Prepared by: National Stigma Clearinghouse


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December 21, 2003 - News of the Week


Slurs and demeaning words have been called bias having a good time. But language can also promote bias while seeming innocent.

In a letter below, Harold Maio alerts New York City's Village Voice to a language stereotype that lumps a wide range of individuals under a collective label. As Harold shows, this stereotyping has catastrophic results.

Thursday, December 11, 2003


Re: The Police and "the" Mentally Ill


Why can't the police interact better with "the" mentally ill is deceptively simple to answer: There is no "the" mentally ill.
We are individuals.
The police, and the writers and editors of the Voice, are responding to a non-existent stereotype, a stereotype each creates and each fears. Why would you choose to contribute to that stereotype?
Hitler invented "the" Jews, and we recognize that metaphor, but once the term after the article "the" changes, we reveal we have learned nothing. It is a powerful act to create a generic group of people, for whom there are generic answers.
"The" police is also that same metaphor. Throughout the nation there are police departments learning how to interact with someone who may be experiencing a mental problem. A better question to ask is, Why are the police in New York not accessing the learning? Memphis has a program, and the city of St Petersburg, Florida. I know, because I edited the latter.
Several curricula are available, and all can be accessed through the net. After taking the classes one California district reported no deaths for several years- up to the present.
We know it works.
The man recently killed in New York was experiencing chaos in his mind, and in the midst of that chaos comes a group of police, sirens blaring, physically threatening, approaching, each adding to the problem, exacerbating the chaos.
When the response should have been maintaining a calming distance and demeanor, instead the police accelerated the chaos, and then justified the death.
Proper procedure is quite simple: Maintain a safe distance,10, 20 feet-police safety is the first concern, and project a calming attitude. Wait out the situation exactly as one would wait out a hostage situation, they are very similar.
Value the person.
Harold A. Maio, Board Member
Partners in Crisis
Ft Myers FL 33907
PIC is an organization of law enforcement, the judiciary and advocates, including individuals who have experienced mental health problems, working together for solutions.

December 7, 2003 - News of the Week


During his senior year in college, artist John Cadigan had a psychotic break. He dropped out and for years cycled through a number of doctors and medications. John's struggle to bring order to his chaotic universe continued into his 30's, when he decided to film the uneven course of his recovery. His sister Katie, who heads the production company ImageReal in San Mateo, California, encouraged John to capture his experience on film. Making the documentary expanded John's own perception and understanding. More broadly, the film gives audiences an empathetic experience that so often eludes outsiders.

"People Say I'm Crazy" has taken off more dramatically than John and Katie ever dreamed it could. In addition to being showered with awards and critics' praise, the film has found a national audience as part of the HBO Frame by Frame Documentary series, and it will air on Cinemax in 2004.

The film is available for purchase or rental, and the filmmakers are available for speaking engagements.

FOR COMPLETE INFORMATION (about John, his art; film reviews and credits, and more) go to:

November 30, 2003 - News of the Week


(See letter below from Harold Maio)

Marvel Comics' special Spider-Man tribute to the heroes of the World Trade Center terrorist attack is a stark example of "how-to-stigmatize."

A New York Times feature (11/23/03) about the Marvel Comics chief, Joe Quesada, saw fit to print a riveting illustration from Marvel's special " Amazing Spider-Man" issue. Two captions accompany the toppled towers:
"The sane world will always be vulnerable to madmen, because we cannot go where they go to conceive such things."

"Only madmen could contain the thought, execute the act, fly the planes."

Will this collector's item set back years of antistigma work?

The Times described Marvel's Joe Quesada as driven but thoughtful. A competitor said, " matter what he does, Joe hits a home run." Marvel's themes are intended to mirror real issues. As Quesada put it, "With comic books, you look at real-life situations and try to find the right metaphor." But in this case, the metaphor misses the mark and instead stigmatizes millions of blameless people.

Will the mental health community convince Joe Quesada to reconsider "Spider-Man's" false and simplistic blaming of mental illnesses for the world's evil?

Contact information:
Joe Quesada, Editor in Chief
Marvel Enterprises, Inc.
10 East 40th Street
New York, NY 10016
Tel: 1-212-696-1132
Fax: 1-212-576-4075

Bill Keller. Executive Editor
The New York Times
229 West 43rd Street
New York, NY 10036
Tel: 212-446-1234

Below are excerpts from a response to Joe Quesada from Harold Maio:

From: (Harold A. Maio)
Date: Tue, Dec 2, 2003, 2:05pm
Cc: (NYTimes) (Jean Arnold)

Re: Cartoon captions:
"The sane world will alway be vulnerable to madmen, because we cannot go where they go to conceive of such things"

"Only madmen could contain the thought, execute the act, fly the planes"

Unfortunately, the opposite is true. The myth of madness applied in this manner is not unusual. We want very much to excuse behaviors by labeling the person or persons responsible as mad, but the reality is we fail to recognize just how normal evil people appear.

Hitler was most assuredly not "mad", nor is Bin Laden. Viewed as mad, we endow people with an excuse for their behavior they do not merit. We conflate evil and "madness", two entirely separate phenomena.
The very first plane to be sabotaged by a bomb did not occur in the mind of a "madman", but in the mind of playwright Rod Serling on his TV show, "The Twilight Zone", and it was, according to him, the script he most regretted writing.
Please do not excuse evil by labeling its perpetrators "mad", that is the fairy tale version we were fed as children. Evil people are calculatingly clever, organized to the extreme, and charismatic to the point they have no problem finding followers.
Stalin "mad"? No. Hitler? No. The people in this country who organized the "Trail of Tears"? The doctors in Tuskeegee who let syphilis run its course so they could study the Black men dying from it? Are the presidents of tobacco companies mad? The executives of Enron? Are the exploiters of humans as commodities in third world countries "mad"?
It is the very saneness of evil people's acts that we should fear, for their acts of sanity far outweigh the John Hinckleys, the Unibomber, people truly not in control of their mental faculties.

What you are doing has occurred throughout history. You are screaming rape with a vulnerable person in the room, and rationally and sanely inciting a lynching. It is emotionally satisfying. For the moment. For anyone not subject to become the victim of the hysteria.
And you are morally wrong. But you I can excuse, you are a comic book publisher, "a riveting illustration" readers expect. One should expect extremes in comics.
The Times' editors? They simply illustrate how news is contemporarily reduced to comics. News media? Now there is something to fear.

Harold A. Maio

November 23, 2003 - News of the Week



(Better than reading about the site, click

The mental health community has long needed a comprehensive site dedicated entirely to assisting antistigma/anti-discrimination work. Look no further! The new website of the national ADS Center is designed to fill this longstanding need. The site will serve the ADS Center's goal: to help states, local communities, providers, managed care organizations, advocates, family members and consumers counter discrimination and prejudice.

For an advocate concerned about where to begin and what to do to combat discrimination, the website devotes special sections to employment, housing, healthcare, the media, and policy makers. These sections link site visitors to resources needed to help landlords, employers, insurers, healthcare providers, educators, legislators and others to understand mental illnesses and the vulnerabilities they may cause.

To keep site visitors well-informed, there will be periodic updates concerning new innovations, campaigns, and research, as well as commentary and opinion pieces by people who are involved in countering stigma and discrimination.

We recommend bookmarking this long-needed resource.

Below is an ADS Center press announcement with full details.

New Web-Based Resource Launched To Address Discrimination And Stigma Associated With Mental Illnesses
November, 2003
A new Web site has been launched to serve as a centralized resource in collecting and providing information for addressing discrimination and stigma associated with mental illnesses : .
The recent President's New Freedom Commission Report, "Achieving the Promise: Transforming Mental Health Care in America," identifies stigma as a pervasive barrier to understanding mental illnesses and the importance of mental health.  It points out the need to reduce stigma by increasing public understanding about mental health and mental illnesses with multi-faceted approaches, such as public education activities, factual information, dialogues, and interpersonal contact with people with mental illnesses. The new Web site serves as a comprehensive resource of useful information to address this need.
The Web site offers a wealth of useful information related to stigma and discrimination. Descriptions of innovative international, national and local anti-stigma/anti-discrimination initiatives and programs can assist people to build understanding and knowledge related to people with mental illnesses.  Also, this information can be used to identify and implement specific activities to counter discrimination and stigma in communities, schools, and workplaces.

Information on resources such as articles, fact sheets, brochures, books, data bases, and research are provided on issue areas such as employment, housing, healthcare, the media and many more. Numerous resource organizations are listed to help landlords, employers, insurers, healthcare providers, educators, and others better understand mental illnesses and the people who have them.
Also available on the Web site is a periodic memorandum, with information on new and/or innovative resources and campaigns, research, and columns by people involved in countering stigma and discrimination.  The Web site is associated with the Resource Center to Address Discrimination and Stigma (ADS Center).
The goal of the ADS Center is to help States, local communities,providers, managed care organizations, advocates, family members, and consumers of mental health services to design and implement programs to reduce stigma and the discrimination and prejudice it engenders. The Center provides useful resources and information about effective approaches to counter stigma and discrimination.   It offers information about available publications, events and relevant issues, provides technical assistance and trainings through on-site assistance and teleconferences, and brokers speakers to make presentations.
The ADS Center's toll-free number is 1-800-540-0320 and the Center is open Monday-Friday 9:00 a.m. to 5:00 p.m. (ET) with bilingual (English/Spanish) staff available.
The ADS Center is a program of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, and operated by a contract with The Gallup Organization and the Mental Health Association of Southeastern Pennsylvania.

-End of ADS Center Announcement-

November 16, 2003 - News of the Week


Here is more evidence to discredit popular assumptions about mental illnesses and violence. It is interesting to note that in New Zealand, like the U.S., mental health system failings cause some of the rare murders committed by people with mental illnesses.

Copyright 2003, New Zealand Herald,

Murder and the Mentally Ill


Everyone knows society is more dangerous these days: there's violence on the streets and it's beamed into our living rooms. And it's no coincidence that the closure of Carrington, Tokanui, Lake Alice and other mental institutions led to this surge in murders, right?

Psychiatrist Sandy Simpson tests the theory on his masters students and the community groups he addresses: do they think the proportion of murders committed by the mentally ill has risen or fallen in the past 30 years? "They all think it's getting worse."

But a study released today quashes myths about the risk posed by the mentally ill. It finds no basis to claims that care of psychiatric patients in the community has contributed to the increase in murders. It even suggests that the likelihood of violence by people with mental illnesses has fallen since "deinstitutionalisation".

"Community care hasn't failed," says Jim Burdett, who represents people in contact with mental health services. "People aren't being killed by lunatics in huge numbers.

"The study, Myth and reality: the relationship between mental illness and homicide in New Zealand, examined the files of 1501 murderers between 1970 and 2000. It found 133, or 8.9 per cent, were judged not fit to stand trial or not guilty by reason of insanity, in line with rates for low homicide countries internationally.

But an interesting trend emerged. Although the number of murders has tripled, from fewer than 20 a year in the early seventies to between 50 and 70 in recent years, the number of killings by the mentally ill has remained steady - and is usually less than six a year.

The result: murders by the mentally ill have fallen as a proportion of total homicides from nearly 20 per cent in the early seventies to around 6 per cent today.

