Along with most mental disorders, bipolar disorder and schizophrenia are diagnosed far too often. From 1994 to 2003, the estimated number of children diagnosed with bipolar increased by more than 4000 percent in the United States according to patient records from the National Ambulatory Medical Care Survey.1 This is unprecedented. This increase is largely due to psychiatrists like Joseph L. Beiderman, Chief of Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at the Massachusetts General Hospital who popularized bipolar diagnoses in children. Beiderman secretly received $1.6 million from drug companies over the course of eight years,2 including $700,000 from Johnson & Johnson, the maker’s of the antipsychotic Risperdal to “research” (i.e. promote) it. The number of children diagnosed with attention deficit disorder (ADD) has also risen exponentially in recent years. But children who have trouble focusing in school are often under-stimulated and lack motivation and enthusiasm from teachers. The problem is not their brains. Propaganda in schools doesn’t help either. Children would also likely have less difficulty focusing if they weren’t bombarded with the constant stimulus of media outside of school. Children who act out for whatever reason are often pathologized as well in some other way by therapists, teachers, and principals who do not know how else to brand their behaviors.
Large pharmaceutical companies have no misgivings about getting kids addicted to amphetamines, bipolar drugs, and antipsychotics, whether they need them or not. There are a number of moral child psychiatrists, but pharmaceutical companies influence them as well. They can assure doctors and patients their medications are safe for children when they know they are not and receive few legal consequences for their lies.
As a whole, child psychiatry may be even more corrupt than adult psychiatry because children are easier to exploit. Their opinions often matter less to doctors, teachers, principals, parents, and courts because they do not have the same legal rights as adults and they are considered “too young to know better.” Child psychiatry also has a tendency to become more punitive when the parents are abusive and dishonest. Parents are expected to do what is best for their children, so abusive parents sometimes go undetected by therapists, teachers, and judges. Abused kids are also sometimes labeled as the “problem kids,” which leads to further punishment, punitive therapies and prescriptions, and negative cycles of behavior. To prevent this so long as there are governments, parents and other adults should not have so much legal power over their kids. Emancipation is only possible when children have the ability and money to apply for it. No one, regardless of age, should be “owned” under the law. Everyone should have bodily autonomy. Of course, parents may need to do something their infants don’t want to do for their health (like give them medicine for a congenital heart condition) but this should only be in emergency situations. and children should not be required by law to attend school either as schools often indoctrinate kids with propaganda and instill in them obsequiousness. When kids resist the various authority figures they subjected to they may be punished with punitive psychiatry or by police and the juvenile prison system. Resistance or opposition to authority is even classified as a mental disorder called the Oppositional Defiant Disorder by the International Statistical Classification of Diseases (ICD), as well as the Diagnostic and Statistical Manual of Mental Disorders. This is nothing but an egregious attempt to stifle critical thinking and dissent to illegitimate authority, and it ensures kids will grow up to be statist drones who never question authority.
The development of many children can look abnormal to some adults. But it is helpful to be mindful of the fact that we are all on our own paths, and sometimes pitfalls and bouts of depression or rebellion can be constructive. Most childhood phases are learning experiences that come and go. The brains of children are vulnerable as they are still developing, so psychiatric medication should be a last resort in all cases. It should only be prescribed if they have been informed about it honestly and they give consent.
As mentioned in previous sections, there are no medical tests for schizophrenia or bipolar disorder, aside from subjective, behavioral tests, and not one singular, organic cause has been found for them or any mental disorder. Only one doctor is needed to make these diagnoses, which are rooted in their personal biases and sometimes the opinions of other staff. These diagnoses often affect those given them for the rest of their lives, and some children are branded as schizophrenic before they even reach ten years of age.
Because schizophrenia and bipolar disorder can produce so many different symptoms, it is possible that they are not discrete disorders but are rather several disorders or just sets of behaviors. Most people with schizophrenia have less gray matter in their brains than average persons, but this may just be due to the widespread prescription of antipsychotics to those diagnosed, which can substantially reduce gray matter.
Another similarity among people with schizophrenia symptoms is many have been shown to have reduced default-mode network activity in the medial prefrontal cortex and greater frontopolar cortex activity while those with bipolar have greater activity in their parietal cortex . Those with bipolar disorder have also been found to have ventral medial prefrontal cortex abnormalities while those diagnosed with schizophrenia tend to have more abnormalities in the dorsal aspect of the medial prefrontal cortex.3 However, it is easy to find studies that show the opposite and something else entirely because the differences between those diagnosed tend not to be consistent.
