Linda, Richard, Patrick et al.
You all have my permission to share this article with others. As I have said
anything I write and email is free to distribute all around the global
world. I will continue to be transparent and candid within all my human and
civil rights work and I believe totally within 'copy-left' for the good of
all human-kind, that all information ethically and morally belongs to all
the human race, for the good of all our future children and their
'wellbeing'.
Linda, as you know that I am not on the original UN Disability Convention,
as I have transferred my membership over to the Disability Convention-2
forum, but you are welcome to post any of my emails there too.
'Nothing about us, without us'
FREEOURPEOPLE
Yours
Colin
MINDFREEDOM NEWS ALERT - 23 August 2005
http://www.MindFreedom.org - please forward
American Psychiatric Association President Admits the Psychiatric Profession
is Now Dominated by the "Bio-Bio-Bio" Pill Model.
APA President warns "Big Pharma's" huge "kickbacks and bribes" hurt
credibility.
MindFreedom welcome's APA admission but replies: "Too little, too late. Meet
us."
How *YOU* can e-mail the APA President with your comments and responses
now.
The below column by the President of the American Psychiatric Association
(APA) --
Stephen S. Sharfstein, MD of Baltimore -- officially admits that the APA's
current model has become the "bio-bio-bio model" dominated by a "pill and an
appointment."
Dr. Sharfstein laments, "If we are seen as mere pill pushers and employees
of the pharmaceutical industry, our credibility as a profession is
compromised."
He especially denounces a growing practice where drug sales representatives
actually sit on on meetings between psychiatrists and their patients to give
advice. The marketing trick is called "preceptorships."
MindFreedom's response: "Of course we welcome APA's admission that they have
a drug problem. But this is too little, too late," commented David W. Oaks,
director of MindFreedom International. "Just look at the reforms Dr.
Sharfstein recommends at the end of his column! These are tiny tweaks
compared to the nonviolent revolution that's needed in the mental health
system."
MindFreedom calls for a US Congressional investigation of what they call a
drug industry takeover of the mental health system.
MindFreedom has requested a meeting with Dr. Sharfstein to discuss far
deeper changes in psychiatry. You are welcome to e-mail your *civil*
comments to Dr. Sharfstein at [log in to unmask]
President Sharfstein's column was printed this week in the APA's official
newspaper:
http://pn.psychiatryonline.org/cgi/content/full/40/16/3
Psychiatric News_August 19, 2005 page 3
Published by American Psychiatric Association, From the President of APA
Big Pharma and American Psychiatry:
The Good, the Bad, and the Ugly
Steven S. Sharfstein, M.D.
e-mail: [log in to unmask]
APA's annual meeting is one of the largest medical meetings in the United
States and the largest psychiatric meeting in the world. There is something
for everyone at our wonderful meeting,
but many have commented to me on the extraordinary presence of the
pharmaceutical industry throughout the scientific programs and on the
exhibit floor.
The U.S. pharmaceutical industry is one of the most profitable industries in
the history of the world, averaging a return of 17 percent on revenue over
the last quarter century. Drug costs have been the most rapidly rising
element in health care spending in recent years. Antidepressant medications
rank third in pharmaceutical sales worldwide, with $13.4 billion in sales
last year alone. This represents 4.2 percent of all pharmaceutical sales
globally. Antipsychotic medications
generated $6.5 billion in revenue.
When the profit motive and human good are aligned, it is a "win-win"
situation.
Pharmaceutical companies have developed and brought to market medications
that have transformed the lives of millions of psychiatric patients. The
proven effectiveness of antidepressant,
mood-stabilizing, and antipsychotic medications has helped sensitize the
public to the reality of mental illness and taught them that treatment
works. In this way, Big Pharma has helped reduce
stigma associated with psychiatric treatment and with psychiatrists. My
comments that follow on the
pharmaceutical industry and its relationship to psychiatry bear this in
mind.
The interests of Big Pharma and psychiatry, however, are often not aligned.
The practice of psychiatry and the pharmaceutical industry have different
goals and abide by different ethics. Big Pharma is a business, governed by
the motive of selling products and making money. The profession
of psychiatry aims to provide the highest quality of psychiatric care to
persons who suffer from psychiatric conditions.
There is widespread concern of the over-medicalization of mental disorders
and the overuse of medications. Financial incentives and managed care have
contributed to the notion of a "quick
fix" by taking a pill and reducing the emphasis on psychotherapy and
psychosocial treatments. There is much evidence that there is less
psychotherapy provided by psychiatrists than 10 years
ago. This is true despite the strong evidence base that many psychotherapies
are effective used alone or in combination with medications.
In my last column, I shared with you my experience, and APA's, in responding
to the antipsychiatry remarks that Tom Cruise made earlier this summer as he
publicized his new movie in a succession
of media interviews. One of the charges against psychiatry that was
discussed in the resultant media coverage is that many patients are being
prescribed the wrong drugs or drugs they don't need.
