn't. I know it is inhumane, that it is discrimination based on *a real or perceived* disability; making it "legal;" but not in reality, since it is unconstitutional, and violates individual rights Under Color of Law. That it uses the same convoluted ignorant reasoning; the same type propaganda, and the same social control tactics that were used to implement Eugenics as a "public health" and "social services" policy in this country is horrifying---Doesn't anyone in America know any American History? Implementing these kind of "beneficent" social service programs which deprive people of their human dignity, their Human Rights, and their freedom for life Under Color of Law has been done before in the US Eugenics Era and in Germany leading up to WWII.

via the New Existentialists:

Eugenics and Psychiatry: A Brief Overview of the History

a couple of excerpts:
"In my casual observations in conversation with colleagues, I find that very few mental health professionals are aware of the historical link between psychiatry and eugenics."

"Has psychiatry today fully exorcised the demons of it’s past? I think not. Children in poverty, especially those on public welfare and in foster care, are much more likely to be drugged with harmful antipsychotic drugs. I see this kind of psychiatric abuse as an extension of the eugenics project, and it needs to stop. Psychiatry is also still used to perpetuate racism. Today, we still see that black men are misdiagnosed with schizophrenia five times more often than white people. It is easier to label a person with madness and force his compliance with antipsychotic drugs than to endure the difficult job of listening to a man who lived with the darkness of a lifetime of victimization by racism. Until we see such patterns disappear from psychiatry practice, I will remain unconvinced that psychiatry has fully escaped the weight of its shameful eugenic legacy."

-- Brent Dean Robbins here

available at Amazon

"IF we want to understand violence as a whole, we cannot leave any of its major manifestations in a fog of half-knowledge. But this is exactly what has happened with an unprecedented occurrence of mass violence, the deliberate killing of large numbers of mental patients, for which psychiatrists were directly responsible. To both the general public and the psychiatric profession, the details and the background are still imperfectly known. This is not only a chapter in the history of violence; it is also a chapter in the history of psychiatry. Silence does not wipe it out, minimizing it does not expunge it. It must be faced. We must try to understand and resolve it." Fredric Wetham, M.D. A SIGN FOR CAIN An Exploration of Human Violence
A SIGN FOR CAIN An Exploration of Human Violence FREDRIC WERTHAM, M.D.Chapter 9 (pdf) http://ow.ly/h5dfY  on Leonard Roy Franks website

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Eugenics photo credit

The Experts: The American Psychiatric Association Department of Government Relations, Assessing the Risk for Violence and Access to Firearms

No one should be surprised that the "experts," in the American Psychiatric Association do not have any plan, "Policy" or "Position Statement" on how the APA will act to mitigate the risk for violence caused by the adverse effects of the psychotropic drugs they use off label without any valid indication the drug will treat the symptom it is being prescribed to treat...In fact, there is no mention that the drugs they use are a factor in many school shootings. Obviously, the APA does not use all of the relevant information available when offering "expert opinions" on Public Policy. It is unprofessional and unethical for a psychiatrist, let alone a group of them, to use incomplete and biased information when offering a professional opinion. Psychiatrists offer professional opinions to people seeking treatment, to educate child-serving professionals, and the general public; and psychiatrists provide "expert" opinions on Public Policy.

The risks inherent in each of the contexts psychiatrists offer a "professional opinion" are serious; and potentially fatal. Apparently, the APA is not capable, or is simply unwilling to be honest. If it were honest, the APA would not pretend there is no elephant in the room, e.g. the adverse effects of psychotropic drugs. The adverse effects of the drugs must be considered in every honest discussion about the treatment of psychiatric diagnoses, and people who have a psychiatric diagnosis who have violent and aggressive behaviors. It's not possible to offer an "expert opinion" or make a treatment recommendation without dicussing the known risks of following a treatment recommendation. It is unethical to provide misleading and inaccurate information about drug risks.

via forums.officer.com

                 

AMERICAN PSYCHIATRIC ASSOCIATION

DEPARTMENT OF GOVERNMENT RELATIONS

Statement of Paul S. Appelbaum, MD
Representing the American Psychiatric Association
January 9, 2013
The American Psychiatric Association (APA) appreciates this opportunity to submit comments to the Gun Violence Task Force. I am Paul Appelbaum, a former president of the APA and the Dollard Professor of Psychiatry, Medicine & Law at Columbia University. I have spent several decades studying violence and mental illness, and thinking about systemic issues in the delivery of mental health care.