Most mental institutions treat magical thinking as a symptom of mental “illness.” But religious beliefs are usually only considered magical thinking if they are very extreme or egocentric in nature, (e.g. beliefs about being or embodying a prophet or a God). However, when mentally troubled individuals are indoctrinated with religion, many predictably take their beliefs to these kinds of extremes. These extremes already exist in religious literature as well, so this is not surprising. Filling the heads of mentally troubled people with more magical thinking (religious or not) is not constructive. Some religious staff and doctors make genuine efforts to introduce religion as a way to help, but this is rarely helpful in the long-term.
Schizophrenia in practice is the catchall term used for people therapists cannot otherwise label, but those who exhibit schizophrenia symptoms are all different. Schizophrenia symptoms are often caused by years of trauma, abuse, or drug use, and the solutions need to be discussed with doctors, loved ones, and ideally with people who have overcome similar experiences.
“Mania” is the symptom of bipolar disorder that separates it from depression. Mania comes from the Greek word, μανία, meaning “madness,” and it is a state of elevated energy, mood, agitation, or sexual drive. Depressive episodes do not have to present with a manic episode for a diagnosis of bipolar disorder to be made, which may be another reason the diagnosis is made so often. Individuals can certainly suffer during episodes of mania and even become psychotic, but mania is not always unpleasant because it can increase a person’s creativity and productivity and even feel euphoric. “Manic depression” may just be a diagnosis used for people who are depressed, but who have normal, rare bursts of energy and productivity that are labeled as “mania,” thus pathologizing and stigmatizing the most potentially positive of their behaviors.
Every mental disorder is unique because every person is unique, and this has to be considered by psychiatrists, doctors, and psychologists. Patients ought to be seen as distinct individuals and their needs should be most important to therapists and doctors. When there is no existing label for the symptoms psychiatrists perceive, they often diagnosis these patients with “unspecified psychotic disorder” just to keep them institutionalized, medicated, or both. Unspecified psychotic disorder is an extremely vague label that is unhelpful for both patients and doctors. It is considered one of the thirteen subtypes of schizophrenia. Most of the categories of mental disorders also have similar subtypes termed “not otherwise specified,” which are used when patients do not fit the exact criteria for any disorder. This demonstrates the need for a more fluid conception of mental health and disorders. People should not be labeled and placed into rigid categories because behaviors can change and labeling gives those labeled the opposite impression.
The underlying problems that cause mental disorders are rarely identified or measured scientifically. Diseases that attack the brain like brain cancer can be, but disorders like depression are not diseases and they can be very abstract and fleeting. They do not have to be life-long. People with these disorders usually have unusual neurochemical activity, but the sources of these chemical differences can be very disparate. They can be external, inherited, or self-imposed. Identifying and discussing these sources is vital. Many disorders are just learned behaviors, and these behaviors can be improved and unlearned. For patients with severe emotional and physical trauma in their past or present, talking about these experiences and addressing them can be more helpful than any medication.
Antipsychotics prescribed to those diagnosed with schizophrenia are mostly dopamine antagonists. Dopamine antagonists bind to dopamine receptors, but do not activate them, blocking the dopamine agonist, which normally binds to receptors and causes neurons to fire, mimicking the neurotransmitter. Antagonists interrupt neuron signaling, thereby reducing the effect of the neurotransmitter. People with schizophrenia are prescribed these drugs because the dopamine hypothesis of schizophrenia speculates that schizophrenia is caused by an excess of dopamine due to signaling malfunctions triggered by environmental and genetic factors.
Individuals diagnosed with schizophrenia are still widely over-prescribed neuroleptics because when they are administered they become easier to control and subdue. Neuroleptics may have a temporary anti-psychotic or tranquilizing effect, but when administered for a long period of time the body adapts to antagonists by producing more receptors to compensate for the blocked receptors and increasing the sensitivity of existing receptors, which means dopamine over time will have a more powerful effect. This can lead to a malady of side-effects, which are often mistaken for worsening symptoms of schizophrenia and treated by doctors with more antipsychotics, resulting in a vicious cycle. This doesn’t just occur with anti-psychotics but with virtually all neurotransmitter antagonists.
