California Medical Evaluation Field Manual

August 17th, 2014

California Medical Evaluation Field Manual

In 1991, Dr. Lorrin M. Koran prepared the Medical Evaluation Field Manual at the request of the California legislature.

Quoting from the Introduction:


“This Field Manual shows California mental health program administrators and staff how to screen their patients for active, important physical diseases. The Manual explains how, where, and when to screen, how to initiate and staff a screening program, and how to maximize its cost-effectiveness. The Manual also includes a list of clinical findings that characterize patients whose mental symptoms are quite likely to be caused by an unrecognized physical disease.

“For several reasons, mental health professionals working within a mental health system have a professional and a legal obligation to recognize the presence of physical disease in their patients. First, physical diseases may cause a patient’s mental disorder. Second, physical disease may worsen a mental disorder, either by affecting brain function or by giving rise to a psychopathologic reaction. Third, mentally ill patients are often unable or unwilling to seek medical care and may harbor a great deal of undiscovered physical disease. Finally, a patient’s visit to a mental health program creates an opportunity to screen for physical disease in a symptomatic population. The yield of disease from such screening is usually higher than the yield in an asymptomatic population.”


The conclusions drawn in this manual are not theoretical; they were arrived at by extensive experimental evidence, and include such findings as:

“1. Nearly two out of five patients (39%) had an active, important physical disease.

“2. The mental health system had failed to detect these diseases in nearly half (47.5%) of the affected patients.

“3. Of all the patients examined, one in six had a physical disease that was related to his or her mental disorder, either causing or exacerbating that disorder.

“4. The mental health system had failed to detect one in six physical diseases that were causing a patient’s mental disorder.

“5. The mental health system had failed to detect more than half of the physical diseases that were exacerbating a patient’s mental disorder.”

The step-by-step procedures in this manual detected more physical diseases than the mental health programs had detected among 476 patients sampled, did so at a lower cost per diagnosed case, and can be performed by mental health personnel after very limited training.

Why Is This Important?

CCHR has always recommended a full, searching medical examination by a non-psychiatric health care professional, with appropriate clinical tests, to determine if there are undetected and untreated medical conditions that could be causing or contributing to mental distress.

The Missouri Department of Mental Health, with the recent passage of Senate Bill 716, is now instructed to develop guidelines for the screening and assessment of persons that address the interaction between physical and mental health to ensure that all potential causes of changes in behavior or mental status caused by or associated with a medical condition are assessed. This legislation goes into effect August 28, 2014.

One expects that this implies that those medical conditions found would then be medically treated, rather than simply passing out harmful and addictive psychotropic drugs, as is the more usual practice. We need to reinforce this expectation with our contacts, calls and letters to the Missouri DMH.

If you have professional expertise for helping to develop such guidelines, please volunteer your efforts to the Missouri Department of Mental Health.

If you would like to read the California Medical Evaluation Field Manual, you may download it from the CCHR St. Louis website.

War and Psychiatrists

August 5th, 2014

War and Psychiatrists

We like to acquaint our readers with interesting things we read, and then work out how psychiatry is involved. The most recent interesting thing we have read (although not the most interesting thing in the world) is an article titled “The Truth About Iraq And why it matters” by Dick Cheney and Liz Cheney, in the July 21, 2014 issue of The Weekly Standard. (Click here to read the article.)

Keep in mind, we are not arguing for or against the Cheneys’ viewpoints; that is something about which one must come to one’s own conclusions. However, we’d like to take two quotes from the article, out of context to be sure, and expound on the issue as it relates to psychiatry.

Quote the first: “We also know, again confirmed in documents captured after the war, that Saddam provided funding, training, and other support to numerous terrorist organizations and individuals over decades, including to Ayman al Zawahiri, the man who leads al Qaeda today.”

A relatively innocuous statement, perhaps — but not to someone who recognizes the name and its relation to psychiatry (which the authors may not recognize, or may not consider significant.)

