‘Mothers on the Edge’ was broadcast last night.
Thanks to the anonymous* source in the South London and Maudsley Hospital Trust PR department for reporting the following conversation, which took place about eighteen months ago:
‘Great! Louis Theroux is interested in filming on the perinatal unit.’
‘Is that really a good idea? His 2010 programme on ‘America’s Medicated Kids’ received quite sceptical reviews about psychiatry and medication from the Guardian, and Mumsnet readers. Louis got the children and teenagers to open up quite a lot, undermining the idea that their behaviours were merely ‘symptoms’. He even filmed a Pittsburgh psychiatrist admitting that drugs were often used in preference to psychosocial interventions.’
‘So he won’t stray from the script of psychiatrists doing their best to be psychosocial, and only using medication if absolutely necessary?
‘We have already agreed the consultant will not be challenged on claims about ‘trauma’ being addressed in all patients. No awkward questions about #Pharma COI involving SLAM, or personality disorder, either.
‘I am still surprised they want to film at one of the best-funded perinatal units in the country, rather than somewhere that is struggling and likely to use even more drugs.’
‘The BBC are much less interested in challenging the medical establishment than they used to be. Of course we want to be discreet about ex-BBC journalists now working in PR, but unfortunately some, like the RCPsych’s Kim Catcheside, can’t resist bragging occasionally about their influence.’
* and fictional.
One law for Dr Appleby, Dr Burn, Dr Morrison and Dr Huda, another for their critics: the GMC’s double standard.
Today the GMC’s application to the Medical Doctor’s Tribunal (MPTS) to suspend me was allowed, although reduced from 15 to 12 months. A review automatically occurs in 6 months, although I understand I can apply now for a review in 3 months if I consider there were irregularities in this tribunal.
For now, I will focus on just one: the failure of the tribunal to adequately address (in the 5 pages of its written decision) my submissions on the GMC’s treatment of complaints against senior psychiatrists. I argued that their ‘smears and abuse’ were more serious than the allegations about my own Tweets and blog pieces.
I showed the tribunal this tweet in which Dr Louis Appleby smears me (I was not saying that I am targeted any more than others, but this happens to be a good example):
and then this expanded image of the Tweeter who ‘liked’ it, Dr Wendy Burn:
I said: ‘This is a Tweet from Dr Louis Appleby to me 11 months ago. Dr Appleby is the government’s lead on suicide prevention, and also a Professor in Manchester.
You can see in the last sentence that he clearly accuses me of being a conspiracy theorist. Now this term can quite happily be bandied about by non-professionals without serious harm, but I submit that psychiatrists have power and authority in society in relation to diagnosis, and what might lie behind it such as compulsory admission and treatment.
‘Conspiracy theorist’ is a quasi-diagnosis which, from a psychiatrist, carries the implication of psychotic or fantasist, or perhaps personality disorder. I believe it should not be used as a smear in this way.
You can see that one Twitter user has ‘liked’ this smear, and that is Dr Wendy Burn, the current president of the RCPsych. I have expanded her icon below.’
I had previously showed the tribunal this Tweet from Dr Paul Morrison:
I said: ‘‘Young Kinderman’ is Peter Kinderman, a prominent clinical psychologist. In this Tweet Dr Morrison claims that a complaint Mr Kinderman had made in February 2018 about him, relating to Dr Morrison’s alleged ‘bullying, harassment and misogyny’, again on Twitter, had not been upheld. Dr Morrison, as you can perhaps see from his Twitter icon, adopts the persona of Rumpole.
I suggest this Tweet, with the image below and the caption ‘I’ve got a bag of Shh, with your name on it’, is unpleasant and threatening to Mr Kinderman. […] last week I made a complaint to the GMC that Dr Morrison was very likely to have been dishonest in his statements about the bullying and misogyny complaint.
Now looking again at the ‘likes’ below this Tweet you will see an icon on the left, and that is the icon of Dr Samei Huda. Dr Huda is an NHS consultant psychiatrist in Tameside, to the East of Manchester. In the latter part of last year I had an amicable Twitter relationship with Dr Huda, but we fell out in early December because he refused to discuss my concerns about Psychiatry’s relationship with the Pharmaceutical Industry, or Pharma. He blocked me and then in early January […] I criticised him as someone who closed down debate, and pointed out that in the past he had criticised others for the same.’