Dopamine re-uptake inhibitors like cocaine and crack have essentially the opposite effect. (Technically, the opposite of a dopamine antagonist like an antipsychotic is a dopamine agonist.) They block the reuptake of dopamine in the synapses temporarily by binding to the transporter protein responsible for delivering it to the receiving neuron as more dopamine enters the synapse, thus increasing the concentration of the neurotransmitter in the synapse. But these drugs ultimately decrease dopamine levels in the synapses and receptor sensitivity to dopamine when addiction sets in as the body adapts to the excess of dopamine created by the drug. Some dopamine reuptake inhibitors may actually have a positive long-term effect on those with schizophrenia for this reason if long-term dopamine reduction is what they truly need, but this is very speculative. However, this (along with the temporarily alleviating high) may be why so many schizophrenics try to self-medicate with these drugs.
Most antipsychotics have high affinity for the D2 subtype receptor, which is one of the five major subtypes of dopamine receptors, but many antipsychotics can also bind to other dopamine subtypes, serotonin receptors, and various other receptors, which can produce a host of side effects. They can also cause many separate mental disorders like tardive dyskinesia, which is characterized by involuntary movements, twitching, and twisting of the limbs. Most of the negative symptoms of schizophrenia like avolition, flat affect, and lack of speech seem to be caused by the very dopamine antagonists used to “treat” it, and there are many other side effects of antipsychotics, which are far from minor. These include reduction of life expectancy, weight gain, loss of motor control, decrease in white blood cell count, neuroleptic dysphoria, (unhappiness or general malaise) neuroleptic malignant syndrome, and even tardive psychosis (although tardive psychosis is often referred to as “hypothetical” in most studies).4 Chronic use of neuroleptics can also lead to neuronal death, irreversible abnormalities in brain function, and large decreases in brain volume.5
Many doctors believe that schizophrenia is a neurodegenerative disorder, but this may not be the case. Most individuals with schizophrenia have smaller than average brain volume, but many only receive the diagnosis of schizophrenia after having been on antipsychotics for years, so these reductions in brain size may only be due to the medications themselves. In 2010 doctors Joanna Moncrieff and Jonathan Leo analyzed data from multiple studies on the subject and found that patients diagnosed with schizophrenia in every study who had never taken antipsychotics showed “no major differences in global cerebral, grey-matter, ventricular, or CSF (cerebrospinal fluid) volumes,” whereas patients who chronically used antipsychotics “showed a greater reduction in whole-brain, cortical or grey-matter volumes, or a greater increase in CSF or ventricular volumes, compared with controls” in 14 of the 26 MRI studies.6
About fifty percent of people diagnosed with schizophrenia have abused substances or are currently addicted7 and most (regardless of whether or not they use illicit drugs) are prescribed antipsychotics as well, so it is possible drugs of one form or another are the most common cause of schizophrenia symptoms, especially since the symptoms can be experienced by anyone. The symptoms of delusions and hallucinations also do not have to be present to be diagnosed with the disorder. The “positive”, “negative,” and “cognitive” symptoms of schizophrenia like avolition (inability to experience pleasure), disorder of thoughts or words, blunted or flat affect (reduced emotional response), poor executive functioning, catatonia (motionlessness or excess motor activity) and movement disorders like “facial grimacing” can all be produced by the very antipsychotics used to “treat” schizophrenia.
Drug addicts (especially stimulant addicts) and casual drug users who do not have schizophrenia are often incorrectly labeled as schizophrenic by doctors. Cocaine and amphetamine psychoses are considered separate mental disorders by the DSM. These drugs can cause severe psychosis, but it does not make much sense to identify temporary, drug-induced psychosis as a mental disorder. The DSM also classifies just about every illicit drug as a potential cause of psychosis and a “mental disorder.” Many drugs can cause psychosis but only at very high doses. Any drug can become poison at a high enough dose.
A number of therapists like Dr. David Healy, an Irish psychopharmacologist and author, have claimed that drug companies have tried to legitimize the dopamine hypothesis of schizophrenia (like the serotonin hypothesis of depression) in order to increase the sales of their poisonous drugs. The etiology of schizophrenia (if the disorder exists at all) is likely more complex than drug companies would have us believe. It is a poorly understood condition and the “quick-fix” of antipsychotics will likely be seen as egregious malpractice in the future. Electroconvulsive therapy (ECT), which is sometimes used in conjunction with antipsychotics, will likely be seen as medieval when less dangerous therapies become more common. Yesterday’s medicines are often considered barbaric by today’s doctors, especially in the West, but few consider current medications and treatments may be just as primitive as our older treatments. And there are many natural medicines that are ancient like cannabis, which are now being suppressed, despite their usefulness. Some individuals who have received ECT “therapy” have sued for consequent, significant brain damage and memory loss. Lobotomies are even more barbaric and it is unconscionable that they are still performed.
