Retspsykiatrien

Sol Gudimage

PCOTUs holdning til Psykofarma og Psykiatri :

Psykiatrien “stjæler” Patienternes sjæle når de pilleskyder uskyldige krystal børn på de lukkede afdelinger. Man søvndysser sanse systemet med Psykofarma i stedet for at lære hver patient individuelt at kende føres der ens og systematisk sagsbehandling. Hjertets renhed renses for de dybe følelser af lykke eller sorg. Psykofarma Medicinen blokerer hjertets hellige sanse system således at dybe følelser af glæde eller sorg ikke opleves på naturlig vis. Der ligges enten låg på glæden eller der flygtets fra smerten eller sorgen.
De dybe følelser er ædle og af allerhøjeste værdi og må betragtes som hellige i den forstand at al kunst skabes ud fra enten glædesstrålende humør bomber eller dybt patetiske hjælpeløse og melankoliske kunstner sjæle der netop tør være i henholdsvis lykken / sorgen og forvandle energierne til noget konstruktivt : Kunst.

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Det er meget ulykkeligt at være vidne til nutidens vanvittige diagnose vanvid set i forhold til det, at blive større sammen og det at begynde at tale et nyt sprog , hjerte sproget, hvor følelser tages seriøst og vurderes som den vigtigste og mest sunde guide / kompas indstillet til at fortælle hvorvidt du befinder dig godt eller dårligt, og derudfra et sådant grundlag bør enhver bevidst målrettet handling udspringe.
Patienterne i Psykiatrien bliver lokket og misledt med Psykofarma som gør dem til Zombier, hypokondriske, ensporede, mindre begavede, a la det hvide snit ja blot med kemisk fremstillet medicin i stedet lukkes der godt og grundigt ned for mange sanser og dette beskrives så hjerteligt som bivirkninger. Følelserne som før kunne mærkes i hjertet er efter de forskellige kemiske stoffer i form af forskellige typer Psykofarma sætter ind sat sådan i skak mat, at de kun kan mærkes i maveregionen hvilket jo er et rigtigt dårligt tegn, når vi jo netop bedst heales igennem symptomerne og hjertes følelser og ikke ved at flygte fra symptomerne og følelserne i vores hjerter?
Derudover oplever de fleste patienter, at de efter at have startet i det Psykofarma regi, at lysten til sex helt udebliver og at de næsten intet kan mærke mere under sex akten???
Sexual kraften er igen hellig og bør ikke forsvinde helt eller delvist under en medicinsk behandling for sindslidelser? Det er at diskriminere psykisk syge mennesker at fjerne deres dyrebare sexualitet på den her måde?

Forfattet af Folkeråds Fører ;

Shirin Brokmann Herbert Nielsen

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Abolishing Forced Treatment in Psychiatry is an Ethical Imperative

By PETER GØTZSCHE, MD

Foreign Correspondent June 17, 2016
Forced treatment in psychiatry cannot be defended, neither on ethical, legal or scientific grounds. It has never been shown that forced treatment does more good than harm, and it is highly likely that the opposite is true. We need to abolish our laws about this, in accordance with the United Na­tions Convention on the Rights of Persons with Disabilities, which virtually all countries have ratified.

Forced treatment in psychiatry is not evidence-based medicine, as this builds on reliable research, clinical expertise and the patients’ values and preferences, none of which apply.

First and foremost, the patients’ values and preferences are not being respected, although the fundamental human right to equal recognition before the law applies to everyone, also to people with mental disorders. This is clear from the Universal Declaration of Human Rights, the Interna­tional Covenant on Civil and Political Rights and the United Na­tions Convention on the Rights of Persons with Disabilities.1,2

Secondly, clinical expertise is highly misleading in psychiatry. Doctors tend to credit the drugs for any spontaneous improvement and to put the blame for any untoward symptoms on the disease. What makes the practice of psychiatry particularly problematic is that many drugs can create the diseases they were supposed to alleviate, or worse diseases, or they have adverse effects that are similar to the symptoms used to define other psychiatric disorders.2Therefore, many patients get several psychia­tric diagnoses and become in treatment with several drugs.2Because of the changes in the brain caused by antipsychotics, for example, continued treatment can lead to supersensitivity psychosis, which should be treated by tapering off the drug, but which is usually treated by an increase in dose, or the addition of an additional antipsychotic, which increases the harms.2 When patients try to come off their drugs, they often get abstinence symptoms similar to the disease being treated, and they are therefore usually put back on full dose.2

Thirdly, it has never been shown that forced treatment does more good than harm, and it is highly likely that the opposite is true. A register study of 2,429 suicides showed that the closer the contact with psychiatric staff – which often involves forced treatment – the worse the outcome.3Compared to people who had not received any psychiatric treatment in the preceding year, the adjusted rate ratio for suicide was 44 (95% confidence interval 36 to 54) for people who had been admitted to a psychiatric hospital. These patients would of course be expected to be at greatest risk of suicide (confounding by indication), but the findings were robust and most of the potential biases in the study favoured the null hypothesis of there being no relationship. An ac­companying editorial noted that some of the people who commit suicide during or after an admission to hospital do so because of conditions inherent in that hospitalisation.4

Antipsychotics are the most commonly used drugs in forced treatment and if we wish to find out how deadly they are, we cannot use the placebo controlled randomised trials in patients with schizophrenia, as they seriously underreport deaths. For example, only 19 of 50 deaths on olanzapine described in trial summaries on websites also appeared in journal articles; and for suicides and suicidal events the numbers were one versus nine and four versus 18, respectively.5 Another reason why trials in schizophrenia are unreliable is their cold turkey design. Patients are almost always in treatment with an antipsychotic drug before they are being randomised,2 and when they are abruptly switched to placebo, their mortality risk increases markedly. One in every 145 patients who entered the trials for risperidone, olanzapine, quetiapine and sertindole died, but none of these deaths were mentioned in the scientific literature, and the FDA didn’t require them to be mentioned.6 Many of the patients killed themselves; the suicide rate was two to five times the usual rate for patients with schizophrenia, and a ma­jor reason was withdrawal-induced akathisia.6