The study is one of only four in the world to look at time trends in homicides, and is touted to be the most comprehensive. [Bold type added]

Researchers satisfied ethical and privacy concerns to cross-match data from the police, coroners' office, Ministry of Health, Justice Department, Parole Board and New Zealand Herald archives.

Simpson, who led the research team, says it is significant that the study period coincides not only with deinstitutionalisation but an era of increasing social fragmentation.

Rising unemployment, poverty, marriage breakdowns, drug and alcohol abuse and increased exposure to violence are factors which could lead us to expect an increase in mental illness. But the 18 killers judged to be mentally ill in the past five years of the study period compares favourably with the 20 identified in the first five years.

"It almost makes me proud that, in a less hospitable world, people with mental illness haven't succumbed to these pressures in the same way that people without mental illnesses have by murdering more often," says Burdett, who himself has a mental illness.

The study for the Mental Health Research and Development Strategy addresses another myth: that community care raises the risk of being killed by a stranger who knocks on the door or "loses it" in the street.

Of 84 murders by strangers between 1988 and 2000, only two offenders were mentally ill. The flipsides: mentally "normal" perpetrators are more likely to kill strangers and the mentally ill are more likely to target loved ones and family.

Tony O'Brien, senior lecturer in mental health nursing at Auckland University, says the research confirms there's more reason to fear a drink or drug-affected single young male than someone with a mental illness.
"The fact that homicides by the mentally ill have stayed constant over this long period of deinstitutionalisation suggests mental health services are doing a pretty good job of managing the risk."

In the cauldron of emotion, science and politics that is mental health, there is reluctance to make too much of the findings, a mere stepping stone in research to improve the delivery of mental health services. The researchers admit the data has limitations and expect robust scrutiny from both the pro-institution lobby and mental health service consumers.

"I don't think you can say it gives community care a free bill of health," says Simpson, clinical director of the Mason Clinic in Auckland. "We're not saying dreadful things haven't occurred because of deinstitutionalisation. "Nor are we saying there's not a case for more acute beds and some long-term beds."

When he started at Porirua Hospital in the mid-1980s, there were 1200 beds. Now there are no more than 800 nationwide. But Simpson says it's important not to romanticise the past.

"We would have two or three nurses in a villa with 35 people in it and one doctor in charge. The quality of care we could provide to people in terms of frequency of review and planning of rehabilitation was very limited indeed.

"Then when we shifted into the community the resources were never adequate to provide thorough care."

The failings of community care fuelled public suspicion that deinstitutionalisation was aimed more at cost-cutting than better service. Many services failed to come to grips with law changes which protected privacy and allowed patients not subject to compulsory treatment orders to refuse medication.

After the Raurimu massacre, and again after Malcolm Beggs was killed by his flatmate, coroners linked community care to the rising number of homicides and suicides. Politicians took up the cause, including former Prime Minister and psychiatric social worker Mike Moore, in 1997: "The care of acutely disturbed psychiatric patients outside hospitals ... has not worked and has been discredited internationally as a failed experiment.

"How many more people must be killed, or hurt ... and how many more reports must the Government receive before action is taken?

"In fact, inquiries generally laid the blame not with the policy but with the performance of mental health services - and not always the result of underfunding. In the case of Mark Burton, who stabbed his mother to death a day after a medical officer released him from Southland Hospital's acute unit, an inquiry exposed a service riddled with organisational failings.

Government financing did improve - and Simpson says the homicide study is one indicator that service levels are approaching what is needed.

"Have we still got gaps out there - yes, we have. Are we closing them at a rate in which the service can actually grow and improve - I think we probably are. Everyone would say there are quality gains to be made, but we have also come a long, long way."

The report offers hope that services are getting it right - most of the time.
"It may be that the improved quality of services that people have striven for in the past decade are preventing more tragedies than we may have expected," he says. "That's the other way of looking at the numbers - we don't know about all the homicides we have saved."

While citing the advent of community support, recovery-based policies, forensic services and better medicines, the study offers pointers for the future. Just over half the mentally ill killers suffered psychotic illnesses such as schizophrenia, conditions associated with delusions and hallucinations that can lead to violence. Half had been admitted to psychiatric hospitals or acute facilities, 10 per cent within the previous month and 20 per cent within the previous year.

But most had been admitted only once or twice in the previous five years and nearly a third had no previous contact with mental health services.

Burdett says although things have improved, some mentally ill people still end up rejecting medication, taking harmful drugs and languishing in boarding houses.

The study acknowledges the need to do better in reaching people with psychotic illnesses earlier, including the 30 per cent whose offence is their first episode of illness.

Which sounds fine until you consider that services in Auckland are still stretched to the limit and said to be counting down to the next tragedy. Last year, a crisis team in West Auckland took industrial action against being overloaded with patients, leaving an answerphone message saying "temporarily unable to provide a service due to lack of resources".

In March, crisis workers complained that
staff numbers were dangerously low and that bed shortages were forcing them to put patients in police cells. Their workload was forcing them to skimp on patient risk assessments, a practice criticised after the Malcolm Beggs killing.

But Tony O'Brien, crisis intervention worker at Auckland Hospital's emergency department, says the chances of someone not receiving follow-up care are lessening. "It's still difficult to access inpatient beds and acute care. If somebody went into crisis today it would be difficult to get a bed.
"There's always the potential for things not to work for somebody, but I actually think we are doing a reasonable job."

Does this mean society has nothing to fear from mental illness? Not quite, says Simpson. The mentally ill whose illnesses are not well managed do have a greater tendency to violence than the rest of the population.

The second most common diagnosis for mentally ill killers in the New Zealand study was major depression, a common cause of infanticide - which helps to explain the higher proportion of mentally ill women who murder than in "mentally-well" homicides. "If we can decrease the number of people with active psychotic illnesses or provide better care for postnatal depression - these interventions may lead us to reduce homicides even further."

But Simpson anticipates criticism of the data from both the "reinstitution" lobby and relatives of homicide victims. Given the number of prisoners diagnosed with mental illness, it's obvious that some mentally ill killers have been "missed" by the judicial system.

The report admits the classification of 81 murder suicides as "mentally normal" is arguable, but records indicate that only nine had evidence of previous mental health contact. "Murder suicides were generally domestic tragedies with evidence of immense turmoil and distress, but uncommonly with mental illness."
Simpson says the statistics also highlight the hairline judgments which must be made on psychiatric risk.

It is estimated that 12,000 people have a psychotic illness at any one time. The research found these responsible for half the murders by the mentally ill, maybe two or three each year. "So we are trying to predict a very rare event, a very shocking and horrible event, but nonetheless very rare.

"With modern medicine and treatment it's not the diagnosis that defines risk, but the relapse of illness, he says. "The real challenge is to do better at predicting when individual patients are at risk of lapsing into a dangerous state."

He acknowledges that the public, and especially victims, find it difficult to accept that mentally ill killers do get better.
"They have that image of the horror of what occurred frozen in time."

The reoffending rate among people with a serious mental illness is much lower than with people who are not ill because the motivation is different. "People who offend when they are mentally ill generally believe they are doing the right thing; they are driven to act by a moral imperative. Once their moral judgment is no longer affected by illness they are normal and moral people."

From a nursing perspective, Tony O'Brien says the task of predicting risk is "quite fraught".

"If you are talking to someone and they're hearing voices and you know they're abusing alcohol or methamptheatmines or marijuana, you know there's an increased risk.

"But if they are currently well and not abusing, you may know there's a degree of risk but there's no way of telling. Distant risk is a much harder issue that's not well understood."

But while the mental health service can make further progress in reaching potentially dangerous people and diagnosing risk, it's clear from the study that this will have only a tiny impact on the homicide rate.

More must be done outside the mental health sector to prevent homicides, such as targeting substance abuse and alcohol problems, says O'Brien.

Director of mental health David Chaplow says the report should nevertheless help change the perception that we live in a violent country. Our murder rate is on a par with Britain and Australia and a third that of the United States.

"If you have a fairly stable home environment and you stay at arm's length from illicit drugs and alcohol your chances of dying violently by another's hands are almost zero."

Chaplow says more than 30,000 people are in contact with mental health services over the course of a month and perhaps a dozen will come before the courts. "Should we lock up the 30,000? The study also shows that at least 30 per cent [of mentally ill killers] have never come in contact with mental health services.

"It's really a matter of who we target, and we have a better idea now: people with psychotic illnesses and a past history of risk to themselves or others.

"But that 30 per cent figure means we also need to say to the community, 'If you have a loved one who's acting strangely, who has funny ideas and is frightening you, then get help real quick'."
©Copyright 2003, NZ Herald

NOTE from National Stigma Clearinghouse: Hundreds of examples in our archive attest to the exaggeration of a "mental illness/violence connection" to sell products, entertain mass audiences, and even get laws enacted. We congratulate the New Zealand Herald for bringing a small measure of balance to the public's attention.

SPECIAL POSTING: October 28, 2003
This excellent article shows the wide diversity within the mental health community.


Sunday Times Magazine,
The Los Angeles Times
October 26, 2003
Losing the Mind

David Oaks and Others in the 'Mad Pride' Movement Believe Drugs Are Being Overused in Treating Mental Illness, and They Want the Abuse to Stop.

By David Davis

Standing on a concrete island in downtown San Francisco, David Oaks yells into a bullhorn the climactic line from the film "Network": "We're mad as hell and we're not going to take it anymore."

The line would be a cliché if it weren't for one thing: Oaks means to be taken literally.

On this sunny day, as thousands of mental-health professionals stream into the air-conditioned cool of the Moscone Center for the 156th annual meeting of the American Psychiatric Assn., Oaks and his cadre of supporters are quite mad, thank you. They are former patients in what many would call a dysfunctional mental-health system.

As protesters carry signs that read "Psychiatrists Cure Dissent, Not Disease" and "Self Help Works," Oaks invokes his holy trinity of social activists -- Martin Luther King Jr., Cesar Chavez and Justin Dart, the father of the Americans with Disabilities Act.

"We're calling for a nonviolent, global revolution of self-determination and empowerment," he says, eyes dancing. "The inmates are ready to take over the asylum."

Soft-spoken and even-keeled in private, Oaks unleashes his rage publicly by tapping into the trauma he experienced as a patient in the mental-health system. In the 1970s, while he was a student at Harvard University, Oaks was diagnosed as schizophrenic. He was institutionalized and forcibly medicated. He recovered, he says, by rejecting drugs and getting support from family and friends. "I was put on Haldol and Thorazine, and it was torture," he tells the San Francisco crowd. "They took a wrecking ball to the cathedral of my mind."

Oaks, now 48, is executive director of MindFreedom Support Coalition International, a Eugene, Ore.-based umbrella group for the "Mad Pride" movement. The grass-roots campaign, also known as "MindFreedom," includes so-called psychiatric survivors and dissident psychiatrists who reject the biomedical model that defines contemporary psychiatry. They say that mental illness is caused by severe emotional distress, often combined with lack of socialization, and they decry the pervasive treatment with prescription drugs, sales of which have nearly doubled since 1998. Further, they condemn the continued use of electro-convulsive therapy -- or ECT, also known as electroshock -- which they say violates patients' human rights.