Before antipsychotics were invented lobotomies were common “treatments” for schizophrenia, and they still are used when patients do not “respond” to medication. The first lobotomy was conducted in 1935 and it was a very commonly used procedure for two decades in mostly developed, rich countries. Between 1939 and 1951, 18,000 lobotomies were performed in the United States alone.8
In my opinion, using a lobotomy to “cure” a mental disorder is much like trying to fix a TV set by smashing it with a hammer. It is one of the most crude, invasive, and amoral procedures to ever be used as a “treatment” for any condition and it is still used today for addiction and even mental disorders like depression and OCD, particularly in the US and the UK. The only reason lobotomies are supported by doctors is because they make patients easier to control like antipsychotics.
In 1948 MIT professor and author, Norbert Weiner, explained “Prefrontal lobotomy… has recently been having a certain vogue, probably not unconnected with the fact that it makes the custodial care of many patients easier. Let me remark in passing that killing them makes their custodial care still easier.” The most upsetting aspect of lobotomies is that victims may never know how they were affected by them. They might feel fine despite being drastically different, less intelligent, and suffering a host of other side-effects.
5.19 Rethinking Mental Disorders, Brain Diseases, their Relationship with Bodily Diseases, and For-profit Psychiatry
The mental health industry pathologizes not only normal human differences, but also normal human emotions. However, it is not sensible or realistic to expect only consistent emotions and complete rationality since the world is rarely sensible or rational. If we never question ourselves and attempt to understand why we are who we are and instead we just do what is most commonly accepted, we become complicit to the agendas of the institutions that control us.
Genetic differences in organisms furthers evolution. Those most fit for their environments survive. But we have left it up to people in power to decide which differences are beneficial, and they thereby have the power to direct the course of our evolution. They select what they perceive as “natural” behaviors and weed out the extremes while destroying the natural world.
In my opinion, real mental health can only be achieved by being fully in tune with the irrationality, harshness, and uncertainty in life, and not accepting easy answers. A healthy life includes a gamut of emotions and the pursuit of meaningful goals and balance. Generally, people who are in tune with the world’s unpleasant realities tend to act more uncommonly. But the most common behaviors are generally not the most socially or environmentally productive behaviors. When there are fewer human extremes and more uniformity in personality and identity, fewer people feel stimulated to change and improve.
Defining a mental disorder is difficult because mental health is subjective. As stated a disorder ought to be considered only an affliction that harms others or interferes with the quality of life of the person with it instead of a simplistic label for behaviors considered strange. Most mental disorders are not like illnesses that affect other parts of the body like viral infections or cancer, which can be physically seen and treated often using the same medications time and time again. Sometimes changes and abnormalities in the brain can be seen by using fMRIs, brain scans or microdialysis, but these technologies only provide a glimpse into an individual’s mental health.
Bodily illnesses like cancer cannot be treated with cognitive behavioral therapy (CBT) or by “thinking them away.” They are identified and diagnosed using medical instruments while mental disorders are not. A perfectly healthy, “sane” individual can fake the symptoms of any mental disorder and be admitted into a psychiatric “hospital” for life. But a person cannot “fake” high cholesterol or cancer. Most individuals with depression and other common disorders don’t receive tests to determine which neurotransmitters are too abundant or scarce or which receptors are overactive. Very unusual results alone are not enough to make a diagnosis anyway. Doctors cannot know exactly what is wrong (if anything) without talking to their patients extensively. The brain is just too complex for mental health to be summed up entirely by either current hard science or observational theory alone. Diagnosing a person with a mental disorder to explain a vague and broad set of observed behaviors and symptoms oversimplifies the human mind and the person being observed.
Therapists cannot view psychiatry as a way to “fix” minds because the problems patient have are often external rather than internal and the solutions involve bettering their environments to better themselves. Therapy should only be seen as a way to create health. There is also too much focus on the diagnosis of mental disorders rather than the reason for the diagnosis. Diagnoses of mental disorders stigmatize certain behaviors. They make those who are diagnosed overly aware of them, but behaviors are not the sole problems, just as drugs are not the sole problem for addicts. They are coping mechanisms. Until the causes of mental disorders in each specific case are addressed, the sufferers can only mask their symptoms or tone them down but not achieve real peace of mind.