In trials in dementia, pre-treatment with antipsychotics is less likely, and a meta-ana­lysis of short-term trials of newer antipsychotics showed that for every 100 patients treated, there was one additional death on the drug.7 It could be even worse because deaths are underreported.5

Patients are also being forced to receive electroconvulsive treatment (ECT) although it is one of the most controversial treatments in medicine. Some psychiatrists say they only use it in life-threatening situations but it has never been documented that ECT can save lives whereas we know it can kill. The death rate appears to be around one per 1000.8 The randomised trials are of poor quality and there is no evidence for any long-term benefit beyond the treatment period for either schizophrenia or depression, whereas it is clear that ECT “works” by damaging the brain.8With a strict definition of memory loss, between 29% and 55% of the patients are affected.9

Two patient stories

Forced treatment inevitably leads to abuse and gross human rights violations.2 Here are two patient stories I know about personally, as I have met with the patient and the father, respectively.

A very moving documentary tells the story of Mette, a young Danish nurse, who, after having been diagnosed with paranoid schi­zophrenia received vast amounts of medicine and 150 elec­troshock treatments.10 Mette was seriously harmed, stigmatised and surrounded by prejudice and ended up on disability living allowance. One day, however, she decided to reclaim her own life and escape from psychiatry, which she did successfully and then achieved some of the greatest goals of her life. Mette’s story illustrates that forced treatment is easily abused.2 Even when it so clearly doesn’t work and actually harms people, psychia­trists continue with it out of despair in an endless progression, causing further harm for the patients’ brains and personalities.2

Garth Daniels in Melbourne began smoking marihuana heavily and was admitted to hospital in an acutely psychotic state aged 21. He is now 38 and has spent about 14 years in mental hospitals; has been seen by some 400 psychiatrists and registrars; and has accumulated an estimated 15,000 pages of files. He has had virtually every known psychiatric drug, often in heroic doses, as well as ECT, which he hates. His family has observed that he has had akathisia (which predisposes to violence)2 and that his behaviour deteriorated when he was given large doses of drugs. In contrast, on each of five occasions over the years when his dosage was reduced, his condition improved. Depot injections have been particularly bad and have resulted in visual hallucinations, agitation and violence, leading to restraint, more drugs, more agitation and still more drugs. Garth’s father says that his son is normally a quiet and placid person and that when he was on a moderate dose of amisulpride, he presented as alert, aware and affectively intact to the point of being a warm and interested person.

The hospital has routinely applied for permission to give another 12 ECTs each time they completed the approved course, although this went against Garth’s Advance Directive and his family’s wishes. Garth has been given about 100 ECTs despite the fact that guidelines recommend a maximum of 1211 and that the number of ECTs is the best predictor of long-term brain damage.12

Garth has been seriously abused against official guidelines in other ways, e.g. he has been tied to his bed for 69 days straight and began to give up hope. His father was concerned it could result in suicide if his forced treatment didn’t stop, but the response of the psychiatrist responsible for Garth’s care, Professor Paul Katz, Clinical Director of the Mental Health Program at Eastern Health, was to make an application to a Civil and Administrative Tribunal (VCAT) to revoke the father’s Medical Power of Attorney and to remove the father as guardian. Garth then sued Katz for assault. With a devilish kind of irony, one of the treating psychiatrists has admitted that part of the reason that Garth was incompetent to withhold consent for the ECTs was because his memory was impaired as a result of the ECTs, so they had to keep giving it to him against his will!

Garth was recently examined by an independent psychiatrist, Niall McLaren, who had access to his voluminous files. Garth is regarded by his usual psychiatrists as an incurably dangerous schizophrenic although he does not show any symptoms which could sustain such a diagnosis or a disturbance of contact with reality. Garth has been subjected to two decades of treatment for schizophrenia and has utterly failed to respond. McLaren also noted that Garth’s medication had been reduced very quickly, even abruptly, which is serious professional malpractice, as it markedly increases the risk of suicide and homicide.2

Garth’s family recently moved to another state and took him with them, thus evading the reach of the Victorian Mental Health Act. He is currently being treated as an out-patient on low doses of medication, with no ECT. His family report that his mental state has never been better. Despite the dire claims of his former treating psychiatrists, he has absolutely no signs of psychosis.

The courts don’t respect the evidence or human rights

In 2006, lawyer Jim Gottstein won an Alaska Supreme Court case about forced treatment with olanzapine.2The court decided that the government cannot drug someone against their will without first proving by clear and convincing evidence that it is in their best interests and there is no less intrusive alternative available. In another case, the court decided that if an alternative is “feasible,” the state has to either provide it or let the person go.

Gottstein has noted that the public’s opinion is that the drugs work, and that if people weren’t crazy, they would know that the drugs are good for them.13 Accordingly, psychiatrists argue at court hearings that no sound person would refuse medically sound treatment, and the courts comply with their wish. It was therefore essential for Gottstein’s success to use scientific data to convince the Supreme Court that this isn’t true. The court ruled that, “Psychotropic medication can have profound and lasting negative effects on a patient’s mind and body” and “are known to cause a number of potentially devastating side effects.”

This was a stunning victory for human rights in psychiatry but there is a long way to go. The lawyers assigned to represent the patients generally fail miserably, and the psychiatric profession has explicitly acknowledged that psychiatrists regularly lie to the courts,2 e.g. by exaggerating the dangerousness of a mentally ill person’s behaviour, or by stating that the treatment works even when this is clearly not the case, or by ignoring its harms.

