Foster Children Prescribed Psychiatric Drugs At Four Times the Rate of Non-Foster Children, New Study Finds

Previous government recommendations for improved oversight of psychotropics in foster care have not resolved the overdrugging problem.

NEWS PROVIDED BY

Citizens Commission on Human Rights, National Affairs Office

WASHINGTON, DC, August 24, 2023 — Despite government recommendations over more than a decade for more oversight of the psychotropic drugs given to foster children, a new study reveals that the powerful, mind-altering drugs are still disproportionately prescribed to these children as compared to non-foster youth.

Researchers at the Baylor College of Medicine in Houston, Texas, reviewed the Medicaid prescription claims of 397,340 children ages 1 to 18 to investigate the rates of psychotropic drug prescriptions for foster children as compared to youth not in foster care. Psychotropic drugs include antidepressants, antipsychotics, stimulants (ADHD drugs), antianxiety drugs, and mood stabilizers.

They found that foster children were prescribed at least one psychotropic drug at four times the rate (35%) of non-foster children (8%).

“Across all age groups, children in foster care on Medicaid were prescribed psychotropic medications disproportionately more than their non-foster peers on Medicaid,” concluded lead author Rachael J. Keefe, MD, MPH, FAAP, a pediatrician and associate professor of pediatrics-public health, writing in the Journal of Child and Adolescent Psychopharmacology.

The study comes at a time of renewed scrutiny of the amount of psychotropic drugs administered to children in the foster care system. These are children already traumatized by being removed from their homes, where they may have been abused or neglected. Giving them psychotropic drugs exposes them to the risk of having to also deal with drug side effects, some of the most serious of which are significant weight gain, uncontrollable restlessness (akathisia), uncontrollable muscle movements (tardive dyskinesia), heart problems, mania, violence, and suicidal thoughts and actions.

In April, a federal judge in Texas said he was appalled at “the massive amount of drugs that are given to these [foster] children” in psychiatric residential treatment facilities and expressed concern for the children’s safety. The judge was responding to a report on visits to 14 facilities housing foster children, which also showed a lack of proper monitoring of children taking the drugs.

Earlier this year, a federal class-action lawsuit was filed by several disability and civil rights organizations against the Maryland Department of Human Services and its Social Services Administration, alleging that up to 34% of Maryland foster children are prescribed psychotropic drugs, with over half of them prescribed more than one drug. The suit suggests that the drugs are being used on some children as a form of chemical restraint, according to a media report.

More than a decade ago, after an analysis of psychotropic drug use by Medicaid children in five states, the U.S. Government Accountability Office (GAO) issued a report in 2011 finding that foster children were prescribed psychotropic drugs at double to quadruple the rate of non-foster children. The GAO further found that hundreds of children were taking five or more psychotropic drugs, and thousands were prescribed doses higher than maximum levels recommended by the U.S. Food and Drug Administration (FDA). The GAO recommended government guidance be provided to increase oversight and protections for these children.

A seminal series of articles in 2014 in the San Jose Mercury News brought national attention to the problem again, detailing the high rate of psychotropic prescriptions continuing for children in the California foster care system.

The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) investigated claims for antipsychotics, a large class of psychotropic drugs, paid for by Medicaid, the health provider for most foster children. Its 2015 report included findings of too many drugs or wrong doses being prescribed and poor monitoring of the children taking the drugs. The OIG recommended enhanced government oversight and reviews of psychotropics prescribed to children.

The OIG issued another report three years later, revealing that one in three children in foster care receiving psychotropic drugs did not receive required treatment planning or medication monitoring. The OIG again recommended better government oversight of psychotropic prescriptions.

Now, the new Texas study shows that the overdrugging of foster children is still occurring. Government recommendations for improved oversight to date have not resolved the problem.

The Citizens Commission on Human Rights urgently calls on state and federal governments to act to protect foster children from the massive overprescribing of psychotropic drugs and the physical and mental health risks the drugs carry.

WARNING: Anyone wishing to discontinue or change the dose of a psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

The Citizens Commission on Human Rights (CCHR) continues to raise public awareness of the risks of serious side effects and withdrawal symptoms from antidepressants and other psychiatric drugs, so that consumers and their physicians can make fully informed decisions about starting or stopping the drugs. CCHR supports safe and science-based non-drug approaches to mental health.

CCHR also recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of depression or other unwanted mental and behavioral symptoms, which might otherwise be misdiagnosed and incorrectly treated as a psychiatric disorder.

The Citizens Commission on Human Rights was co-founded in 1969 by members of the Church of Scientology and the late psychiatrist and humanitarian Thomas Szasz, M.D., recognized by many academics as modern psychiatry’s most authoritative critic, to eradicate abuses and restore human rights and dignity to the field of mental health. CCHR has been instrumental in obtaining 228 laws against psychiatric abuse and violations of human rights worldwide.

The CCHR National Affairs Office in Washington, DC, has advocated for mental health rights and protections at the state and federal level. The CCHR traveling exhibit, which has toured 441 major cities worldwide and educated over 800,000 people on the history to the present day of abusive and racist psychiatric practices, has been displayed at the Congressional Black Caucus Foundation Annual Legislative Conference in Washington, DC, and at other locations.

Anne Goedeke
Citizens Commission on Human Rights, National Affairs Office

Posted in Big Muddy River Newsletter | Tagged , , , , , | Comments Off on Foster Children Prescribed Psychiatric Drugs At Four Times the Rate of Non-Foster Children, New Study Finds

Antidepressants Increase Risk of Suicidal Behavior in Children and Young Adults, Don’t Reduce Risk in Adults, Study Says

Other recent research has found antidepressants double the risk of suicidal thoughts and actions in adults.

NEWS PROVIDED BY

Citizens Commission on Human Rights, National Affairs Office

WASHINGTON, DC, August 17, 2023 — A new study adds fresh evidence that treatment for depression with antidepressants increases the risk of suicidal behavior, including attempted and completed suicides, in children and young adults under age 25. The findings support previous studies that have also found a greater risk of suicidal thoughts and actions in young people taking antidepressants – drugs that are prescribed to reduce that risk.

