Ten Years That Changed The Face Of Mental Illness

An absorbing account of the development of chlorpromazine written by a participant working with the original team.

The human suffering associated with mental illness is something that more than one in five Canadians face at some point in their life.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

David Healy follows his widely praised study, The Antidepressant Era, with an even more ambitious and dramatic story: the discovery and development of antipsychotic medication. Healy argues that the discovery of chlorpromazine (more generally known as Thorazine) is as significant in the history of medicine as the discovery of penicillin, reminding readers of the worldwide prevalence of insanity within living memory. But Healy tells not of the triumph of science but of a stream of fruitful accidents, of technological discovery leading neuroscientific research, of fierce professional competition and the backlash of the antipsychiatry movement of the 1960s. A chemical treatment was developed for one purpose, and as long as some theoretical rationale could be found, doctors administered it to the insane patients in their care to see if it would help. Sometimes it did, dramatically. Why these treatments worked, Healy argues provocatively, was, and often still is, a mystery. Nonetheless, such discoveries made and unmade academic reputations and inspired intense politicking for the Nobel Prize. Once pharmaceutical companies recognized the commercial potential of antipsychotic medications, financial as well as clinical pressures drove the development of ever more aggressively marketed medications. With verve and immense learning, Healy tells a story with surprising implications in a book that will become the leading scholarly work on its compelling subject.

This book chronicles the conceptual and methodological facets of psychiatry and medical psychology throughout history. There are no recent books covering so wide a time span. Many of the facets covered are pertinent to issues in general medicine, psychiatry, psychoanalysis, and the social sciences today. The divergent emphases and interpretations among some of the contributors point to the necessity for further exploration and analysis.

Use of psychotropic drugs has come to dominate clinical practice in psychiatry worldwide—perhaps owing largely to perceived simplicity, ease of use, and apparent efficiency, as well as apparent cost-effectiveness of such treatments. Nevertheless, medicinal treatments for patients with psychiatric disorders are but one component of comprehensive clinical care of complex human problems. Extensively updated since its second edition in 1985, Chemotherapy in Psychiatry, Third Edition, again addresses basic aspects of modern psychopharmacology and clinical applications of drugs used in the treatment of major psychiatric disorders, with major emphasis on psychotic, bipolar, and depressive disorders. The presentation covers descriptions of the main classes of psychotropic drugs, selected information concerning their known action mechanisms and metabolic disposition, and their clinical applications for acute illnesses and to prevent recurrences and long-term morbidity. Also covered are limitations and adverse effects of each type of agent, with emphasis on the fact that all psychotropic medicines have adverse effects that range from annoying to potentially lethal. Chemotherapy in Psychiatry, Third Edition, outlines the need to balance benefits and risks at the level of individual persons. Authoritative, and an important contribution to the literature, Chemotherapy in Psychiatry, Third Edition is an invaluable resource for physicians, scientists, trainees, and policymakers.

Here is a frank examination of the pharmaceutical industry and of one of the most popular drugs of the last twenty years by a psychiatrist who has been a consultant to many of the top companies. Sales of Prozac, Paxil and Zoloft now account for billions of dollars worldwide. Despite outward expressions of confidence in these new miracle drugs, drug companies and researchers still do not know exactly how they work, or what their potential side effects are. After years of consulting to the major companies, independent study, and prescribing Prozac and its sister antidepressants, David Healy shows that some of the patients taking Prozac, Paxil and Zoloft can become suicidal and commit suicide at a much higher rate than if they had been left untreated. The manufacturers have refused to acknowledge this risk, key national regulators have not taken appropriate steps to protect the safety of their citizens, and critics of these drugs have been harassed and threatened. In this book David Healy describes his transition from drug industry consultant to independent-minded critic. We meet leading figures in drug research, industry promotion, and government regulators. We are taken into back rooms of lawsuits where industry experts go head-to-head with lawyers and victims families looking for compensation for apparently Prozac-induced suicide. Near the conclusion of the book we witness Healy being offered a prestigious job at the University of Toronto, then having the offer rescinded. Only because on university faculty union support for his case did the university back down, with the result that Healy is now Visiting Professor of Medicine at the University of Toronto.