Statement on the Role of Mental Illness in Violent Behavior

July 2, 2014

Given the widespread media accounts of horrific shooting sprees over the last few months, ISEPP wishes to clarify the factors that lead to violent behavior in our society. Focusing on mental illness as a risk factor is a distraction, a waste of valuable resources, and a threat to personal autonomy and freedom.

A diagnosis of mental illness does not increase one’s risk of being violent. Actually, some research suggests one of the most serious of mental illness diagnoses, schizophrenia, reduces the risk of being violent. This disconnect between a mental illness diagnosis and violence is because mental illness does not refer to a brain disease that causes violence. No such disease exists. Unlike a diagnosis of real illness like diabetes, mental illness diagnoses are merely broad descriptive labels given to clusters of very common human problems, not brain defects. People “qualify” for a diagnosis only if they exhibit a specified number of items from a menu-­‐like checklist. One item too few, and there is no diagnosis; they are not mentally ill.

While a diagnosis of mental illness does not increase the risk of violence, some specific emotional, cognitive, and behavioral problems can. Still, no one thing causes violence. It is the end result of multiple, complex, and interwoven risk factors that increase the probability of violence. Years of research show the factors that increase one’s risk of being violent are: 1) being male; 2) being younger; 3) a history of antisocial patterns; 4) past violent behavior; 5) easy access to weapons, especially lethal ones like guns; 6) poor social support; 7) feelings of being persecuted and difficulty controlling thoughts; and 8) use of drugs/alcohol to cope with stress. Whereas some of these factors show up among items in the checklist menu approach to mental illness diagnosing, none by themselves necessarily qualify for a diagnosis, and so they can increase a person’s risk of being violent while the person would not be considered “mentally ill”. More importantly, these risk factors do not show up in the majority of people who are labeled with mental illness diagnoses. In short, most people who are diagnosed with mental illness are no more at risk of becoming violent than the general public. Even though these factors increase the risk of violence, they are not precise enough to use as a prediction tool. Doing so would result in a huge false alarm rate in which the great majority of the people identified as being prone to violence would never commit violent acts.

Conventional psychiatric treatment that views people as patients with illnesses, instead of fellow human beings with very common troubles, can actually increase the risk of violent behavior by ignoring the personal, moral, economic, political, spiritual, and existential elements of one’s struggles. Such traditional mental health interventions can easily lead to a sense of being misunderstood and oppressed (risk factor 7), as well as being socially ostracized due to the particularly damaging stigma that the illness model instills (risk factor 6). Further, the common use of psychiatric drugs can also lead to an increase in violence risk (risk factor 8). Regulatory agency and drug company black box warnings attest to the potential of these drugs’ chemical effects increasing the risk of violence and suicide. Research shows that of the top 31 prescription drugs associated with violent adverse outcomes, 26 are psychiatric drugs. Psychiatric drugs create very unpleasant and risky sensations to include emotional numbing, caring less about things, and feeling like a different person. Finally, all psychiatric drugs can have very harmful withdrawal effects, especially if they are stopped abruptly. These drug effects can clearly contribute to the development of risk factors 6 and 7 above, just like illicit drugs and alcohol can.

We call on public policy makers, mental health professionals, and the lay public to be aware of these factors in order to make more informed decisions with the hope of reducing the risk of violent incidents in the future.

Statement on APA Ethics Office Decision to Dismiss Charges Against Dr. John Leso

March 1, 2014

The International Society for Ethical Psychology and Psychiatry joins with Psychologists for Social Responsibility and the Coalition for an Ethical Psychology in denouncing the American Psychological Association’s recent refusal to take disciplinary action against military psychologist Dr. John Leso for his involvement in torturous interrogations at Guantanamo Bay, Cuba. This is yet another in a line of failures by the APA to enforce the most basic ethical standards as outlined in their Ethical Principals of Psychologists and Code of Conduct and the long-­‐standing APA-­‐ stated policy against torture, effectively hollowing out their public statements that any APA member so involved will be held accountable. APA’s actions in this case weaken psychology’s reputation as a humane endeavor independent of governmental influence, and place in question APA’s standing as a legitimate national organization for psychology.

The extant evidence cannot be clearer. Documentation confirms that Dr. Leso participated in the development, planning, and execution of coercive interrogation techniques on Mohammed al Qahtani during Dr. Leso’s tenure with the Behavioral Science Consultation Team in Guantanamo Bay, Cuba, between June 2002 and January 2003. By all authoritative standards at the time of his actions, the interrogation techniques were considered torture and a violation of the APA Ethics Code. Even the U.S. convening authority on military commissions during the presidency of George W. Bush concluded Qahtani was tortured, which contaminated any evidence, and thus she declined to pursue prosecution for his alleged involvement in the 9/11 attacks.

We urge the APA to reconsider their decision, to open a transparent and substantive investigation into this allegation, and to fulfill its promise to enforce the prohibition against psychologists engaging in torture. To do otherwise will set a very dangerous precedent.