“The present study finds similar results to prior observational research – that is, consistent evidence of an increased risk of suicidality during treatment with SSRIs in children and adolescents,” wrote lead author Tyra Lagerberg, at the Karolinska Institutet in Stockholm, Sweden, and the psychiatry department at Oxford University’s Warneford Hospital in the U.K. The study was published in Neuropsychopharmacology.

Lagerberg led a team of Swedish researchers who used medical and death registry records of roughly 162,000 depressed individuals from 2006-2018 to find the risk of suicidal behavior within 12 weeks after the patients either were or were not started on selective-serotonin reuptake inhibitor (SSRI) antidepressants following a diagnosis of depression. Overall, the study revealed an increased risk of suicidal behavior among the antidepressant users.

The greatest increase in risk was to youth 6 to 17 years of age, who were three times more likely to engage in suicidal behavior, followed by 18- to 24-year-olds, whose risk was doubled.

“Our results confirm that children and adolescents under age 25 are a high-risk group, in particular children aged under 18 years,” Lagerberg concluded.

While this study did not find an increased risk of suicidal behavior from antidepressants in older patients or patients who previously attempted suicide, it did find that taking the drugs did not reduce the risk for these groups.

The research confirms the validity of the stringent, black-box warning first required in 2004 by the U.S. Food and Drug Administration (FDA) on antidepressant packaging to alert consumers and prescribers to the increased risk of suicidal thoughts and actions for children and adolescents. The action came after drug trials indicated that youth taking antidepressants were almost twice as likely to have suicidal thoughts or suicide attempts as those receiving placebos. The warning was expanded in 2007 to include young adults through age 24.

Critics have since complained that the warning resulted in more suicides by youngsters not treated with antidepressants. However, researchers recently re-analyzed clinical trial data and concluded that the data demonstrated an increased risk of attempted and completed suicides among youth taking antidepressants and that the FDA’s warning is clearly justified.

Other recent research has found antidepressants double the risk of suicidal thoughts and actions in adults. A re-analysis of safety summaries submitted to the FDA for approval of antidepressants found that the rate of suicide attempts in drug trials was about 2.5 times higher in adults taking antidepressants as compared to those given placebos.

Another study found that when healthy adults with no signs of depression were given antidepressants, their risk of suicidality and violence doubled.

Antidepressants may be prescribed to prevent suicides, but a recent examination of coroner inquests in which the decedents used antidepressants revealed that about half of the deaths were determined to be suicides. One in eight of the deaths involved an overdose of antidepressants.

More fundamentally, a landmark 2022 study questioned the prescribing of antidepressants at all, after finding the common reason for taking them – to correct a chemical imbalance in the brain – had no scientific basis. The study investigated whether evidence supported the theory that a low level of the brain chemical serotonin causes depression.

“The serotonin theory of depression has been one of the most influential and extensively researched biological theories of the origins of depression,” the researchers wrote. “Our study shows that this view is not supported by scientific evidence. It also calls into question the basis for the use of antidepressants.”

WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

The Citizens Commission on Human Rights (CCHR) continues to raise public awareness of the risks of serious side effects and withdrawal symptoms from antidepressants and other psychiatric drugs, so that consumers and their physicians can make fully informed decisions about starting or stopping the drugs. CCHR supports safe and science-based non-drug approaches to mental health.

CCHR also recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of depression or other unwanted mental and behavioral symptoms, which might otherwise be misdiagnosed and incorrectly treated as a psychiatric disorder.

The Citizens Commission on Human Rights was co-founded in 1969 by members of the Church of Scientology and the late psychiatrist and humanitarian Thomas Szasz, M.D., recognized by many academics as modern psychiatry’s most authoritative critic, to eradicate abuses and restore human rights and dignity to the field of mental health. CCHR has been instrumental in obtaining 228 laws against psychiatric abuse and violations of human rights worldwide.

The CCHR National Affairs Office in Washington, DC, has advocated for mental health rights and protections at the state and federal level. The CCHR traveling exhibit, which has toured 441 major cities worldwide and educated over 800,000 people on the history to the present day of abusive and racist psychiatric practices, has been displayed at the Congressional Black Caucus Foundation Annual Legislative Conference in Washington, DC, and at other locations.

Anne Goedeke
Citizens Commission on Human Rights, National Affairs Office

Posted in Big Muddy River Newsletter | Tagged , , , , , , | Comments Off on Antidepressants Increase Risk of Suicidal Behavior in Children and Young Adults, Don’t Reduce Risk in Adults, Study Says

No Clear Benefit, But Serious Side Effects Common for Older People Taking Antidepressants, Study Finds

Adverse effects from taking antidepressants are more common and serious for the elderly because they have more fragile health and take more medications.

NEWS PROVIDED BY

Citizens Commission on Human Rights, National Affairs Office

WASHINGTON, DC, August 9, 2023 — A new review of recent medical literature on antidepressant use by older people with depression revealed no clear evidence of benefit, while adverse effects were found to be especially common and problematic. Alternative treatments for depression were advised.

The review was conducted to provide an overview of studies from the past decade of the benefit and harms of treatment of older persons with selective serotonin reuptake inhibitor (SSRI) antidepressants. The studies under review comprised depressed patients aged 55 and older who were taking SSRI antidepressants in comparison to control groups receiving placebos.

As reported in Mental Health Science, the evidence indicated that antidepressants have little, if any, benefit over placebos in this age group. There was even less evidence of depression remission.

“The evidence of the benefits of antidepressants in the elderly was weak and alternative treatments are advised,” wrote study author Michael Hvidberg, Ph.D., of the psychology department at the University of York in the U.K.

In the U.S., 15.6 million Americans aged 60 and older are prescribed antidepressants –
that’s one of every five (19%), with one in four (24%) of them women.

Adverse effects from taking the drugs are common and more serious among the elderly because they have more fragile health, deal with more medical issues, and take more medications. “Treatment with antidepressants may lead to more [adverse events] due to polypharmacy and age-related physiological changes,” Hvidberg writes, advising other treatment instead of the drugs.

