Junk Science Hits Front Page Headlines: Most Americans Will Be Mentally Ill at Some Point – NIMH / Harvard Study Says
Tue, 7 Jun 2005
Americans may be astonished to learn that $20 million in taxpayers’ money was spent on a study whose unacknowledged purpose is to increase the use of psychotropic drugs.
The study, called the National Comorbidity Survey Replication, found that the United States ranks No. 1 globally for mostly overlooked mental illness. This study was conducted jointly by Harvard and the National Institute of Mental Health (NIMH). It is part of an orchestrated effort by Big Pharma, the government (i.e., the New Freedom Commission on Mental Health report), and the psychatric establishment, to screen the nation for hidden mental illnesses.
Demonstrating Big Pharma’s insidious influence at our nation’s premier medical research institutions, the study’s primary sponsor, Dr. Thomas Insel, director of the NIMH said: “The key point to remember is that mental disorders are highly prevalent and chronic.” According to the study, “Younger sufferers are especially overlooked, the survey found, even though mental illness is very much a disease of youth. Half of those who will ever be diagnosed with a mental disorder show signs of the disease by age 14, and three-quarters by age 24. But few get help.”
Translation: detection of chronic mental disorders will require chronic treatment to enrich the pharmacuetical industry and mental health professionals at taxpayers expense.
Dr. Paul McHugh, former chairman of psychiatry at Johns Hopkins University, and a member of the President’s bioethics commission, scoffed at the claimed findings:
“Fifty percent of Americans mentally impaired – are you kidding me?” Dr. McHugh noted the flawed diagnostic tool that psychiatry relies on: “the problem is that the diagnostic manual we are using in psychiatry is like a field guide and it just keeps expanding and expanding.” “Pretty soon,” he said, “we’ll have a syndrome for short, fat Irish guys with a Boston accent, and I’ll be mentally ill.”
One wonders whether Congress will buy into this contrived effort to divert public budget allocations to enrich the mental health industry. The declared mental health epidemic in the US is an irresponsible marketing ploy whose veiled purpose is to encourage increased chronic use of mind-altering prescription drugs whose hazardous effects pose a threat to the health and safety of the community.
The drugs-psychostimulants, antidepressants, and antipsychotics-induce severe hazardous effects in some who take them. The hazards often exceed the symptoms for which they are prescribed. They include: insomnia, mania, agitation, akathisia (i.e., excruciating physical and psychological restlessness), sexual dysfunction, violent outbursts, liver damage, diabetes mellitus, and potentially fatal effects, including cardiovascular damage, NMS, stroke, violent suicidal /homicidal acts, not to mention they retard children’s growth.
NIMH director, Dr. Insel, indicated that “mental disorders are highly prevalent and chronic.”
But prevalence and chronicity are correlated to widespread use of psychotropic drugs in the US. A body of evidence shows that chronic use of psychotropic drugs–including psychostimulants, SSRI / SNRI class of antidepressants, and the most dangerous drugs of all, the antipsychotics–results in drug dependency.
If the NIMH-Harvard study is taken seriously and we accept its claim that most of the US population is mad, the credibility of our leaders and our national policies will be the butt of international ridicule.
Contact: Vera Hassner Sharav
THE NEW YORK TIMES
June 7, 2005
Most Will Be Mentally Ill at Some Point, Study Says
By BENEDICT CAREY
More than half of Americans will develop a mental illness at some point in their lives, often beginning in childhood or adolescence, researchers have found in a survey that experts say will have wide-ranging implications for the practice of psychiatry.
The survey is the most comprehensive in a series of censuslike mental health studies undertaken by the government. The findings of those studies are frequently cited by researchers, advocacy groups, policy makers and drug manufacturers to emphasize the importance of diagnosing and treating mental illness.
The earlier, less comprehensive surveys, which were published in 1984 and 1994 and which also found a high prevalence of mental illness, came under attack on the ground that they defined mental illness too broadly. Now, experts say, the new findings are sure to renew debate about whether mental illness can be reliably distinguished from garden-variety emotional struggles that are part of any life.
