Dr. Dan L. Edmunds, Ed.D,B.C.S.A.,DAPA.

Dr. Dan L. Edmunds, Ed.D,B.C.S.A.,DAPA.
e-mail: batushkad@yahoo.com

Monday, April 09, 2007


In examining the issues related to the current state of the mental health system- we must ask ourselves can one truly be 'neutral'. The notion of 'neutrality' is a convenient stance as it allows us to remain ignorant and continue on a path even if it is an erring path. In reality, there are two sides to the coin in the mental health system- either one subscribes to the bio-psychiatric paradigm or one does not. The common abuses within the psychiatric system occurred when there was no individuals willing to speak out and take a stand. Actually, throughout history we will see some of the most grave attrocities arising from periods where individuals simply accepted the status quo and chose not to ask critical questions. It is necessary to be critical at times.
Individuals have personal freedom. One can choose to follow various conceptions. It is never my intent to take away personal choice and freedom.
The issue lies in informed consent. Many are unaware that alternatives do exist to the bio-psychiatric paradigm and are often unaware of such information as to the subjective nature of diagnosis, that black box warnings exist on anti-depressants discussing increased suicidal ideation, that the FDA has stated that stimulants can cause psychosis in some children, among other concerns. Should individuals be completely aware of these concerns and choose this avenue, this is their perogative.
It appears an ethical responsibility faced with these dangers, that parents should be informed of alternatives and also that these dangers exist.
In addition, I have seen a number of disturbing situations, for example parents seeking to obtain financial gain from having their child diagnosed and medication presctibed. The story of 4 year old Rebecca Riley comes to mind. This child's parents are now being charged with murder as they fabricated various symptoms which the psychiatrist did not question, was prescribed psychotropic drugs from which she later overdosed. Also, there have been situations where parents have disagreed over the means to address their child's needs. In these situations, it would appear the least restrictive option would take precedence, and this would be to utilize alternatives to psychotropic drugs and implement psycho-social approaches. Most would agree that a physical restraint is a restrictive option and should be avoided, so one must then ask why is it not equally valid to state that psychotropic drugs which are a chemical restraint should be avoided as well?
It is not to say that in certain situations that psychotropic medications could not have a place. If we can demonstrate through objective means that an actual physical abnormality exists, and that the individual is dangerous to self or others, it could be seen as valid for psychotropic medication to be incorporated, but even in this circumstance, this does not need to be permanent and certainly is not the solution to the challenges. Psychotropic drugs are never a cure for anything but mrely subdue certain behaviors. The long term use of such drugs as anti-psychotics actually increases the potential for the development of tardive dyskinesia, a permanent debilitating neurological condition.
Is what is 'mainstream' always correct? We must remember the days when cold, dark psychiatric institutions where electroshock and insulin coma were accepted practices. People were treated without dignity. This was the mainstream. Or we may look at various social injustices and inequalities throughout history which were part of the 'mainstream'- if there was no one to take a stand, there would have been no change to such inhumanity.
My stand has been simply this- that science must be equated with ethics, and that the experience of the individual must be heard not simply diagnosed.
Martin Luther King Jr. stated, "Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity."

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