Although mental disorders are sets of cognitive and physical behaviors, this does not mean they are all voluntary or always voluntary. Some are hard to control; some are easier to control, and some are impossible to control. But they are all just behaviors in the sense that they do not infect us. Someone diagnosed with depression is not “sick” with depression. A person could just look up that the sky and observe the universe and all of a sudden feel very alone. It doesn’t make sense to classify such transient moments as mental disorders. We shouldn’t expect constant happiness or consistent emotion because it’s just not reasonable. There is also a large difference between genetic depression and environmental depression. Depression can be a perfectly reasonable response to upset and tragedy and have nothing to do with genetic abnormalities. Labeling mental disorders “illnesses” can make those labeled feel these diagnoses are life-long and this serves the interests of drug manufacturers more than anyone else.
The pathologizing of normal human differences in psychiatry and psychology today can seriously hinder the minds of brilliant people. For example, creative geniuses be labeled so-called “schizoid” personalities that make their everyday functioning difficult, but their avoidance of social interaction and potential external criticism can also help them create brilliant works. While a lifestyle choice of isolation may not be very healthy nor enjoyable, it is ultimately a choice. “Schizoid” people can still positively affect other people to a great extent, despite their isolation.
People who are positive or negative outliers can teach us the most about what makes people be perceived as good or bad and strange or normal. They can be a product of social constructs or other underlying, broader problems, and recognizing these can help influence the most common behaviors and the zeitgeist. Positive and negative habits, lifestyles, and personal traits, unwanted and wanted, are too often grouped together and labeled as distinct mental illnesses when many are just changeable behaviors.
Social withdrawal, high sensitivity, and introversion are all symptoms of “schizoid personality disorder”. But these can be healthy qualities. They are traits only a minority has, but this doesn’t mean they are always detrimental. Dr. Nancy McWilliams wrote, “one reason schizoid people are pathologized is because they are comparatively rare. People in majorities tend to assume that their own psychology is normative and to equate difference with inferiority.”9 This is accurate and unfortunately, what is considered “normal” behavior right now, for the most part, is mostly destructive.
People can be diagnosed as “schizoid” without determining whether or not they prefer this lifestyle, which doesn’t make any sense. Having an active social life may be more healthy and enjoyable for most, but a person can also have many friends and still feel very alone. Short periods of isolation can also be very beneficial for most people. While the regular stimulus of other people can be grounding and comforting, if we are constantly stimulated by other people, we will have little time to reflect, look inside ourselves, and develop very unique identities. The point is we are all at different stages of development. Some need more time by themselves than others and some need or thrive from constant interaction, but no one lifestyle should be seen as the only healthy one. Lifestyles and behaviors also constantly change. One day a person may feel like an introverted hermit and the next feel like a convivial extrovert. Stigmatized or pejorative labels for behaviors can prevent us from improving our habits and lifestyles. These labels can make us believe that we are not capable of changing ourselves when we can.
One of the symptoms of the many mental disorders defined by the DSM is literally “unconventional beliefs” that go against “societal norms.” If unconventional beliefs are symptomatic of mental disorders, then every brilliant thinker who challenged societal norms should be considered ill. Einstein or Copernicus could be perceived as having been “ill,” and many who were dogmatically and diametrically opposed to them likely did them see this way. Unconventional beliefs are what change conventional beliefs. Without them, society would never change. As Karl Marx said, “the ideas of the ruling class are in every epoch the ruling ideas,” and this only keeps the ruling class in power. We should not assume that society will head in the right direction by conforming to societal norms that were created by a small group of people who never had public interest in mind. The institutions that control us define what’s normal. We do not collectively, but we certainly could.
The spectrum approach to mental disorders attempts to explain a broader variety behaviors and symptoms that can overlap. Because people with bipolar disorder, for example, are very different, a spectrum is used to describe more traits as bipolar. The word spectrum is better suited to describe mental health. Narrowly defined labels, on the other hand, often just reduce the self-esteem of those labeled, and unwanted behaviors can worsen and become more frequent as a result.
