Federal government launches marketing campaign for psychiatric industry

Regional meetings in support of the National Anti-Stigma Campaign (NASC), a nationwide television, radio and print public service advertising program funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), were held this past summer in Los Angeles, Denver, Chicago and Washington, D.C. According to a senior technical assistance specialist at the SAMHSA Resource Center to Address Discrimination and Stigma Associated with Mental Illness (ADS Center), the ad campaign, which will target 18-25-year olds, will be launched today. A campaign directed at older adults and ethnic and racial minorities will follow.

On its surface, the campaign’s message may seem perfectly appropriate, even compassionate. Its stated objective is to “encourage, educate and inspire 18-25-year olds to step up and support friends they know are experiencing a mental health problem.” One ad, for example, shows a man with his hand over his eyes. “Sometimes I find myself turning away from or just ignoring someone with a mental illness, avoiding eye contact,” he says. “I know it is not their fault but sometimes I don’t know how to communicate with them.”

But there can be no doubt about the real purpose of the campaign’s emotional appeal: to create customers for the psychiatric/pharmaceutical industry. This is clearly evident at SAMHSA’s website and in its literature. It is no accident that 18-25-year olds were chosen as the first target. A SAMHSA “Fact Sheet” states, “Among 18-25-year olds, the prevalence of serious mental health conditions is high . . . yet this age group shows the lowest rate of help-seeking behaviors [emphasis added].” “Help-seeking behavior” is, of course, a euphemism for being psychiatrically diagnosed and drugged. The 18-25-year old demographic represents a huge untapped market for psychiatric drugs and services. According to SAMHSA’s website, the anti-stigma media blitz “has been designed to establish a ‘new norm,’ in which individuals, without hesitation, will seek out the mental health services they need and deserve.”

The drug industry seeds NASC

Further evidence of SAMHSA’s marketing agenda is found in the origins of the National Anti-Stigma Campaign. The program was first recommended by a federal commission that had extensive ties to the pharmaceutical industry. In its 2003 report, Achieving the Promise: Transforming Mental Health Care in America, the President’s New Freedom Commission (NFC) on Mental Health called for the government to “undertake a national campaign to reduce stigma.” The NFC proposed “national education initiatives” to “shatter the misconceptions about mental illnesses, thus helping more Americans understand the facts and making them more willing to seek help for mental health problems” and advocated “actions of reducing stigma, increasing awareness, and encouraging treatment . . . (emphasis added).”
Several members of the NFC had extensive ties to the pharmaceutical industry, principally by way of an industry marketing scheme that was developed in Texas in the 1990s. Known as the Texas Medication Algorithm Project, or TMAP, it was designed to make the newest and most expensive psychiatric drugs the first (and virtually only) treatment option for mental health care. The project was nurtured at the University of Texas Southwestern Medical Center in Dallas, a major research center that conducts drug trials for pharmaceutical companies, with significant funding coming from the drug companies themselves. Pharmaceutical company gifts to the Texas Department of State Health Services totaled $1.3 million from 1997 to 2004, with at least $834,000 earmarked for TMAP.

Backed by drug industry funding, TMAP was then exported to other states via the National Association of State Mental Health Program Directors (NASMHPD).

The chair of the NFC, Michael Hogan, was the Mental Health Program Director in Ohio when the Ohio Medication Algorithm Project (OMAP), was adopted there. A 2004 Janssen (makers of the atypical antispsychotic, Risperdal) publication, “Mental Health Issues Today,” lists Hogan as a member of their Advisory Board. In 2005, Eli Lilly (makers of the atypical antipsychotic, Zyprexa and the antidepressant, Prozac) gave Hogan its Lifetime Achievement Award. Hogan was president of the NASMHPD from 2003-2004 and president of the NASMHPD Research Institute, which is heavily funded by the pharmaceutical industry, from 1989-2000.

Another NFC member, Stephen Mayberg, was the California State Mental Health Program Director when TMAP was adopted in that state. Mayberg is also a past president of NASMHPD and the NASMHPD Research Institute.
NFC member Charles Curie, who recently stepped down as the administrator of SAMHSA, was the Deputy Secretary for Mental Health and Substance Abuse Services in Pennsylvania when PENNMAP was enacted. According Allen Jones, an investigator in the Pennsylvania Office of Inspector General and a whistleblower, Curie is reported to have set up a slush fund from which state employees could solicit grants from the pharmaceutical industry.

NFC member psychiatrist Rodolfo Arredondo served on the board of the Texas Department of Mental Health and Mental Retardation during TMAP’s development, while another NFC commissioner, Robert Postlethwait, has had a long career with Eli Lilly and Company.

According to Jones, at least 14 of the 22 NFC members have drug industry ties. Not surprisingly, the NFC selected TMAP as a model program and stated that the “biggest challenge” was to ensure that TMAP was “implemented in other states and localities.”

The psychiatric industry is well on its way to meeting that challenge -- with disastrous results for our youth. A similar pattern emerges in states which have adopted TMAP. In Texas, 19,404 teenagers were prescribed an antipsychotic in July or August of 2004. Ninety-eight percent received the newer atypical antipsychotics. In April of 2004, the Texas Comptroller, Carole Strayhorn, released a report, Forgotten Children, that was highly critical of the psychiatric drugging of foster children in Texas.

In 2005, the Columbus (Ohio) Dispatch ran a two-part story, “Drugged Into Submission,” on the psychiatric drugging of children, including 700 babies and toddlers, under state care. Part one was titled, “Forced Medication Straitjackets Kids.”