Theirs is a philosophy born of "being chewed up and spit out by the system," says Oaks, and their views pit them against nearly everyone within the medical establishment, including American Psychiatric Assn. members, the pharmaceutical companies that increasingly fund drug development and testing, and even the National Alliance of the Mentally Ill, a prominent advocacy group.

Broadly speaking, those organizations believe that decades of research have proven that schizophrenia, bipolar, severe depression and other mental disorders are biological illnesses of the brain caused by some undiscovered combination of genetic, neurochemical and social factors. They believe that, along with psychotherapy, these illnesses should be treated with drugs (and sometimes a panoply of drugs) that target the biochemical mechanisms of psychiatric disorders.

"Our brains are biological organs by their very nature," says Dr. Paul Appelbaum, past president of the American Psychiatric Assn. "Any disorder is in its essence a biological process."

Given the expertise and money involved in those organizations, Oaks and his allies would seem to face hopeless odds.

MindFreedom operates on the fringe of the mental-health community; its protest in front of the Moscone Center drew all of 100 people. Oaks admits that he has no evidence to dispute the medical-scientific model of mental illness. What he and his small army do have is look-in-the-mirror evidence about their recovery from mental illness, often accomplished by not taking medication. They also trumpet evidence that, notwithstanding the experts' medical degrees and their "miracle" drugs, confirms that the nation's mental illness system is in crisis.

  • Four of the 10 leading causes of disability worldwide are neuro-psychiatric disorders, according to a 2001 World Health Organization study.

  • The National Institute of Mental Health estimated in its most recent study in 1995 that the annual cost of mental illness in the U.S., including medical care and lost productivity, was $185 billion.

  • Only about one in five Americans with major depression receives adequate care, according to a recent _Journal of the American Medical Assn._ study.

  • More than 30,000 Americans committed suicide in 2001, 10,000 more than those
    killed in homicides that year.

  • "The system is broken," says Robert Whitaker, author of "Mad in America: Bad Science, Bad Medicine and the Enduring Mistreatment of the Mentally Ill." "The so-called triumph of the psychiatric-pharmaceutical model has produced the horrible outcomes we have today."

    Given those outcomes, can anyone completely dismiss the experiences of people who have lived with, and overcome, mental illness?

    In conversation, Oaks is earnestly persuasive. He keeps his wavy hair tied back in a ponytail, and his pale blue eyes are hidden behind clunky glasses. Because of a fused spine, he is unable to turn his head normally.

    The incidents that turned him into a radical activist occurred during his sophomore and junior years at Harvard. He arrived in Cambridge in 1973 on an academic scholarship, a working-class kid from Chicago's South Side who wanted to study government and economics (or, as he calls it, "power and money").

    Intimidated by Harvard's lofty reputation and the boarding-school backgrounds of many of his classmates, Oaks says he struggled to find his place. After experimenting with marijuana during his sophomore year, he entered what he describes as "an altered state." He heard voices and believed he was communicating with God -- classic signs of schizophrenia, a disease suffered by more than 2 million Americans.

    At the college infirmary, Oaks was given medication that included heavy doses of Thorazine, an anti-psychotic drug. Oaks says he only managed to take Thorazine for 10 days before quitting. "It just wiped me out," he says.

    He managed to finish the term, then returned to Harvard after the summer. Again he smoked pot and experienced hallucinations. "I thought the CIA was making my teeth grow, and the TV was talking to me, and God was communicating with me through the radio."

    This time he was taken to McLean Hospital, where Nobel Prize-winning mathematician John Nash ("A Beautiful Mind") and poets Robert Lowell and Sylvia Plath had been treated. Oaks says he was locked in solitary confinement and underwent what patients call "a gooning," or forced drugging. "The male attendants hold you, pull down your pants and inject you in the butt," he says. "It felt incredibly intrusive and humiliating. I felt like it was about them dominating my being rather than about helping me."

    He left McLean after one month, then flushed his remaining lithium down the toilet. He then found the Boston-based Mental Patients Liberation Front, one of the original rights groups for mentally ill patients, where he learned how to eat healthfully and exercise, to ask for and get support from peers, to feel part of a community.

    The latter half of the 1970s was a heady time for psychiatric survivors. Former patient Judi Chamberlin had just written "On Our Own," her critique of the mental-health system that has since become the movement's bible. Support groups sprang up across the nation. Their message: Recovery is possible through housing arrangements, job training and rehabilitation.

    "The doctors told me I had a broken brain," Oaks says. "They told me there was nothing I could do about it. Well, I did get better."

    The self-empowerment model provides hope for those recovering from mental illness, says Dr. Daniel Fisher, a psychiatrist and executive director of the National Empowerment Center, an information clearinghouse for medical services consumers. "People need to realize that they can and do fully recover from mental illness, but they have to be an agent in their own life. If they're a passive recipient [of care], they're worse off. They may not have severe symptoms anymore, but they're never going to go out and get a job."

    Oaks worked with the Mental Patients Liberation Front for four years before moving to Berkeley and then settling in Eugene. Throughout the 1980s, he organized rallies against the American Psychiatric Assn., protested the revival of electroshock therapy and wrote for Madness Network News, a now-defunct magazine for the nation's psychiatric survivors. In 1990, he and others founded Support Coalition. Now called MindFreedom, it has an annual budget of about $80,000, which comes from membership fees, donations and sales of books and T-shirts.

    Some 100 grass-roots groups have joined as sponsors. Bearing names such as "Prozac Survivors Support Group," "Women Prisoners Convicted by Drugging" and "Network Against Psychiatric Assault," they promote alternative options for psychiatric treatments.

    "The fact that the movement has survived is due in large part to David's ability to work like a dog for almost no money and his ability to mollify those people who are outraged," says Dr. Loren Mosher, former director of the National Institute of Mental Health who resigned from the American Psychiatric Assn. over what he dubs the "unholy alliance" between psychiatrists and drug companies. "He has managed to keep a lot of disparate opinions under the tent."

    Oaks quips that he is now "quote-unquote normal" by society's reckoning. He owns a home, is happily married and works full time with MindFreedom. He boasts that the movement to which he's devoted his life has earned respect and tangible gains. State and federal governments routinely fund local community drop-in centers, support groups and the annual "Alternatives" conference. The survivors' perspective is included in President Bush's New Freedom Commission on Mental Health, while MindFreedom has been accredited by the United Nations as a nongovernmental organization with consulting status.

    Psychiatric survivors now have "a seat at the table," says Sally Zinman, executive director of the Sacramento-based California Network of Mental Health Clients.

    At the American Pychiatric Asn. convention, it's not difficult to see what Oaks is up against. The floor of the Moscone Center resembles a brightly colored field of California poppies. Dozens of carpeted booths, in lavish hues of aqua green and shocking purple, line the gigantic hall, each one trumpeting the benefits of modern-day pharmacology. Here's Paxil, for relief of anxiety; there's Zoloft, to combat depression; and here's Ritalin, for attention-deficit disorder. Even the schedule for the hotel shuttle buses is "sponsored" by Risperdal, a popular treatment for schizophrenia.

    The effect is, at once, soothing and disquieting. Help is at hand, these drugs promise, while the sheer volume of products screams: You Need Help, Now!

    Oaks and other Mad Pride advocates emphasize that they're not anti-drug; many of their members take medication to overcome mental illness. What they object to is the pervasiveness of medicating every facet of human behavior. "This pill-for-every-ill method is just a quick fix that treats the symptoms, not the problems," says Fisher. "We've lost something along the way -- connecting with people and helping them."

    Many of these highly touted drugs, notes journalist Whitaker, have been deemed harmful. Thorazine was introduced by pharmaceutical giant Smith, Kline & French in 1954, when many psychiatrists believed that it and other "mind-ordering"
    anti-psychotics would help patients recover. Its development, according to one medical historian, "initiated a revolution in psychiatry, comparable to the introduction of penicillin in general medicine."

    Thorazine proved effective, but it also had debilitating side effects. Some patients developed symptoms similar to those of Parkinson's disease, including a shuffling gait and drooling. Permanent brain damage can occur.

    Thorazine has been replaced by a new generation of anti-psychotics known as atypicals, which psychiatry boasts are more effective in treating schizophrenia. But research would appear to bolster Mad Pride's claim that the drugs have unintended side effects. This year, a Veterans Administration study indicated that certain atypicals increase the risk of diabetes in some patients.

    In addition, studies have demonstrated that the drugs currently used to combat depression -- known as SSRIs, or selective serotonin reuptake inhibitors -- are dangerous for some patients. The UnitedKingdom has banned the use of Paxil in children under 18 following a spate of suicides; the FDA announced that it will re-examine clinical trial data on Paxil. And the _Archives of General Psychiatry_ reported that SSRI use during late pregnancy may cause neurological disorders in babies.

    Many in the Mad Pride movement blame the pharmaceutical companies' deep pockets. The companies routinely bankroll the studies published in the most prestigious medical journals -- often without the public's awareness of this practice. According to pharmaceutical sales data and information from the consulting company IMS Health, sales of psychotherapeutics reached $21 billion in 2002, almost double the $11billion in sales in 1998.

    Even one of Oaks' most vocal critics, Dr. E. Fuller Torrey, president of the board of the Arlington, Va.-based Treatment Advocacy Center, agrees that psychiatry has been usurped. "Many of my colleagues have accepted more money [for research and as gifts] than they should have," he says. "This is a huge problem."

    But Rick Birkel, executive director of the National Alliance of the Mentally Ill, defends the drug companies as funding critical research and development of lifesaving drugs. "We couldn't do this work -- we couldn't make the advances we've made -- without industry developing psychiatric drugs. Those medications allow some people to live the lives they want."

    Drugs aside, the treatment Oaks objects to most vehemently is electroshock therapy. ECT induces a series of epileptic-like seizures through shocks to the brain. Although its use diminished in recent decades as drugs became more prevalent, ECT has made a quiet comeback as a last-resort treatment for the severely depressed.

    In California, one of a handful of states that require tracking of ECT, the Department of Mental Health reports that nearly 3,200 patients have received ECT.

    According to Torrey, ECT is effective in emergency situations. "ECT is a primitive form of therapy, but it's the only form that works for some severely depressed patients," he says. "We will all be happy when we can develop something different, but ECT can be a lifesaver."

    Oaks considers ECT "barbaric," with a high relapse rate, and notes that it often causes memory loss. He says that, in certain situations, ECT is administered without patients' consent. This gets to the heart of MindFreedom's philosophy; to Oaks and his allies, such invasiveness is a violation of civil rights. As pioneer activist Chamberlin put it, "If it isn't voluntary, it isn't treatment."

    To the medical establishment, this is heresy. Its members have lobbied for laws that mandate involuntary treatment of the severely mentally ill, including California's AB-1421, also known as Laura's Law, named for the 19-year-old woman shot to death by someone who was mentally ill.

    Without such safeguards, they argue, patients could harm themselves or others.

    "There are a small percentage with mental disorders who by virtue of the disorder lose the insight into their own condition to appreciate they're ill and that they need treatment," Appelbaum says. "Mental illness is no different than other illnesses that may impair the decision-making capacity of an individual."