Here’s the point. Very few may know about an Egyptian psychiatrist, formerly Osama bin Laden’s right hand man, named Ayman al-Zawahiri. Former psychiatrist Ayman al-Zawahiri “is the guy—he’s the operational commander … number one, on the right-hand side of Osama [bin Laden] … He believes that violence is purifying.” [Vincent Cannistraro, former counter-terrorism official, U.S. Central Intelligence Agency]

Ayman al-ZawahiriWell, so bin Laden is now out of the picture, but al-Zawahiri is not.

A psychiatrist and surgeon who was convicted of terrorism in Egypt and sentenced to death in absentia; al-Zawahiri studied behavior, psychology and pharmacology as part of his medical degree at Cairo University. Interpol issued an arrest warrant for al-Zawahiri relating to his role in the terrorist attacks on the World Trade Center and Pentagon.

Quote the second: “We won’t defeat our enemies by retreating. We won’t win if we adopt a false narrative about the past, fail to learn the lessons of history, or seek security in disengagement and isolationism. We will only defeat our enemies if we are clear-eyed about the threat and have the will to do what it takes for as long as it takes—until the war is won.”

Cheney was talking about Iraq and al Qaeda. We’re talking about war, terrorism and psychiatry. We think this quote still applies. What do you think?

Find out more about war, terrorism and psychiatry by clicking here.

Missouri Governor Signs Two Anti-Psych Bills

July 31st, 2014

Missouri Governor Signs Two Anti-Psych Bills

SS SCS SB 532 (Senate Substitute for Senate Committee Substitute for Senate Bill 532) – Modifies provisions relating to educational and medical consent provided by relative caregivers. Signed by Governor Nixon 7/9/2014; goes into effect 28 August 2014.

This act allows relative caregivers, acting under an affidavit, to consent to medical treatment and educational services for a minor child with whom such caregiver lives if consent of the legal parent or guardian cannot be obtained through reasonable efforts. A parent may also delegate such consent authority to the relative caregiver in writing. “Relative caregiver” is defined as a competent adult who is related by blood, marriage or adoption, who is not the legal parent or guardian and who represents in the affidavit that the child lives with the adult and that the adult is responsible for the care of the child.

This is an important protection as it prevents consent for medical treatment, including psychiatric treatment, from defaulting to the state if the parent is not available.

CCS#2 HCS SCS SB 716 (Conference Committee Substitute No. 2 for House Committee Substitute for Senate Committee Substitute for Senate Bill 716) – Modifies provisions relating to public health. Signed by Governor Nixon 7/10/2014; goes into effect 28 August 2014.

VULNERABLE PERSON ABUSE INVESTIGATIONS (Sections 630.017 and Section 2)

This act provides that upon receipt of a report of possible vulnerable person abuse, the Department of Mental Health shall initiate an investigation within 24 hours and shall complete all investigations within 60 days, unless good cause for the failure to complete the investigation is documented.

For investigations alleging neglect of a patient, resident, or client, the guardian shall be notified of the investigation and given an opportunity to provide information to the investigators; the results of the investigation shall be provided to the guardian within five working days of its completion. The department of mental health shall obtain two independent reviews of all patient, resident, or client deaths that it investigates.

This act also requires the department of mental health to develop guidelines for the screening and assessment of persons receiving services from the Department that address the interaction between physical and mental health to ensure that all potential causes of changes in behavior or mental status caused by or associated with a medical condition are assessed. The provisions of this act relating to screening and assessments shall only apply to state owned or operated facilities and not to long-term care facilities or hospitals.

This is an important change in the law as it recognizes that mental symptoms can be caused by physical issues and requires the Missouri Department of Mental Health to assess persons for medical conditions and not just for mental symptoms. If you know someone who might have input into such guidelines, now is the time to have them contact the DMH. California developed such guidelines in 1991, called the Medical Evaluation Field Manual, which will be the subject of a future newsletter.

Texas Foster Children Health Care News

July 27th, 2014

Texas Foster Children Health Care News

Legislation signed by the Governor of Texas and effective starting 9/1/2013 provides expanded safeguards for foster children in Texas regarding their health care.

HB 915 (House Bill 915) should be taken strongly to heart by all state legislatures.

Here are some of the important points safeguarding foster children from dangerous psychotropic drugs. We have paraphrased the legalese to make it easier to read. The actual bill text can be found here.

