Wednesday, 15 July 2015

the dominance of biological psychiatry in Dundee: pushing ECT on female patients; polypharmacy; NMD - going backwards not forwards

Here is an Email I've just sent to psychiatrists and nurse lecturers in Dundee, 14 July 2015:

Strapline: the dominance of biological psychiatry in Dundee: pushing ECT on female patients; polypharmacy; NMD - going backwards not forwards

ACING page of Dundee Advanced Interventions Service website

"Dear Psychiatrists and Nurse Lecturers in Dundee

I am writing to you with my concerns about the dominance of biological psychiatry in Dundee which results in the pushing of ECT on to patients, particularly women.  The polypharmacy used in Carseview Centre to "manage" the patients and the rooms set aside in Ward One for NMD or brain surgery for mental illness.  (I am continually being scapegoated, excluded from stakeholder groups for not toeing the line and doing what I'm told so have to agitate from the outside)

I know that female patients are being pressurised to have ECT when in Carseview as if it was the best thing since sliced bread.  I know this because I've heard it from the patients and from the nurses who say they would have it if mentally unwell (huh I don't believe it).  It makes me very angry to hear this because I believe, along with the feminist academic Bonnie Burstow, Ontario, Canada, that ECT is the "gentleman's way to batter women".  Strong words but with truth in them.  I speak out from experience, having avoided ECT in 1978, Hartwoodhill, by running out of the ward in my pyjamas, supported by my husband.  Female patients were queuing up for it back then, asking for it.  By 1984 there wasn't the same push for ECT.  Although in Carseview and maybe Tayside the push is still there.  ECT which causes memory loss and brain cell damage, like a knock on the head, new pain for old.

As you will be aware, I have a page on my main blog devoted to Dr Christmas's MD NMD thesis where I am slowly but surely working my way through the 421 or so pages with a critical and opposite viewpoint.  That ECT/NMD does not "save" lives and that psychiatrists are not gods.  (I lump shock treatment and brain surgery together because they are inter-related, brain focused)  Death is inevitable and psychiatry hasn't managed to halt the dying process even if some psychiatrists are deluded into thinking they have the power over life and death. 

I am very annoyed at the cocktails of psychiatric drugs used in Carseview on patients, in the IPCU and in the other wards.  I met twice with Dr Gupta to challenge this way of working and he said that their use of polypharmacy was "historical".  In other words they have always done it that way, I suppose he meant.  The psychiatrists continually over-prescribe psychotropic drugs to vulnerable mental patients.  If they have a side effect with one drug then they give the patient another drug for the side effect which in turn produces more side effects.  Soon the patient is disabled and asking for a depot injection because they can't manage the proliferation of pills they are told to swallow.  It's disgraceful and makes me very angry, and upset, to hear people having to be injected with drugs.  Being disabled by the system.  For no good reason.

If the drugs don't work then the drugs don't work, to alleviate mental distress or side effects from other drugs.  Stop pushing drugs onto patients and disabling them, which for some people, if they don't take away the anguish, makes them desperate enough to ask for brain surgery to relieve the suffering.  It's all about the pain but doing more damage to the person, invading their body and brain, cannot be the best way of doing things.  It's a downward spiral for some people towards ever more invasive treatment which is risky and irreversible.  Why should some people have to bear the brunt of a failed drug paradigm?  The mantra of mental illness used as a smokescreen to cover the fact that the drugs don't work.

I've always known the game was a bogey, that mental illness was a psychiatric construct to cover the failures in the paradigm.  Because of the way that my mother was treated in Murray Royal Hospital in the 1950's and 1960's.  She got the same treatment as everyone else.  Forced ECT, many courses of it, and no doubt also Chlorpromazine which came in around 1952, the year I was born.  Which meant my mother always resisted going into the mental hospital.  The family were distressed at having to send her there because there were no other options available.  And the same is still true.  Biological psychiatry, forced drug treatment or nothing, if you experience altered mind states, psychoses, due to the pain of life.  In 60yrs of psychotropic drugs we are no further forward, in fact have gone backwards if having to yet again resort to fiddling in the brains of mentally distressed people. 