It is important, by way of preface, to note some of the key realities related to violence and mental illness. Most violence in this country—96% by the best available estimate—is not committed by people with mental illness, and most people with mental illness are not violent. Indeed, people with mental illness are far more likely to be the victims than the perpetrators of violence; for example, women with mental illness have five times greater risk than other women of being the victims of domestic abuse.

Thus, America’s problem with violence is not mostly a mental illness problem. Whatever is done to reduce violence among the mentally ill will have only a small impact on the overall rate of violence, including firearm violence. That is not an argument for inaction, but it does suggest that focusing on people with mental illness alone is not likely to be a successful strategy for gun violence reduction.

However, the Newtown tragedy—coming so soon after the mass shootings in Tucson and Aurora—has opened a discussion about how we might improve the treatment of mental illness. Given the great needs for improved delivery of care for mental illnesses, this is too important an opportunity to allow it to pass. We may currently have an opportunity to begin rebuilding a system of care that has been decimated over the last several decades by the progressive withdrawal of resources in both the private and public sectors. As the task force heard, public sector appropriations alone have dropped by $4 billion dollars over the last 4 years.

In response, I would like to suggest 4 approaches to this issue that I think are worth of attention.

1) Appointment of a Presidential Commission to Develop a Vision for a System of Mental Health Care – It is a truism in discussions about mental health in America that no real system of care exists. Evaluation and treatment are difficult to access, often unaffordable, and fragmented across a variety of providers and payers. Families of children with mental illness in particular can recount horror stories of their efforts to find someone to treat their loved ones. Transitions from inpatient to outpatient treatment often result in patients falling through the cracks, and mental health and general medical treatment are rarely coordinated. Substance abuse treatment frequently takes place in an entirely different system, again with little coordination with mental health care. Auxiliary interventions of the sort essential to many people with serious mental illnesses—supported housing, employment training, social skills training—to the extent that they are available, may be offered through other agencies altogether. Our mental health system is a non-system.

The last major reconceptualization of how to deliver mental health care in this country began in 1955 with an act of Congress that resulted in the appointment of the Joint Commission on Mental Health. The Commission’s report, Action for Mental Health, provided a vision of a community-based mental health treatment system that included preventive and supportive services, along with community outreach and education. This vision helped to motivate the downsizing of large state hospitals and in 1963 culminated in the passage of the Community Mental Health Services Act. The Act envisioned the creation of a network of mental health centers spanning the country, so that every citizen would have a single point of access to the care they required.

Unfortunately, fewer than half of the centers envisioned were ever built, and adequate support for their operation was never provided. The promise of an effective community-based system of care was unfulfilled. But the Act represents the last thoroughgoing effort to conceptualize what a system of mental health care for all Americans should look like. We are now 50 years later, in a different world, for which a different vision may be required. However, the essential notion of having an integrated system of care is too important to relinquish. President Obama has the opportunity to initiate a process that would think creatively about the how a genuine system of mental health care could be created today. Establishment of a Presidential Commission to propose a vision for the mental health system and suggest realistic steps to implement that vision could be a landmark contribution. It would shape the next half-century of mental health and constitute a positive legacy from the tragic events that led to the creation of this task force.

2) Creating a Mechanism for Facilitating Response to Key Mental Health Issues – In addition to the long-term issues regarding mental health care that a Commission could address, there are a large number of more immediate concerns. These range from ensuring that the implementation of the Affordable Care Act operationalizes the promise of parity for mental health treatment to reintegrating returning Iraq and Afghanistan veterans with their high rates of post-traumatic stress disorder (PTSD) and traumatic brain injury. Response to these issues by the Administration would be facilitated by the designation of a member of the White House staff as the point person (perhaps a “mental health coordinator’”) for mental health issues as they affect domestic policy. Such an appointment would also be seen as a strong statement about the importance that the Administration places on mental health issues.