Duties required by a guardian ad litem appointed for a child include reviewing the medical care provided to the child, and in a developmentally appropriate manner, elicit the child’s opinion on the medical care provided. For a child at least 16 years of age, advise the child of the child’s right to request the court to authorize the child to consent to the child’s own medical care.

For a child receiving psychotropic medication, determine whether the child has been provided appropriate psychosocial therapies, behavior strategies, and other non-pharmacological intervention, and has been seen by the prescribing physician, physician assistant, or advanced practice nurse at least once every 90 days.

For a youth taking prescription medication, the department shall ensure that the youth’s transition plan includes provisions to assist the youth in managing the use of the medication and in managing the child’s long-term physical and mental health needs after leaving foster care, including provisions that inform the youth about the use of the medication, the resources that are available to assist the youth in managing the use of the medication, and informed consent and the provision of medical care.

A person may not be authorized to consent to medical care provided to a foster child unless the person has completed a department-approved training program related to informed consent. The training required must include training related to informed consent for the administration of psychotropic medication and the appropriate use of psychosocial therapies, behavior strategies, and other non-pharmacological interventions that should be considered before or concurrently with the administration of psychotropic medications.

Consent to the administration of a psychotropic medication is  valid only if the consent is given voluntarily and without undue influence, and the person authorized by law to consent for the foster child receives verbally or in writing information that describes the specific condition to be treated, the beneficial effects on that condition expected from the medication, the probable health and mental health consequences of not consenting to the medication, the probable clinically significant side effects and risks associated with the medication, and the generally accepted alternative medications and non-pharmacological interventions to the medication, if any, and the reasons for the proposed course of treatment.

The department shall notify the child’s parents of the initial prescription of a psychotropic medication to a foster child and of any change in dosage of the psychotropic medication at the first scheduled meeting between the parents and the child’s caseworker after the date the psychotropic medication is prescribed or the dosage is changed.

The person authorized to consent to medical treatment for a foster child prescribed a psychotropic medication shall ensure that the child has been seen by the prescribing physician, physician assistant, or advanced practice nurse at least once every 90 days to allow the physician, physician assistant, or advanced practice nurse to appropriately monitor the side effects of the medication, and determine whether the medication is helping the child achieve the treatment goals, and continued use of the medication is appropriate.

Note the emphasis on Informed Consent. Click here for more information about Informed Consent.

The real problem is that psychiatrists fraudulently diagnose life’s problems as an “illness”, and stigmatize unwanted behavior or study problems as “diseases.” Psychiatry’s stigmatizing labels, programs and treatments are harmful junk science; their diagnoses of “mental disorders” are a hoax — unscientific, fraudulent and harmful. All psychiatric treatments, not just psychiatric drugs, are dangerous.

Contact your own state legislators and suggest that they review this Texas legislation and additional information about Informed Consent so that they may compare it to existing state laws on the matter and provide needed protections for children under state care. In Missouri, visit here to find your legislators.

 

Psychiatric drug ER trips approach 90,000 a year

July 19th, 2014

Psychiatric drug ER trips approach 90,000 a year

“Bad reactions to psychiatric drugs result in nearly 90,000 emergency room visits each year by U.S. adults, with anti-anxiety medicines and sedatives among the most common culprits.

“A drug used in some popular sleeping pills was among the most commonly involved sedatives, especially in adults aged 65 and older.

“Most of the visits were for troublesome side effects or accidental overdoses and almost 1 in 5 resulted in hospitalization.

“The results come from an analysis of 2009-2011 medical records from 63 hospitals that participate in a nationally representative government surveillance project. The study was published [July 9, 2014] in JAMA Psychiatry.

“Overall, the sedative zolpidem tartrate, contained in Ambien and some other sleeping pills, was involved in almost 12 percent of all ER visits and in 1 out of 5 visits for older adults.”

Read the full MSN News article here.

An unexpected finding of the study was that rates of antipsychotic, sedative, anti-anxiety, and antidepressant adverse drug event emergency room visits were highest among adults aged 19 to 44 years.

