The following interview is part of a “future of mental health” interview series that will be running for 100+ days. This series presents different points of view about what helps a person in distress. I’ve aimed to be ecumenical and included many points of view different from my own. I hope you enjoy it. As with every service and resource in the mental health field, please do your due diligence. If you’d like to learn more about these philosophies, services, and organizations mentioned, follow the links provided.
Interview with Martin Whitely
EM: You are critical of the current dominant paradigm of “diagnosing and treating mental disorders based on symptom pictures.” Can you describe your position a bit?
MW: My good friend Adelaide psychiatrist Jon Jureidini calls labels like ADHD ‘unexplanations’ because they rob understanding of an individual’s personal circumstances. Jon’s right - causes matter. You can’t properly fix many problems without understanding what is causing them. Psychiatric diagnoses rarely involve identifying a cause and virtually never involve finding a cure.
Too often ‘diagnosis’ means applying a dumbed down, one size fits all label to a very broad set of behaviours. In the long run – which biological psychiatry routinely ignores - treatments should match causes. The current emphasis on quick generic diagnosis matched to a drug de jour sometimes delivers limited short-term symptom relief but often at massive long-term cost.
I accept that for individuals exhibiting extreme psychotic symptoms it is often necessary to intervene and sometimes sedate without knowing the cause. However, I don’t know anybody who has benefitted from being labelled a schizophrenic. Most of the so-called schizophrenics I know are mentally healthy most of the time. Labels like schizophrenic, pre-psychotic and depressive rob human dignity and too often create a self-fulfilling prophecy of misery.
What is even more worrying is when ordinary behaviours like losing things, fidgeting, being forgetful, distracted or impulsive are turned into symptoms for concocted ‘disorders’ like ADHD. They are not symptoms, they are behaviours; perfectly normal behaviours, especially for children. In some cases they may require some attention, love and/or discipline, but they don’t require amphetamines.
EM: You take a special interest in ADHD (Attention Deficit Hyperactive Disorder) and dispute whether it is a scientifically sound, objective or legitimate “diagnostic category.” Can you share your thoughts on ADHD?
MW: Nothing demonstrates what a nonsense diagnosis ADHD is better than the now well established late birthdate effects. Four (soon to be five) large scale international studies have established that children who are born in the later months of their school year cohort are far more likely to be labelled ADHD and drugged than their older classmates.
This late birthdate effect is just as strong in Taiwan and Western Australia where prescribing rates are relatively low as it is in North America the home of ADHD child drugging. That says ADHD isn’t over-diagnosed or overmedicated, it is fiction.
Imagine if the ADHD label hadn’t been invented and I suggested to you that we give amphetamines to children who frequently lose things, fidget, play too loudly, are distracted and interrupt. You would dismiss me as either a fool or a charlatan and you would be right.
The ADHD industry has been incredibly successful because they have reversed the burden of proof. Instead of them offering compelling scientific evidence that ADHD is a neurobiological disorder, the onus has been put on poorly resourced ADHD sceptics to prove it isn’t.
The ADHD industry uses half-truths to build a lie. Yes some children are naturally more inattentive and/or impulsive than others. Yes there is probably a genetic basis to behaviours and yes low dose oral amphetamines narrow focus. But none of that makes losing your toys or fidgeting a disease.
Put plainly ADHD is BS and it is time responsible grown-ups said so. Drugging distracted kids with amphetamines and similarly dangerous drugs is disgraceful. Twenty years from now adults will look back and wonder what their parent’s generation was thinking.
EM: You were also in politics and know politics from the inside. Given the reality of politics, how can the “institutionalization” of the current dominant mental health paradigm be effectively disputed, if it can?
MW: For most politicians mental health is a mysterious field. Many believe we need to do something about mental health, however very few have any concept of what needs to be done. As a consequence they rely heavily on ‘experts’ for advice. This is standard practice as politicians can’t be expert in everything they are required to make decisions about.
The problem is that in Australia - and I suspect internationally - most of the influential, well resourced ‘experts’ are ‘industry friendly’ proponents of biological psychiatry. The most dangerous of them are those that talk the language of ‘recovery’ and ‘prevention’ but in fact promote speculative labelling and the too early use of biochemical interventions.