These Tweets are similar to many others that have been complained about to the GMC: they have done very little, while they have claimed that some of my Tweets are deliberately ‘antagonistic’.
I have to be careful on how I report on the tribunal because some allegations concerned non-professionals.
But the MPTS tribunal’s silence on these senior psychiatrists is concerning: a single sentence in the written decision made no acknowledgement of the abusive nature of these Tweets.
My title has ‘one law’ rather than ‘one rule’ because the behavioural standards of medical doctors are supposed to be based on the Medical Act 1983.
More to come. I now have to get the train from Manchester back down to London.
(Submitted as an e-letter responding to Duncan Double’s BJPsych article ‘Twenty Years of the Critical Psychiatry Network‘. The article will not be open-access in the future, so please let me know if this link expires.
the e-letter is lightly edited here [mainly to remove a repeat of ‘but’]. After several weeks it was published.)
Duncan Double tells us that the CPN is an embattled minority trying to push back against the ‘mainstream’ who hold that ‘mental illness is brain disease’, but the only evidence he cites for most ordinary UK psychiatrists holding such views is Sami Timimi’s memoir.
He does not mention that the CPN is officially approved and promoted by the Royal College of Psychiatrists’ leadership, through the CPD module written by its co-chairs Hugh Middleton and Joanna Moncrieff: http://www.psychiatrycpd.co.uk/learningmodules/criticalpsychiatry.aspx
The reality is that the CPN is very much part of the psychiatry establishment’s failure to address long-term decline in NHS spending on mental health and learning disability services, from around 25% of the total health budget decades ago, to 11% today. The latest ‘Five Year Plan’ trumpets ‘a real increase’, but closer examination shows the commitment to be a mere 0.1%, well within the margin of error: https://www.longtermplan.nhs.uk/publication/nhs-long-term-plan/
As with ‘Critical Psychology’, the common factor of the range of views within the CPN is a commitment to anti-diagnosis purism (http://www.criticalpsychiatry.co.uk/docs/LanguageOfDisorder.pdf), hence the repeated employment of the ‘brain disease’ strawman by its members.
Dr Double stresses ‘minimising the use of coercion’ and ‘helping people improve their social situation’, but his solution of a ‘non-eclectic’ biopsychosocial approach seems Utopian, given his failure to call for adequate funding of community-based services.
For failure on mental health and learning disability funding by the psychiatry establishment and one of its ‘fronts’, see my piece on ‘Asylum Magazine‘.
For further evidence that the CPN is far from critical of establishment psychiatry, see this polite ‘debate‘ between Joanna Moncrieff and internationally prominent Pharma-psychiatrist Carmine Pariante, which barely touched on Pharma-psychiatry enmeshment, and completely avoided the smears and abuse of people concerned about ‘Prescribed Harm’ by Dr Pariante’s close Pharma-psychiatry colleagues.
In the last two weeks Dr Moncrieff has declined to confirm whether she still claims the CPN are ‘dissidents’:
(See also a more recent piece on a ‘Medical Humanities’ paper co-authored by professor Spandler, with comments on her funding by the ‘Pharma-loaded’ Wellcome Trust)
(Expanded 12th January)
The decades-old Asylum Magazine (AsylumMag) claims to promote ‘open debate’, and has an edgy Twitter banner mocking dead Conservative politicians:
But, surprisingly, it disagrees with my suggestion that similarly edgy ‘visuals’ are reasonably employed in highlighting the enmeshment of psychiatric (and other) academics and professionals with the pharmaceutical industry (Pharma). It has ruled that they are not ‘decent’. The choice of word recalls Margaret Thatcher’s contemporary, Mary Whitehouse:
AsylumMag, true to its ‘democratic’ editorial stance, claims to be a ‘collective’. However, it has a ‘Managing Editor’, which from early 2017 has been the academic Professor Helen Spandler:
I met Profesor Spandler (who was then a senior lecturer but told me she was hopeful of being elevated) at the ‘Critical Psychiatry Network’ conference earlier this year, and asked about another UCLAN Professor, Dr Sue Bailey FRCPsych, who was President
of the Royal College of Psychiatrists (RCPsych) from 2011 to 2014, and was then in an
arguably even more powerful position as the Chair of the Academy of Royal Medical Colleges from 2015 to 2018 (she still has a committee role there). She accepted an OBE in 2002 and a Damehood in 2014.