We expect that most people do not realize that Ambien is a psychiatric drug, since it is usually prescribed as a sedative for insomnia. In fact, drugs of this nature are variously called “anti-anxiety drugs” or “minor tranquilizers” or “sedative hypnotics.”

Today, at least 20 million people worldwide are prescribed these “minor tranquilizers.”

Daily use of therapeutic doses is associated with physical dependence. Addiction can occur after 14 days of regular use. Of the 72 different reported adverse reactions, some are anxiety, hostility, aggression, depression, sleep-walking, sleep-driving, and suicide. The typical consequences of withdrawal are anxiety, depression, sweating, cramps, nausea, psychotic reactions and seizures. Elderly people taking these drugs for anxiety or insomnia are at increased risk for motor vehicle crashes. There is also a “rebound effect” where the individual experiences even worse symptoms than they started with as a result of chemical dependency; medical experts point out that this is the drug effect, not a “mental illness.”

Courts have determined that informed consent for people who receive prescriptions for psychotropic (mood-altering) drugs must include the doctor providing information about possible side effects and benefits, ways to treat side effects, and risks of other conditions, as well as information about alternative treatments. Yet very often, psychiatrists ignore these requirements.

All patients should first see a non-psychiatric medical doctor, especially one who is familiar with nutritional needs, who should obtain and review a thorough medical history and conduct a complete physical exam, ruling out all the possible problems that might cause the person’s symptoms.

There are far too many effective options to list them all here. Psychiatrists, on the other hand, insist there are no such options and fight to keep it that way. Patients and physicians must urge their local, state and federal government representatives to endorse and fund non-drug health care options instead of dangerous psychiatric drugs.

The Hard Truth #2

July 9th, 2014

The Hard Truth #2

In our May 5th newsletter we introduced The Hard Truth Magazine. We are delighted to recommend issue number 2 just released.

Here is a brief quote from this latest issue:

“In China, the Falun Gong (a pacifistic religious sect whose politically menacing motto is ‘Truthfulness, Compassion and Tolerance’) came to the attention of the Chinese Ministry of State Security because of its rapid growth. The state teamed with resident psychiatrists and developed a new mental disorder specifically for the Falun Gong: Evil cult-related mental disorder. … There are now thousands of Falun Gong practitioners in mental hospitals in the People’s Republic of China undergoing unspeakable torture. When they renounce Falun Gong, they are cured.”

Religions are facing an insidious assault that is not only sapping their spiritual and material strength, but in some cases threatening their very survival.

In the late 1800′s psychiatrists sought to replace religion with their “soulless science.” In 1940, psychiatry openly declared its plans when British psychiatrist John Rawling Rees, a co–founder of the World Federation for Mental Health, addressed a National Council of Mental Hygiene stating: “…since the last world war we have done much to infiltrate the various social organizations throughout the country … we have made a useful attack upon a number of professions. The two easiest of them naturally are the teaching profession and the Church … .”

The consequences have been devastating for both society and religion. Until recently, it was religion that provided man with the moral and spiritual markers necessary for him to create and maintain civilizations of which he could be proud. Religion provides the inspiration needed for a life of higher meaning and purpose. In this crisis, it falls upon religious leaders to take the decisive steps. Men of the cloth need to shake off the yoke of soulless materialism spawned by psychology and psychiatry and put religion back into the hands of the religious and out of the hands of psychiatry.

Subscribe to The Hard Truth Magazine at www.thehardtruthmag.com.

Find out more about psychiatry’s war against religion here.

Parents can get refunds for some anti-depressant drugs given to kids

July 6th, 2014

Parents can get refunds for some anti-depressant drugs given to kids

St. Louis Post-Dispatch, July 5, 2014
by Blythe Bernhard

“Thousands of Missouri parents are entitled to refunds for antidepressants prescribed to children because the drugs were unapproved for use in that age group, a federal judge has ruled.

“Forest Laboratories and its subsidiary Forest Pharmaceuticals, which is based in Earth City, agreed to pay up to $10.4 million in refunds for misleading parents into giving the drugs Celexa and Lexapro to children and teenagers, according to a recent settlement of a class action lawsuit.

“A judge in the case ruled that under the Missouri Merchandising Practices Act, “parents have the right to be fully informed about the potential efficacy of a drug,” said Brent Wisner, a Los Angeles-based attorney for the plaintiffs.