Side effects of taking antidepressants include weight gain, nausea, insomnia, agitation, emotional blunting, sexual dysfunction, and even deepening depression. Psychiatrist Peter Breggin, M.D., describes antidepressants as neurotoxic because they harm and disrupt the functions of the brain and can cause abnormal thinking and behaviors, including anxiety, aggressiveness, loss of judgment, impulsivity, and mania, which can lead to violence and suicide.

Discontinuing antidepressants can bring on withdrawal symptoms, including electric shock-like sensations (“brain zaps” and “body zaps”), muscle spasms and tremors, hallucinations, confusion, irritability, and mania. One study found that more than half (56%) of people attempting to come off antidepressants experience withdrawal symptoms, with nearly half (46%) of them describing those symptoms as severe.

The new study’s finding of no clear benefit to patients from antidepressants is consistent with the results of a 2022 study, which found no clinically significant difference in measures of depression symptoms between adults treated with antidepressants and those taking placebos, whether over a shorter or longer time frame and regardless of the depression severity of the study participants.

Because the drugs have no strong evidence of benefit to patients, but carry the risks of significant side effects, researchers in another recent study advised primary care physicians not to prescribe antidepressants to depressed patients initially, but instead to recommend alternative approaches for treatment.  Similar guidance was issued in 2021 by the London-based National Institute for Health and Care Excellence, the organization that develops standards for health care practices in England.

One alternative approach to depression that has been repeatedly validated as effective in research studies is exercise. The results of one new study found that even exercise below levels of physical activity commonly recommended in health guidelines resulted in significant antidepressant benefits for older adults.

More fundamentally, a landmark 2022 study questioned the prescribing of antidepressants at all, after finding the common reason for taking them – to correct a chemical imbalance in the brain – had no scientific basis.  The study investigated whether evidence supported the theory that a low level of the brain chemical serotonin causes depression.

“The serotonin theory of depression has been one of the most influential and extensively researched biological theories of the origins of depression,” the researchers wrote. “Our study shows that this view is not supported by scientific evidence. It also calls into question the basis for the use of antidepressants.”

WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

The Citizens Commission on Human Rights (CCHR) continues to raise public awareness of the risks of serious side effects and withdrawal symptoms from antidepressants and other psychiatric drugs, so that consumers and their physicians can make fully informed decisions about starting or stopping the drugs.

CCHR also recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of depression or other unwanted mental and behavioral symptoms, which might otherwise be misdiagnosed and incorrectly treated as a psychiatric disorder.

The Citizens Commission on Human Rights was co-founded in 1969 by members of the Church of Scientology and the late psychiatrist and humanitarian Thomas Szasz, M.D., recognized by many academics as modern psychiatry’s most authoritative critic, to eradicate abuses and restore human rights and dignity to the field of mental health. CCHR has been instrumental in obtaining 228 laws against psychiatric abuse and violations of human rights worldwide.

The CCHR National Affairs Office in Washington, DC, has advocated for mental health rights and protections at the state and federal level. The CCHR traveling exhibit, which has toured 441 major cities worldwide and educated over 800,000 people on the history to the present day of abusive and racist psychiatric practices, has been displayed at the Congressional Black Caucus Foundation Annual Legislative Conference in Washington, DC, and at other locations.

Anne Goedeke
Citizens Commission on Human Rights, National Affairs Office

Posted in Big Muddy River Newsletter | Tagged , , , , , , , , | Comments Off on No Clear Benefit, But Serious Side Effects Common for Older People Taking Antidepressants, Study Finds

Electroshock’s Serious Risks, Ineffectiveness Not Adequately Disclosed to Patients, Audit of Information Pamphlets Finds

Patients are not given enough information about the drawbacks of electroshock to give true informed consent for the procedure, researcher says.

NEWS PROVIDED BY

Citizens Commission on Human Rights, National Affairs Office

WASHINGTON, DC, August 3, 2023 — While a million people – mostly women and the elderly, but even young children – receive electroconvulsive therapy (ECT, or “electroshock”) each year, patients are not being given enough information about the serious risks and lack of effectiveness of the procedure to give true informed consent to receive it, according to professor of psychology John Read, Ph.D.

Writing in Psychology Today, Read reports on three audits of patient information leaflets about ECT in the U.K., which he conducted with colleagues over the past two years. They found that pertinent information about risks were omitted, such as the cardiovascular risks, the risk of death, the lack of evidence of long-term benefits, and the fact that it is not known how ECT is supposed to work. There is not even proof of any brain dysfunctions that ECT, by running strong electrical currents through brain tissue, could correct.

In some information pamphlets, the risk of memory loss was minimized, or effectiveness was asserted without mentioning that similar rates of recovery were achieved by people receiving sham (placebo) treatment.

“The minimisation of risks is not uncommon in ECT practice and research,” writes Read.

According to the U.S. Food and Drug Administration (FDA), electroshock can cause brain damage, cognitive impairment, permanent memory loss, prolonged or persistent seizures, worsening psychiatric symptoms, cardiovascular complications (including heart attacks), breathing complications and death.

Even psychiatrist Max Fink, considered “the grandfather of American ECT,” admitted that “the principal complications of ECT are death, brain damage, memory impairment and spontaneous seizures.”

ECT shoots up to 460 volts of electricity through brain tissue to induce a grand mal seizure that can last up to 30 minutes. A grand mal seizure is the most serious type of seizure, the kind usually caused by epilepsy. Emergency room doctors treat a grand mal seizure as a medical emergency. Psychiatrists performing the procedure call it “therapy.”

Read disputes any claim that electroshock is “highly effective,” writing that no proof of that exists.

“There have…been no placebo-controlled studies of ECT for depression since 1985, and all 11 studies prior to that date were very small, severely flawed and conducted on adults,” he pointed out in previous commentary, published in Brain and Behavior. “There have been no placebo-controlled studies on children or adolescents.” Despite that fact, statistics on electroshock usage in the U.S. for 2019 reveals ECT was administered to children 5 years of age or younger in at least four of 27 states reporting ECT use to Medicaid.

What’s more, there is no lasting benefit  to patients after a course of electroshock. “No studies have found any evidence that ECT is better than placebo beyond the end of treatment,” Read wrote for the MadInAmerica website.

Even the U.S. Food and Drug Administration (FDA) requires ECT machines to have signs next to them stating, “The long-term safety and effectiveness of ECT treatment has not been demonstrated,” Read observed.