    Counters Chamberlin, "It's a coercive system by its nature, one that doesn't listen to, much less respect, the people. The person thinks her life is worse [on medication], but the doctor says she's better. He's the judge, jury and executioner."
    By staking out turf at the fringe of the survivors' movement, Oaks regularly clashes with the National Alliance of the Mentally Ill, which bills itself as a "grass-roots, self-help, support and advocacy organization of consumers, families and friends of people with severe mental illnesses."

    Oaks and others accuse the group of taking substantial donations from pharmaceutical companies. The result, he says, is that the drug industry has appropriated it. "They want a simple answer," he says. "They want to dam up the problems, even if that means forcible drugging and years of being locked up in an institution. As long as an adult child isn't homeless or openly hurting themselves, they think it's a success."

    Birkel says the alliance does accept millions in drug company donations, estimating that the money is about 20% of the group's budget. He defends the practice, saying that "all advocacy groups in the health fields take donations from the pharmaceutical industry. The real issue is how do you maintain independence? We can walk away from the pharmaceutical industry on any issue."

    Birkel claims that Oaks is targeting the wrong groups. "I don't know what they do, other than the protests," Birkel says. "I don't think they're the good guys."

    Other survivors, however, believe that Oaks' radical politics serve as a necessary counterbalance. "David is like the Malcolm X of the psychiatric survivor movement," says Zinman of the California Network of Mental Health Clients. "He's out there speaking the truth in all its rawness and purity."

    Oaks and the psychiatry establishment may disagree philosophically, but they do agree on one point: America's mental-health system is in a shambles. "At a time when treatment for psychiatric illness has never been more effective, access to that care is fragmented, discontinuous, sporadic andoften totally unavailable," a recent
    American Psychiatric Assn. Task Force concluded. "The numbers of individuals with serious and persistent mental illness who are incarcerated or homeless and without support have reached epidemic proportions."

    Birkel has called it "a broken system of care," while the American Psychiatric Assn.'s Appelbaum concedes that "we've focused on new, more effective treatments, but we've neglected to pay attention to put the systems in place to implement them."

    To publicize the crisis in mental health, Oaks took a page from his heroes' book by staging a hunger strike in August. Holed up in a small building in Pasadena, he and several others challenged the American Psychiatric Assn., the National Alliance of the Mentally Ill and the U.S. surgeon general to produce evidence that established "the validity of schizophrenia, depression or other major medical illnesses as biologically based brain diseases" and that "any psychotropic drug can correct a 'chemical imbalance' attributed to a psychiatric diagnosis."

    The alliance and the surgeon general did not officially respond. Says Birkel: "I found the challenge to be useless -- it's like proving how many angels dance on the pin."

    The American Psychiatric Assn. did reply, meeting personally with a delegation of hunger strikers. In a statement released in September, the association said that "it is unfortunate that in the face of this remarkable scientific and clinical progress, a small number of individuals and groups persist in questioning the reality and clinical legitimacy of disorders that affect the mind, brain and behavior."

    The association, however, also conceded that "brain science has not advanced to the point where scientists or clinicians can point to readily discernible pathologic lesions or genetic abnormalities that in and of themselves serve as reliable or predictive biomarkers of a given mental disorder or mental disorders as a group . . . . Mental disorders will likely be proven to represent disorders of intercellular communication; or of disrupted neural circuitry."

    To Oaks, who fasted for 12 days of the 22-day strike, that admission was no small victory. "They acknowledged that they didn't have the biological evidence [of mental illness], so that's on the record," he says. "Now it's time for the APA to implement a far more complex model [of mental illness] that reflects the whole person and not just this narrow, reductionist, biological model."
    David Davis last wrote for the magazine about cowboy singer and actor Herb Jeffries.


    To submit brief letter (about 100 words) to editor of _LA Times Magazine:

    A Note from MindFreedom
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    November 2, 2003 - News of the Week



    Date: Friday, October 31, 2003
    McMan's Depression and Bipolar Weekly 5#28

    Special New Bipolar Treatment Guidelines Issue

    Lead story: Prisons as mental hospitals.

    Also in this issue: Antidepressant/kids warning, Serzone under fire, New European Zyprexa BP indication, Chrominum for depression, Antipsychotics and EPS, In the pipeline, Stigma watch, New Canadian dietary supplements legislation, Worth quoting, Depression and work, Kids on meds, Stanley Foundation findings, Meds with supplements, McMan's Web, Donations.

    Human Wrongs
    Pray that your next florid manic or psychotic outbreak - heaven forbid - lands you in a hospital rather than a jail or prison. According to a new report by Human Rights Watch, 16 percent of federal and state adult prisoners in the US are mentally ill, translating to 230,505 mentally ill adults in prison and 106,476 in jail, three times the hospitalized patient population. Each year, more than 700,000 mentally ill Americans are processed through jail or prison, typically in conditions of unspeakable horror. Of the female population, 40 percent of young white women are mentally ill. According to one estimate, on any given day, at least 284,000 people with schizophrenia and bipolar are incarcerated in the US, and 547,800 are on probation. Two of the largest mental health providers in the US are the Cook County and LA County jails.

    Says Human Rights Watch: "Thousands of mentally ill are left untreated and unhelped until they have deteriorated so greatly that they wind up arrested and prosecuted for crimes they might never have committed had they been able to access therapy, medication, and assisted living facilities in the community. Mental health professionals told Human Rights Watch that it is next to impossible to get their clients admitted to hospitals or treatment programs until after they have deteriorated to such a point that they have already committed a crime."

    Once inside, things tend to go from bad to worse. Human Rights Watch cites the case of Mark Walker of Montana, a hard-core felon whose diagnosis was changed and lithium discontinued by a prison psychiatrist after a cursory half-hour evaluation without consulting his medical records. Over the next year, as Mark's condition deteriorated, he became increasingly disruptive and was transferred to maximum security. Three suicide attempts followed, but rather than receive treatment, his behavior was treated as a disciplinary matter and he was placed in "lock down" for six months in a windowless cell smeared with blood, feces, and vomit. Several times, he was stripped of all privileges, confined to his cell for 24 hours a day, with no clothing and bedding, spending his days and nights naked, and forced to sleep on a concrete slab. In April this year, the Supreme Court of Montana ruled that Mark's treatment constituted cruel and unusual punishment. Incredibly, a lower court came to the opposite conclusion.

    As for treatment, forget about it. Only 231 of the nation's approximately 1,400 prisons are accredited by the National Commission on Correctional Health Care. The state of Iowa has a prison population of more than 8,000, with as many as 2,000 mentally ill. Yet the entire Department of Corrections has only 30 psychologists, most with just a bachelor's degree, and three psychiatrists. A 1998 investigation into conditions at the Wyoming State Penitentiary found that of 95 people referred to for mental health services in a three-month period, only six were actually given psychiatric evaluations. In virtually all prison systems, medication is equated with treatment, generally improperly administered and inadequately monitored, with virtually no counseling and other therapies.

    The yearly bill for using prisons as de facto mental hospitals comes to about $35,000 per person, way less than the $90-$100,000 tab for sending people to real hospitals, but tremendously short-sighted in light of the saving that could be achieved by diverting offenders into community treatment programs, Human Rights Watch concludes.

    Human Rights Watch monitors human rights abuses in more than 70 countries. Turning its attention to an oppressed minority closer to home speaks volumes, but don't expect anyone to be listening. For a good many of us, blind justice is also hearing-impaired.

    Meanwhile in New York ...

    The Correctional Association of New York reports that nearly one in four New York state prison inmates who are locked alone in a cell for at least 23 hours a day are mentally ill. Forty-four percent had previous suicide attempts. More than half of the prison system's suicides have occurred in lock down units over a three-year span.

    Antidepressants/Kids Warning

    The FDA has sent an advisory to physicians warning of suicidal ideation and suicide attempts in clinical trials of various antidepressants tested on more than 4,100 pediatric patients with major depression. The eight drugs under scrutiny are Celexa, Prozac, Luvox, Remeron, Serzone, Paxil, Zoloft, and Effexor. Although there have been no suicides in the trials, the FDA "has not at this point been able to rule out an increased risk of suicidality for any of these drugs." The FDA noted that of seven drugs evaluated for pediatric major depression, only Prozac proved effective, though the FDA added this does not necessarily mean the other drugs are ineffective. The FDA urged that all the drugs should be used with caution, with close supervision of high-risk patients. The FDA will undertake further review.


    The consumer watchdog group Public Citizen is urging the FDA to ban Serzone due to risk of liver toxicity. This follows a similar request made by Public Citizen in March this year. In its new submission, Public Citizen notes that the drug has been recently banned in Canada, and that Bristol-Myers Squibb has pulled the product from Europe and Scandinavia. In its March petition, Public Citizen cited 53 cases of liver injury, including 21 cases of liver failure involving 11 deaths and seven liver transplants. Its updated petition cites an additional 41 cases of liver toxicity, including nine deaths and five liver transplants. The drug contains a black box warning.


    The European Commission has approved Zyprexa for preventing the relapse or recurrence of mania, mixed episodes, and bipolar depression. The approval was based on six trials involving more than 1,500 patients, including a head-to-head study with lithium showing delayed time to relapse for both mania and depression. Last year, Zyprexa was approved in Europe for short-term treatment of mania


    Psychology Today reports that several small studies have found that the mineral chromium - either by itself or with antidepressants - has proved effective for treating mild to severe depression. A recent Duke University study found 600 mg of chromium picolinate resulted in a reduction of symptoms associated with atypical depression, including a tendency to overeat. Chromium may act on insulin, which controls blood sugar (researchers have linked depression and diabetes). The mineral is found in whole grains, mushrooms, liver, and brewer's yeast.

    Antipsychotics and EPS

    An article on Medscape by Martin Korn MD, a New York psychiatrist, and Henry Nasrallah MD of the University of Cincinnati on atypical antipsychotics notes that there needs to be a binding rate of 80 to 90 percent of dopamine D2 receptors to induce EPS ( a range of side effects involving involuntary spasms and other movements). Risperdal is the agent most likely to induce EPS due to tighter binding, though it is most likely at higher doses (at greater than six mg). Seroquel, with looser binding, cannot be distinguished from the placebo in terms of EPS. Clozaril also has a low EPS rate.
    Patients most susceptible to EPS include those with mood disorders, the elderly, African Americans, and some Asians.

    In the Pipeline

    From HealingWell and other sources:

    In Phase III (final testing)

  • Pfizer and Organon's asenapine, an atypical antipsychotic being tested for both bipolar and schizophrenia.

  • Zomaril (iloperidone), Novartis' atypical antipsychotic.

  • Bifeprunox , Lundbeck and Solvay's atypical antipsychotic.

  • Emend (aprepitant), Merk's substance P antagonist for depression.

  • Sunepitron, Pfizer's depression/anxiety med.

  • Symbiax (OFC), Lilly's Zyprexa-Prozac combo for treatment-resistant depression.

  • Pending FDA approval:

  • Symbiax for bipolar depression.

  • Cymbalta (duloxetine), Eli Lilly's dual action antidepressant.

  • Ariza (Gepirone), Organon's antidepressant.

  • Pregabolin by Parke_Davis, an improved Neurontin, for depression/anxiety/bipolar.

    Stigma Watch

    A computer game that features a detective tracking a "maniacal killer" at a New Jersey mental hospital is drawing the wrath of mental health advocates. "I find it really upsetting that this type of product could be put on the market," said Deborah Taggart, executive director of the Mental Health Association in Morris County, NJ.