Another problem with traditional psychiatry is the approach, which can be likened to the observer effect in the field of physics. To detect an electron, light is needed to see it, but that very light changes its position. Similarly, doctors change the outcome (the patient’s behavior) by observing it. Knowing your behavior is being analyzed (especially if you are insecure about your behaviors or you are institutionalized and the decision to release you is contingent upon how you act) often leads to paranoia and anxiety. This anxiety can then be used to validate preexisting concerns and expectations doctors have, and ostensibly symptoms can worsen across the board as a result. Patients need to feel they are under no pressure, which is nearly impossible for any patient involuntarily committed. Even those admitted voluntarily are under the same amount of scrutiny if they are deemed a “danger” to themselves or others.
Modern psychoanalysis is also flawed because it is not intended to be a natural conversation, but more like an interview or an interrogation at a court room. It is very one-sided. It can be accusatory, demeaning, and condemning of perceived behaviors and thoughts. It is also not an equal trade. Many therapists do not exchange anything personal about themselves. They believe they should be “neutral parties” who are not emotionally invested, but as a human being it is impossible to be completely neutral. You can strive to be as objective as possible, but personal biases inevitably affect diagnoses and their recommended treatments, which is why they should be made open to patients. I believe it is incredibly important to know who your therapist is and what you have in common in order to establish trust and a beneficial patient-therapist relationship. Michael Foucault, a notable critic of psychiatry and mental institutions argued that the mental asylum is “not a free realm of observation, diagnosis, and therapeutics; it is a juridical space where one is accused, judged, and condemned.”
When patients have delusions, some doctors provoke them by asking questions that make them expand on their delusions. They provoke them to be more irrational and delusional, instead of asking why they believe in what they do and trying to help them adopt a more scientific perspective of the world. Therapists often make patients incriminate themselves by admitting to violent urges they have. This information is sometimes used against them in court, instead of being used to help control or curb negative urges or thoughts. For example, a former clinician at Salt Lake Behavioral Behavioral Health Center in South Salt Lake Utah explained in intake assessments clinicians are encouraged to ask those there for a free assessment, “If you had a plan, [to commit suicide] how would you do it?” The answer is then recorded as a plan, which is used in an attempt to justify holding them against their will for money.10 Another former intake worker at the health center added “People don’t understand. They think we’re going to diagnose them for anxiety or depression. Our goal is to admit them to the hospital.” Patients in mental hospitals should not have to worry about self-incrimination in their sessions because crime is not prevented by betraying the trust of patients. And so long as governments exist, self-harm and suicide should not be considered crimes.
Salt Lake Behavioral Center is owned by Universal Health Services (UHS), the largest chain of psychiatric hospitals in the country that made $6.96 billion in revenue in 2012 alone. 11 In 2013 more than half of all medicare claims by UHS were submitted on behalf of patients allegedly admitted for suicide ideation, 4.5 times the number submitted by hospitals not owned by UHS. UHS hospitals have been investigated and fined by the government numerous times. For example, after former therapists Megan Johnson, Leslie Webb, and Kimberly Stafford-Payne at UHS owned Keystone Marion Youth Center filed a lawsuit against UHS, the Department of Health and Human Services investigated the chain and found that between 2004-2010 UHS hospitals provided substandard treatment to adolescents, and misrepresented the UHS owned Keystone Marion Youth Center as a treatment facility for children who receive Medicaid when in reality it was a juvenile detention center. No medical director or licensed psychiatrist even directed psychiatric services there.12 The hospital also falsified records and provoked patients so that they could use their responses as excuses to keep them there for profit. UHS agreed to pay the government $6.9 million to resolve the fraud investigation and the Keystone Marion Youth Center was closed indefinitely. UHS settled out of court because they knew the courts would find them guilty of Medicaid fraud under the False Claims Act. Far from improving their practices, in 2013 the Department of Health and Human Services then subpoenaed 10 hospitals belonging to UHS.
UHS employees are encouraged to admit everyone with insurance who calls in to inquire about simple assessments. Karen Ellis, a former counselor at Salt Lake Behavioral explained “They keep track of our numbers as if we were car salesmen.” Lauren Singer, a former employee of UHS owned Colorado’s Highlands Behavioral said she would be chastised by higher-ups for telling those waiting to be assessed what the evaluation process entailed and explained “If someone came in voluntarily, I wasn’t allowed to let them out of the door.”
Additionally, staff from 15 UHS hospitals reported to Buzzfeed News that they were being instructed to keep patients who did not need to be held until their insurance provider was no longer willing to pay. One such hospital in Oklahoma has been overrun with riots. Three former heads of UHS hospitals claimed their divisional vice president, Sharon Worsham, reiterated: “Don’t leave days on the table.” Rick Buckelew, former head of UHS owned Austin Lakes Hospital in Texas explained “If an insurance company gave you so many days, you were expected to keep the patient there that many days.
