Troubling discrepancies in Rosenhan's “On Being Sane in Insane Places”?

>>Anon84+(OP)
The United States' mental health system feeds itself with its palliative approach. As bad as the system might have been 50 years ago, in Rosenhan's time, I'm sure it's much worse today, on account of 50 years of development of non-helpful drugs. For example, one of my sources says that each generation of anti-depressants was less effective than the generation that preceded it. The MAOI's were reasonably-effective for short-term use [2], but fell from favor as their patents expired. Their replacements were less effective, but patent profits paid for drug companies to promote them to doctors. The SSRI's are the least-effective of all. Second-generation "atypical antipsychotics" aren't appreciably better than first generation antipsychotics, and in some cases are actually much worse (some of the latest and greatest antipsychotics, which are actually anti-serotonin drugs, might be worth using on a very-short-term basis).

Robert Whitaker says that 20th century psychiatric medications take what would have been an episodic condition, and make it chronic [0][1].

There are now vastly more people who need help than capacity to help them. I've recently come to appreciate that we have a bifurcated approach. People who have no one to advocate for them get a catch-and-release treatment, because the holding tanks can only hold people for a few days before they have to be transferred for involuntary evaluation or released to the street. Those with an advocate are given priority.

In my state, the process for helping people who don't realize they need help goes 48-hour hold -> involuntary evaluation (3 days max) -> filing of petition for court-ordered treatment (weeks and weeks).

My friend got the catch-and-release treatment once. She'd escaped from her involuntary treatment program, where her ability to control her alcohol intake (the actual cause of her condition) was not helped by the palliative psychiatric drugs she was forced to take. She did well for a month, then resumed drinking.

After a few weeks of drinking she disappeared. Maybe two days later she called and asked me to pick her up from "big city", but didn't give a specific location. A few days later I got a call from a mental hospital. She said she was being transferred for involuntary evaluation, then she stopped calling. Her father said she'd been released.

I suggested to her father that we should file a missing person report. He concurred. When I called the police, the officer said they'd prefer I come down to the main station or a precinct to file the missing person report in person, so the officer would know I wasn't harassing someone. I was also told it'd help to get her family involved too.

So her father and I went down to the main station. The officer working the desk was skeptical, but after a few minutes he agreed to look up my friend. When he came back and said my friend wasn't missing, because they'd taken her back to the crazy-tank the day before.

Her father had already hired a lawyer. The social worker said they have dozens of petitions for court-ordered evaluation expire every week, on account of not having room to transfer the patients for their evaluations. I think the social worker greased the wheels to make sure my friend wasn't released to the street again.

From the fine article:

> But the problem is that scientific research needs to be sound. We cannot build progress on a rotten foundation.

The 'rotten foundation' in our mental health system is treating people's symptoms without concern for their cause. Scientists have actually figured out most of the causes behind patients' symptoms, so we don't actually have to treat them palliatively anymore. It's just conveniently profitable for the system to play make-believe that our current selection of FDA-approved patent medicines are the best we can do.

[0] https://news.ycombinator.com/item?id=15353109 [1] https://news.ycombinator.com/item?id=12068958

[2] https://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitor - "New research into MAOIs indicates that much of the concern over their supposed dangerous dietary side effects stems from misconceptions and misinformation, and that it is still underutilized despite demonstrated efficacy. ..."

zlacker