    The Synergy Saga

    Canada's House of Commons has passed a bill to amend its Food and Drugs Act that would allow dietary supplements to be treated as foods rather than drugs. The bill goes to a committee for further review. Final passage would ensure that Health Canada could no longer block access to natural health products such as Synergy's Empowerplus, a nutrient supplement that many people are using to treat their bipolar. Earlier this year, Health Canada prevented Synergy from shipping its supplement to its Canadian clients and raided the offices of its nonprofit arm, Truehope. Health Canada has also prevented clinical trials of Empowerplus from proceeding.

    Worth Quoting

    "I try to take one day at a time, but sometimes several days attack me at once." Jennifer Unlimited


    A survey of 751 depressed working women by the American Medical Women's Association and the National Mental Health Association has found that 83 percent perceive depression as the number one barrier to success in the workplace, over child and elder care responsibilities, pregnancy, and sexual harassment. Nearly one-third said that their depression "completely interferes" with their ability to do their job. Ninety-four percent reported improvements at work after seeking treatment.

    Kids on Meds

    "'The problem,' warns Dr. Glen Elliott, director of the Langley Porter Psychiatric Institute's children's center at the University of California, San Francisco, 'is that our usage has outstripped our knowledge base. Let's face it, we're experimenting on these kids without tracking the results.'"

    From a Time Magazine cover story, "Are We Giving Kids Too Many Drugs?" The article reports on how a Lexapro-Adderall combo gave back the life of an 18-year-old, and how a four-drug cocktail has been a godsend to a 13-year-old bipolar patient, as well as citing a recent study linking antidepressant use to a drop in youth suicide rates, but cautions that even the drug companies acknowledge that pills alone are not the ideal answer.

    From the Stanley Network

    An article in Bipolar Disorders reviews some of the recent findings of the seven-site Stanley Foundation Bipolar Network, including:

  • A survey of its first 258 patients over 12 months, which found that patients were on an average of 4.1 medications, yet 25 percent were ill for more than 75 percent of the year, 40.3 percent remained intermittently ill, 32.9 percent stayed minimally ill, and only 11.2 percent remained virtually well. Patients averaged 40 days of mania or hypomania over twelve months and 121 days of depression. Ninety-seven percent were on mood stabilizers, 53 percent on antidepressants, 49 percent on benzodiazepines, 21 percent on atypical antipsychotics, and 17 percent on the older antipsychotics. Bipolar I patients comprised 76 percent of the group.

  • The interim results of a study that found that 50 percent of 127 patients responded after 10 weeks to adjunctive antidepressants. Of the 67 patients who continued treatment for 12 months, 43.8 percent were responders. Nearly 13 percent of the patients in the 10-week trial switched into mania or hypomania with some dysfunction, 17.9 percent of those who continued treatment switched into mania or hypomania with some dysfunction, and another 20.9 percent switched into hypomania with little or no dysfunction. Only 19.2 percent of the 67 patients were successful in completing a full year of antidepressant treatment.

  • A study by Altshuler et al that found that 70 percent of those who discontinued adjunctive antidepressants relapsed into depression vs 36 percent who stayed on their antidepressants, with no significant differences in mania switch rates between the two groups. However, the study population represented but 15 percent of those who had responded to their antidepressant, the rest having quit their antidepressant due to manic switches, failure to respond, or poor tolerance.

  • A study by Leverich et al of 631 patients that found that those who experienced extreme stressors (eg physical or sexual abuse) in childhood or adolescence had earlier illness onset, more adverse course of illness, and more co-occurring psychiatric illnesses. Further study of a smaller group of patients over 2.8 years found those with a history of early physical or sexual abuse experienced increased time ill, a greater percentage of time depressed, greater severity of depression, and higher rate of suicide attempts.

  • A study by Frye et al that found a two to three times greater risk of alcoholism in bipolar men and a sevenfold risk for bipolar women.

  • A preliminary examination of patients on either Seroquel, Risperdal, or Clozaril found that Seroquel as an add-on reduced depression scores in the first month and continued to be effective as maintenance treatment, but not Risperdal and Clozaril.

  • A study by Kupka et al reported an increased prevalence of anti-thyroid antibodies in Stanley patients (28.3 vs 14.2 percent general population), which was associated with increased risk of lithium-induced hypothyroidism, but not with greater rapid-cycling, and was not a predictor of clinical response or outcome. Females are at increased risk for hypothyroidism (22.8 percent vs 11.6 percent males).

  • A study by Keck et al that found that six grams of EPA (found in omega-3) fared no better than the placebo over four months.
    East and West

    Bonnie writes:

    Besides needing to take psychotropic meds, I also have considerable gastrointestinal problems. After I went toxic on lithium for the umpteenth time, I spoke to my doctor about lowering my lithium intake yet again.

    On the same note, due to being so physically sick, I consulted with a homeopathic psychiatrist. The first thing she did was test my folic acid level and my B-12 level. My folic acid level was fine, but my B-12 level was almost off the charts in terms of the low side. Due to my compromised GI tract, I began getting monthly B-12 shots. I could feel the difference almost immediately as B vitamins, especially B-12 are known to help with regulation of mood. I also began taking a B complex vitamin as well.

    The other things that I did was to take evening primrose oil to help with female hormone fluctuations that caused me mood problems and for some time I took omega 3, but that didn't last long because I had trouble breaking down the fat within them.

    So, for me a combination of western (psychotropic) and eastern (supplements) medicine saved my life.

    McMan's Web
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    John McManamy
    "Knowledge is necessity."
    Copyright 2003 John McManamy

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  • October 26, 2003 - News of the Week

    Source: The Toronto Star
    October 17, 2003

    Prejudice, discrimination cause more problems than illness

    Patients and experts take on the labels, misconceptions


    Psycho. Basket case. Looney.

    Those labels, along with others even more unflattering, plaster the illustrated door. The drawing also shows a woman, peeking tentatively from behind that imposing barrier.

    "I drew her small because it's belittling," says the artist. "I filled in dark all around her because that's where she is. She's kept in the dark, she's not rejoiced about, she's not understood."

    For decades, advocates have been trying to open that very stubborn door, to get society to look past the labels and misconceptions that discriminate against those suffering from mental illness.

    Last week, interested parties from around the globe came to Kingston for a conference on stigma sponsored by the World Psychiatric Association.

    "Stigma has been in the making more than 5,000 years. It is a beast that has to be broken," says Switzerland's Dr. Norman Sartorius, the scientific director of a major international anti-stigma program that the World Psychiatric Association has implemented in more than 20 countries since 1996.

    For those struggling with mental disorders, stigma is indeed a beast. Research has shown that the prejudice and discrimination against those with mental illness can cause more problems than the disorders themselves.

    "I would argue that many of the problems of mental illness are not due to the illness," says Pat Corrigan, a rehabilitation psychologist and director of the Chicago Consortium for Stigma Research.

    "There is clear evidence that landlords won't rent to people with mental illness, that employers won't hire, that police will over-respond, and that the media will misrepresent," Corrigan says.

    In fact, analyses of newspaper content in many countries show a clear pattern of such misrepresentation.

    Stories linking mental illness with violence are given more prominence, more space, and more emphasis than stories about violence where the suspect did not have a mental disorder.

    The overall impression left by such coverage is that people with mental illness are dangerous and the source of a considerable amount of crime. This, despite the fact that people who do not have a mental disorder commit more than 95 per cent of violence in the community.

    "We see that the stigmatizing articles are bigger, the headlines are bigger, and the photos are bigger," says Dr. Christina Gramandani, part of a research team that recently analyzed newspaper and magazine articles about mental illness in Greece.

    The "axe-wielding psycho" is just one of numerous commonly held myths about mental ill-health. Many still believe that "once crazy, always crazy," despite the fact that the majority of people with mental illness recover. Others cling to the misconception that people with mental disorders are lazy, unpredictable, unreliable. There's us ... and then there's them.

    "It's like a 21st century form of racism," said one young man who was attending the conference. A former Ontario Scholar, he was recently diagnosed with a mental illness.

    One of the troubling aspects of stigma is that large numbers of people suffering from symptoms of mental illness do not seek any assistance, despite the availability of effective treatments, because they are ashamed or concerned about what others might think. Many don't share their thoughts or feelings even with close friends due to similar fears.

    And those who do seek help sometimes find their own self-image eroded by what's known as self-stigma, internalizing all of those negative perceptions.

    "I felt stigma when I was first diagnosed," says the woman who sketched the door. "It was a big blow to my self-esteem, because then I began to see myself in that light. And as the treatment continued, my family began to see me in that light, it began to influence the way they looked at me."

    So deeply entrenched is stigma that many authorities in the field believe it has become institutional. Funding for mental health programs and research is always the poor cousin to the realm of physical health, despite the vast numbers of people affected and the growing body of knowledge that physical and mental health are closely intertwined. In Ontario, core funding for community mental health programs has been frozen for more than a decade.

    "For research, we get 5 per cent when there's 25 per cent of the population that will develop mental illness," says Dr. Julio Arboleda-Flórez, professor and head of the Department of Psychiatry at Queen's University.

    "Sometimes bigotry gets institutionalized," says Corrigan. "Governments tend to put a lot less into mental health services, therefore the services aren't as good." Which poses yet another barrier to recovery.

    One Ontario psychiatrist said stigma extends into the primary health care arena. She said she's had patients whose valid complaints of physical ailments were ignored once the mental health history was disclosed.

    "You have to think twice before you put down a particular diagnosis, because that diagnosis is the first thing that will be seen when they're triaged. I've seen more cases than I feel comfortable with where patient's physical concerns have been disregarded," she says.

    There has not, historically, been a powerful mental health lobby. Were another identifiable group such as an ethnic minority discriminated against in similar fashion, some suggest change would have occurred long ago.

    "There would be hell to pay. Because first of all, they'd have a lobby. And secondly, because (this kind of discrimination is) unconstitutional. They'd scream murder, and they'd get somewhere," says Heather Stuart, associate professor with the department of Community Health and Epidemiology and the Department of Psychiatry at Queen's.

    The encouraging news is that, slowly, progress is being made. Advocacy groups in Canada and elsewhere are speaking with a stronger and more cohesive voice. Efforts like the World Psychiatric Association's Open The Doors campaign are helping to eradicate some of the myths (especially with schizophrenia), and have actually generated data showing that perceptions can be changed, especially when there's direct contact from a person with who has openly disclosed that they have a mental illness.

    "Absolutely. But it can't change unless we have people with the illness talking to them. You can have professionals talk until they're blue in the face. They're going to increase the knowledge, but not that attitude. That comes with direct contact," says Fay Herrick, of the Schizophrenia Society of Alberta, Calgary chapter.

    The drawing of the woman behind the labelled door was selected for a poster at the Kingston conference. In fact, the artist drew three of the six that were on the poster.

    Despite caring a great deal about stigma, she did not want to sign her name.

    "It's not that I won't sign my artwork. But it's that I won't sign this type of artwork. I live in a small town, and there's a lot of small-town views here. I really feel I would just be more of a target."

    Her first name is Donna. And, for now, that's about all she feels comfortable having you know.