‘How awkward it must be’, I said, ‘to campaign on AsylumMag’s issues when your senior academic colleague was and remains a leading establishment psychiatrist responsible for failing to secure adequate funding for mental health, and failing to address Pharma influence’ (I paraphrase).
But I had not actually read AsylumMag for several years. Perhaps I covered this up a bit. Professor Spandler seemed rather evasive, and later when I looked at recent issues I found no criticism of any RCPsych committee members’ role in service funding or Pharma, let alone the Presidents’.
Every President since Dr Mike Shooter (2002-5, who did speak publicly about Pharma concerns) has been an academic professor. The RCPsych committees, especially the Psychopharmacology Committee, are dominated by academics.
Decades ago, funding for mental health and learning disability services was around 25% of total NHS spending. It has been 11-12% for the last decade, and RCPsych leaders have not made a serious effort to redress that. They trumpet each piece of ‘new money’ using their team of spin doctors and tame journalists, and use the range of distracting PR techniques that New Labour adopted so enthusiastically, but in fact the RCPsych has admitted that under ‘Dame’ Sue Bailey and ‘Sir’ Simon Wessely spending actually went down.
That had been reported a month before I met soon-to-be-Professor Spandler, but she seemed happier to talk about the nuances of Marxist theory in the 1980s ‘radical’ antipsychiatry movement than how today’s senior doctors are influenced by special pay awards and trips to Buckingham Palace to collect honours.
It would not be unreasonable to see Asylum Magazine as a self-censoring academic front for establishment psychiatry. That establishment falsely promotes the idea that there is a binary choice between anti-diagnosis purism and itself:
In a further piece(s) I plan to look at how AsylumMag was founded in the 1980s by a drug trialist with a dubious record on mental hospital closure, and how some of its other editorial policies can be seen as supporting fiscal conservatism.
My thanks to the non-professionals who have helped me draft this piece.
1. The Royal College of Psychiatrists (RCPsych) and other Medical Royal Colleges will acknowledge that work by Charles Medawar, Dr Richard Smith, Dr David Healy FRCPsych, Dr Bernard Carroll MD, and others, led to the major series of civil fines and criminal convictions of pharmaceutical companies in the United States. Much of this work was brought to the general public’s attention through the BBC Panorama Secrets of Seroxat programmes (2002-7).
2. Many of those fines and convictions concerned marketing. The RCPsych will actively promote adequate scrutiny and awareness of pharmaceutical industry (Pharma) marketing, in the past, present and future. The RCPsych Dean Dr Kate Lovett FRCPsych has stated that general marketing and even ‘Western materialistic culture’ often has negative impacts on mental health, but to be credible the psychiatric establishment must take substantial responsibility for its collusion with the over- and mismarketing of psychiatric drugs. That collusion has often involved over- and mis-diagnosis.
3. The RCPsych will seek to bring UK pharmaceutical regulation back into the Department of Health.
4. The RCPsych will seek full compulsory disclosure of all pharmaceutical company payments to mental health professionals (MHPs), including speaking and meeting attendance payments (with date, location, and details of the meeting), research funding, and expert witness work. This should be available together on an easily searchable database, and not merely for three years, as on the very limited current ABPI speaking and meeting attendance register.
5. The RCPsych will oppose the employment of people in regulatory bodies, who were previously employed by a pharmaceutical company with any record of wrongdoing in any country. Exceptions would be those who have clearly shown to the public that they opposed and reversed wrongdoing while working for such a company.
6. Ex-GlaxoSmithKline (GSK) CEO ‘Sir’ Andrew Witty has not shown that. The RCPsych will ask Dr Ben Goldacre MRCPsych to withdraw, or provide credible evidence for, his statement in 2012, made shortly after GSK’s 3 billion dollar fine and criminal conviction mostly in relation to paroxetine and bupropion, that Mr Witty was ‘a good guy’.
7. The RCPsych president Dr Wendy Burn FRCPSych will apologise to Dr Peter Gordon MRCPsych, harmed by GSK’s paroxetine, for her discourteous and unprofessional shunning of his enquiries and submissions.