In one such case I was involved with, I demonstrated to a Norwegian High Court that the psychiatrist’s arguments were scientifically wrong and that the patient’s treating psychiatrists had committed serious malpractice by not responding to dangerous symptoms of intoxication, but the court didn’t care the least and ordered continued treatment with olanzapine although the patient was already objectively damaged by this drug in terms of tardive dyskinesia and had possibly even had malignant neuroleptic syndrome, which carries a high mortality. I find this absolutely disgusting. The lawyer’s appeal to the Supreme Court was rejected with the argument that there was nothing of a principled nature. The Supreme Court didn’t seem to care that some of the key evidence provided by the psychiatrist was objectively wrong. I doubt this is how courts react in murder cases when it is shown that the evidence provided to a lower court was wrong.

Jim Gottstein invited me to Anchorage in June 2016 to give a talk about abolishing forced admission and treatment and to meet with various people. The trip was sponsored by the Law Project for Psychiatric Rights and made possible by a grant from the Alaska Mental Health Trust Authority. Jim arranged for me to be an expert witness in a case of forced drugging and the proceedings could best be characterised as a sham where the outcome was determined beforehand. The lawyer for the patient is not informed that there will be proceedings until the day of the proceedings, which means that there is no possibility for preparing a proper defence.

Furthermore, the petitions I saw for continued confinement and drugging of patients in Alaska were untruthful to the extreme. Although the patients were very different, the arguments were the same for all of them and there was a prefabricated text on the forms (in italics below), e.g.:

Petitioner has reason to believe the patient is incapable of giving or withholding informed consent. The facility wishes to use psychotropic medication in a non-crisis situation.This is a statutory requirement AS 47.30.839(a)(2). So, this is just saying that the criterion has been met, but the petition doesn’t state what the facts are that lead to that conclusion.

The patient’s prognosis with this course of treatment: good.

The patient’s prognosis without these medications: poor.

Of the medications requested, the patient has previously taken the following medications and experienced these results or side effects: Has taken these medications and done well without side effects.

The following less intrusive treatment options/alternatives are available: none.

Firstly, it is highly unlikely that the patients are unable to provide or withhold informed consent. The UN Convention makes it clear that “unsoundedness of mind” and other discriminatory labels are not legitimate reasons for the denial of legal capacity, and that the concept of mental capacity is highly controversial in and of itself:1 “Mental capacity is not, as is commonly presented, an objective, scientific and naturally occurring phenomenon. Mental capacity is contingent on social and political contexts, as are the disciplines, professions and practices which play a dominant role in assessing mental capacity … In most of the State party reports that the Committee has examined so far, the concepts of mental and legal capacity have been conflated so that where a person is considered to have impaired decision-making skills, often because of a cognitive or psychosocial disability, his or her legal capacity to make a particular decision is consequently removed. This is decided simply on the basis of the diagnosis of an impairment (status approach), or where a person makes a decision that is considered to have negative consequences (outcome approach), or where a person’s decision-making skills are considered to be deficient (functional approach). The functional approach attempts to assess mental capacity and deny legal capacity accordingly. It is often based on whether a person can understand the nature and consequences of a decision and/or whether he or she can use or weigh the relevant information. This approach is flawed for two key reasons: (a) it is discriminatorily applied to people with disabilities; and (b) it presumes to be able to accurately assess the inner-workings of the human mind and, when the person does not pass the assessment, it then denies him or her a core human right — the right to equal recognition before the law. In all of those approaches, a person’s disability and/or decisionmaking skills are taken as legitimate grounds for denying his or her legal capacity and lowering his or her status as a person before the law. Article 12 does not permit such discriminatory denial of legal capacity, but, rather, requires that support be provided in the exercise of legal capacity.”

Secondly, there is no sound scientific evidence in support of blanket statements that the patient’s prognosis is good with medications and poor without. The fact that these patients have often received their drug cocktails for a long time actually demonstrates that the prognosis with the drugs is poor, which is also what the science tells us: the prognosis with treatment with antipsychotic drugs is poor.2,6,13 Patients fare better the less these drugs are being used.

Thirdly, it is close to impossible to take antipsychotic drugs or any other psychiatric drugs without side effects. It is therefore almost invariably misleading, and usually flatly untrue, to state that the patient “Has taken these medications and done well without side effects.”

Fourthly, it is misleading in the extreme to suggest that there are no less intrusive treatment options available. There are always less intrusive options available, as the very wide variation in ECT usage shows, and forced drugging is not necessary, as there are no psychiatric drugs that can cure psychiatric disorders whereas all of them can make matters worse.14,15 Compounding the matter, psychiatric trainees are required to pass tests in administering ECT but they are never required to show proficiency in not using ECT or in notusing drugs or in tapering them off.

As regards ECT, the patients should be told that many psychiatrists treating similar conditions will hardly ever or never use ECT and that it is wholly a matter of chance or risk which type of psychiatrist the patient sees. Many jurisdictions insist that patients can be forced to have ECT against their will if they “unreasonably refuse” it. However, it is not at all clear what would constitute “reasonable refusal to accept ECT,” and what criteria the hospitals apply in deciding when refusal is unreasonable. In practice, refusal to accept ECT is always taken to be “unreasonable.”

Whom should the judges believe?