Paul Sexton, former head of the UHS Highlands Behavioral in Colorado demanded to know why patients were released before the days their insurance providers agreed to pay were up and shamed doctors for doing so according to two former staff members. Five UHS hospitals, including Highlands, have been found by the feds to be violating regulations for keeping patients against their will without medical need and the proper documentation.13
Gayle Eckerd, the top executive of the UHS owned River Point hospital in Jacksonville, Florida told doctors that they needed to keep patients admitted for at least ten days because this is the length of time Medicare will pay. By 2010 70% of Medicare recipients admitted there stayed 10 days or longer. According to UHS’s own annual report of 2016, “Medicare and Medicaid revenues represented 32% of our net patient revenues during 2016, 34% during 2015 and 38% during 2014. Revenues from managed care entities, including health maintenance organizations and managed Medicare and Medicaid programs accounted for 56% of our net patient revenues during 2016, 54% during 2015 and 52% during 2014.” 14
In contrast, those who don’t have Medicaid, Medicare, or any insurance are released as soon as possible or not admitted at all since they usually cannot pay themselves. For example, Kevin Burns, a Florida resident diagnosed with schizophrenia and major depression was denied entry to UHS owned Suncoast Behavioral Health in Bradenton for this very reason and he subsequently went to Walmart, bought razors, and tried to kill himself. The hospital was fined a mere $1000 as a result.15 The hospital claims it denied him entry because he made threats to the staff but Burns denied this. He did have Medicaid but the last time he was hospitalized, eight of the 13 days of his stay were not covered by the insurance provider, which was the real reason he was refused entry.
One former UHS hospital executive explained his corporate superiors told him to lie to patients without insurance and explain they had no beds when they did as an excuse to deny them entry. Rebecca Palmer, a former employee at the Ridge Behavioral Health System in Lexington Kentucky and Suncoast Behavioral Health in Bradenton, Florida corroborated this, explaining that patients with health insurance were admitted even if the hospital was at capacity, using seclusion rooms and rubber mats as makeshift bedrooms when they ran out of beds, whereas those without insurance were regularly denied entry even when the hospital had plenty of beds. According to a review of UHS owned Hartgrove Hospital Mental.“The UIC reviewers were reliably informed by confidential sources that UHS Hartgrove officials had been routinely exceeding its licensed bed capacity since 2007 in an effort to maximize financial profit”16
According to a copy of the 2013 executive compensation plan, UHS staff is also rewarded financially at their hospitals for increasing revenue while improving patient care barely increases their pay. Most are understaffed and those hired are under-trained to increase profits. And complaints about under-staffing from corporate directors like Nancy Smith who resigned as a result are ignored. Multiple doctors at UHS hospitals reported to Buzzfeed News that they had so many patients that they could only meet with patients for a few minutes at a time.
UHS owned hospitals have even killed patients due to their negligence. The aforementioned Highlands Behavioral Center prescribed Carson Mangines, an opiate addict, with Fentanyl for “pain relief,” giving him multiple doses in short periods. Carson was found dead as a result from acute opiate toxicity and his family later sued the hospital. Refusing to ever admit to wrongdoing as this could compromise profits, UHS called the opiate prescription to Carson “appropriate” after his death, intimating it was appropriate to kill him.
Another way that mental hospitals can compound patients’ issues is by incessantly monitoring them. Most feel it is necessary for liability reasons to monitor and record all of their patients. The job of therapists is to get in their patients’ heads by using in-depth psychoanalysis, so it is understandable why some patients believe doctors have literally “entered their heads” with “recording equipment” or that their thoughts are being “broadcast.” Paranoid delusions and many symptoms of mental disorders are often created by mental institutions because patients have every reason to be paranoid and afraid. Some may develop irrational fears but usually because of very real dangers and intrusions of privacy as most mental institutions are not safe places and many patients are abused by the staff and other patients. But doctors define what constitutes paranoia and which fears are irrational or rational, as well as what is true and false. Patients are almost always considered less “reliable.”
One common symptom of schizophrenia is “delusions of grandeur,” which are delusions of extreme personal significance. These can be brought on by mental hospitals when they treat mental patients so differently than other people. Therapists in mental hospitals assume these roles as superior caretakers who decide their patients’ fates, much like prison wardens. Some of them assume these positions because they are narcissistic and power-hungry or they have what could be called delusions of grandeur.