A key to changing the dominant ‘label and drug’ paradigm is confronting the disease mongers and debunking their pseudoscience. Another key is to demand from our politicians that our regulators are independent and guided by robust science. However, it is not enough to just win the debate in the scientific literature. It needs to be won in the media, both social and traditional.
So much of the excesses of Biological psychiatry like ADHD and Juvenile Bipolar Disorder are ripe for ridicule. If you can win the popular culture debate, public opinion and therefore our political leaders, will follow. The most influential expose of psychiatric excess in the 1970’s was One Flew Over the Cuckoo’s Nest. We need similar exposes that both entertain and educate. Very few can deliver Hollywood blockbusters but cheap youtube options like Ray Moynihan’s Motivational Deficit Disorder mockumentary allow many of us the chance to speak the truth robustly.
Psychiatrists and other mental health professionals concerned about the direction of mental health policy and practice have a special responsibility to speak bluntly and make their profession worthy of survival. In my opinion they need to be more willing to take on their own rogues and with less emphasis on polite discourse and more on the truth.
EM: What are your general feelings about prescribing so-called “psychiatric medication” to young children, youths and adolescents?
MW: I would have no problem if medications were used for the benefit of the child alone, within scientifically justified parameters, as a short-term intervention in extreme cases where all other less invasive options have been tried. However, we are so far away from this that the best policy might be to push for a blanket ban on the use of psychotropic medications in children under a specified age.
The current reality is drugs are frequently prescribed off label as the first line, long-term treatment for the benefit of people other than the child. I find the argument for medicating ‘ADHD children’ so that their siblings, parents, teachers and classmates like them more particularly disturbing. The growing off label use of SSRI’s in children given the FDA’s black box warning for increased suicide risk is another disturbing example of how irrational common psychiatric practice has become.
Even when medications are prescribed within approved guidelines, too often approval has been granted based on biased, shallow, short-term research. I have focussed most of my attention on ADHD drugs, not just amphetamines but drugs like Strattera. Strattera is particularly worrying. It is a failed antidepressant that causes suicidality but is approved as a means of stopping children exhibiting ADHD i.e. fidgeting, being distracted and losing things. How can anyone think that makes sense?
EM: If you had a loved one in emotional or mental distress, what would you suggest that he or she do or try?
MW: Firstly I hope I would have the good sense to listen to them, hear what is distressing them and try to respond accordingly. I don’t profess to have any special expertise but I do think traumatised people are best off in familiar environments surrounded by people they know, love and trust.
In terms of seeking professional help if I couldn’t get them to see one of the psychiatrists I trust in my home town of Perth, Western Australia, my advice would be stay away from psychiatrists. In my experience of advocating for hundreds of mental health patients a significant minority of psychiatrists are very poor listeners, who are too quick to label and too free with the prescription pad. They may only be a minority but they do enormous damage. Randomly choosing a psychiatrist is not a lottery I would want any loved one to have a ticket in.
Martin Whitely PhD is a mental health advocate, researcher and former teacher and politician. Much of Martin's focus during his 12 years as a Member of the Western Australian (WA) Parliament went into tackling what her terms the ADHD Industry. When he was first elected in 2001 WA was a world ADHD child prescribing hotspot, however after prescribing-accountability measures where tightened in 2002 there was a 50% fall in WA ADHD per-capita prescribing rates by 2010. This coincided with a 51% fall in self-reported teenage amphetamine abuse rates in WA. Martin contends this shows if you stop giving children a free source of amphetamines they stop abusing them. For more information see http://speedupsitstill.com/about-martin-whitely/
Eric Maisel, Ph.D., is the author of 40+ books, among them The Future of Mental Health, Rethinking Depression, Mastering Creative Anxiety, Life Purpose Boot Camp and The Van Gogh Blues. Write Dr. Maisel at email@example.com, visit him at http://www.ericmaisel.com, and learn more about the future of mental health movement at http://www.thefutureofmentalhealth.com
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