Statement Supporting the British Psychological Society’s Statement on Functional Psychiatric Diagnoses

May 16, 2013

The International Society for Ethical Psychology and Psychiatry (ISEPP) strongly supports the Position Statement on the Classification of Behaviour and Experience in Relation to Functional Psychiatric Diagnoses that was recently issued by the Division of Clinical Psychology (DCP) of the British Psychological Society (BPS).

We especially endorse the following elements of the Statement in which the DCP expresses:

A need for a paradigm shift in relation to the experiences (classified as diagnoses by the Diagnostic and Statistical Manual of Mental Disorders [DSM] and the International Classification of Diseases: Classification of Mental and Behavioral Disorders [ICD]) towards a conceptual system not based on a disease model;

Concern over the limited reliability and questionable validity of the psychiatric diagnoses in the DSM and ICD;

Concern about the increasing medicalization of distress and behavior in both adults and children;

A call for an approach that fully acknowledges the growing amount of evidence for psychosocial causal factors, does not assign an unevidenced role for biology as a primary cause and that is transparent about the very limited support for the disease model in such conditions;

Recognition that psychiatric diagnosis obscures the link between people’s experiences, distress and behavior and social, cultural, familial and personal historical contexts;

Recognition that diagnosis can lead to an over-reliance on medication while underplaying the impact of (medication’s) physical and psychological effects;

A call for an approach that is multifactorial, contextualizes distress and behavior and acknowledges the complexity of the interaction involved in all human experience.

ISEPP applauds the British Psychological Society for sounding the alarm on the harm that is done by the classification system that is represented by the DSM and ICD and urges the American Psychological Association to take a stand, one way or the other, on that system

ISEPP Congratulates Senator Murray and The Congress on Passage of the Mental Health ACCESS Act Of 2012

January 8, 2013

The International Society for Ethical Psychology and Psychiatry (ISEPP) today congratulated Senator Patty Murray (D-WA), Chair of the Senate Committee on Veterans Affairs, and the U.S. Congress on passage of the Mental Health ACCESS Act.  The Act was adopted as part of the National Defense Authorization Act for Fiscal Year 2013 that was recently passed by the Congress and signed by President Obama.  Senator Murray introduced the Act in the summer of 2012.

The Act is designed to improve mental health treatment of soldiers returning from Iraq and Afghanistan by:

Providing enhanced oversight for Department of Defense (DOD) suicide prevention and resilience efforts;

Expanding services for the families of soldiers;

Improving the training and education of providers;

Increasing peer-to-peer counseling opportunities; and

Improving timely access to effective mental health services.

Reviewing existing research to determine safe and effective treatment of veterans and military members.

ISEPP has mounted an initiative called Operation Speak Up to work with the DOD and Department of Veterans Affairs (VA) on improving the treatment of soldiers suffering from Post-Traumatic Stress Disorder (PTSD) by stopping the use of psychotropic drugs as the primary modality of treatment and using non-drug approaches that have been proven to be safe and effective.

“Passage of this Act is a big step in the direction of improving the treatment of soldiers who are experiencing Post-Traumatic Stress Disorder (PTSD),” said Chuck Ruby, Director of Operation Speak Up. “ISEPP is encouraged by recent moves by the DOD and VA to use non-drug approaches to helping soldiers suffering from PTSD. This is another move in that direction.” 

Ruby said ISEPP is prepared to help the Department of Defense and the Veterans Administration in the implementation of the Act’s provisions.  “Our organization includes many mental health professionals who are experienced in the use of non-drug approaches to helping people recover from trauma,” he said.  “We would like to help the DOD and VA in their commitment to provide safe and effective treatment to our soldiers.” 

Statement on The Connection Between Psychotropic Drugs and Mass Murder

January 2, 2013

         The Board of Directors and membership of the International Society For Ethical Psychology and Psychiatry send condolences to the people of Newtown, Connecticut on their horrific losses.  Our hearts go out to the parents of the children who were killed and to the families and friends of the adults who were killed.

We are calling for an inquiry into the connection between these acts of mass murder and the use of psychotropic drugs.  Although the media have cited family members and acquaintances saying Adam Lanza was taking prescription drugs to treat “a neurological-development disorder”, we do not know if he was on psychotropic drugs.  But we do know that James Holmes, the Colorado "Batman” shooter, had taken 100 milligrams of Vicodin immediately before he shot up the movie theatre.  And we do know that:

Christopher Pittman was on antidepressants when he killed his grandparents;

Eric Harris, one of the gunmen in the Columbine school shooting, was taking Luvox and Dylan Klebold, his partner, had taken Zoloft and Paxil;

Doug Williams, who killed five and wounded nine of his fellow Lockheed Martin employees, was on Zoloft and Celexa;

Michael McDermott was on three antidepressants when he fired off 37 rounds and killed seven of his fellow employees in the Massachusetts Wakefield massacre;

Kip Kinkel was on Prozac when he killed his parents and then killed 2 children and wounded 25 at a nearby school.

In fourteen recent school shoots, the acts were committed by persons taking or withdrawing from psychiatric drugs, resulting in over 100 wounded and 58 killed. In other school shootings, information about the shooter’s prescription drug use and other medical history were kept from public records.