Dr. Thomas Insel, director of the National Institute of Mental Health, the primary sponsor of the study, said in a conference call with reporters, “The key point to remember is that mental disorders are highly prevalent and chronic.” The study, Dr. Insel added, “demonstrates clearly that these really are the chronic disorders of young people in this country.”
On the other side are psychiatrists who say they believe that the estimates are inflated. “Fifty percent of Americans mentally impaired – are you kidding me?” said Dr. Paul McHugh, a professor of psychiatry at Johns Hopkins University. While the new survey was carefully done, Dr. McHugh said, “the problem is that the diagnostic manual we are using in psychiatry is like a field guide and it just keeps expanding and expanding.”
“Pretty soon,” he said, “we’ll have a syndrome for short, fat Irish guys with a Boston accent, and I’ll be mentally ill.”
The report comes amid debate about whether adults and children should be screened for mental disorders, and where the line between illness and health should be drawn. The answers will have an enormous effect on who receives treatment and which disorders are covered by insurance.
The $20 million survey, which in addition to the government financing received some support from health research foundations and pharmaceutical companies, appears in a series of four papers in the June issue of The Archives of General Psychiatry. The investigators arranged face-to-face interviews with a broad cross section of 9,282 Americans ages 18 and over, and the interviewers asked the participants whether they had experienced periods of extended sadness, alcohol or drug abuse, irrational fears or a host of other symptoms. If so, the interviewers probed more pointedly about the episodes, asking how long they lasted and how they affected the participants’ behavior.
People who described symptoms that met criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual were classified as having had a mental disorder.
As expected, the researchers found that the most common problems were depression, affecting about 17 percent of the people at some point in their lives, and alcohol abuse, affecting 13 percent. Phobias were also common, including social phobia, a form of extreme anxiety that affected 12 percent.
More than a quarter of those interviewed had had a mental disorder in the last year.
Of those people who had suffered from a mental illness at some point in their lives, most developed the problem at a young age. Mood disorders like depression typically first struck people in early adulthood, in their 20’s or early 30’s. But impulse-control problems like attention deficit hyperactivity, and anxiety problems like phobias, usually started far earlier, often by age 11.
Dr. Ronald C. Kessler, a professor of health care policy at Harvard Medical School, was the lead author of the survey, and was joined by a team of researchers from other universities and from the National Institute of Mental Health. Dr. Kessler said the rates of illness found should not be surprising.
“If I told you that 99 percent of Americans have had a physical illness, you wouldn’t blink an eye,” he said in an interview. “The fact is that there is a very wide range included here, with the equivalent of many psychiatric hangnails. We don’t want to demonize those, but we don’t want to trivialize them, either, because we know in many cases they lead to serious problems later on.”
The investigators also asked the study participants about treatments, and found mixed results. Although people were more likely to find care than they were 10 years ago, only a third of the treatments met even minimal standards for effectiveness, said one co-author, Dr. Philip S. Wang, an assistant professor in the department of health care policy at Harvard.
Study: U.S. Leads In Mental Illness, Lags in Treatment
By Rick Weiss
Washington Post Staff Writer
Tuesday, June 7, 2005; A03
One-quarter of all Americans met the criteria for having a mental illness within the past year, and fully a quarter of those had a “serious” disorder that significantly disrupted their ability to function day to day, according to the largest and most detailed survey of the nation’s mental health, published yesterday.
Although parallel studies in 27 other countries are not yet complete, the new numbers suggest that the United States is poised to rank No. 1 globally for mental illness, researchers said.
“We lead the world in a lot of good things, but we’re also leaders in this one particular domain that we’d rather not be,” said Ronald Kessler, the Harvard professor of health care policy who led the effort, called the National Comorbidity Survey Replication.
The exhaustive government-sponsored effort, based on in-depth interviews with more than 9,000 randomly selected Americans, finds that the prevalence of U.S. mental illness has remained roughly flat in the past decade — a possible glimmer of hope given that previous decades had suggested the rates were gradually rising.