Read reports he was recently an expert witness in a trial in which the jury found that Somatics, a manufacturer of machines for administering ECT, failed to adequately warn about the risks associated with its device. In settling a prior lawsuit, the company had already added the risk of “permanent memory loss and brain damage” to the list of adverse effects it is disclosing about its machine.

The failure of the ECT to reduce the risk of death by suicide is the finding of other recent research. One study found that the odds of patients committing suicide in the year after receiving ECT were not statistically different from the odds of those who did not receive it.

Another study revealed that patients are 44 times more likely to die from suicide in the two years following ECT treatment than those who did not get the procedure and twice as likely to die from any cause.

The Citizens Commission on Human Rights (CCHR) advocates a total ban on ECT and continues to raise public awareness about the brain damage it causes. More than 133,000 people have signed the CCHR online petition to ban ECT.

CCHR recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of depression or other unwanted mental or behavioral symptoms, which might otherwise be misdiagnosed as a psychiatric disorder and incorrectly treated.

The Citizens Commission on Human Rights was co-founded in 1969 by members of the Church of Scientology and the late psychiatrist and humanitarian Thomas Szasz, M.D., recognized by many academics as modern psychiatry’s most authoritative critic, to eradicate abuses and restore human rights and dignity to the field of mental health. CCHR has been instrumental in obtaining 228 laws against psychiatric abuse and violations of human rights worldwide.

The CCHR National Affairs Office in Washington, DC, has advocated for mental health rights and protections at the state and federal level. The CCHR traveling exhibit, which has toured 441 major cities worldwide and educated over 800,000 people on the history to the present day of abusive and racist psychiatric practices, has been displayed at the Congressional Black Caucus Foundation Annual Legislative Conference in Washington, DC, and at other locations.

Anne Goedeke
Citizens Commission on Human Rights, National Affairs Office

Posted in Big Muddy River Newsletter | Tagged , , , , | Comments Off on Electroshock’s Serious Risks, Ineffectiveness Not Adequately Disclosed to Patients, Audit of Information Pamphlets Finds

Half of Depressed, Anxious Teens Recover Without Mental Health Treatment, Study Finds

Research indicates the resilience of adolescents is effective and can avoid the ineffectiveness, harms and costs of pharmacological and psychological treatments.

NEWS PROVIDED BY

Citizens Commission on Human Rights, National Affairs Office

WASHINGTON, DC, July 26, 2023 — A systematic review and meta-analysis on adolescents experiencing depression and/or anxiety reveals that half of them recovered on their own, without any mental health treatment.  Researchers say the result indicates that strengthening young people’s own resilience is key to their long-term mental health.

Noting that experiencing mental distress is common in the transition from adolescence to adulthood, a team of researchers reviewed previous studies to find the recovery rate of depressed and/or anxious adolescents who dealt with their teen angst without psychiatric drugs, psychotherapy, or other specific mental health treatment.  They found that within one year, half of depressed and/or anxious teens had recovered on their own.

“The findings suggest that after 1 year, about 54% of young people with symptoms of anxiety and/or depression recover without any specific mental health treatment,” according to the study’s lead author, Anna Roach, a PhD candidate at Queen Mary University of London.  Due to certain limitations of the study, the researchers suggest that the true rate of recovery is likely even higher. 

This result is an indication of teens’ ability to adapt and adjust to difficulties in life, “a sign of resilience, with young people bouncing back from their experience of distress,” the researchers wrote, reporting in the online peer-reviewed British medical journal, BMJ Open.

The high rate of recovery without involvement in the mental health system challenges the growing number of programs set up to screen and refer depressed or anxious teens to mental health practitioners for further evaluation and treatment.  As the researchers put it, “the question arises as to whether [teenagers] should routinely be considered for specialised treatments or whether one should wait with such decisions for a year, by which time about 54% are likely to have recovered without treatment.”

Instead of channeling young people into the mental health system, the study calls for new approaches to mental health care, noting also that psychiatric drugs and psychotherapy are both largely ineffective and costly.

Research on safe and effective alternative mental health treatment already exists.  For example, a 2023 study found that exercise is as effective in reducing symptoms of depression as antidepressant drugs or psychotherapy, regardless of the type or intensity of the exercise or whether done in a group or not.  Similarly, a 2020 study found exercise is effective in significantly reducing the symptoms of anxiety.

Many young people already avoid mental health treatment.  A recent study found that one in three depressed young adults preferred self-reliance instead of getting mental health treatment.  One in four cited concerns about being involuntarily committed to a psychiatric facility or having to take psychiatric drugs, while one in seven did not think mental health treatment would help them.

The most widely prescribed psychiatric drugs in the U.S. are antidepressants.  A recent study, published in World Psychiatry, advises doctors not to prescribe antidepressants as first-line treatment for most depressed patients because the benefit of the drugs is so small that it may not be clinically significant, and the drugs carry the risk of significant side effects.  Instead, the researchers suggest prescribing non-drug approaches first for the patients.

Some 45 million Americans are currently taking one or more antidepressants, including 5.7 million children and young adults under the age of 25, for whom the FDA requires a warning on the drug’s prescribing information of the increased risk of suicidal thoughts and actions.

Other adverse effects of antidepressants include weight gain, nausea, insomnia, agitation, emotional blunting and sexual dysfunction.  One recent study found that half of antidepressant users experience sexual problems, which can strain their relationships and lead to a worsening of their depression.   

Doctors have no clear guidance for tapering or discontinuing antidepressants, leaving their patients at greater risk of experiencing withdrawal symptoms that for many will be severe and incapacitating. 

A recent study found that more than 56% of people who attempt to come off antidepressants experience withdrawal effects, with nearly half (46%) of them rating the symptoms as ‘severe.’”

More fundamentally, a landmark 2022 study questioned the prescribing of antidepressants at all, after finding the common reason for taking them – to correct a chemical imbalance in the brain – had no scientific basis.

“These studies all point to the desperate need for a drastic overhaul of the badly broken U.S. mental health system, which relies on the psychiatric drugs and practices that scientific research has found ineffective and harmful,” says Anne Goedeke, president of the National Affairs Office of the Citizens Commission on Human Rights.

WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

CCHR recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of depression, anxiety, or other unwanted mental and behavioral symptoms, which might otherwise be misdiagnosed and incorrectly treated as a psychiatric disorder.

The Citizens Commission on Human Rights was co-founded in 1969 by members of the Church of Scientology and the late psychiatrist and humanitarian Thomas Szasz, M.D., recognized by many academics as modern psychiatry’s most authoritative critic, to eradicate abuses and restore human rights and dignity to the field of mental health.  CCHR has been instrumental in obtaining 228 laws against psychiatric abuse and violations of human rights worldwide.

The CCHR National Affairs Office in Washington, DC, has advocated for mental health rights and protections at the state and federal level.  The CCHR traveling exhibit, which has toured 441 major cities worldwide and educated over 800,000 people on the history to the present day of abusive and racist psychiatric practices, has been displayed at the Congressional Black Caucus Foundation Annual Legislative Conference in Washington, DC, and at other locations.

Anne Goedeke
Citizens Commission on Human Rights, National Affairs Office

Posted in Big Muddy River Newsletter | Tagged , , , , | Comments Off on Half of Depressed, Anxious Teens Recover Without Mental Health Treatment, Study Finds

New Study Finds Troubling Mental and Physical Side Effects Are Main Reason Patients Stop Taking Antidepressants

NEWS PROVIDED BY

Citizens Commission on Human Rights, National Affairs Office

WASHINGTON, DC, July 19, 2023 — A new study investigating why patients stop taking antidepressants found the most common reason given was the adverse physical and mental side effects experienced. The findings add to prior research revealing the troubling, and even dangerous side effects of these mind-altering psychotropic drugs.

Researchers in the U.S. and U.K. analyzed 667 reviews posted on the online health forum WebMD by users of seven common selective serotonin reuptake inhibitor (SSRI) antidepressants. The most common reason users gave for discontinuing antidepressants was the negative side effects they experienced.

Mental side effects were the adverse events most mentioned in the reviews, including apathy, anxiety, insomnia, loss of sexual drive, and suicidal ideation. These side effects were reported more often in the online posts than in the formal reporting systems set up by the U.S. Food and Drug Administration and the U.K. Medicines and Healthcare Products Regulatory Agency, leading the researchers to note that the online comments provide valuable, additional information for government drug regulatory agencies about the adverse effects of SSRIs.

“It is not merely feasible to collect data from online comments and reviews regarding SSRI medication changes, but…doing so can provide important supplementary information to reporting systems,” wrote lead author Su Golder, PhD, of the University of York in the U.K., reporting in JAMA Network Open.

Other top adverse events reported by SSRI users as reasons for discontinuing antidepressants were physical side effects, such as dizziness, drowsiness, headache, diarrhea, vomiting, weight gain, itchiness, excessive sweating, and sexual dysfunction.

“These results suggest that reasons for changes in SSRI use can be identified in online drug reviews and that adverse events mentioned may reflect those more salient to patients for discontinuing their medication,” according to Golder.

Though the study was intended to discover why SSRI users discontinue antidepressants so that ways to keep them on the drugs could be developed, the study provides additional evidence of the harm from the drugs that users contend with. Other recent research findings on the negative effects of antidepressants are much more disturbing.

A 2019 study indicated that the rate of attempted suicide was about 2.5 times higher in those taking antidepressants as compared to placebo. Those results were similar to a 2016 study that found antidepressants, given to healthy adult volunteers with no signs of depression, doubled their risk of suicidality and violence.

Antidepressant use has risen significantly over the past 15 years – and so have suicides and senseless acts of violence like mass shootings. In 2020, some 45 million Americans, or roughly one in seven, were taking antidepressants, up from 34 million in 2006. This 32% increase in users parallels the 35% increase in suicides in the U.S. over the same period. During the same time, many school shootings and other acts of senseless violence were committed by individuals taking antidepressants or in withdrawal from them.

A 2020 study found that half of antidepressant users experience sexual problems that can strain their relationships and lead to a worsening of their depression.  In a 2017 survey of antidepressant users, 44% of respondents reported the drugs negatively impacted their sex lives, 27% their ability to work or study, and 21% their relationships with friends or family.

For all the risk of serious side effects, recent research has found little, if any, benefit to antidepressants over placebos.  A 2022 study found no clinically significant difference in measures of depression symptoms between adults treated with antidepressants and those taking placebos, whether over a shorter or longer time frame and regardless of the depression severity of the study participants.

Another study in 2018 found that those who used antidepressants any time during the 30-year period of the study had an 81% greater chance of having more severe depression symptoms at the end of that time.

More fundamentally, a landmark 2022 study questioned the prescribing of antidepressants at all, after finding the common reason for taking them – to correct a supposed chemical imbalance in the brain – had no scientific basis. The study investigated whether evidence supported the theory that a low level of the brain chemical serotonin causes depression.

“The serotonin theory of depression has been one of the most influential and extensively researched biological theories of the origins of depression,” the researchers wrote. “Our study shows that this view is not supported by scientific evidence. It also calls into question the basis for the use of antidepressants.”

WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

The Citizens Commission on Human Rights (CCHR) continues to raise public awareness of the risks of serious side effects and withdrawal symptoms from antidepressants and other psychiatric drugs, so that consumers and their physicians can make fully informed decisions about starting or stopping the drugs.

CCHR also recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of depression or other unwanted mental and behavioral symptoms, which might otherwise be misdiagnosed and incorrectly treated as a psychiatric disorder.

The Citizens Commission on Human Rights was co-founded in 1969 by members of the Church of Scientology and the late psychiatrist and humanitarian Thomas Szasz, M.D., recognized by many academics as modern psychiatry’s most authoritative critic, to eradicate abuses and restore human rights and dignity to the field of mental health. CCHR has been instrumental in obtaining 228 laws against psychiatric abuse and violations of human rights worldwide.

The CCHR National Affairs Office in Washington, DC, has advocated for mental health rights and protections at the state and federal level. The CCHR traveling exhibit, which has toured 441 major cities worldwide and educated over 800,000 people on the history to the present day of abusive and racist psychiatric practices, has been displayed at the Congressional Black Caucus Foundation Annual Legislative Conference in Washington, DC, and at other locations.