    "Open The Doors," World Psychiatric Association website This is a comprehensive overview, in several languages, of antistigma activity around the world.

    A large annotated Bibliography of antistigma literature (PDF)

    October 19, 2003 - News of the Week


    For a textbook case of how to create prejudice and discrimination, look no further than the campaign to promote U.S. Senator Charles E. Schumer's gunlaw amendment, the NICS Improvement Act of 2003. NICS is the National Instant Criminal-background Check System. Representative Carolyn McCarthy is the bill's chief sponsor in the House, where a version of the bill passed last year.

    The gunlaw amendment's purpose is a worthy one: keep guns out of the hands of violent people. But the method of selling the law to the public suggests deliberate exploitation by its sponsors.

    Senator Schumer and Rep. McCarthy must find a way to undo the damage they have done.

    In misrepresenting the bill's purpose with misplaced emphasis on mental illnesses, Schumer and McCarthy have maligned millions of law-abiding citizens who comprise only about 6% of the individuals whose names should be on the NICS national criminal database but are not.

    There has been a lack of outcry against this obvious and blatant distortion. Have decades of stigmatizing images dulled our outrage? Would any other stigmatized minority accept such callous exploitation by political figures?


    An estimated 38 million criminal records are missing from the NICS database. (Source: S. 1706, Sec.2, Findings)

    The following analysis is from the National Education Association. (Note: the mental health records are non-criminal.)

    Felony Records: The typical state has automated only 58% of its felony conviction records. The FBI estimates that 16 million to 39 million felony arrest records lack final disposition information.

    Drug Abusers: The General Accounting Office estimates than only 3% of the 14 million records of drug abusers are automated (not including felons and wanted fugitives). States have supplied only 97 of those records to NICS, which the GAO estimates as representing less than 0.1% of the total records of those with drug records that would deny them a firearm.

    Domestic Violence: 20 states lack a database for either domestic violence misdemeanors or temporary restraining orders or both. 42% of all NICS denials based on restraining orders come from one state - Kentucky - which does the best job of automating temporary restraining orders (TROs) from the bench. The Department of Justice estimates that nearly 2 million restraining order records are missing from the database.

    Mental Health: 33 states keep no mental health disqualifying records and no state supplies mental health disqualifying records to the NICS. The General Accounting Office estimates that 2.7 million mental illness records should be in the NICS databases, but less than 100,000 records are available (nearly all from VA mental hospitals). States have supplied on 41 mental health records to NICS. Combined with the federal records, the GAO estimates than only 8.6% of those disqualified from buying a firearm for mental health reasons are accessible on the NICS database.

    Note: Boldtype emphasis has been added

    The disparity in numbers raises ethical questions about the skewed publicity.

    And why have the bill's sponsors downplayed restraining orders in the Peter Troy case (the impetus for the bill)? These restraining orders were cause to deny his gun purchase (Group 3 above), and are a far better predictor of violence than his psychiatric hospitalization.

    Just as important is the fact that the first three groups listed above are individuals who have committed illegal offenses, whereas the members of the fourth group -- people with mental illnesses -- have not.


    For copies of the bills, Click here and enter NICS Improvement Act of 2003. (Bills are S 1706 and HR 3237)

    For links to background info, please scroll down to September 4 News items.

    September 28, 2003 - News of the Week


    What "Protections" Have Been Added?

    Let Your U. S. Senators Hear From You

    On Friday, the New York Times reported (article below) that a gunlaw amendment to list felons, illegal immigrants, and others on a national criminal database is moving rapidly toward approval by Congress.

    The article mentioned only briefly the people with mental illnesses whose names will be added to the database, along with lawbreakers and criminals, if the new bill is adopted.

    According to the Times, privacy safeguards in the legislation will protect the people on the list. Does anyone know what these safeguards may be? We suggest that advocates try to find out by contacting the national headquarters of their mental health organizations or the offices of Senator Charles Schumer (Tel: 202-224-6542, Fax: 202-228-3027. Schumer's NYC office may be more reachable: Tel 212-486-4430).

    ARTICLE: The New York Times, Sept. 26, 2003 (copyright 2003)

    Bipartisan Agreement Is Reached on Gun Bill in Congress

    WASHINGTON, Sept. 25 — In an unlikely alliance of politicians often at odds on gun issues, leading Republicans and Democrats in Congress announced a deal today on legislation that would provide more than $1.1 billion to help prevent felons, illegal immigrants and others from buying guns.

    The legislation appears headed for passage in both houses of Congress, a rare achievement in the hot-button area of gun legislation. Backers said the measure, if passed, would represent the most significant gun safety initiative to be approved by Congress in seven years.

    The measure is supported by a bipartisan coalition of lawmakers who at first blush appear to be "strange bedfellows," acknowledged Representative John D. Dingell, a Michigan Democrat who has been an ardent foe of past gun control bills.

    But in a rare area of agreement, gun rights backers like Mr. Dingell and gun control advocates believe that the F.B.I.'s system for conducting background checks on some seven million would-be gun buyers each year is badly broken.

    Gun groups complain that despite recent improvements in the process of checks, it still takes too long for many purchases to be approved. And gun control groups assert that thousands of felons, spouse abusers, illegal immigrants, people with a history of mental illness and others banned by federal law from buying guns continue to slip through the cracks.

    The proposal announced today seeks to repair the system by providing state agencies and courts with $375 million a year for the next three years to upgrade their databases on criminals and other types of banned people. It would also penalize states that fail to meet certain performance markers by cutting their federal grant money.

    The aim, said Senator Larry E. Craig, Republican of Idaho, was to create "an effective, accurate, speedy background check" and to keep guns from people who are prohibited from owning them.
    Mr. Craig, a board member of the National Rifle Association, and Mr. Dingell, a past board member, have sparred with gun control advocates like Senator Charles E. Schumer and Representative Carolyn McCarthy, both Democrats of New York. Mr. Craig and Mr. Schumer, for instance, remain on opposite sides of the current debate over bills protecting gun makers from legal liability and reauthorizing a ban on certain types of assault weapons.

    But all four lawmakers appeared at a news conference today to support the background-check legislation. And by securing the backing of Senator Orrin G. Hatch, the influential Utah Republican, backers predicted swift passage by both houses of Congress.

    Mr. Hatch helped to stall similar legislation in the Senate last year after it had passed the House, but he has now pledged his support after stiffer penalties were included as a "stick" against states that fail to upgrade their databases.

    Even the N.R.A., which has worked to derail many past gun control measures, said today that it supported the plan.

    "We think this is a step in the right direction," said Andrew Arulanandam, a spokesman for the N.R.A., "and with Larry Craig and John Dingell as co-sponsors, we're confident that this legislation will help bring about the promise of an instant gun check for Americans."

    Some mental health advocates have objected to the proposal because they said it could further stigmatize the mentally ill and violate their privacy rights by putting more medical information into a national database. But backers said that they had been careful to include safeguards in the legislation that they believed would protect the privacy rights of the mentally ill while preventing them from buying guns.

    Backers said the measure, if approved, would represent the first substantial piece of federal gun legislation since at least 1996, when Congress expanded the list of banned gun buyers to include domestic abusers.

    "The significant thing about this legislation," said Jim Kessler, policy director for Americans for Gun Safety, which worked with lawmakers in developing the bill, "is that it explodes the myth that nothing can be achieved on guns in Congress."

    In a study last year, Mr. Kessler's group found that flawed record keeping had allowed nearly 10,000 people who fell into a banned category to pass background checks and buy guns in a 30-month period. The group gave failing grades to 22 states "for having grossly inadequate criminal, domestic violence and mental disability records."

    For BACKGROUND LINKS and CONTACT INFORMATION please go to the end of the Sept. 4 News Item, just below.

    Note: 50% of Dealers Willing to Sell Handguns Illegally, Study Says (article by Eric Lichtblau,New York Times, June 17, 2003).  Abstract: "UCLA study finds that half of firearms dealers questioned in undercover survey are willing to allow buyers to make 'straw purchases' that could violate or sidestep federal law."

    September 4, 2003 - Special Posting


    Bill Would Add 2.7 Million Non-criminals to Criminal Database

    "IT'S A TERRIFYING THOUGHT! Right now, right here in New York, 3,000 people who've been involuntarily committed to mental institutions can go buy a gun when they get out! " WCBS-TV, News at 5, Sept. 2
    These words kicked off a publicity campaign by U. S. Senator Charles E. Schumer, who hopes to amend the NICS (National Instant Criminal Background Check System) in the current Senate session.

    The Schumer Bill (aka "Our Lady of Peace Act" and "NICS Improvement Act") would help states to automate their records of people prohibited from purchasing guns. Currently, according to the Bill, 25 states have automated less than 60 percent of their felony criminal convictions records.

    Oddly, the Schumer campaign has ignored the missing data on convicted criminals, focusing intead on law-abiding people with mental illnesses.

    Schumer's appearance on the WCBS newscast followed several days of promos for the 5-minute feature. Here's a sample:
    "Guns in the hands of the mentally ill is a loophole in the law putting your life at risk!"

    Fear-mongering is an effective way to get laws passed. But how honest was the WCBS piece?

    1) The inclusion of the John Hinckley and Colin Ferguson cases had nothing to do with the proposed law. Neither man had a record of criminal violence or psychiatric hospitalization prior to their violent acts. The proposed law would not have prevented either man from buying a gun.

    2) The description of Peter Troy who killed a priest and a parishioner on Long Island last year was relatively factual. But it was Troy's lawbreaking acts of domestic violence that would have put him on the NICS database. His record of involuntary hospitalization should be irrelevant to his name appearing on the list.

    3) Senator Schumer, in his comments, assumed that an episode of involuntary commitment proves a person's violence and lasting mental incompetence. This alarming false assumption appeared repeatedly throughout the program.

    4) NAMI's Ron Honberg, a critic of the flawed amendment, got only about 10 seconds of airtime.

    5) Questionable statistics: We question the 3,000 figure said to be the number of NY residents to be added to the NICS list. By contrast, a 2.7 million figure was given for the nation. What is the authority for these numbers?

    6) These 2.7 million involuntarily-committed people are non-criminals whose only "crime" is having a mental illness. What are the figures for the missing data on convicted criminals and domestic abusers? The number must be far higher.

    7) Perhaps most disturbing was Schumer's decision to dwell on mental illness (and briefly, domestic violence) and ignore other more glaring gaps in the NICS database. Such skewed emphasis wrongly implied that people with mental illnesses are threats to public safety.

    The bill would give $375 million to states to update their criminal record-keeping technology. But should this be the nation's highest priority when essential mental health programs are falling under the budget axe? And in a 1999 investigation, Schumer himself found that most gun crimes are committed with illegally purchased guns that are easy for anyone to buy.

    Leading experts have called the law a "privacy nightmare" for law-abiding non-violent people with mental health needs because their names will be on a criminal database used by police departments throughout the nation.

    Our requests for information from Schumer's offices have been ignored. As of today, the Bill's flaws have not been corrected.

    Alert your U.S. Senator that the Schumer Bill must be put on hold pending consultation with key mental health advocates.

  • Click Here for background. These earlier articles have useful links at the end of most of them.

