On February 11th and 12th, 54 mental health experts from 13 states, including 22 psychiatrists met in Portland Oregon to begin developing ‘medication optimization’ protocols and national and state policy reforms to help improve mental health care outcomes. Two days of discussion cited research from recent articles and books indicating that medications work well for some people, but that many who are diagnosed with bipolar, schizophrenia, and depressive disorders are not served well by medications over the long term.

The gathering included psychiatrists with teaching affiliations at Harvard University as well as Beckie Child, Director of Mental Health America of Oregon and Dr. Daniel Fisher of the National Coalition for Mental Health Recovery and international consumer activist Will Hall.

“Attendees were clear that our systems of mental health care have become too medication focused, and it’s time for a broader approach. History will show that this national shift began this weekend in Portland, Oregon.”

Robert Whitaker, science journalist, catalyst and author of the Anatomy of an Epidemic was a guest of the Symposium. The Anatomy of an Epidemic compiles evidence showing that the number of individuals with disabling mental illness has more than doubled in two decades, despite the dramatic increase in our nation’s use of psychiatric medications by both children and adults.

An Opinion piece by Dr. Stefan Kruszewski on ABC News , recommends that physicians follow the precautionary principle of medicine: prescribing less drugs may improve outcomes: "Excessive Pills, Overtreatment, May Do More Harm Than Good"

"With a few exceptions, when physicians talk, they recommend. Take this. Try that. They satisfy theexpectation that automatically comes with a patient’svisit or phone call. The physician is compelled tomake a recommendation — a pill, a device or aprocedure. Both the physician and medical supplierfinancially benefit. But is your doctor’s advice alwaysin your best interest?"

"Not always. In a 2000 JAMA publication, Julie Magno Zito of the University of Maryland and her coauthorsstated that there had been an explosion in psychotropic prescriptions for pre-schoolers withoutadequate safety and long-term studies and generallywithout FDA approvals. Dr. Joseph Coyle of HarvardMedical School editorialized on this "troublingchange in practice." Likewise, in a 2001 JAMA article,Dr. Chunliu Zhan of the Agency for HealthcareResearch and Quality and his colleagues found thatAmerican elderly patients are often overly andinappropriately medicated. And, there are medicalerrors. Reports from the Institute of Medicine and HealthGrades indicate that there have been 400,000 to 1.2 million error-induced deaths in the United States from 1996 to 2006."

 

Vera Hassner Sharav