Anne Goedeke
Citizens Commission on Human Rights, National Affairs Office

Posted in Big Muddy River Newsletter | Tagged , , , , , , , , | Comments Off on New Study Finds Troubling Mental and Physical Side Effects Are Main Reason Patients Stop Taking Antidepressants

Study Adds to Research Showing Involuntary Psychiatric Hospitalization Does More Harm Than Good

NEWS PROVIDED BY

Citizens Commission on Human Rights, National Affairs Office

WASHINGTON, DC, July 13, 2023 — A new study has found that involuntary hospitalization for substance abuse treatment is not effective, adding to the growing body of research finding that forced behavioral health treatment does more harm than good and raising ethical questions about the use of coercion by the psychiatrists typically in charge of the treatment.

Researchers from Harvard Medical School and Brigham and Women’s Hospital in Boston investigated the outcomes of 22 patients involuntarily committed for substance abuse treatment after first coming to a hospital emergency room. The result was that after release, none of the patients stayed off their alcohol and/or drugs, and all of them ended up back in the emergency room within a year because of their substance misuse.

“One year following involuntary commitment, all patients had relapsed to substance use and had at least one emergency department visit,” wrote lead author John C. Messinger. Half reverted to substance abuse within two months after the start of their involuntary treatment.

“The study adds to a growing literature recognizing the harms of involuntary commitment for substance use disorder,” the researchers concluded.

Other research has found that forced hospitalization is also ineffective and harmful for mental health treatment. A study earlier this year found no benefit to patients’ mental health condition and no lower risk of death from nonconsensual mental health treatment.

This follows a 2020 study which found that psychiatric in-patients were actually more likely to attempt suicide after release if they were admitted and treated against their will as compared to those who were not.

The harm and lack of benefit from involuntary commitment for psychiatric treatment has resulted in some people avoiding mental health treatment. The U.S. 2011-2019 National Survey on Drug Use and Health revealed that one in four depressed young adults cited their concern over being involuntarily committed to a psychiatric facility or forced to take psychiatric drugs against their will as a reason not to seek mental health treatment.

The potential of involuntary psychiatric hospitalization and treatment doing more harm than good has led some medical professionals to argue that such acts violate the Hippocratic oath of “first do no harm” and should be abolished.

Among them is the co-founder of the Citizens Commission on Human Rights (CCHR), the late professor of psychiatry and humanitarian Thomas Szasz, M.D., who advocated an end to forced psychiatric treatment. Considered by many scholars and academics to be psychiatry’s most authoritative critic, Dr. Szasz wrote: “Increasing numbers of persons, both in the mental health professions and in public life, have come to acknowledge that involuntary psychiatric interventions are methods of social control. On both moral and practical grounds, I advocate the abolition of all involuntary psychiatry.”

The World Health Organization (WHO) has also taken a strong position against coercive mental health practices. In a series of guidelines issued in 2021, WHO stated that nonconsensual practices are used “despite the lack of evidence that they offer any benefits, and the significant evidence that they lead to physical and psychological harm and even death.”

The guidelines further state: “People subjected to coercive practices report feelings of dehumanization, disempowerment and being disrespected. Many experience it as a form of trauma or re-traumatization leading to a worsening of their condition and increased experiences of distress.”

WHO’s call for an end to involuntary mental health treatment extends even to those experiencing acute mental distress. The guidelines note that individuals in mental health crisis “are at a heightened risk of their human rights being violated, including through forced admissions and treatment.”

WHO challenged United Nations member nations, including the United States, to ensure that their mental health services are free from coercion, including forced drugging, the use of physical and chemical restraints and seclusion, electroshock without consent, and involuntary institutionalization.

The Citizens Commission on Human Rights has been a global leader in the fight against the coercive and abusive use of involuntary commitments, seclusion and restraints, psychiatric drugs, and electroshock. In 1969, CCHR issued a Mental Health Declaration of Human Rights that laid out fundamental human rights in the field of mental health to ensure the right to one’s own mind and the right to be free from forced mental health treatment.

CCHR was co-founded in 1969 by members of the Church of Scientology and Dr. Szasz to eradicate abuses and restore human rights and dignity to the field of mental health. CCHR has been instrumental in obtaining 228 laws against psychiatric abuse and violations of human rights worldwide.

The CCHR National Affairs Office in Washington, DC, has advocated for mental health rights and protections at the state and federal level. The CCHR traveling exhibit, which has toured 441 major cities worldwide and educated over 800,000 people on the history to the present day of abusive and racist psychiatric practices, has been displayed at the Congressional Black Caucus Foundation Annual Legislative Conference in Washington, DC, and at other locations.

Anne Goedeke
Citizens Commission on Human Rights, National Affairs Office

Posted in Big Muddy River Newsletter | Tagged , , , , , , , , | Comments Off on Study Adds to Research Showing Involuntary Psychiatric Hospitalization Does More Harm Than Good

Devastating Movement Disorders Caused by Antipsychotic Drugs Not Listed for Discussion at Psychiatrists’ Annual Meeting

NEWS PROVIDED BY

Citizens Commission on Human Rights, National Affairs Office

WASHINGTON, DC, July 4, 2023 — None of the hundreds of meetings and sessions offered at the annual conference of the American Psychiatric Association in May was dedicated to discussing the potentially disabling and irreversible movement disorders, including tardive dyskinesia and akathisia, caused by the antipsychotic drugs the psychiatrists prescribe.

Tardive dyskinesia (TD) refers to the drug-induced, involuntary muscle movements that can develop over time from taking antipsychotic drugs, the class of drugs typically prescribed for symptoms of psychosis, mania, anxiety and depression. TD has also been linked to other classes of psychiatric drugs, including antidepressants, mood stabilizers and stimulants.

This psychiatric drug-induced physical disorder is characterized by repetitive, involuntary muscle movements of the face, lips, tongue, limbs, and torso that can range from a slight tremor, unnoticed by the patient, to uncontrollable movements of the entire body. More severe involuntary movements can become a disabling condition and can cause such embarrassment that the individual withdraws from social interaction.