But the rest of the news from the survey — which did not include some of the most serious disorders, such as schizophrenia, for which patients are often institutionalized — is mostly discouraging.
Less than half of those in need get treated. Those who seek treatment typically do so after a decade or more of delays, during which time they are likely to develop additional problems. And the treatment they receive is usually inadequate.
Younger sufferers are especially overlooked, the survey found, even though mental illness is very much a disease of youth. Half of those who will ever be diagnosed with a mental disorder show signs of the disease by age 14, and three-quarters by age 24. But few get help.
Many factors contribute to these failings, the reports conclude, including inattention to early warning signs, inadequate health insurance and the lingering stigma that surrounds mental illness.
“The system has to get its act together to get its quality of care up,” Kessler said.
Thomas Insel — chief of the National Institute of Mental Health, which funded the $20 million study — said the nation needs to recognize that mental illness is a chronic condition that requires expert medical attention just as heart disease, Alzheimer’s and diabetes do.
He said he was disappointed to learn from the survey that despite the availability of effective treatments for many mental illnesses, including depression and anxiety, about a third of people in need rely solely on nonprofessional sources such as Internet support groups and spiritual advisers.
“You wouldn’t rely on your priest for treatment if you had breast cancer,” Insel said. “Why would you go to your priest for a major depressive disorder? These are real medical and brain disorders, and they need to be treated that way.”
Mental health surveys have been conducted nationwide since the 1940s, but they offered only crude measures until 10 years ago, when the first National Comorbidity Study was performed. That highly structured survey asked questions specific enough to provide an accurate diagnosis for a wide range of mental disorders.
The study’s 10-year follow-up, described in four reports in the June issue of the Archives of General Psychiatry, goes further by measuring, for the first time, the severity and persistence of people’s mental illness and the quality of their treatment.
The survey, conducted by the University of Michigan, included 9,282 households selected at random in 34 states. Nearly 300 trained interviewers traveled about 8 million miles over a year and a half. They knocked on doors at all hours of the day and night to ensure they would not systematically miss alcohol abusers who spend their days at bars, people with depression who can go weeks hardly able to pull themselves out of bed and people with social phobia who only rarely answer the doorbell.
The interview notes were uploaded to a central repository for analysis by psychiatrists and other health professionals at Harvard Medical School.
The survey focused on four major categories of mental illness: anxiety disorders (such as panic and post-traumatic stress disorders); mood disorders (such as major depression and bipolar disease); impulse control disorders (such as attention-deficit/hyperactivity disorder); and substance abuse.
Almost half of Americans meet the criteria for such an illness at some point in their lives, the survey found. Most cases are mild and probably do not require treatment. But every year about 6 percent of adults are so seriously affected that they cannot perform even routine activities for periods averaging three months. Because schizophrenia, autism, and some other severe and relatively common disorders were not included, actual prevalence rates are somewhat higher, Kessler said.
Comorbidity — the simultaneous occurrence of two or more illnesses — is common, the survey found. Nearly half of people with one mental disorder met the criteria for two or more. That’s a problem because mental health services are usually geared toward one illness or another.
“Our findings highlight the importance of integrating treatments, of treating the people instead of the disorder,” said NIMH investigator Kathleen Ries Merikangas.
The fraction of the population treated for mental illness over a 12-month period has grown to 17 percent from 13 percent a decade ago — a sign, perhaps, that advertisements for antidepressants and other drugs are working, and the stigma of being treated is decreasing.
But most of those affected receive either no help or are being treated by nonmedical providers or nonspecialists, whose care typically fails to meet minimal standards of adequacy, Kessler said.
It is not clear why Americans have such high rates of mental illness, but cultural factors clearly play a role. Immigrants quickly increase their risk of mental health problems, especially if they do not live in native ethnic communities. Minorities also tend to have lower levels of mental health problems despite lower economic status, suggesting that the social support they provide each other is protective.
C 2005 The Washington Post Company
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