8. Specialist NHS clinics for people with Prescribed Harm and related problems will be set up. The RCPsych will seek out Pharma-sceptic psychiatrists, some of whom may have left NHS employment or retired early, and other mental health professionals, for this work.
9. The RCPsych will ask former president Dr Dinesh Bhugra FRCPsych, Dr David Nutt FRCPsych, Dr Guy Goodwin FRCPsych and Dr Stephen Lawrie FRCPsych, to withdraw and apologise for their 2014 Lancet article which smeared, without citing any evidence, people with Prescribed Harm as ‘conspiracy theorists’ and/or motivated by financial gain to manufacture ‘bizarre’ symptoms.
10. Dr Edward Bullmore FRCPsych, the most senior psychiatrist in Cambridge (UK), who is part of the RCPsych’s ‘Gatsby Commission’, will withdraw and apologise for his ‘neurophobia’ smear against critics of psychiatry-Pharma’s exaggeration of evidence for ‘chemical imbalance’, widely used for marketing purposes. He will also undertake to fully disclose, at all future events, that he is a vice-president of GSK.
11. Given his senior position within the pharmaceutical industry, the RCPsych will ask Dr Bullmore to what extent the industry has used tactics similar to that of the tobacco industry against critics and litigants. Recent concerns about the use of non-disclosure agreements (NDAs) by Harvey Weinstein and others have highlighted how civil legal proceedings can suppress relevant information, against the public interest.
12. The RCPsych will ask Dr Bullmore about Pharma marketeers’ use of the term ‘Drug Whore’ to describe ‘Key Opinion Leaders’ (KOLs), as revealed by Gwen Olsen in 2005. It may be necessary for Dr David Baldwin FRCPsych to clarify his recent statement about language critical of his own position as a KOL.
13. The RCPsych will remove Dr Jeffrey Lieberman MD from the Gatsby Commission. Dr Lieberman’s response to the concerns about Pharma in the 2000s was very limited. In 2013 he claimed that the pharmaceutical industry had reformed, but as one of the most senior doctors in the United States he must take substantial responsibility for the subsequent prescription opioid epidemic in the United States, which clearly showed that it had not. He continues to avoid answering questions about the ethics of his experiments giving stimulants to people with schizophrenia in order to deliberately provoke psychotic symptoms.
14. The RCPsych will remove Dr Simon Wessely FRCPsych from the Gatsby Commission. Dr Wessely downplayed the potential for conflicts of interest between Pharma and psychiatry as early as 2003, describing it as a ‘non-problem. In 2015 he claimed on national radio that he had ‘never worked for pharma‘, but despite his past record of being funded to speak at conferences, he has declined to make a public correction. As a very prominent psychiatrist internationally, Dr Wessely must take some responsibility for the opioid epidemic in the United States.
15. The withdrawn and redacted 2007 BBC Panorama programme on ADHD medication featured the same journalist (Shelley Jofre) who investigated Secrets of Seroxat. The RCPsych will support a request to the BBC to make the programme’s full interviews with psychologists and other experts available (with appropriate redaction of material – if any – discussing individual patients).
16. A historical review of Benzodiazepines, antipsychotics, and all other psychiatric medications will be undertaken, and the RCPsych will look to engage both amateur and professional historians.
17. The RCPSych spokesperson Dr Carmine Pariante MRCPsych, who has not repeated his claim that the 21st February Cipriani et al Lancet meta-analysis ‘finally puts to bed the controversy on antidepressants’, will make a full retraction which the RCPsych will promote to the media.
18. The RCPsych will critically review the continued influence of corrupt academic psychiatrists such as Dr Charles Nemeroff MD, on psychiatric research and practice. The worst excesses resulting from Pharma-psychiatry enmeshment appear to have been in the United States, where direct-to-patient advertising and lack of corporate regulation have led to both overmedication and higher prescription charges.
19. Many people who have suffered prescribed harm are very suspicious of the pharmaceutical industry. However, substantial improvements in regulation and behaviour of the industry and of psychiatry in the UK may lead to increased patient confidence for products developed and tested here rather than in the US (or even the post-Brexit EU). In turn, this may result in a relative growth of employment in the UK-based industry.
20. The RCPsych will consult with Pharma-sceptic psychiatrists, other mental health professionals, and current and former patients to determine what further steps should be taken.