  • To reach your Senator, go to Google Search and enter "Senate Members"

  • It would help to contact the members of the Senate Judiciary Committee. Use the Google Search and enter "Senate Judiciary Committee." FYI, Patrick Leahy of Vermont and Ted Kennedy of Massachusetts are key people on the committee.

  • To E-mail Senator Charles E. Schumer, go to Click "contact" and fill out the webform.
    Fax: 202-228-3027
    Tel: 202-224-6542
  • August 31, 2003 - News of the Week


    FLASH! Latest develpment: article in Washington Post, "Raising Doubts About Drugs"
    (Source: E-mail message from MindFreedom)

    Earlier Message:
    Date: Fri, Aug 29, 2003
    Subject: Op-Ed in Seattle Post-Intelligencer

    Here's a really unique opinion piece. It covers the Fast for Freedom in Mental Health which is an ongoing hunger strike (Day 14) that claims the psychiatric drug industry is squeezing out freedom of choice in America, and globally.

    For more info on Fast, go to
    See other useful links at the end of the reprinted article just below.
    29 August 2003
    _The Seattle Post-Intelligencer_

    No proof mental illness rooted in biology By KEITH HOELLER -- GUEST COLUMNIST

    What is "the mental health movement?" Its proponents claim that millions of Americans are afflicted with a mental illness, which is a disease "just like any other" and that the mentally ill suffer from a chemical imbalance in the brain that is corrected by psychiatric drugs.

    Mental illness is said to be the cause of many of our society's social ills, such as suicide, murder, divorce, child abuse, sex offenses, depression and various addictions. If only mental illness could be cured, mental health supporters say, all of these ills could be prevented.

    Because the mentally ill often are unaware of their disease, treatment must be forced on the mentally ill. All 50 states have laws that allow involuntary treatment if professionals deem they are a danger to self and others.

    Psychiatrists, we are told, can now accurately diagnose mental illness and have safe and effective treatments. Psychiatry is considered a valid medical specialty, like cardiology, and the claims of the movement are based on scientific research.

    The largest lay group is the National Alliance for the Mentally Ill (NAMI). The media routinely refer to NAMI as advocates for the mentally ill, although its membership consists almost entirely of family members and not the mentally ill themselves. NAMI ascribes to the "biological basis of mental illness," and endorses forced treatment of the mentally ill.

    The movement's major source of funding is the highly profitable pharmaceutical industry, which funds the drug research; which funds psychiatric journals, and even the American Psychiatric Association itself; which funds advertising to doctors and the public; and even funds lay groups such as NAMI (at least $11 million) and Children and Adults with Attention Deficit Disorder (at least $1 million).

    Yet many professionals claim that the mental health movement is not a legitimate medical or scientific endeavor, let alone a civil rights movement, but a political ideology of intolerance and inhumanity. Numerous psychiatrists and psychologists have examined the psychiatric research literature and found it to range from smoke and mirrors to quackery.

    Psychiatrists have yet to conclusively prove that a single mental illness has a biological or physical cause, or a genetic origin. Psychiatry has yet to develop a single physical test that can determine that an individual actually has a particular mental illness. Indeed, The Diagnostic and Statistical Manual of Mental Disorders uses behavior, not physical symptoms, to diagnose mental illness, and it lacks both scientific reliability and validity.

    On Aug. 16, eight members of MindFreedom (, an umbrella organization of mental patients who call themselves "psychiatric survivors," began a Fast for Freedom "to press for human rights and choice in psychiatry" and to "demand that the mental health industry produce even one study proving the common industry claim that 'mental illness is biologically-based.' "

    Dr. James Scully of the American Psychiatric Association responded to the hunger strikers by claiming the evidence was so vast one need only look at "Mental Health: A Report of the Surgeon General" (1999) or a recent psychiatry textbook.

    An expert panel for the strikers, made up of members (like myself) of the International Center for the Study of Psychiatry and Psychology (, quickly responded by pointing out that neither of these works contains any such conclusive proof. Actually, the surgeon general's report on mental health states that "the precise causes (etiology) of mental disorders are not known" and "there is no definitive lesion, laboratory test, or abnormality in brain tissue that can identify (a mental) illness." The Textbook of Clinical Psychiatry (1999) states: " ... Validation of the diagnostic categories as specific entities has not been established."

    In its reply to the fasters, the National Alliance for the Mentally Ill did not cite any scientific evidence at all.

    In 1784, a similar debate raged in Paris about the scientific validity of the latest psychiatric nostrum (hypnotism) and its inventor, Dr. Franz Anton Mesmer, who claimed to have discovered a physical mechanism he called animal magnetism. The Academy of Sciences formed a panel, including American scientist Benjamin Franklin and French chemist Antoine Lavoisier, to assess the movement sweeping the city, and concluded that Mesmer's "cures" had no scientific basis. They were due entirely to the power of suggestion, now called the placebo effect. The Royal Society of Medicine issued a report with similar findings on Aug. 16, 1784.

    Let us hope the Fast for Freedom has a positive outcome for all involved.

    If not, let us insist that the American Medical Association (or similar body) form a panel of objective, non-psychiatric scientists, without any ties to drug companies, to examine whether psychiatry should continue as a medical specialty or if it should join the historical ranks of alchemy, astrology and phrenology as a pseudoscience.

    Dr. Keith Hoeller is editor of the "Review of Existential Psychology & Psychiatry" in Seattle. E-mail: -END of Op-Ed article-

  • For the latest news release plus lots of updates, published media articles, commentary, fact sheets, latest actions you can take to support the fast, and how to become a member of MindFreedom, check:

  • For daily Fast photos, a lively public message board with hunger striker discussion, and more see:

  • For photos of a delegation of hunger strikers meeting with the Presidennt of the American Psychiatric Association:

  • For some of the latest published media articles on the fast:

  • For direct link to the lively public message board that you can post to, and dialogue with hunger strikers, see:

  • For a sample of the debate going on about the "biological basis of mental illness" see:

  • For a "blog" started by a Fast supporter see:

    * * * PLEASE FORWARD TO ALL * * *
    * * * APPROPRIATE PLACES * * *
    * * * ON AND OFF THE INTERNET * * *


  • 2) WHAT DOES "TREATMENT" REALLY MEAN?(Comment by National Stigma Clearinghouse)

    When an everyday word shows up with a new meaning, confusion is sure to follow.

    In the Op-Ed article above by Keith Hoeller, the word "treatment" is used several times. Each time, in our view, "medication" would have been a more accurate word.

    Because the word 'treatment" so often means neuroleptic medication and little else, one can no longer assume that treatment is an umbrella term for programs and services that meet the needs of people who have psychiatric disabilities.

    If the word "treatment" has been taken over by the prescription-drugs alliance, it is doubly important for advocates to be specific when talking about what they need.

    August 24, 2003 -
    of the Week

    1) UPDATE ON HUNGER STRIKE (see NEWS postings Aug. 17 and Aug. 3)

    Click here


    As we write this, the Fast For Freedom is in Day 8. Both the American Psychiatric Association (APA) and the National Alliance for the Mentally Ill (NAMI) have sent incomplete responses to the hunger-strikers' requests for information. Judging from the points made in a rebuttal from the strikers' scientific panel, the stage is set for a meaningful debate.

    Meanwhile, media interest is growing.

    Click here for 11 links to media coverage.

    Here is a sampling of articles:
  • "Hunger Strikers Protest Drug Industry's Stranglehold on Psychiatry", by Michel Cicero, Pasadena Weekly, 23 August 2003.

  • " 'Fast for Freedom' Reaches New River Valley, Virginia," , by Greg Esposito, Roanoke Times, 22 August 2003

  • A Fast for Freedom in Mental Health, an ongoing series," by Nicholas Regush, Red Flags Weekly




    Go to

    For news of the Hunger Strike as it develops on a daily basis, use the following links:




  • ***************************************


    The Result Is A Powerful, Award-Winning Documentary, "People Say I'm Crazy"

    Click here
    for John Cadigan's reasons for making the film, how to purchase it, a screenings schedule, examples of John Cadigan's artwork, and more.

    Review by David Gonzalez, media critic and activist

    "People Say I'm Crazy" by John Cadigan
    The Real-Life Story of an Artist's Struggle with Schizophrenia

    During his senior year in college, artist John Cadigan had a psychotic break. He dropped out of school and cycled through a number of drugs and doctors, then decided to film his agonizing battle with schizophrenia.

    "People Say I'm Crazy" is the first documentary ever photographed and directed by someone with schizophrenia. John invites viewers to tour the inside of his mind, a chaotic and creative universe, where he struggles to know what is real and what is not. 

    In the vein of "A Beautiful Mind," "People Say I'm Crazy" is a documentary of hope and courage which tears down stereotypes about the violent and deranged "schizophrenic," challenges the current doom-and-gloom forecast of people diagnosed with schizophrenia, and forces the audience to question their own beliefs about mental illness.

    Sooner or later, every documentary maker runs into a prickly, unhelpful subject. For Palo Alto artist and novice filmmaker John Cadigan, a diagnosed schizophrenic who set out to chronicle his illness on camera, that uncooperative interviewee was himself.

    "When I'm feeling awful, I can't film," he admits in "People Say I'm Crazy." Just as disturbing are the sequences in which he expresses a distrust of his sister, Katie, who produced the doc with him. "We included those scenes," Katie says, "because they were some of the most clearly articulated paranoias he had in the course of filming."

    Wisely, the siblings figured out long ago how to skate through rough patches. "If the paranoia erupts, we have a regular system of checking in," Katie says.

    An alumna of Stanford's graduate doc program who profiled John in her 1994 thesis film, "Out of My Mind," Katie reports that shooting "People" was much easier for her brother - since he controlled what got recorded - than editing. "Looking back at the darker moments could trigger minor meltdowns for him," she explains. "But by the time we were to fine cut, he was able to watch the whole thing through comfortably."

    And when "People" had its world premiere six weeks ago at the USA Film Festival in Dallas, John signed autographs for the folks who lined up. "Through the process of making this film and going so public with his intimate story, John has become quite comfortable with public audiences," Katie says.

    The Cadigans are collaborating on another documentary, about the hysterical and misleading portrayals of schizophrenia in popular culture. As its title (Wacko) suggests, it's intended to be funny as well as scathing. John and Katie Cadigan will be on hand when "People Say I'm Crazy" premieres locally on June 7 at 8 p.m. at Yerba Buena Center for the Arts as part of HBO's documentary showcase, "Frame by Frame." Commentary by David Gonzalez

    For David Gonzalez's perceptive movie review of "The Spider," visit his website, David is currently participating in a Hunger Strike for Human Rights and Choice. See coverage on his website and on the MindFreedom website,


    Review from The San Francisco Chronicle

    "Schizophrenic tells his story"
    Edward Guthmann, Chronicle Staff Writer Wednesday, June 4, 2003

    Holding a video camera, John Cadigan approaches his mother and asks her to tell him how she felt when he was diagnosed with schizophrenia. In other scenes, Cadigan speaks to his therapist, shows the woodcuts he makes when he's not crushed by depression and speaks directly to the camera about the debilitating nature of his disease.

    The result, "People Say I'm Crazy," is a remarkable document that goes beyond "A Beautiful Mind" to offer a demystifying, firsthand look at mental illness. Cadigan, a Palo Alto artist, conceived, photographed and co-directed the film with his sister, Katie, also a Bay Area resident.