3) Improving Early Identification of Young People with Mental Health Problems – Many of the organizations represented at this meeting emphasized the importance of early identification and treatment of children and adolescents with mental health problems. The need for such mechanisms has been underscored by the murders in Tucson, Aurora, and Newtown, among similar tragic events, which frequently have been carried out by troubled adolescents and young adults who have not received necessary mental health care.

Fortunately, the American Psychiatric Foundation, an arm of the APA, developed in the wake of the Columbine shootings a highly effective program for outreach to schools called Typical or Troubled?® School Mental Health Education Program that trains teachers to distinguish between students who are “just being adolescents” and those manifesting early signs of mental disorders. Typical or Troubled?® has trained staff in 500 schools across 38 states, and recently developed a culturally competent Spanish version of the program. It could serve as a model for early identification programs of the sort that should be available in every school. I left information about Typical or Troubled?®with Ms. Feldman of the Vice President’s staff, but we would be delighted to provide further information about the program if that would be helpful.

4) Sensible, Non-Discriminatory Approaches to Keeping Firearms Out of the Hands of Dangerous People – While we attend to meeting unmet mental health treatment needs, consideration also needs to be given to concrete approaches to restricting firearms access for persons who are likely to use those guns to harm themselves or others. Nearly 20,000 gun suicides occur in the U.S. each year, and guns are used in over two-thirds of all murders. Much of the public’s attention has been focused on means of limiting access to guns by people with mental illnesses. However, as is clear from the statistics cited earlier, people with mental illness account for approximately 4% of violence in the U.S. Thus, focusing on this group is not likely to be a highly effective strategy, and runs the risk of reinforcing the stigmatizing association in public perceptions between mental illness and violence.

In contrast, an Indiana statute provides an alternative approach. Indiana empowers law enforcement officers to seize weapons from persons who by their behavior indicate a likelihood of committing violent acts. One provision addresses people with mental illness, but a second does not require that the person be mentally ill. A judicial hearing follows within a prescribed period of time at which the state bears the burden of proof that the weapons should not be restored. Evaluation of the statute’s operation has shown that although a majority of people whose weapons are seized are perceived to have a mental illness (though they are far more often believed dangerous to themselves than to others), many are not. The latter include people involved in substance abuse, domestic disputes, and other behaviors presenting a serious risk of violence. Although there is no single cure-all for the problem of violence, Indiana’s law (Connecticut has a somewhat different statute that requires a court order for seizure) offers a model for a commonsense approach to reducing the risk of gun violence that does not overtly discriminate against people with mental illness. (See Indiana Code, Title 35, Article 47, Chapter 14)


AMERICAN PSYCHIATRIC ASSOCIATION
DEPARTMENT OF GOVERNMENT RELATIONS
AMERICAN PSYCHIATRIC ASSOCIATION DEPARTMENT OF GOVERNMENT RELATIONS 1000 WILSON BLVD, SUITE 1825, ARLINGTON, VA 22209
Tel: 703-907-7800 Fax: 703-907-1083 www.psychiatry.org

Position Statement on Assessing the Risk for Violence

Approved by the Board of Trustees, July 2012
Approved by the Assembly, May 2012

"Policy documents are approved by the APA Assembly and Board of Trustees…These are…position statements that define APA official policy on specific subjects…"

– APA Operations Manual.

This position statement was proposed by the Workgroup on Violence Risk of the Council on Psychiatry and Law. During their careers most psychiatrists will assess the risk of violence to others. While psychiatrists can often identify circumstances associated with an increased likelihood of
violent behavior, they cannot predict dangerousness with definitive accuracy. Over any given period some individuals assessed to be at low risk will act violently while others assessed to be at high risk will not. When deciding whether a patient is in need of intervention to prevent harm to others, psychiatrists should consider both the presence of recognized risk factors and the most likely precipitants of violence in a particular case.
The members of the Workgroup on Violence Risk are Alec Buchanan, M.D. (Chairperson), Michael A. Norko, M.D., Renee L. Binder, M.D., and Marvin Swartz, M.D.

via Daniel Mackler

Almost 2 million Americans are addicted to prescription opiates; addiction is not rare

Washington Post

There is no justification for corrupting the medical evidence base, 

undermining the ethical integrity of the medical profession, 

and causing the deaths of countless patients.