“Anyone who bought Celexa for someone under 18 from 1998 to 2013 or Lexapro from 2002 to 2013 is eligible for partial to full refunds, or $50 if the total amount spent on the drugs cannot be proven.”

Click here to read the full article. Send a note to the author and let her know what you think.

Click here for some of the legal stuff.

We might remind you that the devastating side effects of Celexa and Lexapro can be found here.

Psychiatric drugs are only the symptom. The real problem is that psychiatrists fraudulently diagnose life’s problems as an “illness”, and stigmatize unwanted behavior or study problems as “diseases.” Psychiatry’s stigmatizing labels, programs and treatments are harmful junk science; their diagnoses of “mental disorders” are a hoax – unscientific, fraudulent and harmful. All psychiatric treatments, not just psychiatric drugs, are dangerous. Click here to find out more about this.

Criminalization of Mental Health Care

July 2nd, 2014

Prisons: America’s New Asylums

Reference: “The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey”, 8 April 2014, Treatment Advocacy Center.

Although the Treatment Advocacy Center (TAC) is motivated primarily by psychiatric treatment and psychiatric drugs, they do present some interesting facts and viewpoints on mental health care in prisons and jails.

A major part of the treatment for prison inmates (used less for rehabilitation than for managing and disciplining inmates) is a regimen of powerful psychiatric drugs, despite numerous studies showing that aggression, violence and suicide are tied to their use. One study in California reported that 73 percent of prison suicides had a history of mental health treatment (meaning psychotropic drugs.)

The TAC report, of course, does not mention the violence and suicidal side effects of psychotropic drugs, preferring to push psych treatment and psych drugs instead.

Prisons and jails have become America’s new mental asylums. The number of individuals with serious mental symptoms in prisons and jails now exceeds the number of patients in state psychiatric hospitals tenfold. The cost of maintaining these inmates in prison skyrockets when psychiatric drugs are being used.

Notice we said “mental symptoms” instead of the popular press phrase “mental illness.” This is because, while people can indeed have debilitating mental trauma, this is not in fact a “mental illness”; it is a set of symptoms indicating some root cause which has not yet been found and handled. More than likely it is a legitimate medical problem that has not been diagnosed and treated, or it is the end result of illiteracy, or it is a side effect of taking drugs — legal or otherwise.

From 1770 to 1820 in the U.S., mentally traumatized persons were routinely confined in prisons and jails. This practice was inhumane, and it was replaced by housing such persons in hospitals until 1970. Since 1970 the earlier practice of routinely confining such persons in prisons and jails has resumed. So it has been known for almost 200 years that confining persons with mental trauma in prison is inhumane, yet this is now the current state of affairs.

In 2012, approximately 356 thousand inmates with mental health issues were confined in prisons and jails. On the other hand, only 35 thousand were in state psychiatric hospitals. In Missouri, it is estimated that 20 percent of the prison population has mental health issues, and this figure has apparently been steadily increasing.

TAC, in lockstep with the psycho-pharmaceutical industry, believes that providing appropriate treatment for inmates with mental health issues is the administration of psychiatric drugs.

Unfortunately, in TAC’s view, a prisoner can object to treatment with psychiatric drugs. Thus, the primary purpose of the referenced paper is to examine how psychiatric drugs can be forced on prison inmates without their permission. They call it “treatment over objection,” and it has its own mental diagnosis as justification.

This diagnosis is called “anosognosia,” from the Greek a + nosos + gnosis, meaning not + disease + knowing. In English terms, it means “ignorance of the presence of disease.” In other words, a person who refuses treatment (in this case a prison inmate refusing psychiatric drugs) is diagnosed with anosognosia as a justification for forcing treatment on the person against their will, since they are obviously ignorant of their own diseased condition.

In 1990, the U.S. Supreme Court (Washington v. Harper) held that an inmate with mental trauma need not be imminently dangerous before being medicated against his or her will, and that such an authorization may occur by administrative hearing rather than a judicial one. Thirty-one states, including Missouri, implement prison policies that allow an administrative (not a court) proceeding to force an inmate to take psychiatric drugs.