    Both filmmakers will appear 8 p.m. Saturday when "People Say I'm Crazy" screens at the Yerba Buena Center for the Arts, in the second Frame by Frame documentary series. Presented by HBO, the 12-film showcase spans a very wide world: Cuban immigrants, a ransvestite, a Brazilian bus hijacking and the secret anguish of Las Vegas showgirls.

    The series also includes...(article continues) Source: San Francisco Chronicle (copyright 2003)
    Please note: the National Stigma Clearinghouse does not support the dehumanizing use of of the word "schizophrenic" as a noun or adjective.
    Website: "People Say I'm Crazy"


    August 17, 2003 - News of the Week


    Charles E. Harman, M.D., J.D. seeks to refute the diagnosis of schizophrenia, an onerous word that inflicts untold anxiety, pain, and harm to people labeled "schizophrenic" and their families. Harman argues that psychiatrists have failed to explore alternative systems of classification of emotion, behavior and thought that affects large numbers of people.

    Dr. Harman takes a dim view of the "elitist psychiatrists" and their ties with the drug industry. He devotes a chapter, "Schizophrenia: Science or Mythology" to the questionable process that created the the DSM diagnostic manual used by nearly all American psychiatrists today.

    Other topics in this unsettling book concern The History of Moral Treatment, The History of Man's Attempts to Diagnose Others, The Myths of Kraepelin, Alternatives to DSM Diagnoses, The Nazi Connection, and much, much more.

    Dr. Harman supports his strong views with scores of references. This is a provocative book and a rich reading experience.

    Below is a review of The Diagnosis And Stigma Of Schizophrenia by Internet Bookwatch, June 2003

    The Diagnosis And Stigma Of Schizophrenia
    by Charles E. Harman
    Old Court Press
    P.O. Box 4031, Brookings, OR 97415
    0964939134 $15.50

    The Diagnosis And Stigma Of Schizophrenia offers an intriguing alternative to standard DSM diagnostic and traditional psychiatric statistical manuals. Citing the medical history and the harmful emotional stereotypes attached to the very word "Schizophrenia," The book presents workable solutions to the potential harm of simply labeling a person as schizophrenic. A thoughtful, thought-provoking, persuasively argued and iconoclastic account by Charles E. Harman, the Diagnosis And Stigma Of Schizophrenia is a strongly recommended addition to professionals and academic Human Psychology collections and especially recommended reading for anyone having to struggle with the emotional and intellectual distresses commonly lumped under the generic psychiatric classification of schizophrenia.

    HUNGER STRIKE FOR FREEDOM: Update From MindFreedom

    As we announced on our NEWS posting on August 3, the FAST FOR FREEDOM is scheduled to begin on Saturday, August 16. There will be a news conference on Monday, August 18.

    For complete information, including background and links, go to:
    Also see:

    August 10, 2003 - News of the Week

    "Rare indeed is the news story that sensitively describes the strange, scary things that can occur at the intersection of race and mental illness." Amy Alexander, in Africana Newsletter 8/11/03 (

    Columnist Amy Alexander, in "Reading Between the Lines: Race, the Media and Mental Illness," applauds two Boston Globe journalists who covered a potentially sensational story with accuracy, compassion, and a lack of bias.

    As she retraces the reporters' steps, Ms. Alexander offers insight into their methods of non-biased reporting.

    Click Here"Reading Between the Lines: Race, the Media and Mental Health, by Amy Alexander, Africana:Gateway to the Black World

    August 3, 2003 - News of the Week


    1) Advocates Announce Hunger Strike for Human Rights and Choice

    2) President's Commission Introduces Recovery-Oriented Vision

    On August 16, five former mental patients and a dissident social worker will begin a hunger strike in Pasadena, CA. The group decries the over-reliance on medication favored by the mental health establishment, noting that there are many different ways to help people experiencing severe mental and emotional crises. (See links below.)

    In a similar spirit, the President's New Freedom Commission on Mental Health would reshape the present system that currently asks people to accept the treatment they are offered or drop out. The transformed mental health system would put a strong focus on strengthening the abilities and resilience of people diagnosed with psychiatric vulnerabilities and disabilities. (See links below.)

    Without a strong commitment from key officials, however, advocates say the new vision could die on the drawing board.

    In the hopeful words of the Commission's sole mental health system survivor, Daniel Fisher, Ph.D., M.D.: "This report has the potential to fire the imaginations of millions of people in recovery."


    Article: "Fast for Freedom in Mental Health," MindFreedom Online

    MindFreedom PRESS RELEASE

    Article: "Mental Health Advocates View Commission Report as Opportunity," Mental Health Weekly

    Commentary: "Keeping The Promise of Community Mental Health," by Michael B. Friedman, Journal News, August 8, 2003

    Final Report: President's Commission on Mental Health, July 22, 2003

    July 27, 2003 - News of the Week


    In New York City, violence by people with diagnoses of serious mental illnesses is so rare that in this teeming city of over 7 million people, incidents in the news are few and far between.

    Nevertheless, a headline-grabbing fatal shooting last week in Manhattan's City Hall worried mental health advocates. Would there be a rush to judgment by the press? In the past, inexplicable acts of terror sometimes have triggered finger-pointing at people with serious mental illnesses before the facts are known. Such damaging assumptions stick in peoples' minds despite later proof that the assailant was what society generally calls normal.

    To our relief, the press reported Wednesday's pandemonium at City Hall responsibly. In describing the two political rivals who died in the shootings, there was almost no stigmatizing guesswork about mental illness. Of 24 headlines gathered by Columbia Newsblaster from around the country, only one paper, the notoriously inflammatory New York Post, used the word "deranged" in a headline, and it was an inside headline at that.

    But responsible journalism is not yet universal. Just two weeks earlier, on July 11, the Washington City Paper published an egregiously inflammatory and denigrating cover story called, "The Sick and the Dead." Using slurs, guesses, and self-contradictory statements, the article was clearly intended to promote forced psychiatric medication.

    Unfortunately, the damage done by fear-mongering writing is irreparable, no matter how excellent the rebuttals published later may be. (See below.)

    It has been said that offensive language is bias having a good time. Advocates on both sides of the forced-medication issue must do everything within their power to ensure honest, unbiased reporting.

    Rebuttal letter from Leah Harris and Laura Van Tosh, with 31 advocates' signatures

    Rebuttal letter, Bazelon Center for Mental Health Law

    Rebuttal letter, National Stigma Clearinghouse

    "The Sick and the Dead," Washington City Paper

    July 20, 2003 - News of the Week

    !!! COMING SOON !!!

    "WEST 47th STREET"
    Point of View (P.O.V) Series


    (Check local listings)

    A film by Lichtenstein Creative Media

    "This film holds the potential to change the way Americans look at people with mental illness." -- Mike Faenza, president of the National Mental Health Association

    "A documentary masterpiece" -- Cleveland International Film Festival

    Life on the streets of New York City for the poor and homeless is an unforgiving struggle. For those who also battle a mental illness, it is marked by the additional pressures of fear, isolation and misunderstanding. The new award-winning documentary film, West 47th Street, reveals the human face of mental illnesses, and the faith and courage with which its victims fight to recover control of their lives.


    Now your help is needed to maximize the impact of this unprecedented opportunity to reach the American public on the issues of mental illness and mental health care, stigma and access to treatment.

    On August 19th, West 47th Street will make its national television premiere on the highly-acclaimed PBS TV series P.O.V. (Point of View), public television's showcase for independent documentary film. The film will reach 96% of all American homes, with a projected audience of four million viewers.

    This cinema verite documentary, shot without interviews or narration, offers an unprecedented window onto the lives of people who are often feared, seldom understood, who approach tremendous obstacles with humor, optimism and grace.

    The film is directed by Bill Lichtenstein and June Peoples and produced by the Peabody Award-winning Lichtenstein Creative Media, creators of public radio's The Infinite Mind.

    Beginning with the film's broadcast will be a national educational and community engagement campaign which will take the powerful, emotional response viewers have to the film and channel it into an effective effort to change public attitudes and highlight public policy about such issues as the need for better diagnosis and treatment, access to the best quality care, equitable insurance coverage for mental illnesses, and stigma.

    To date, over $30,000 in mini-grants and or support have been made available by Lichtenstein Creative Media and P.O.V. to over two dozen local mental health advocacy organizations to hold community events utilizing the film. But the overwhelming response is beyond anyone's expectations. More than 80 community mental health advocates are seeking mini-grants from $500 to $3,000 to use the TV broadcast of the film and community screenings in highly innovative ways, with a dozen new requests coming in daily.

    These include the following:

    * Mental health advocates and public TV station in major city seeking a mini-grant to screen the film at a major art center for 500 people, to include a discussion with local mental health advocates;

    * Depression center at a major university seeking a mini-grant to screen the film for students and staff;

    * A Michigan mental health group seeking a mini-grant to organize a statewide screening to promote better mental health care;

    * New Mexico mental health association that requested a mini-grant to set up screenings for rural, Hispanic populations;

    * Minnesota mental health advocacy group seeking a mini-grant to organize a statewide screening and discussion on mental health care and funding;

    * Massachusetts mental health clubhouse requesting mini-grant to produce local follow-up programming in conjunction with the TV broadcast of West 47th Street;

    * Wisconsin community service program requesting a mini-grant to screen the film for law enforcement and mental health professionals to facilitate discussion about the treatment of people with mental illnesses;

    * New Mexico advocacy groups seeking mini-grants to bring the film to local Pueblo, Navajo and Apache tribes throughout the state who otherwise have limited access to mental health information and care.

    Nearly 100 local mental health advocates across the country, including affiliates of the National Mental Health Association, National Alliance for the Mentally Ill and Depression and Bipolar Support Alliance are urgently requesting mini-grants from $500 to $3,000 to carry out these innovative and cost-effective efforts, designed by the people in each community who best know the issues they face and how the film can help them.

    But your help is urgently needed! Your contribution will help maximize the impact of this unprecedented effort (see below). All donations are tax-deductible.

    Thank you for your consideration of helping support this critical national effort to bring these important issues into the forefront of national dialog.

    Bill Lichtenstein, Co-Producer, West 47th Street
    June Peoples, Co-Producer, West 47th Street

    Help support West 47th Street's Educational and Community Engagement Campaign!

    All donations are processed by LCM's Yahoo store, and are tax-deductible through our 501(c)(3) fiscal sponsor, the New York Foundation for the Arts.

    For donations over $1,000, please contact Bill Lichtenstein or June Peoples at LCM directly at (212) 967-1200.

    For a list of events already planned, e-mail or

    For more information about mini-grants, please contact Michelle Materre, outreach coordinator for West 47th Street and Eliza Licht, P.O.V.'s Community Engagement Manager,,  

    Use a GOOGLE search (enter "west 47th street film") for more information, including a press release, photos, a trailer and more.

    West 47th Street is a non-profit production of Lichtenstein Creative Media, in association with the New York Foundation for the Arts.

    THIS WEEK, listen to "Mental Illness and the Media, a program on "The Infinite Mind," a weekly public radio series. Don't miss this superb probe of the media's role in promoting prejudice and discrimination. Click to hear the broadcast (premiered July 2002).






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