When psychiatrists say the treatment is helpful while the patients say it is not, we should let the patients decide, as they know best. Indeed, they are the only ones who can tell how a drug affects them subjectively. Drug trials is psychiatry are biased in many ways, e.g. because the placebo controlled studies have not been adequately blinded.2 The blinding is often broken due to the drug’s side effects and this leads psychiatrists to overestimate the effect,2 sometimes to such an extent that they can see the exact opposite of what is actually true. This was demonstrated in a double-blind placebo controlled trial funded by the US National Institute of Mental Health and reported on in 1964. It was a six-week study of newly admitted patients with schizophrenia in treatment with phenothiazines like chlorpromazine. None of the 270 patients became worse and the drugs were reported to reduce apathy, improve motor movement and to make patients less indifferent – exactly the opposite of what these drugs do to patients, and which the psychiatrists had admitted a decade earlier – and side effects were said to be “mild and infrequent … more a matter of patient comfort than of medical safety.”6,16

Antipsychotics are very poor drugs. Even helped by all the formidable biases in the trials,2 the outcome is poor. The minimal improvement on the Clinical Global Impressions Ratings corresponds to about 15 points on the Positive and Negative Syndrome Scale,17 but what was obtained in recent placebo controlled trials in submissions to the FDA was only 6 points,18 although it is easy for scores to improve quite a bit if someone is knocked down by a tranquilliser and express their abnormal ideas less frequently. Thus, the FDA has approved newer antipsychotic drugs whose effect is far below what is clinically relevant.

Although patients are not often subjected to forced treatment with antidepressants, it is nonetheless telling that the patients themselves, both children and adults, say in double-blind placebo controlled trials that the drugs don’t work for them while their psychiatrist say in the same trials that the drugs work.2 It is also noteworthy that in a large sur­vey from 1995, people thought that antidepressants, antipsychotics, electroshock and admission to a psychiatric ward were more often harmful than beneficial.19

Abolishing laws of forced treatment

Forced treatment cannot be defended, neither on ethical, legal or scientific grounds. We need to abolish our laws about this, in accordance with the United Na­tions Convention on the Rights of Persons with Disabilities.1The evidence we have tells us that forced treatment increases the harm done not only to patients but also to others.2,6,14.15 Violence breeds violence, but perhaps the strongest argument against forced drugging and ECT is that, apart from psychiatric patients, only soldiers at war are forced to run risks against their will that might kill them. The difference is that soldiers have usually chosen themselves to become soldiers whereas psychiatric patients have not chosen to become psychiatric patients.

In rare cases force may be needed, e.g. if a patient is dangerous, but restraint without belts, i.e. holding the patient firmly, will suffice. And if that is not enough, the case should be a matter for the police, which it is in Iceland and in Trieste.2

It is a myth that psychiatrists need access to forced treatment. With adequate leadership and training of staff in de-escalation techniques, it is possible to practice psychiatry without using force.2,20,21 In Iceland, belts have not been used since 1932 when a psychiatrist burnt them, and there are psychiatrists all over the world who have dealt with deeply disturbed patients for their entire career without ever having used antipsychotics, ECT or force.2 Peter Breggin never uses such treatments, and Niall McLaren has never used ECT. While he was head of department for a total of eight years at two Australian hospitals, ECT wasn’t used at all (McLaren, personal communication). He didn’t bar it, simply made it more difficult for his staff to use it, as they had to justify it by showing there was no alternative. At the same time, the admission rate to the hospital dropped, the average duration of stay dropped and the bed occupancy rate dropped by as much as half. In both hospitals, some time after his appointments had expired and he had moved, ECT was resumed and the bed occupancy rate quickly rose again.

There are many initiatives to reduce the amount of forced treatment.2 But the necessary culture change will never happen if we don’t make it illegal. Surely, there will be difficult cases where it will be missed, but we will need to live with that, as the benefits of abolishing forced treatment are far greater than the harms.2 Further, there are ways of dealing with the difficult cases without force. For example, we are allowed to prevent a patient with anorexia from dying by feeding her and don’t need psychiatric laws for this; we are entitled to save people’s life if we can.

In many countries, a person considered insane can be admitted to a psychiatric ward on an involuntary basis if the prospect of cure or substantial and significant improvement of the condition would otherwise be significantly impaired. But is this ever the case? Are there any treatments that can cure insane patients, or which can lead to such substantial improve­ments that the patient’s condition would be significantly impaired if she is not forced to go to hospital immediately? I don’t think so, and, considering the abuse that takes place at psychiatric wards,1,2 this clause should be removed from the law of all nations. There is already a clause that, if patients present an obvious and substantial danger to themselves or others, they can be involuntarily admitted, but we don’t even need this. According to the National Italian Mental Health Law, a reason for involuntary treatment can no longer be that the patient is dangerous. This is a matter for the police.2

In 2015, the UN Committee on the Rights of Persons with Disabilities called on States parties to protect the security and personal integrity of persons with disabilities who are deprived of their liberty by eliminating the use of forced treatment, seclusion and various methods of restraint in medical facilities, including physical, chemical and mechanic restrains.22 The Committee found, like patients do,2that these practices are not consistent with the prohibition of torture.

If you still accept forced treatment and involuntary detention after having read my article, I hope you will read a heart-breaking book, “Dear Luise,” that describes virtually everything that is wrong with psychiatry.23 Luise had begged and begged not to be treated with antipsychotics, which she didn’t tolerate, and had seen her best friend at the care home being killed by them. Luise was herself killed only six months later, aged 32, by a lethal injection. Both women dropped dead on the floor. The system, however, congratulated itself for its first-class homicide where everyone seems to have been immunised beforehand against being found guilty. Luise’s mother was told that Luise had received the ”highest standard of specialist treatment.” The officially accepted term for deaths such as Luise’s is “natural death.” She had told her mother: “I’ll be next.”

We must stop this, and as the psychiatric profession is not likely to reform itself, real court cases – not sham proceedings – might be a good way forward.

Acknowledgements: I have been inspired by the hundreds of patient stories I have received from patients or their relatives; by the many previous patients who have reclaimed their life and escaped from psychiatry and now call themselves psychiatric survivors; and by my collaboration with lawyer Jim Gottstein and previous Supreme Court lawyer Ketil Lund, psychiatrists Peter Breggin, David Healy, Joanna Moncrieff and Neill McLaren, science journalist Robert Whitaker, psychologist John Read, and Dorrit Cato Christensen, the mother of the young Danish woman killed by antipsychotic drugs who established the organisation “Death in Psychiatry.”

