Who's Researching the Researchers?

national | miscellaneous | news report Friday March 14, 2003 20:40 by E. Commins elishacommins at hotmail dot com Co. Galway 087-9317233

Questioning Our Mental Health Strategies

Well-known mental health expert and author of ‘Beyond Prozac: Healing Mental Suffering Without Drugs’ Dr. Terry Lynch has called for a public inquiry into the treatment of mental illness in this country and for greater government supervision of the so-called experts.

‘I don’t think the public are getting the truth’, says Lynch. It’s long been accepted in the medical profession that anti-depressants have a 70% effectiveness rate. But last month the Royal College of Psychiatrists in London downgraded the effectiveness of anti-depressants to only 50%. ‘The effectiveness of these drugs have been over-stated for years,’ he says. ‘This is a huge development but it has received no attention in the Irish media or amongst the medical profession’.

Speaking at NUI Galway this week Lynch condemned what he sees as ‘the intransigence of the medical profession and its strict adherence to accepted dogma.’

Explaining that mental health problems are principally treated with medication on the basis that many mental illnesses are caused by biochemical brain abnormalities, he says this in nothing more than an unproven hypothesis since mentally ill patients never have their alleged biochemical imbalance checked by clinical tests.

Despite this many in the medical profession claim depression is no different from many other physical illnesses such as diabetes. And so the medical approach focuses on alleged depleted serotonin levels to the exclusion of the psychosocial causes of emotional distress.

But Lynch argues there is a wealth of difference between the depth of understanding of diabetes and depression. The treatment of depression is very imprecise in comparison to the administration of insulin for diabetes.

And whereas diabetes requires lifelong treatment, depression is usually treated with anti-depressants for a period of only 3-9months. ‘Where did the biochemical abnormality go?’ asks Lynch, ‘and what happens when the patient comes off the medication? The patient’s serotonin levels are never checked since we do not know what constitutes normal or abnormal levels’.

Referring to the recent controversy surrounding the anti-depressant Seroxat, he pointed out that on the leaflet accompanying the medication it is claimed that the drug will bring serotonin back to normal levels. ‘How is this possible if the patients’ serotonin levels are never checked?’ he asks. This is a drug that has been validated by the Irish Medicines Board.

Lynch has been in correspondence with the Board in relation to these claims and they have agreed with him on this point but it remains to be seen what they are going to do about it.

‘When people read this information leaflet they believe there’s hard science behind it’, he says. ‘The absence of any real understanding of the causes of mental illness must be publicly acknowledged.’

‘Who’s researching the researchers?’ he asks, ‘who’s keeping an eye on the experts?’ Lynch believes the government should be because the public aren’t getting optical mental healthcare service.

He believes the public are deeply misinformed about depression. ‘By focusing exclusively on an unproved physical cause of mental illness and ignoring the psychosocial issues something really important is being missed,’ he says. But there’s an entirely different way of looking at it, that is, to see it as distress.

He refers to the eminent mental health expert Dorothy Rowe who also remarks on the total loss of all self-confidence that she sees in patients with mental illnesses and describes mental disorders as ‘desperate defences against annihilating fear’.

‘Mental illnesses arise from issues to do with the patient’s life, how it’s going and how they can’t cope’, says Lynch. ‘Yet this approach is receiving no attention and that’s highly unscientific’.

It’s his opinion that often the medical profession tend to diagnose according to the treatment available. Counselling is dismissed as ‘for people who are not happy and waste of time for depressives’, despite the fact that the response to counselling has been proved to be as effective as anti-depressants.

But what does he see as the reason for the remarkable medical reliance on medication in absence of scientific basis to support it? ‘Sometimes people say that doctors don’t have the time, the resources to look at other treatments but I believe there’s more to it than that. It’s about belief systems and power. If counselling is effective where does that leave doctors/ psychiatrists? It’s quite threatening to their belief systems which are built around medicines and biology’.

Although Lynch believes many in the profession are mis-guided, he believes that doctors do not seek to mislead patients. His problem is when it’s medication and nothing else that’s used to treat the patient.

Pointing to the down-grading of the effectiveness of anti-depressants and why it remained unpublicised in Ireland and the blocked attempts of the Irish Association of Counselling and Psychotherapy to get regulated Lynch says: ‘It’s not as innocent as we don’t have the time or the money. I think it’s because we [the medical profession] don’t want to go there.’

Lynch believes change will come from the ground up when the public become empowered with information and start questioning the treatment of mental illness.

‘Psychosocial issues have to be paid more attention. Counselling should be far more available and professionally organised. But counselling isn’t the whole answer either. There has to be a graded process of social re-integration for patients, a process of helping them to get their life back on track’, he says. Since stress is a well-known trigger for mental illness, he also advocates methods of helping people to deal with and avoid stress. He believes assertiveness and confidence-building courses should be widely available too.

Dr. Terry Lynch is a qualified GP from Co. Limerick and has re-trained as a psychotherapist. Since his book ‘Beyond Prozac: Healing Mental Suffering Without Drugs’ was published 2 years ago, he has received over 2, 000 phone calls from readers. ‘People are angry and are speaking out more’, he says. His book began as ‘a search for truth and understanding, asking question where questions need to be asked’. It contains an important message for society and the medical profession.