24th October: ‘That collusion has often involved over- and mis-diagnosis.’ added to end of No.2. Thanks to Alan Johnson (@RunAgainstCastr) for prompting me to add this.
As a psychiatry-curious junior doctor (or medical student), you probably know that some patients and ex-patients have always been dissatisfied with their treatment. There has been an ‘Anti-Psychiatry’ movement, supported by a few psychiatrists, and other mental health professionals, since the 1960s.
But you may not know that the UK’s psychiatric establishment, in the form of its monopoly professional body, the Royal College of Psychiatrists (RCPsych), has actually appeased and even encouraged some aspects of ‘Anti-Psychiatry’.
Although RCPsych leaders claim that they have government agreement for psychiatry remaining the lead profession in Mental Health for the foreseeable future, there is nothing legally binding about that assurance, and there will be at least two general elections in the next ten years.
There is evidence that RCPsych leaders are, in fact, ready to let clinical psychologists take over, perhaps quite soon. If that happens then many who choose psychiatry now may never become consultants, or even have a job at all in 2028.
In 2015 Dr Simon Wessely FRCPsych was the guest speaker at the ‘Critical Psychiatry Network’ (CPN) conference, during the first year of his RCPsych presidency. Neither he nor the CPN have written about or publicised this, although it appears that he expressed sympathy for their anti-diagnosis views. A few months ago I obtained some unpublished photographs of the 2015 conference, including one showing Dr Wessely on a panel with Peter Kinderman, past president of the British Psychological Society and author of A Prescription for Psychiatry (2014):
(Panel discussion at the 2015 Critical Psychiatry Network (CPN) Conference: (left to right) Dr Joanna Moncrieff MRCPsych, CPN co-chair; Dr Simon Wessely FRCPsych, President of the Royal College of Psychiatrists (RCPsych) 2014-7; (unknown); clinical psychologist Peter Kinderman; Dr Hugh Middleton MRCPsych, CPN co-chair.
In A Prescription for Psychiatry, Kinderman states (p 50) ‘In my experience, the system of psychiatric diagnosis is demeaning and dehumanising…Ultimately, I believe there is no place for medical diagnosis in mental health care.’ After his reforms, he proposes (p 47) to ‘leave psychiatry – especially social psychiatry – as a key profession in a multidisciplinary service.’
But without diagnosis, what would psychiatrists actually do? Here the anti-diagnosis proposals become rather hazy. Kinderman and academic CPN psychiatrists such as Dr Joanna Moncrieff (who was Dr Wessely’s MD student) tend to imply that abolishing diagnosis will lead, by itself, to a reduction in medication but as a backstop they say that some medication will still be necessary on a symptomatic basis.
It may all sound fanciful, but in fact learning disability psychiatry (in which I was an NHS specialist for ten years) has been a testing ground for anti-diagnosis views. The RCPsych has not released figures on consultant numbers, but there has been a marked decline in the number of nurses. Symptomatic use of medication has, if anything, increased.
Peter Kinderman has held a senior management role within NHS mental health services. His updated version of Anti-Psychiatry is attractive to politicians because he claims that he can increase patient satisfaction at no extra cost, or even with a reduction in cost.
Clearly, one saving which can be achieved if use of medication is merely symptomatic, is to get more of it prescribed by GPs, or non-consultant grades. This has already happened in the case of depression: most people treated in the NHS never see a consultant.
Faced with clinical psychologists promising such a mental health Utopia, RCPsych leaders have been reluctant to point out its faults, and have opted for short-term appeasement, allowing investment in mental health services to remain flat.
They have refused to address pharmaceutical industry regulation, conflicts of interest, and hyping of neuroscience in mental health, which continue to be major sources of credibility for anti-diagnosis extremism.
Anti-diagnosis views are actually quite useful for psychiatrists themselves to strategically adopt, when they exclude perceived low-risk conditions such as ADD / ADHD and much ‘borderline personality disorder’ from services.
For relieving the taxpayer in this way, RCPsych leaders have been rewarded with honours and knighthoods.