References

1 United Nations Convention on the Rights of Persons with Disabilities. General comment No. 1 2014 May 19. http://daccess-dds-ny.un.org/doc/UNDOC/GEN/G14/031/20/PDF/G1403120.pdf?OpenElement (accessed 1 April 2015).

2 Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015. 3 Hjorthøj CR, Madsen T, Agerbo E, et al. Risk of suicide according to level of psychiatric treatment: a nationwide nested case-control study. Soc Psychiatry Psychiatr Epidemiol 2014;49:1357–65.

4 Large MM, Ryan CJ. Disturbing findings about the risk of suicide and psychia­tric hospitals. Soc Psychiatry Psychiatr Epidemiol 2014;49:1353–5.

5 Hughes S, Cohen D, Jaggi R. Differences in reporting serious adverse events in industry sponsored clinical trial registries and journal articles on antidepressant and antipsychotic drugs: a cross-sectional study. BMJ Open 2014;4:e005535.

6 Whitaker R. Mad in America. Cambridge: Perseus Books Group; 2002.

7 Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA 2005;294:1934–43.

8 Read J, Bentall R. The effectiveness of electroconvulsive therapy: a literature review. Epidemiol Psichiatr Soc 2010 Oct-Dec;19:333-47.

9 Rose D, Fleischmann P, Wykes T, et al. Patients’ perspectives on electroconvul­sive therapy: systematic review. BMJ 2003;326:1363.

10 Mettes Stemme (Mette’s Voice). http://madinamericainternationalfilmfestival.com/mettes-stemme-mettes-voice/ (accessed 9 Dec 2014).

11 Royal College of Psychiatrists. Information about ECT (Electro-convulsive therapy). http://www.rcpsych.ac.uk/healthadvice/treatmentswellbeing/ect.aspx. July 2015 (accessed 5 Feb 2016).

12 Sackeim HA, Prudic J, Fuller R, et al. The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology 2007;32:244-54.

13 Whitaker R. Anatomy of an Epidemic. New York: Broadway Paperbacks; 2010.

14 Breggin P. Brain-disabling treatments in psychiatry: drugs, electroshock and the psychopharmaceutical complex. New York: Springer; 2007.

15. Breggin P. Medication madness: the role of psychiatric drugs in cases of violence, suicide, and crime. New York: St. Martin’s Griffin; 2008.

16 Cole JO. Phenothiazine treatment in acute schizophrenia; effectiveness: the National Institute of Mental Health Psychopharmacology Service Center Col­laborative Study Group. Arch Gen Psychiatry 1964;10:246-61.

17Leucht S, Kane JM, Etschel E, et al. Linking the PANSS, BPRS, and CGI: clinical implications. Neuropsychopharmacology 2006;31:2318-25.

18 Khin NA, Chen YF, Yang Y, et al. Exploratory analyses of efficacy data from schizophrenia trials in support of new drug applications submitted to the US Food and Drug Administration. J Clin Psychiatry 2012;73:856–64.

19 Jorm AF, Korten AE, Jacomb PA, et al. ”Mental health literacy”: a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Med J Aus 1997;166:182-6.

20 Fiorillo A, De Rosa C, Del Vecchio V, et al. How to improve clinical practice on involuntary hospital admissions of psychiatric patients: Suggestions from the EUNOMIA study. Eur Psychiat 2011;26:201-7.

21 Scanlan JN. Interventions to reduce the use of seclusion and restraint in inpa­tient psychiatric settings: what we know so far, a review of the literature. Int J Soc Psychiat 2010;56:412–23.

22 Committee on the Rights of Persons with Disabilities. Guidelines on article 14 of the Convention on the Rights of Persons with Disabilities. The right to liberty and security of persons with disabilities. Adopted during the Committee’s 14th session, held in September 2015.

23 Christensen DC. Dear Luise: a story of power and powerlessness in Denmark’s psychiatric care system. Portland: Jorvik Press; 2012.

Peter Gøtzsche, MD
Deadly Psychiatry and Organised Denial: Professor Peter C. Gøtzsche, MD, co-founded the Cochrane Collaboration. He has published more than 70 papers in the top 5 general medical journals and 5 books, most recently, Deadly Psychiatry and Organised Denial.

 

 

 

 

 

 

Nu faller psykiatrins teori om den ”kemiska obalansen”

Pressmeddelande • 2015-05-15 21:03 CEST

Nu faller psykiatrins teori om den ”kemiska obalansen”
Teorin om ”den biokemiska obalansen” – att brister och överskott av signalsubstanser i hjärnan orsakar psykiska problem – är troligen psykiatrins största bluff. Det är denna pseudovetenskapliga teori som banat väg för massiv utskrivning av toxiska ämnen, i namn av medicin. Men nu rämnar fasaden och ledande psykiatriker gör allt för att ta avstånd från de bevisligen falska påståendena.
Ingen har väl undgått påståendena om att personer som är nedstämda, lider av ”depression”, en brist på ämnet serotonin; att barn och vuxna som är okoncentrerade och överaktiva, lider av ”ADHD”, en brist på ämnet dopamin; att personer som har svåra problem med tänkande, känslor och beteende lider av ”schizofreni”, ett överskott på ämnet dopamin. Och att det nu finns effektiva behandlingar mot dessa brister och överskott – ”läkemedel” som rättar till ”den biokemiska obalansen”.