There are only excuses like this one:

“Because the primary goal was to destigmatize [opioids], 

we often left evidence behind." Dr. Russell Portenoy

The primary goal of medicine is to ethically treat patients, 
using sound medical judgement.  

Sound judgement requires careful consideration of all the available evidence. 

via The Alliance for Human Research Protection:

Rising Painkiller Addiction Shows Damage From Drugmakers’ Role in Shaping Medical Opinion

Tuesday, 01 January 2013
“You could say these marketing tactics are merely concerning. But I think of them as satanic. What the data are telling us is that these drugs are ruining people’s lives,” said Phillip Prior, MD

"Below is the latest in the Washington Post series--Can Medical Research be Trusted? its focus is the continued rise in painkiller addiction and the decisive role played by corrupt pharmaceutical marketing practices.

"Of note, more than a decade ago, in 2002, the US Drug Enforcement Administration (DEA) reviewed medical examiners' toxicology reports from 32 states. The DEA reported that OxyContin was involved in 464 overdose deaths, few included alcohol consumption.

"But, over much of the past decade, the official word on OxyContin was that it rarely posed problems of addiction for patients. The label on the drug, which was approved by the FDA, said the risks of addiction were “reported to be small.”The New England Journal of Medicine, the nation’s premier medical publication, informed readers that studies indicated that such painkillers pose “a minimal risk of addiction.” Another important journal study, which the manufacturer of OxyContin reprinted 10,000 times, indicated that in a trial of arthritis patients, only a handful showed withdrawal symptoms.

"Those reassuring claims, which became part of a scientific consensus, have been quietly dropped or called into question in recent years, as many in the medical profession rediscovered the destructive power of opiates. But the damage arising from those misconceptions may have been vast.

"The nation is confronting an ongoing epidemic of addiction to prescription painkillers — more widespread than cocaine or heroin — that has left nearly 2 million in its grip, according to federal statistics.

“Around here, we call it ‘pharmageddon,’ ” said Lisa Roberts, the public health nurse for the town, whose primary job is to reduce the fatalities associated with drug use. “This has been absolutely devastating to Appalachia. From what we’ve seen, the risks of addiction were tremendous.”

· “It turns out that the doctors didn’t know what they were talking about,” said Barbara Howard, whose daughter Leslie, a home-care nurse, died of an overdose in 2009 in this small Appalachian town devastated by the epidemic. She had developed a habit after knee surgery. She left behind a 9-year-old son.

· “Leslie trusted the doctors. We thought the doctors knew what was best. But they didn’t. We — and lots of the other victims — had no warning.”

“You could say these marketing tactics are merely concerning. But I think of them as satanic. What the data are telling us is that these drugs are ruining people’s lives,” said Phillip Prior, MD

"To refine its policy on opioids, the FDA convened a key meeting in 2002 and invited 10 outside experts for advice. Five of them reported having served as speakers or investigators for Purdue. Three others reported working as speakers for or as advisers and consultants to other pharmaceutical companies.

"One of those FDA advisers, Dr. Russell Portenoy, who was then the chair of the Department of Pain Medicine and Palliative Care at the Beth Israel Medical Center in New York, has since expressed regret for his evangelism on behalf of opioids.

"He was “trying to create a narrative so that the primary care audience would . . . feel more comfortable about opioids,” Portenoy said in a 2010 interview, “Because the primary goal was to destigmatize [opioids], we often left evidence behind. (emphasis mine)

“To the extent that some of the adverse outcomes now are as bad as they have become in terms of endemic occurrences of addiction and unintentional overdose deaths, it’s quite scary to think about how the growth in that prescribing driven by people like me led in part to that occurring.”

"In 2003, Purdue Pharmaceuticals, the manufacturer of OxiContin--whose sales reached $1.3 billion--had the gall to sponsor advertisements warning about prescription drug abuse!

Vera Sharav here

By Peter Whoriskey,

Rising painkiller addiction shows damage from drugmakers’ role in shaping medical opinion

  December 30, 2012    

"Portsmouth, Ohio — Over much of the past decade, the official word on OxyContin was that it rarely posed problems of addiction for patients.

"The label on the drug, which was approved by the FDA, said the risks of addiction were “reported to be small.”