Formally educated therapists in the Western hemisphere go to school to learn about traditional psychology, psychiatry, and basic medicine, but there is no requirement to learn about different ideologies, cultures, and the psychologies of the people apart of them. This makes it difficult for some to understand those who have lived extremely different lives. Their conception of normative psychology is too limited. For example, a happy, rich, Harvard graduates who has never had any major mental problems is not likely to understand (much less relate to) an institutionalized, crack addict diagnosed with schizophrenia and PTSD. The two individuals would not likely have much common ground, but the therapist may say the patient has delusions of grandeur if he or she ever insinuates to know more about his or her own disorder.
In an ideal voluntary mental facility or community, patients would not be constantly monitored, dehumanized and they would be allowed as much personal space as they please. Doctors, nurses, and especially owners and executives of these facilities could be monitored the most by independent agencies and patient advocacy groups to prevent abuse. There would be a greater focus on the improvement of interpersonal skills and relationships, and doctors would actually listen to patients and try to learn from them. Patients could also be offered a variety of courses on a range of subjects to facilitate independence.
Perhaps most importantly, no one should ever be held against their will for “treatment”, even if suicidal, because everyone has the right to choose to live and die. So long as governments exist, patients should also have the same Miranda rights (right to free counsel, right to remain silent, and so on) that suspects of crimes have immediately when admitted involuntarily or even voluntarily for an evaluation. If patients feel they are being persecuted and doctors are not listening, they have every right to remain silent.
One of the largest problems with psychoanalysis and psychiatry discussed in this book already is that it’s a for-profit, capitalist industry. Very few mental health counselors are willing to work not for profit and therefore therapists have a financial incentive to keep their patients unhappy and reliant on them to keep them coming back. Friends, family,and significant others can be a much better source of support and advice because those relationships are ideally built on mutual respect and love. Relationships are two-way streets, whereas the client patient “relationship” only exists because the client has the money to afford it and the client is the only party sharing anything personal. A complete overhaul of the mental health sector is necessary. It would function best as a not-for-profit sector that employs very open-minded, patient-driven approaches that allow for all different types of people to prosper and grow based on their own wants and needs
1 Moreno C. et al. National Trends in the Outpatient Diagnosis and Treatment of Bipolar Disorder in Youth. JAMA. <https://www.ncbi.nlm.nih.gov/pubmed/17768268> September 2007. Print.
2 GARDINER HARRIS and BENEDICT CAREY: Researchers Fail to Reveal Full Drug Pay. The New York Times. June 8, 2008. <<www.nytimes.com/2008/06/08/us/08conflict.html>>
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4 https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml and https://ajp.psychiatryonline.org/doi/10.1176/ajp.161.10.1925-a
5 Glenn T Konopaske, et al: Effect of Chronic Exposure to Antipsychotic Medication on Cell Numbers in the Parietal Cortex of Macaque Monkeys. Neuropsychopharmacology journal. Ocotber 25, 2006. <<https://www.nature.com/articles/1301233>>
6 Joanna Moncrieff and Jonathan Leo: “A Systematic Review of the Effects of Antipsychotic Drugs on Brain Volume.” Psychological Medicine, September, 2010. Journal.
7 Brady, KT. and Sinha R.: Review of Co-occurring Mental and Substance Abuse Disorders: The Neurobiological Effects of Constant Stress. AM J Psychiatry, August 2005. Print.
8 Thomas G. Plante Ph.D.: Abnormal Psychology Across the Ages. Praeger. 2013.
9 Mcwilliams: Psychoanalytic Diagnosis, Second Edition: Understanding Personality. The Guilford Press, 2011. Pg. 196. Print.
10 Rosalind Adams: Locked On The Psych Ward. BuzzFeed. December 7th 2016. <<https://www.buzzfeed.com/rosalindadams/intake?utm_term=.uaDaA7JNy#.cm8Mg04Ld>>
12Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2012. The Department of Health and Human Services and The Department of Justice. February 2013.<<https://www.justice.gov/sites/default/files/dag/legacy/2013/02/12/hcfacreport2012.pdf>> (page 33)
16 Review of UHS Hartgrove Hospital Mental, pg 25. Mental Health Policy Program. Department of Psychiatry University of Illinois at Chicago. 2011.