Psykiatrins utpressningsbudskap har varit att patienter kan se fram mot en mörk framtid, fylld av elände och även kriminalitet, om de inte tar den medicin som rättar till de kemiska störningarna i hjärnan, i en närmast livslång behandling. Problemet är att det här inte är, och aldrig har varit sant. Det är troligen den största, mest förödande och mest inkomstdrivande pseudovetenskapliga bluff, som vi nu har omkring oss. En bluff som förvandlat övergående psykiska problem till kroniska skador för miljontals människor – och skapat mångmiljardvinster för läkemedelsbolag.
LOG IND

KRONIKEN 29. JUL. 2015 KL. 00.01
Psykiatriske patienter i hele Danmark frarøves deres personlige frihed

Foto:
Jeg synes ikke, at jeg har et godt liv i psykiatrien, og jeg drømmer om at blive fri af den, skriver en patient.
Følg
LAILA KLITGAARD GREGERSEN ER PSYKIATRISK PATIENT . HUN ER UDDANNET FOLKESKOLELÆRER OG HAR ARBEJDET SOM LÆRER I 9 ÅR.
Fælles for dagene på psyk er, at de snegler sig af sted. Jeg har prøvet det hele. Tvangsindlæggelse med politi, fordi jeg nægtede indlæggelse, indlæggelse via egen læge og selv at opsøge systemet; jeg har været både på åben og lukket afdeling.

Min diagnose er bipolar. Jeg kommer fra en almindelig skilsmissefamilie på Fyn og har haft en god opvækst med hårdtarbejdende forældre. Jeg er den eneste i min familie, som har været i kontakt med behandlersystemet.
Jeg har altid været stor fan af ’Gøgereden’ med Jack Nicholson i hovedrollen som den frihedselskende oprører, der giver systemet og den følelseskolde ’Nurse Ratchett’ kamp til stregen. Da jeg var i 20’erne, havde jeg aldrig forestillet mig, at jeg selv skulle komme til at stifte bekendtskab med en psykiatrisk afdeling.

Jeg har i en ca. 2-årig periode uden indlæggelser passet lærerjob, to små børn, hus og hjem og haft en døende mor på hospice, hvor jeg samtidig fik 1.000 mg Seroquel Prolong og 900 mg litium
Laila Klitgaard Gregersen
Under en indlæggelse var jeg oprevet over, at jeg ikke måtte få besøg af mine børn, over, at personalet havde taget min mobiltelefon, og over, at de ikke ville høre tale om, at jeg skulle være gift med en skidt ægtemand. Jeg blev skærmet til min stue, som de kalder det.

Jeg overtrådte forbuddet og bevægede mig alligevel over dørtrinnet til den lange gang op mod opholdsstuen og det bur, som personalet en stor del af tiden opholder sig i, hvor de dokumenterer, hvad de observerer ved os patienter. Der bliver også spist et par flødekager derinde og surfet på egne mobiltelefoner og skaltet og valtet, kan man se – men ikke høre.

Jeg bevægede mig ud på gangen, og straks væltede det ud med sygeplejersker og sosu-assistenter. Jeg trak mig tilbage til stuen, og de fulgte med. Jeg skal ikke kunne sige, om mit mod og åbenbart forkerte sindsstemning hang sammen med, at jeg havde menstruation – så jeg havde en pakke hygiejnebind liggende på mit bord på stuen.

Jeg tog et bind og fjernede strimlen fra det hvide og klinisk rene bind og placerede det i panden på en sygeplejerske. »Hun er sgu da også altid så sur og kold«, tænkte jeg. Det skulle jeg ikke have tænkt, for episoden resulterede i, at der blev tilkaldt mere personale.

Jeg var hverken råbende eller korporlig i min fremtoning ud over det med bindet, som blev sat på, uden at jeg mælede et ord. De hentede læderremme, som de spændte på min seng, og så blev jeg lagt op på sengen og lå i bælte i næsten en uge og fik diverse indsprøjtninger med medicin, jeg ikke vidste, hvad var.

Jo, Zyprexa hed noget af det. Det bliver man, ligesom det meste andet psykofarmaka, noget døsig af. Det er så den hage ved Zyprexa, at man som mulig bivirkning kan få mælk i brysterne, og det fik jeg selvfølgelig. Men det er ikke meget bevendt for slet ikke at tale om indholdsrigt at ligge fastspændt i 5 dage i en seng og glo op i et hvidt loft med bitte små ventilationshuller i og i øvrigt lytte til Vejle Nærradio, som de havde installeret som afledning til min fiksering, samtidig med at man har mælk i brysterne.

Set udefra kunne episoden med hygiejnebindet betegnes som tragikomisk præcis som i ’Gøgereden’ eller Panduros humoristiske roman ’Rend mig i traditionerne’, men det er og bliver fiktion. Tiden i bælte blev til min tragiske virkelighed, fordi en fiksering betyder, at man ikke er i kontakt med nogen uden for psyk, men blot må ligge med egne tanker, til en læge beslutter, at man er rask nok til at komme ud af bæltet.

LÆS OGSÅTvang og medicinering styrtdykker

På det psykiatriske sygehus, som jeg har været indlagt på, er der ganske få muligheder for adspredelse. En af dem er, at man kan låne en bog på deres bibliotek, som der i øvrigt er ansat hele to bibliotekarer til at bestyre, og jeg vil tro, at bogsamlingen ikke overstiger 1.000 titler. Halvdelen af bøgerne står i Psyk-Info-biblioteket og omhandler alene psykiske lidelser, hvilket jeg ikke har lyst til at læse om under en indlæggelse.

Jeg bryder mig i øvrigt ikke om ordet psykisk lidelse. Det er muligt, at andre lider under mit fravær fra samfundet i perioder, men jeg synes ikke selv, at jeg lider, så derfor bryder jeg mig ikke om den betegnelse. Psyk-Info har også en del film, selvfølgelig også kun film, der relaterer til psykisk sygdom. Der er f.eks. ’A Beautiful Mind’ og ’Marie Krøyer’, ’Rain Man’ og mange andre, også dokumentarfilm, men ikke ’Gøgereden’.

