Wolves in Sheep’s Clothing

Thu, 14 Aug 2003

Dr. Sally Satel, a psychiatrist whose ready access to the national media gives her greater than ordinary influence with public health policymakers, has been described as “a conservative ideologue in a doctor’s white lab coat.”

In his review of her book, PC,M.D., Dr. Ivan Oransky wrote: “Satel is trying to wrest control of medicine back from patients, whom she sees as ignoramuses who can’t possibly know what’s good for them. Big, paternalistic government is bad, according to conservatives, but paternalistic medicine is evidently good, according to Satel, who doesn’t seem troubled by the contradiction between diminishing patient autonomy and encouraging patients to take responsibility for their own healthcare. She’s arguing for a remarkable sort of paternalism." [http://www.mediatransparency.org/people/satel.htm ]

Indeed, Satel actively promotes legislation to allow the state to force “treatment” for mentally ill people (ie., psychotropic drugs). In the latest in a series of articles this year, in The National Review, Satel joins forces with Mary Zdanowicz, a lawyer (who is the executive director of Treatment Advocacy Center (TAC) an organization that lobbies state legislatures to enact forced treatment laws. Their strategy is to manipulate crime rate statistics and insinuate that crime rates would appreciably decrease if mentally ill people–who have not committed a crime–were stripped of their human rights and forced to swallow toxic drugs.

Satel and Zdanowicz fault the President’s Commission on Mental Health Report for its emphasis on recovery and for not recommending a coercive approach to force patients into submission. They justify their coercive approach by stating: “The problem with the recovery vision is that it is a dangerously partial vision. It sets up unrealistic expectations for those who will never fully “recover,” no matter how hard they try, because their illness is so severe. What’s more, exclusive emphasis on recovery as a goal steers policymakers away from making changes vital to the needs of the most severely disabled.”

The President’s Commission calls the current system “dysfunctional” recommending that how, what, and by who mental health care is to be delivered should be “fundamentally transformed.” “In a transformed system, consumers and family members will have access to timely and accurate information that promotes learning, self-monitoring, and accountability. Health care providers will rely on up-to-date knowledge to provide optimum care for the best outcomes.”

The system is imprisoned by a rigid medical model which is neither supported by science nor a demonstrable track record of accomplishment. The tragedy is that the system–which is fixated on psychotropic drugs which are prescribed indiscriminately in drug “cocktails”– impedes rather than promotes recovery. And the cost of drugs is bankrupting he current mental health system. [http://www.boston.com/dailyglobe2/173/business/Cost_and_consequence+.shtml https://ahrp.org/infomail/0603/24a.php

Among the crucial facts not mentioned by Satel and Zdanowicz: the drugs they would force mentally ill people to take are NOT safe. While antipsychotic drugs may help some patients for short term use, these drugs have not turned out to be the solution for mental illness. They are not effective as has been widely claimed. For that reason, they are mostly prescribed in multiples–“cocktails”–which contradicts good medical practice. In many cases, the drugs’ action has been more harmful than beneficial. Withdrawal symptoms are so severe they can precipitate self-harm and harm to others. These drugs have induced chronic, debilitating, physical illnesses–such as liver damage, elevated cholesterol, diabetes, even after short term exposure, acute mental anguish–agitation which (in some cases) has led to uncharacteristic, violent, even murderous outbursts.

If the doctors were competent and humane and the treatments were effective– force would not be necessary. The heartless approach of these “advocates” brands people with mental illness as a menace to the community, in order to justify coercive measures.

There is a saying, “with friends and advocates like these, you don’t need enemies…”

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President’s New Freedom Commission on Mental Health Achieving the Promise: Transforming Mental Health Care in American http://www.mentalhealthcommission.gov/reports/Finalreport/toc_exec.html

Commission’s Omission The president’s mental-health commission in denial By Sally Satel & Mary Zdanowicz National Review Online July 29, 2003 http://www.nationalreview.com/comment/comment-satel-zdanowicz072903.asp