The Missouri Department of Corrections allows non-emergency involuntary administration of psychiatric drugs in cases where no immediate danger exists but the inmate poses a future likelihood of harm to self or others without treatment. The committee that authorizes this is composed of a psychiatrist, the associate superintendent, and the regional manager of mental health services. County jails may also use the same process.

The responsibility for helping people with mental trauma has gone to prisons and jails. Their primary method of treatment is psychotropic drugs known to cause violence and suicide — both when taking the drugs and when withdrawing from them. Prison violence and suicide are increasing; prison costs are increasing as more drugs are used; coercive measures are used to increase the prison population taking psychotropic drugs.

Does anyone see a problem with this trend?

FIND OUT! FIGHT BACK!

Antidepressant use and suicidal behavior

June 26th, 2014

Antidepressant use and suicidal behavior

Reference: “Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage” BMJ 2014;348:g3596.

A research paper published 18 June 2014 in the British Medical Journal investigates “if the widely publicized warnings in 2003 from the US Food and Drug Administration about a possible increased risk of suicidality with antidepressant use in young people were associated with changes in antidepressant use, suicide attempts, and completed suicides among young people.”

The paper concludes that “Safety warnings about antidepressants and widespread media coverage decreased antidepressant use, and there were simultaneous increases in suicide attempts among young people.”

Some interesting statistics are cited: “In the United States in 2007, suicide was the third leading cause of death among people aged 15 to 24. Nearly 8% of high school students reported attempting suicide in 2011 and 2.4% made an attempt that required medical attention. There has been considerable concern that suicidal behavior is a potential adverse outcome of prescription drug use, including antidepressant and anticonvulsant agents.”

Additionally, “In adolescents and young adults, initiation of antidepressant treatment may precipitate short term increases in suicidal ideation and behavior.”

Expanding on the conclusion, “After the FDA warnings, antidepressant use decreased substantially in all age groups and there were simultaneous, small increases in psychotropic drug poisonings, a validated measure of suicide attempts, among adolescents and young adults; these results were consistent across 11 geographically diverse US study sites.”

How might suicides be increasing while antidepressant use was decreasing?

We can think of two related facts.

1) Suicidal thoughts and attempts are a side effect of psychotropic drugs, particularly antidepressants. The side effects of psychotropic drugs being used don’t go away just because there are less prescriptions written.

2) There are a lot more psychotropic drugs with this side effect than just antidepressants, which are not accounted for in this study.

The real problem is that psychiatrists fraudulently diagnose life’s problems as an “illness”, and stigmatize unwanted behavior or study problems as “diseases,” and then prescribe harmful and addictive, suicide-causing drugs to children. Psychiatry’s stigmatizing labels, programs and treatments are harmful junk science; their diagnoses of “mental disorders” are a hoax – unscientific, fraudulent and harmful.

Find Out! Fight Back!

More About Elliot Rodger and Xanax

June 10th, 2014

More About Elliot Rodger and Xanax

Based on interviews with Elliot’s parents, Peter and Li Chen, the Santa Barbara Sheriff’s Department is being told that he was likely addicted to Xanax (generic name alprazolam), an anti-anxiety drug known to cause psychosis, rage, hostility, and suicide.

Rodger on May 23 killed six people and then himself, in the college town of Isla Vista, California, adjacent to the University of California Santa Barbara campus.

Daily use of therapeutic doses is associated with physical dependence. Addiction can occur after 14 days of regular use. The typical consequences of withdrawal are anxiety, depression, sweating, cramps, nausea, psychotic reactions and seizures. There is also a “rebound effect” where the individual experiences even worse symptoms than they started with as a result of chemical dependency.

Drug experts say that Xanax is more addictive than most illegal drugs, including cocaine or heroin, and once someone is hooked, getting off it can be a tortuous and deadly experience.

Email the Santa Barbara County Sheriff and request that they investigate the role of psychiatric drugs such as Xanax in the violence and suicide of Elliot Rodger.

For more information about violence and suicide caused by psychiatric drugs, download and read the free CCHR booklet Psychiatric Drugs Create Violence and Suicide.