This connection between psychotropic drugs and mass murder is not coincidental.  There is enough evidence that antidepressants cause increased risk of suicide and violence for the U.S. Food and Drug Administration and its Canadian counterpart to require that drug companies include a “black box” warning to that effect on their packages.  Our first knowledge of this association between psychotropic drugs and violence came from studies completed in the early 1950s.  This was supported by research completed on antidepressants in the mid-1970s.  More recent studies have corroborated this association between antidepressants and homicide/suicide.^, Antidepressants, specifically Paxil, appear to more than double the risk of hostility events in adult and pediatric placebo-controlled trials.

All of the classes of psychiatric drugs can cause violent, irrational, and/or manic behavior.  Among other effects, these drugs cause a neurological condition called “akathesia,” which means that persons who take them can’t sit still and feel like they are jumping out of their skin.  They behave in an agitated manner which they cannot control and experience unbearable rage, delusions, and disassociation.  For a detailed explanation of the neurology, chemistry, and physiology of akathesia, see Rethinking Psychiatric Drugs: A Guide to Informed Consent by Dr. Grace Jackson.⁸

Psychotropic drugs – antidepressants, antipsychotics, mood stabilizers – impair the ability of people to accurately and effectively process emotions.  They take away caring.  They dull conscience.  In his book Listening to Prozac, psychiatrist Peter Kramer reported that his patients on Prozac didn’t care as much.  They lost some of their conscience.  This made it easier for them to do things that were hurtful to other people.

In his book Medication Madness, psychiatrist Peter Breggin presents evidence of how psychotropic drugs cause people to lose awareness of how they are behaving and to lose control over their behavior.  Such people are at greatly increased risk of committing acts of crime and violence.

Psychotropic drugs are toxic to the children and adults who take them.  Psychiatrist Grace Jackson writes that “with the possible exception of the chemotherapies used in the treatment of cancer, it would be difficult to identify a class of medications as toxic as antipsychotics.”  The psychiatric drugs that we give to our children and adults in the United States have significant “side effects” including apathy, abnormal dreams, acute respiratory distress, akathesia, agitation, aggression, agoraphobia, paranoia, assorted blood pressure and heart problems, breast enlargement in young boys, measurable brain damage, cerebral atrophy, disinhibition, hostility, homicidal and suicidal ideation, convulsions, diabetes, Parkinson’s symptoms, tardive dyskinesia, tremors, convulsions, psychosis, cerebral vascular accident, inability to express emotion, lethargy, increased chronicity of emotional problems, early dementia and early death.^8,9,10,14

We understand that many factors are involved in acts of mass murder.  We are not suggesting that psychotropic drugs are the only or the major factor.  But we do know there have been 22 international drug regulatory warnings about the impact of psychotropic drugs on suicidal and homicidal ideation, mania, violence and hostility.  We do believe that there is enough evidence of the association between psychotropic drugs and mass murder to warrant an inquiry.  And we believe that psychological autopsy and complete review of all medical records should be standard operating procedure in the investigations of these tragedies.

In spite of the evidence of this connection between psychotropic drugs and mass murder, the mainstream media has failed to write about it or investigate it.  Psychiatrist David Healy says: “Violence and other potentially criminal behavior caused by prescription drugs are medicine’s best kept secret.  Never before in the fields of medicine and law have there been so many events with so much concealed data and so little focused expertise”.   Neither has there been an investigation by our Federal government into this connection.  It is time to open the data and focus our expertise on this issue.

In closing, we again express our sadness at the murder of children and adults at Sandy Hook Elementary School and extend our best wishes during this period of grief.

Statement On August 31 Executive Order on Mental Health Services for Veterans

September 17, 2012

The International Society for Ethical Psychology and Psychiatry (ISEPP) today commended President Obama for his August 31 Executive Order which calls for improved mental health services to veterans, service members and their families and called for increased use of non-drug approaches to treating soldiers experiencing Post-Traumatic Stress Disorder (PTSD).

“We are especially pleased that the President is calling for the hiring of 800 peer counselors to help in the treatment of veterans,” said Al Galves, ISEPP Executive Director.  “We believe that peer counselors and other non-medical approaches are crucial to helping soldiers readjust to civilian life.”

Galves applauded the creation of a National Research Action Plan and the Military and Veterans Mental Health Interagency Task Force and encouraged the Action Plan to include research which compares a cohort of soldiers who are treated without the use of psychotropic drugs to a cohort that is undergoing the standard treatment which uses drugs as a primary modality of treatment.  “Psychotropic drugs do not treat the causes of PTSD and do nothing more than chemically lobotomize patients.” Galves said.  “We need to be using safe and effective non-drug approaches that help soldiers recover from PTSD without the damaging side-effects and high relapse rates that are associated with the drugs.  Included in such approaches are cognitive-behavioral methods and trauma-informed approaches such as Eye Movement Desensitization Reprocessing (EMDR) therapy and Sensorimotor Psychotherapy.”

Galves also called on the President to get behind Senator Patty Murray’s Mental Health ACCESS Act of 2012, which expands mental health services for veterans and service members and expands the use of peer counselors and services to the families of veterans and service members.