Personalet påpeger ofte, at man ikke må få for mange stimuli, hvis ens tilstand skal bedres. De stimuli, der er på mit sygehus, er Stiftstidende hver dag og fjernsynet i opholdsstuen. Det er ligesom det. Tiden går mestendels med at ryge alt for mange cigaretter og så naturligvis snakke med de andre patienter. Måltiderne på snorlige tidspunkter er også en del af tidsfordrivet på en psykiatrisk afdeling.

De hentede læderremme, som de spændte fast på min seng, og så blev jeg lagt op på sengen og lå i bælte i næsten en uge og fik diverse indsprøjtninger med medicin, jeg ikke vidste, hvad var
Laila Klitgaard Gregersen
Man lever godt, og man skal passe på, at man ikke tager på i vægt, da medicinen oftest er meget appetitøgende.

Hvis man nægter at spise pillerne, kan man blive tvangsmedicineret med sprøjte, eller en læge skal komme og se, at man synker pillerne. Man kan klage over tvang i psykiatrien, og så kommer der en patientrådgiver, som jeg ikke oplever som uafhængig af systemet, men nærmere som en del af systemet. Patientrådgiveren er ansat af regionerne, ligesom personalet og lægerne er det.

Jeg har set mange klage over både medicin og tvangstilbageholdelse, men jeg har aldrig oplevet, at en patient har fået medhold i noget.

Patientrådgiverne kan have meget forskellig faglig baggrund. Jeg savner, at vi patienter har ret til en uafhængig jurakyndig rådgiver, som ikke er på regionernes lønningsliste.

Hver morgen er der morgenmøde, hvor en fra personalet kommer ud og sætter sig ved det lange lyse laminatbord i opholdsstuen og disker op med friskbrygget kaffe og en stabel hvide plastikkrus, ikke mindst har hun sin seddel med dagens gøremål for patienter med: »Godmorgen og velkommen til morgenmøde«.

Der sidder vi så. Der er 18 patienter på afdelingen, og typisk er tre patienter stået op til kl. 9, de andre snorker videre på stuerne. »Hvem vil tørre bordet af i dag?«. »Hvem vil kigge, om der mangler saft i køleskabet?«. »Hvem vil tømme askebægeret udenfor?«.

Nogle gange er der ikke nogen, der melder sig, og så bliver situationen med fire mennesker ved bordet lidt pinlig. Andre gange indgår sang som en del af morgenmødet, så sidder vi fire mand stærk og pipper: »Det’ hammer-hammer fedt, jeg kysser dig om lidt«.

Men det kan også være, at der dukker en ergoterapeut op med en hulahopring, som hun smider på gulvet. Vi tre patienter får så hver en ærtepose i hånden og bliver instrueret til at stå 1½ meter fra ringen, og så skal vi ellers se, om vi kan ramme inden for cirklen.

Til slut læser personalen højt af sin seddel og fortæller, hvem der er ens kontaktperson i dag.

Kontaktpersonen er en fra personalet, som man kan henvende sig til i løbet af dagen, hvis der er noget, man vil tale om.

Kontaktpersonen er også med til lægesamtaler, som man typisk har en gang om ugen, måske sjældnere, og det er det eneste tidspunkt, man ser sin læge. Lægen læser, hvad sygeplejersker og sosu-assistenter har dokumenteret om én på computeren, inden man har samtale med dem.

Min oplevelse af psykiatrien er, at man kommer ned i et tempo, der er så larmende lavt, at det er svært at komme i rette gear ude i det rigtige samfund, når man kommer ud.

LÆS OGSÅBarn af psykisk syg: »Ingen talte med mig om min mors sygdom«

Meget medicin kører ikke så godt sammen med at passe et arbejde på grund af træthed og bivirkninger. Jeg har i en ca. 2-årig periode uden indlæggelser passet lærerjob, to små børn, hus og hjem og haft en døende mor på hospice, hvor jeg samtidig fik 1.000 mg Seroquel Prolong og 900 mg litium.

Det er en høj dosis, og til sidst kunne jeg ikke hænge sammen mere og blev afskediget på mit job i forbindelse med nedskæringer.

Jeg tænkte ikke over medicin den gang, jeg spiste bare det, min mand gav mig hver aften. Jeg tror, jeg skulle have haft hjælp på det tidspunkt, måske meget så kunne have været undgået. Jobbet røg sig en tur, og det gjorde manden også. Indlæggelserne er taget til det sidste års tid, måske har min sygdom naturligt udviklet sig, måske er det bare et ret tomt livsindhold at være på ressourceforløbsydelse fra kommunen og i øvrigt bare passe og pleje sit psykiske helbred.

Man skal frem for alt tage den med ro både inden og uden for murerne, får man at vide.

Det vildeste, man kan få lov til på psyk, er at få udgang til Rema 1000 på egen hånd, hvilket vil sige uden personale. Rema 1000 ligger ca. 200 meter fra psykiatrisk afdeling, og det er den helt store treat, hvis vi psykisk syge kan få sådan en tur, hvor det naturligvis inden er besluttet, at man godt kan klare alle de stimuli. Så sjosker man tilbage til afdelingen med en æske Toffefee og en stor cola, for det sælger kantinen på psyk nemlig ikke.

Hvad er det, du står op til her dag ud og dag ind: tv-programmet og avisen på bordet
Laila Klitgaard Gregersen
Man glæder sig over at gå i supermarkedet og tænker: Jeg blender sgu da fint ind i samfundet. Problemer kan opstå, hvis man har fået noget medicin, der som bivirkning har, at ens bevægelsesmønster bliver ramt. Jeg fik en gang et præparat, der hed Abilify, og fik mekaniske bevægelser og meget uro, kunne ikke sove, kunne ikke sidde stille, fik det faktisk så dårligt, at jeg tænkte på min fars jagtgeværer.

Når man kommer tilbage til afdelingen med sit snold, går man måske ned på sin stue, og så spiser og drikker man et hul ind i den ensomhed, man føler.