I escaped lifelong mental illness prognoses by not believing a word of it even if the disorder label (schizoaffective) still sits in my notes to mark me out, to stigmatise and discriminate against me.  I escaped mental illness 3 times and it was easier back in 1978 and 1984 to leave psychiatry behind.  I was even helped by a community psychiatrist who came to my house in 1985, Rigside, Lanarkshire, supporting me in my plans to taper the Chlorpromazine and be off it within the year.  Because I was determined to do it, had done it after the earlier puerperal psychosis.  But in 2002 I was eventually made to take a drug cocktail of Risperidone, Venlafaxine and Lithium.  There was coercion because of my lack of agency due to antipsychotics being forced on to me in Lomond Ward, Stratheden, the week I was a mental patient in around March 2002.  A 72hr detention because I was resistant.  They forced me and took away my agency.  It took me around 2yrs to get back the strength to taper and make a full recovery.

Prof Ian Reid (I called him the king of ECT) used to say to me that my family was "different", in terms of my recovery and others in my family recovering from mental illness.  But I think that's a cop out, as if the exception proves the rule or "the exception confirms the rule in cases not excepted".  I maintain that my recovery in 2004 was due to the fact that I didn't believe in mental illness and got off the drugs under my own steam.  Because they were disabling me.  I have a 6in metal plate in my right fibula because of Venlafaxine, being on maximum doses in my 50's, causing bone loss.  That drug also caused me suicidal impulse, I swallowed a bottle of them at one point and was rushed to Ninewells in an ambulance on oxygen.  I had never before in my life been suicidal, or since.  A very scary side effect.  I hold psychiatry responsible for not alerting me to the dangers of this antidepressant. prior to being prescribed them.

It is way beyond time that we looked for alternative ways of working with people in mental distress that doesn't just mean forcing drugs into them, prolifically, using nurses to do the business at the sharp edge.  Nurses are people too and should be trained in a range of skills so as to engage with patients in distress, to have time to listen and to be with the person/patient, rather than just be enforcers of drugs.  That is demeaning to the nursing profession in psychiatric settings.  They, along with the people they treat, are being dehumanised in the process.  It is not fair on them or on us, the people accessing psychiatric inpatient treatment and the carers, family members, having to pick up the pieces.

I want to see Dundee psychiatrists and nurse lecturers consider ways in which they/you might start to shift the paradigm, and the focus, away from drugs and towards a range of therapies so that there is no recourse to either ECT or NMD. Reducing the "unmet need" by tackling the issue at the root rather than at the stem or fruit.  It's a matter of getting your heads together and redesigning the process, involving critical voices and sceptics, so as to be ahead of the game and focusing on the whole person not just their brain.

I hope this helps in changing the discourse or at the very least brings some light into the discussions.
Yours faithfully,


'More Harm Than Good: Confronting the Psychiatric Medication Epidemic' Conference 18 September 2015 London:

"The Council for Evidence-based Psychiatry invites you to join global leaders in the critical psychiatry movement for a one-day conference which will address an urgent public health issue: the iatrogenic harm caused by the over-prescription of psychiatric medications. 

There is clear evidence that these drugs cause more harm than good over the long term, and can damage patients and even shorten their lives. Yet why are these medications so popular? What harms are they causing? What can be done to address the problem."


blog post 20 April 2015: Dear Prof Matthews: why are female patients in Carseview Centre Dundee being put under pressure to have ECT? (no response from the Professor, yet)

on Mad in America 8 December 2014: Spearheading Doctors and the Re-introduction of Electroconvulsive Therapy for Children


blog post 6 September 2014: Tayside Carers Support Project (Support in Mind Scotland) Newsletter with ECT piece

my comment: "Electroconvulsive Therapy is a contentious treatment because it consists of an electric shock to the brain, performed under anaesthetic, causing a fit to the person, and doctors still don't know how it works.  And it doesn't cure anything, rather it causes short term memory loss and also longer term memory loss for some people."

blog post 1 September 2014: Dear Support in Mind Scotland please present a balanced view of ECT and try not to be patronising 

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