“Tardive dyskinesia is a dreadful disorder caused by all the antipsychotic drugs,” according to psychiatrist Peter Breggin, MD. “People who suffer from it tend to become isolated from society and many become disabled.”

Currently, over 11 million Americans are taking antipsychotics, including more than 800,000 children and teens under the age of 18.

Studies have found that TD will eventually develop in 20%-30% of those taking antipsychotic drugs. Older age is a major risk factor for TD, with up to 50% to 60% of those over the age of 45 ultimately developing the movement disorder. This prevalence suggests that several million Americans may already be experiencing the symptoms of TD.

Race is also a risk factor for TD. A 2004 evaluation found antipsychotic-induced TD is more prevalent in African Americans than Americans of European descent.  This finding is even more consequential in light of the fact that African Americans are disproportionately diagnosed with psychosis and schizophrenia and then are likely to be prescribed antipsychotic drugs.

Even after discontinuing the drugs, TD may persist for years in a majority of patients who develop the condition, and it is often  permanent. A 2014 study at Emory University’s movement disorders clinic found that only about one in eight patients ever fully recover from TD.

Many taking antipsychotic drugs report they were not told of the risk of tardive dyskinesia by their doctor. A 2019 survey found that 58% of patients were not aware that the antipsychotics they were taking could cause TD. Among those suffering TD symptoms, 80% were emotionally distressed by their jerky movements, nearly half (47%) said it affected their job performance, and two-thirds reported a drop in self-esteem (68%) and self-confidence (64%).

Antipsychotics can also cause akathisia, a movement disorder characterized by restlessness and an inability to sit still. According to medical researcher Peter Gøtzsche, MD, “akathisia is one of the most dangerous harms of [antipsychotics] and depression drugs, as it predisposes [patients] to suicide, violence and homicide.” He says that psychiatrists typically misinterpret akathisia’s symptom of restless behavior as the patient’s need for a higher dose of the antipsychotics, which only worsens the situation.

One study found that half of all fights in a psychiatric ward stemmed from the akathisia related to the antipsychotic drugs the patients were taking, while another study revealed that 79% of mentally ill patients who attempted suicide suffered from the agitation of akathisia.

The continued prescribing of potentially disabling antipsychotic drugs is being further enabled by highly profitable drugs that were developed to treat TD, which patients take while they continue to stay on the antipsychotic or other drugs that are causing their TD. Drug companies manufacturing TD treatments have predicted sales of $1 billion to $2 billion per year. The TD-treatment drugs come with their own side effects, ironically including akathisia and agitation, as well as depression and suicidality.

The Citizens Commission on Human Rights (CCHR) continues to raise public awareness of the risks of serious side effects and withdrawal symptoms from antipsychotics and other psychiatric drugs, so that consumers and their physicians can make fully informed decisions about starting or stopping the drugs.

CCHR recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of unwanted mental or behavioral symptoms, which might otherwise be misdiagnosed as a psychiatric disorder and incorrectly treated.

WARNING: Anyone wishing to discontinue or change the dose of a psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

The Citizens Commission on Human Rights was co-founded in 1969 by members of the Church of Scientology and the late psychiatrist and humanitarian Thomas Szasz, M.D., recognized by many academics as modern psychiatry’s most authoritative critic, to eradicate abuses and restore human rights and dignity to the field of mental health. CCHR has been instrumental in obtaining 228 laws against psychiatric abuse and violations of human rights worldwide.

The CCHR National Affairs Office in Washington, DC, has advocated for mental health rights and protections at the state and federal level. The CCHR traveling exhibit, which has toured 441 major cities worldwide and educated over 800,000 people on the history to the present day of abusive and racist psychiatric practices, has been displayed at the Congressional Black Caucus Foundation Annual Legislative Conference in Washington, DC, and at other locations.

Anne Goedeke
Citizens Commission on Human Rights, National Affairs Office

Posted in Big Muddy River Newsletter | Tagged , , , , , , | Comments Off on Devastating Movement Disorders Caused by Antipsychotic Drugs Not Listed for Discussion at Psychiatrists’ Annual Meeting

Many Common Psychiatric Drugs Can Increase Patients’ Risk of Heat-Related Illness

NEWS PROVIDED BY

Citizens Commission on Human Rights, National Affairs Office

WASHINGTON, DC, June 28, 2023/EINPresswire.com/ — Extreme heat, like the heat wave currently gripping the U.S. South, is especially dangerous for those prescribed many common psychiatric drugs, particularly antipsychotic drugs, that increase the risk of heat-related illness, ranging from the mild discomfort of heat cramps to the more serious symptoms of heat exhaustion and life-threatening heat stroke.

Many common psychiatric drugs can impair the body’s cooling mechanism or cause the people taking them to be less sensitive to signs of overheating, thus predisposing them to heat-related illness. Medical emergencies occur when the body’s temperature rises to dangerous levels and the body becomes unable to lower its temperature. Bodily damage, which can be fatal, occurs if steps are not taken to lower body temperature. One study found that taking psychiatric drugs nearly doubled the risk of death during a heat wave.

The elderly are even more susceptible to the risk of heat-related illness. The body’s temperature regulation is generally slower in older adults. Compared to young people, older adults also sweat less and radiate less heat, so the core body temperature rises more easily. The rate of hospitalization for heat stroke is significantly higher for older adults and their hospital stays are longer.

“In special risk situations such as heat waves, the risk/benefit ratio of psychotropic drugs which could interfere with body temperature regulation has to be carefully assessed, particularly in the elderly,” concluded French researchers, led by Karin Martin-Latry, PharmD, PhD, in a study published in European Psychiatry.

How many people taking psychiatric drugs end up with heat-related medical emergencies? Nobody knows.

“Due to the lack of research in the field, it is impossible to estimate the scale of the problem” of the interaction between drugs and heat, Ying Zhang, senior lecturer at the University of Sydney’s School of Public Health, told the Washington Post.

During periods of extreme heat, those taking antipsychotic drugs are at particular risk of heat stroke. Antipsychotics reduce sweating, the body’s natural means of cooling, as well as reduce the users’ behavior to cool themselves, like drinking more water or removing extra clothing. Even a short time in very hot weather can cause a rapid rise in body temperature for people on these drugs.