"The New England Journal of Medicine, the nation’s premier medical publication, informed readers that studies indicated that such painkillers pose “a minimal risk of addiction.”

"Another important journal study, which the manufacturer of OxyContin reprinted 10,000 times, indicated that in a trial of arthritis patients, only a handful showed withdrawal symptoms.

"Those reassuring claims, which became part of a scientific consensus, have been quietly dropped or called into question in recent years, as many in the medical profession rediscovered the destructive power of opiates. But the damage arising from those misconceptions may have been vast. 

"The nation is confronting an ongoing epidemic of addiction to prescription painkillers — more widespread than cocaine or heroin — that has left nearly 2 million in its grip, according to federal statistics." read here

A doctor of psychiatry and his medical instruments

When one realizes that Human Rights crimes are legally mandated but it's called providing "effective medical treatment" to people with a diagnosis of schizophrenia, who don't know what's good for them (because they supposedly have a lack of insight) it's truly stunning.  I realized this was happening when I was a kid---I have been aware way too long to be polite sometimes...The fact that a minority of people with a diagnosis of schizophrenia actually benefit from taking the neuroleptic drugs; but that everyone who takes them faces serious risks to their overall health is not relevant, and neither is determining if the person Court Ordered is among the minority of people the drugs help. The Nation's top psychiatrists, and grassroots mental health advocates for the "seriously mentally ill" lobby for public policies and Legislation so that more people can benefit from psychiatric treatment "for their own good." (and 'protect' society)

The fact that psychiatric treatment commonly results in iatrogenic illness and disability and leads to a decades earlier death is a well established; an obviously accepted, if not intended, outcome. It's plain that disability and early death is the most commonly achieved Real World Outcome for people treated by psychiatry; particularly for people who are diagnosed with schizophrenia. Obviously, words like "safe" "effective" and "treatment" had to be re-defined for psychiatry's clinical standards of care; the terms, "clinical care standards," "best practices" and "off label prescribing priveledges" have also been redefined by psychiatry. Psychiatrists who write, recommend, and use drug based treatment protocols and algorithms and who teach students and other medical professionals to use them, must believe that disability and early death are beneficial to patients; acceptable, desirable treatment outcomes and perhaps even deluded enough to believe that consensus is a substitute for ethical medical research. Doctors of psychiatry, leading psychiatric researchers and public mental health policy makers are providing a standard of care with consistent, reliable results; unfortunately, the most probable outcome is death. This bewing the case, one can understand how perjury and forgery have simply been re-defined, they are now part of psychiatry's standard of care which are supported by the specious claim that teratogenic drugs treat undefined "chemical imbalances" and unidentified "brain diseases" which psychiatrists believe may be causing "mental illnesses;" more accurately described as, psychiatric diagnoses. Unsubstantiated claims are the so-called "evidence" that standard clinical practices are based upon. The neuro-biological disease and/or chemical imbalance hypotheses are, at best, slurs which stigmatize; at worst, they are fraudulent claims made in order to deprive people of their human rights based on eugenic theory repackaged then marketed to the masses as valid, ethical "medical science."

People with a psychiatric diagnosis have their Human Rights violated as a matter of course; the rights most people take for granted. Mental health professionals have a moral and an ethical duty to preserve the fundamental human rights of people whom they give a psychiatric diagnosis. Instead, mental health professionals and 'patient advocates' support legally diminishing what are inalienable rights---but what the hell, safe and effective treatment is not actually safe or effective so what is a little deprivation of one's human rights in order to medically treat the diseases psychiatrists voted into existence! Even clinical care standards are determined by pseudo-democratic political process. The standards are not based on ethical, scientific research; or any ethical medical standards used by any other field of science based medicine. Psychiatry uses the Courts to strip patients of their human rights, psychiatry does not conform to legal standards i.e. Rules of Evidence, and Standard Court Procedures, that are required for for every other type of Court Proceeding, whether civil or criminal.