The current president, Dr Wendy Burn FRCPsych, appears no different. She allowed a CPD module by Dr Moncrieff to be published in February and, very recently, signalled that she would meet with Peter Kinderman’s close clinical psychology associate Lucy Johnstone, despite evidence that Ms Johnstone and other anti-diagnosis psychologists have encouraged abusive criticism, some of which was recently directed at a senior RCPsych psychiatrist:
Having repeatedly raised these issues with the RCPsych leadership over the last few months, and been blocked by them on Twitter from @Choose_Psych, I wish you more luck than I have had in trying to get them to give straight answers.
But if you let yourselves be distracted by their endless variations on how wonderful a mental health ambassador Stephen Fry is; don’t say I didn’t warn you.
Today’s Times newspaper reports that the Chair of the Royal College of Psychiatrists (RCPsych) Psychopharmacology committee has resigned from the Public Health England enquiry into Prescription Drug Dependence (PDD). A ‘campaign of harassment’ from Bloggers has been blamed, and the focus appears to be on whether psychologist John Read and/or his associates have colluded with them.
But one Blogger and Tweeter, ‘Truthman 30’, has been calling Pharma-enmeshed psychiatrists ‘whores’ (and worse) for years: why suddenly bring that up now? Just a few days ago he (I presume he is male) was in a Twitter thread with the RCPsych president Wendy Burn: why didn’t she block him long ago?
This morning I asked the RCPsych ‘communications team’, headed by the ex-BBC journalist Kim Catcheside, what warnings, statements and threats of blocking have been issued to Truthman 30 or anyone else. They have clarified that the ‘worse than Hitler’ comment in the Times headline, together with the ‘rapist’ one, appeared in a 12th September anonymous comment under one of Truthman 30’s Blog pieces. But they have not commented on any warnings or other attempts to improve language.
The above Tweet also shows Dr Burn responding on Twitter to Bob Fiddaman. The RCPsych leadership must know that I called out Mr Fiddaman for his abusive misogynist and racist tweeting months ago, because RCPsych CEO Paul Rees emailed shortly after to inform me that my own Tweets were being monitored. At the same time I became aware that Ms Catcheside had been following me on Twitter.
Nor have the RCPsych leaders seemed bothered to sort out an allegedly upheld, but inadequately dealt with, complaint about ‘bullying, harassment and misogyny’, against a consultant psychiatrist with close links to Dr Baldwin and the psychopharmacology committee.
Frustrated by the pharmaceutical industry (Pharma) and establishment psychiatry blocking enquiry into wrongdoing for decades, ‘Prescribed Harm’ campaigners have at times made comparisons with the Nazi killing of the mentally ill and disabled. This may seem excessive to many members of the general public, but I do not think it is really very different to much historical remembrance of the Jewish Holocaust, to colonialist atrocities, or to the treatment of the suffragettes, to give just three examples.
Four days ago I advised Truthman 30 to stop using ‘whore’ and other forms of swearing:
So if the RCPsych leaders have done little about such language for months and years, why bring it up now?
I suggest that Dr Baldwin and the RCPsych leadership are more likely to be concerned about non-abusive pressure from its own ordinary members, and others. In particular, from Dr Peter Gordon MRCPsych, who has experienced significant harm from Seroxat (paroxetine), with which Dr Baldwin was directly involved.
At the end of August, Dr Gordon (still working in the NHS as a consultant psychiatrist) received a threatening email from CEO Paul Rees, who reminded Dr Gordon of ‘the College’s Code of Conduct (attached)…one of the behaviours we expect from our members is ‘appropriate use of social media, as set out in the RCPsych’s Social Media Policy’”, but failed to give any examples of where the Code might have been close to being breached, or what ‘appropriate’ might mean.
Dr Gordon has been campaigning for over five years, but this year seems to have been making more of an impact. He has repeatedly pointed out the long history of RCPsych-Pharma minimisation and denial, and the responses to him seem to have changed from patronising to irritated. President Dr Burn tried to let him know that his ‘lived experience’ was not wanted (only pro-medication good news stories from Stephen Fry and others are promoted by the ‘communications team’, of course) but he has persisted, as the above links show.
Encouraged by Dr Peter Gordon MRCPsych’s example, I have put my own bit of pressure on Dr Baldwin as well. Let’s hope that the RCPsych has the sense to replace him with a less Pharma-enmeshed representative on the Prescribed Drug Dependence enquiry. But he will still be working in the NHS and as an academic, so he continues to have questions to answer.