“Patients who are prescribed antipsychotics should be aware of the potentially fatal adverse events that can occur from these medications,” warned doctors in a recently published case report on antipsychotic drug-induced hyperthermia.

Stimulant drugs, like ADHD drugs, are known to raise body temperature, as well as interfere with the body’s ability to cool itself down. High summer temperatures can cause body temperatures that are already elevated by these drugs to go higher still.

Tricyclic antidepressants decrease sweating, along with inhibiting the body’s ability to regulate temperature, which can result in body temperature rising to dangerous levels during summer heat waves.

Selective serotonin reuptake inhibitor (SSRI) antidepressants can increase sweating while at the same time reducing thirst, which can lead to dehydration and heat illness in very hot weather.

Those taking psychiatric drugs should limit their exposure to summer heat and strenuous activity and drink plenty of water. Seek immediate medical attention for anyone showing signs of heat stroke, including confusion, unconsciousness, a rapid pulse, a high temperature, or red, hot, dry skin.

The Citizens Commission on Human Rights (CCHR) continues to raise public awareness of the risks of serious side effects from psychiatric drugs, so that consumers and their physicians can make fully informed decisions about starting or stopping the drugs.

CCHR recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of unwanted mental or behavioral symptoms, which might otherwise be misdiagnosed as a psychiatric disorder and incorrectly treated.

WARNING: Anyone wishing to discontinue or change the dose of a psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

The Citizens Commission on Human Rights was co-founded in 1969 by members of the Church of Scientology and the late psychiatrist and humanitarian Thomas Szasz, M.D., recognized by many academics as modern psychiatry’s most authoritative critic, to eradicate abuses and restore human rights and dignity to the field of mental health. CCHR has been instrumental in obtaining 228 laws against psychiatric abuse and violations of human rights worldwide.

The CCHR National Affairs Office in Washington, DC, has advocated for mental health rights and protections at the state and federal level. The CCHR traveling exhibit, which has toured 441 major cities worldwide and educated over 800,000 people on the history to the present day of abusive and racist psychiatric practices, has been displayed at the Congressional Black Caucus Foundation Annual Legislative Conference in Washington, DC, and at other locations.

Anne Goedeke
Citizens Commission on Human Rights, National Affairs Office

Posted in Big Muddy River Newsletter | Tagged , , , , , , | Comments Off on Many Common Psychiatric Drugs Can Increase Patients’ Risk of Heat-Related Illness

White Paper on Improving Psychiatric Patient Outcomes

Reference:
WHITE PAPER on Improving Patient Outcomes, Addressing Treatment Caused Trauma & Injuries, Enhancing Patient Rights, and Grievance Procedures for the Report Required by § 36 of CH 41 SLA 2022 (HB172)
by James B. (Jim) Gottstein, Esq.; Faith Myers; Susan Musante, LPCC; David Cohen, PhD; Peter C. Gøtzsche, MD; David Healy, MD; The International Society for Ethical Psychology & Psychiatry
April 2023, Addenda May 2023
Anchorage, Alaska

[Note: Full references and citations are provided in the original White Paper.]

On July 15, 2022, Alaska Governor Mike Dunleavy signed HB172 into law which requires the Department of Health, Department of Family and Community Services, and the Alaska Mental Health Trust Authority to report on, among other things, improving psychiatric patient outcomes, institutional trauma, enhancing patient rights, the grievance process, and patient injuries.

The Legislation was enacted to comply with a settlement over a successful lawsuit brought against the State of Alaska for illegally confining people for extended periods of time in correctional facilities and emergency rooms awaiting admission to the Alaska Psychiatric Institute for court ordered psychiatric evaluations.

This White Paper provides input for the required Report to the Legislature, focusing on improving patient outcomes, enhancing patient rights, having an effective and legitimate grievance process, and addressing patient injuries and treatment-caused trauma.

Executive Summary of the White Paper

If the fundamental purpose of the mental health system is to improve the lives of psychiatric patients it is failing miserably. That the State does not keep track of institutional trauma and patient complaints, and has no legitimate grievance process are illustrations of the lack of commitment to improving patients’ lives.

The mental health system’s standard treatments are counterproductive and harmful, and often forced on unwilling patients. The overreliance on psychiatric drugs is reducing the recovery rate of people diagnosed with serious mental illness and reducing their life spans. Psychiatric incarceration, euphemistically called “involuntary commitment,” is similarly counterproductive and harmful, adding to patients’ trauma and massively associated with suicides. Harmful psychiatric interventions are being imposed on people by judges in proceedings where the facts about treatments and their harms are not being presented by appointed counsel, rendering the proceedings shams.

Court proceedings to psychiatrically incarcerate people on the grounds it is necessary to protect other people from harm should be eliminated; predictions of violence are not accurate and no one else besides someone who receives a psychiatric diagnosis is incarcerated for something they might do in the future. Court proceedings to psychiatrically drug people against their will on the grounds it is in their best interest should be eliminated. They are not in people’s best interest if unwanted. “If it is not voluntary it is not treatment.” If such proceedings are nonetheless held, they should be conducted in a legitimate manner.

The most important elements for improving patients’ lives are People, Place and Purpose. People—even psychiatric patients—need to have a safe place to live (Place), relationships (People), and to have activity that is meaningful to them, usually school or work (Purpose). People need to be given hope these are possible. Voluntary approaches that improve people’s lives should be made available instead of the currently prevailing counterproductive and harmful psychiatric drugs for everyone, forever regime often forced on people. The White Paper lists at least 8 successful non-drug treatment programs that already exist for people experiencing mental distress. Brutal incarceration and coercive psychiatry is not the only option.

By implementing these approaches, Alaska’s mental health system can improve the recovery rate. As bad as it is for adults, the psychiatric incarceration and psychiatric drugging of children and youth is even more tragic and should be stopped. Instead, children and youth should be helped to manage their emotions and become successful, and their parents should be given support and assistance to achieve this.

Posted in Big Muddy River Newsletter | Tagged , , , , , , , , | Comments Off on White Paper on Improving Psychiatric Patient Outcomes