These charges are true, but it is not psychiatry's fault -- it is the fault
of the broken health care system that the United States appears to be
willing to endure. As we address these Big Pharma
issues, we must examine the fact that as a profession, we have allowed the
biopsychosocial model to become the bio-bio-bio model. In a time of economic
constraint, a "pill and an appointment"
has dominated treatment. We must work hard to end this situation and get
involved in advocacy to reform our health care system from the bottom up.
Furthermore, continuing medical education opportunities sponsored by
pharmaceutical companies are often biased toward one product or another, and
they are more akin to marketing than CME. APA has strict guidelines for the
industry-sponsored symposia presented at our annual meetings; sanctions are
applied when our rules are broken. Our guidelines have been held up as a
standard for medical meetings in other specialties throughout the country.
But there are many grand rounds, evening dinners, and lectures where such
standards do not prevail.
Direct marketing to consumers also leads to increased demand for medications
and inflates expectations about the benefits of medications. As a
profession, we need to be concerned about advertising and the impact it has
on the over-medicalization of our field. Of course, what is marketed
to consumers are the highest-cost, on-patent products, and the cost of
medications is something rarely considered by prescribing clinicians. When
doctors don't prescribe cheaper but equally effective drugs, it consumes
money that could have been used to provide other psychiatric or medical
services.
There are examples of the "ugly" practices that undermine the credibility of
our profession. Drug company representatives will be the first to say that
it is the doctors who request the fancy dinners, cruises, tickets to
athletic events, and so on. But can we really be surprised that several
states
have passed laws to force disclosure of these gifts? So-called
"preceptorships" are another example of the "ugly"; that is, drug companies
who pay physicians to allow company reps to sit in on patient
sessions allegedly to learn more about care for patients and then advise the
doctor on appropriate prescribing.
Drug company representatives bearing gifts are frequent visitors to
psychiatrists' offices and consulting rooms. We should have the wisdom and
distance to call these gifts what they
are -- kickbacks and bribes.
If we are seen as mere pill pushers and employees of the pharmaceutical
industry, our credibility
as a profession is compromised.
Here are several suggestions for remedies in our relationship with the
industry.
** We need to embrace a new professional ethic. The doctor-patient
relationship should not be a market-driven phenomenon.
** Preceptorships should be considered unethical.
** Enticements, gifts, parties, and so on should be reined in because
patients must believe that their doctor has their best interests in mind
when a prescription is handed to them.
** We must re-evaluate single-sponsored medical education events and phase
them out in favor of more general support for CME along with a careful
policing of these events for bias.
** The amount and support received by individual clinicians and researchers
from industry should be transparent and the information readily available.
** When we attend lectures at annual meetings and other educational events,
and read journals and textbooks, we should know very clearly about the
industry support given to presenters and
authors.
As psychiatrists, we should all be grateful for the modern pharmacopia and
the promise of even more improvements in the future. At the same time,
however, we must be very mindful that we cannot accept gratuities in the new
medical marketplace.
http://pn.psychiatryonline.org/cgi/content/full/40/16/3
- end -
MindFreedom has met before with an APA President. Two years ago this month
during
a hunger strike MindFreedom representatives had a civil and productive
meeting with
then APA President Marcia Kraft Goin, MD, PhD.
For info about that hunger strike see:
http://www.mindfreedom.org/mindfreedom/hungerstrike.shtml
~~~~~~~~~~
ACTIONS: Please e-mail your civil comments to Dr. Sharfstein at
[log in to unmask],
and please forward this alert to all appropriate places on
and off the Internet.
~~~~~~~~~~
This news update is a free public service of MindFreedom International.
Since 1987 MindFreedom has won victories for human rights in the mental
health system. MindFreedom unites 100 sponsor and affiliate groups and
thousands of members.
MindFreedom is one of the few totally independent groups in the mental
health field with no funding from governments, drug companies, the mental
health system
or religions.
The MindFreedom mission calls for a nonviolent revolution in the mental
health system.
TO JOIN or RENEW your MindFreedom membership please go here:
http://www.mindfreedom.org/join.shtml
For the all-new improved MAD MARKET of books and products to support human
rights campaigns
in mental health go here: http://www.madmarket.org Featured book: Peter
Lehmann's newest handbook, _Coming Off Psychiatric Drugs_ written by 28
different psychiatric survivors and allies!
MindFreedom International
454 Willamette, Suite 216 - POB 11284
Eugene, OR 97440-3484 USA
http://www.mindfreedom.org
email: [log in to unmask] fax: (541) 345-3737
office phone: (541) 345-9106
USA toll free: 1-877-MAD-PRIDE / 1-877-623-7743
MIND YOUR FREEDOM: United Action for Human Rights.
Accredited by the United Nations as a Non-Governmental Organization (NGO)
with
Consultative Roster Status.
"Human salvation lies in the hands of the creatively maladjusted." - Martin
Luther King, Jr.
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