The nature of psychiatric diagnoses and the effects of the drugs is not relevant in commitment proceedings. No where in our society is psychiatry held to the ethical standards other medical specialties are; not even the ethical standards which are legally mandated by International Law for Clinical Research conducted by Medical Doctors on human subjects. Psychiatry is practiced in a dishonest, unethical manner. There is no evidence that the psychiatric profession values the ethical standards of science, medicine or the law. There is no evidence of psychiatry being compelled by an altruistic intent or that it values or is even aware of a primary ethical duty to psychiatric patients. Patients are disabled and killed at alarming rates by teratogenic drugs and shock treatments prescribed "for their own good."

What psychiatrists do not explain is why the ethical standards of science, medicine or the law do not apply to the practice of psychiatry. What psychiatrists do not explain is why fraud, corruption, and lying in professional journals, textbooks, classrooms and to students and professionals is acceptable. What psychiatry needs to explain is why outright lying and using analogies to explain psychiatric symptoms and coercing "treatment compliance" is ethically acceptable. Dishonesty is not honorable, defense of dishonesty shows an utter lack of ethical integrity.

Why does a group of professionals that is so dishonest and unethical have Police Powers? Courts of Law have lowered all of the ethical legal standards for psychiatry so that the Courts and Police have in effect, become medical instruments used to strip patients of their inalienable rights to force compliance with psychiatric treatment. Rules of evidence do not apply to the "evidence" used against psychiatry's patients, and the lowered legal standard is claimed to be necessary for the patient/victim's "benefit."

It is patently obvious that the lower standards in scientific medical and legal arenas serve primarily to keep facts hidden. Lowered Court standards serve to protect psychiatry while failing to protect psychiatric patients or serve the Justice interests of society as a whole. The same patient can be seen by 3 psychiatrists and get 3 distinctly different diagnoses. Psychiatric diagnoses cannot truthfully be called "diseases." Teratogenic drugs and electrical shocks, both of which cause iatrogenic damage and dysfunction, cannot be truthfully called "safe and effective medical treatments."  Without lowered legal standards, a psychiatrist would not be able to offer "evidence" that a person has a "brain disease" requiring "safe and effective medical treatment." If the Rules of Evidence applied, a psychiatrist could offer little, if any, evidence that would support a petition forcing involuntary psychiatric "treatment."

Lowering scientific, medical and legal standards is necessary, but it is not done to provide "necessary medical treatment" that is "safe and effective." I suspect if any of psychiatry's claims were supported by scientific findings, or grounded in ethical medical principles, i.e. based on facts instead of  subjective opinions, innate biases, errors of attribution, and distorted research; psychiatry would not need to pervert and distort the truth. Police Officers have an ethical duty, an Honor Code, "To Protect and To Serve."  Courts of Law have an ethical duty to apply the law equally to all, as if the Courts were blind to special interests; not biased in favor of predetermined outcomes. In effect, to be blind to subjective biases; basing legal rulings on objective evidence offered in compliance with the rules of evidence, adhering to standard legal procedures. Why has human society allowed psychiatry to subjugate the role of Police Officers and Courts of Law to that of serving the interests of psychiatry? Police Officers and Courts of Law now are performing their jobs as if their ethical duty has become primarily to serve psychiatry as "medical instruments."  Police Officers and Courts of Law serve all of society by enforcing the Law, and preserving individual rights. Service in preservation of Blind Justice is honorable when done with integrity. It is a shameful disgrace; a blight on all humanity when it is not.

via Leonord Roy Frank


A SIGN FOR CAIN
An Exploration of Human Violence
FREDRIC WERTHAM, M.D.



The Geranium in the Window
THE "EUTHANASIA" MURDERS
If the physician presumes to take into consideration in his work whether a life has value or not. The consequences are boundless and the physician becomes the most dangerous man  in the state.

DR. CURISTOPH HUPELAND

(1762-1836)

IF we want to understand violence as a whole, we cannot leave any of its major manifestations in a fog of half-knowledge. But this is exactly what has happened with an unprecedented occurrence of mass violence, tile deliberate killing of large numbers of mental patients, for which psychiatrists were directly responsible. To both the general public and the psychiatric profession, the details and the background are still imperfectly known. This is not only a chapter in the history of violence; it is also a chapter in the history of psychiatry. Silence does not wipe it out, minimizing it does not expunge it. It must be faced. We must try to understand and resolve it. read here

Picture Credit: Just Ducks