Biomedical psychiatry..Questioned by APA?

[undergroundpanther]

From the President
Big Pharma and American Psychiatry: The Good, the Bad, and the Ugly
Steven S. Sharfstein, M.D.


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.



http://pn.psychiatryonline.org/cgi/content/full/40/16/3

[flyingfysh]

1. psychiatric medications work

I have seen this first-hand. My stepson is bipolar and epileptic, and his current medication (which didn't exist a few years ago) is doing very well for him.

[undergroundpanther]

2. They work for SOME

Not all people. And some medicines can hurt you. I have been hurt by biomedical psych.Abilify damaged my colon. I never had hemorrhoids before now they are there and never go away. I think some medicines can help some people..You have to be careful and too many doctors have dollar signs in their eyes so they are NOT careful enough.(some newer drugs have not had the more rigorous testing that older drugs required since reagan and Bush and other re thugs have gutted the FDA of their credibility too much conflict of interests with FDA and Big Pharmacy now)..Ultimately it is the patient who needs to evaluate along with an HONEST doctor if a drug really IS helping them.And to STOP the drug if it causes ANY problems and try something safer or different,or no drugs.Doctors should not be accepting bribes to put patients on new expensive potentially dangerous drugs.

[wysi]

3. Many medications do work...

... but the most pressing issue is the general lack of psychosocial interventions for persons with a psychiatric disability. These exist, but are not often implemented, due to time and $$$ (which are pretty much the same thing when it comes to health care). Concentrating on medication only misses a big part of the problem for many people with a mental illness.

edited for language use

[wli]

4. profit motive = more involuntary commitment

Now there's involuntary outpatient commitment, involuntary medicinal commitment, etc. Don't doubt for an instant it will be heavily politically and heavily racially biased, and used as a yet another yoke of economic repression.