Den føler man også ved sengetid;fire hvide vægge, hvidt og gråt sengetøj og et hvidt loft. Jeg tænker: Det var så endnu en dag uden min pige og uden min dreng.

Jeg har talt med mine børn om, at vi bor i hinandens hjerter, når vi ikke er sammen. Det er hårdt. Man savner også kærlighed fra en voksen, og nogle gange passerer mit liv revy, når jeg ligger der, og de gode og glade stunder bliver omdannet til tårer, fordi den tid er erstattet med en virkelighed, hvor psykiatrien fylder i ens liv.

Det er heller ikke altid rart at vågne på psykiatrisk afdeling, fordi man kan mærke, at man er bombet og sløv af medicinen, så man kan godt tåge lidt rundt den første times tid, og så tænker jeg: Hvad fanden er det for et liv? Hvad er det, du står op til her dag ud og dag ind: tv-programmet og avisen på bordet. Det hele omhandlende et liv, som du er afskåret fra.

Man får det bedre, som dagen skrider frem, selvfølgelig især hvis dagen indeholder at få besøg af sine to lækre unger. Men som oftest er der intet indhold i dagene. Der er avisen, tv’et og måltiderne, that’s it, jo, også samtale med læge eller kontaktperson.

Jeg har haft 10 indlæggelser, og det er muligt, at de alle har været lige nødvendige, men jeg synes ikke, at psykiatrien har bibragt mit liv noget godt.

Jeg har siddet og skrevet ansøgninger om lærerjob under en indlæggelse. En sosu-assistent opdagede mit forehavende og fik det stoppet med ordene: »Du er alt for dårlig til, at du kan passe et lærerjob igen«. »Jamen, jeg er på forsørgelse fra kommunen, og jeg vil gerne arbejde, det giver mig livsindhold«, svarede jeg hende. »Jo, men tror du ikke, at du skal have en pension?«, konkluderede hun.

LÆS OGSÅHvert 2. barn i familier med psykisk sygdom får problemer senere i livet

Jeg synes, at psykiatrien fastholder én i sygdommen frem for at tænke i en form for helbredelse, som man gør på de somatiske sygehuse.

De to ting kan ikke sammenlignes, vil alle sige, og nej, det kan de da heller ikke, men man kunne godt give psykisk syge lidt mere selvværd og lyst til at virke i samfundet og have som mål, at man skal ud af sin sygdom i stedet for mere og mere ind i den.

Jeg har ikke prøvet at få elektrochok, men det er almindeligt brugt i den danske psykiatri. Jeg har snakket med flere, som har fået det, og desværre har jeg aldrig set en medpatient komme tilbage som Jack Nicholson og sige: »The next girl I take to bed, will light up like a pinball machine«.

’Gøgereden’ lever stadig, fordi patienter rundt omkring i hele Danmark frarøves deres personlige frihed. Det kan være forbud mod at forlade sygehusets område, cigaretrationering med ordene: »Du må ryge, hver gang klokken er hel«, eller »ham din ven der er ikke velkommen her«, eller »om aftenen må I kun se DR 1 eller TV 2« og »du må tjekke din telefon to gange om dagen«.

Jeg oplever, at der ikke er grænser for, hvad de kan bestemme. Derudover føler jeg, at deres indgreb i min personlige frihed, som f.eks. at man skal have personale med sig på ruten ned i kantinen for at købe en pakke cigaretter, påvirker hele ens selvfølelse.

Det restriktive, de faste spisetider, mange aflåste døre, hvide vægge og lofter og hele rollen som patient kan være vanskeligt at håndtere.

Jeg er en voksen kvinde på 37 år uden misbrug, og jeg har en ren straffeattest. Straffede personer, der afsoner i fængslerne, ved, hvornår de kommer ud igen, men ens ophold på psyk er for så vidt på ubestemt tid, fordi man først kan udskrives, når de mener, at man er klar til det.

Det faktum gør også noget ved ens personlighed og livsgnist. Ved en lang indlæggelse føler jeg, at min selvværd forringes, og det er lige før, at man er blevet vænnet til at spørge, om man må få lov til at gå på toilettet.

Der er sikkert en mening med galskaben, men den er svær at få øje på, når man er indlagt. Man føler sig som et lille usikkert barn på 7 år, når man pænt banker på ruden til buret og tiggende spørger: »Må jeg godt få lov til at se, om der er nogle beskeder på min mobiltelefon?«.

I ’Gøgereden’ får Jack Nicholson det hvide snit, og hans planer om at flygte til Canada med sin ven indianeren opløses. Indianeren begår til sidst medlidenhedsdrab på Nicholson ved at kvæle ham med en pude. I sidste scene ser man indianeren løbe flygtende væk ud over stepperne til melankolsk musik på sav. Jeg har ofte hørt medpatienter sige: »Jeg gider ikke det lort her mere«, eller »hvad er det for et liv, jeg kan lige så godt lægge mig til at dø«.

Selvmordsraten er høj blandt psykisk syge, og jeg synes ærligt talt, at psykiatrien kunne trænge til at få lidt frisk luft under vingerne; måske nogle helt andre faggrupper kunne komme med inputs til, hvordan behandlingen kunne motivere patienterne til et positivt, indholdsrigt liv og ophold på psyk.

Vi patienter skulle gerne få mod på det rigtige liv og lyst til at virke i vores fælles samfund, når vi bliver udskrevet. Jeg oplever, at livet på afdelingerne medfører en zombielignende tilstand i vores, patienternes, krop og sind, hvor man er så afvænnet fra impulser, stimuli og kærligt nærvær, at man skal bruge meget lang tid på at vænne sig til den virkelige verden igen.

Jeg synes ikke, at jeg har et godt liv i psykiatrien, og jeg drømmer om at blive fri af den, men den har sit tag i folk både inden og uden for murene.
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