In 1998, the Los Angeles Times reported, “Children under state protection in California group and foster homes are being drugged with potent, dangerous psychiatric medications, at times just to keep them obedient and docile for their overburdened caretakers.”

In Pennsylvania, Dr. Stephan Kruszewski, a Harvard trained psychiatrist working for the Pennsylvania’s Department of Public Welfare, complained that children were being heavily drugged with antipsychotics and anticonvulsants (mainly Neurontin). He was fired.

In Washington State, atypical antipsychotics ranked 1, 3, and 5 on the Medical Assistance Administration’s list of top 100 drugs by money paid in 2004, with nearly $78 million spent on those three drugs: Zyprexa ($36 million), Risperdal ($21 million), Seroquel ($20.8 million). Neurontin was #4, at $20.8 million. Antidepressants Zoloft, Effexor and Paxil came in at #7, #11 and #12, with nearly $31 million spent on those three drugs. A 1997 Seattle Post-Intelligencer series charged that an “unmonitored stream of mood drugs imperils children entrusted to state.”

Additional confirmation of the drug industry’s control of SAMHSA comes in the form of an email sent to me by the previously mentioned senior technical assistance specialist at SAMHSA. The email was a response to my inquiry about the anti-stigma campaign. The assistance specialist sent a copy of her response and my original inquiry, to the NASC liaison at NAMI. NAMI, of course, is the National Alliance for the Mentally Ill, a well-known front group for the pharmaceutical industry. SAMHSA is obviously working hand in hand with NAMI -- even forwarding private communication from the public to NAMI’s offices. In 1999, Mother Jones magazine reported that 18 drug firms gave NAMI a total of $11.72 million between 1996 and 1999. NAMI continually promotes psychiatric chemical imbalance theories, minimizes the damaging effects of psychiatric drugs, and advocates for forced psychiatric drugging programs.
On May 28, 2006, the Philadelphia Inquirer reported that NAMI “did not disclose that Lilly [Eli Lilly, makers of Zyprexa and Prozac] marketing manager Gerald Radke briefly ran its entire operation. Radke began in 1999 as a Lilly-paid ‘management consultant,’ then left Lilly and served as NAMI's paid ‘interim executive director’ until mid-2001. The group acknowledged this only after being shown Radke's resume listing the job.”

According to the Inquirer, Lilly gave NAMI $3 million between 2003 and 2005 and “called its executive loans mutually beneficial.” NAMI’s former executive director for 16 years was Laurie Flynn. Flynn is now the Director of Teenscreen, a psychiatric screening program developed by Columbia University’s Child Psychiatry Research Department and, not surprisingly, recommended by the NFC. TeenScreen’s goal is to screen all teenagers in the U.S. for psychiatric disorders.

NASC and screening: Educating Americans to be good customers

Since psychiatric drugging must, in most cases, be preceded by the assignment of a psychiatric label, psychiatric screening is an essential step in the industry’s plans to expand its market. That’s where the anti-stigma campaign and national psychiatric screening -- both recommended by the NFC -- come into play.

The NFC report recommended “early detection of mental health problems in children and adults -- through routine and comprehensive testing and screening . . ." and while NFC chair Hogan has denied that the NFC intended universal screening, in a January 20, 2005 story in the Christian Science Monitor, Hogan said that the commission decided that recommending universal screening would be "a little premature and probably controversial, even though we thought, in the long run, it probably might be the right thing to do.”

In other words, the only barrier to screening everyone in America, as the NFC sees it, is the controversy it would generate. It’s “premature.” Americans have to be prepared to accept mass psychiatric interventions. SAMHSA’s NFC-recommended NASC program is their answer -- a three-year, “long run” program to prepare the population for universal screening, followed, of course, by psychiatric labeling and drugging.

The NASC campaign will advertise that mental illness has reached epidemic levels in the population -- a theme that has been repeated in psychiatric marketing campaigns dating back to the 1940s. The psychiatric industry wants Americans to see mental illness everywhere -- to associate any problem in life with a possible psychiatric disorder that can be treated with a psychiatric drug.

A PowerPoint presentation available at the NASC website warns that “22% of Americans have a diagnosable mental health problem” but “the majority . . . do not seek help.” SAMHSA has produced three brochures that focus on the workplace (Mental Health: It’s Part of Our Lives at Work), the elderly (Mental Health: It’s Part of Aging) and college students (Mental Health: It’s Part of College Life). All state that one in five adults in the U.S. experience a mental illness each year. All stress that not enough people are seeking treatment due to stigma.

At the same time SAMHSA’s Eliminating Barriers Initiative (EBI) is currently being pushed into secondary schools via school administrators' associations. EBI is being piloted in eight states, (Mass., Ohio, Fla., NC, Calif., Texas, Wisc. Pa.). EBI training presentations promoting psychiatric chemical imbalance theories, stating, “Mental illnesses are brain disorders.”

In Massachusetts, the commissioner of Mental Health was brought to one conference and read a student’s suicide note to the assembled school administrators. Suicide is a favorite theme, even though 1) child suicides are extremely rare (4.6 per 100,000 in 2001, according to the Center for Disease Control) and declining; 2) In 2004, the U.S. Preventive Services Task Force (USPSTF) found “no evidence that screening for suicide risk reduces suicide attempts or mortality” and "insufficient evidence that treatment of those at high risk reduces suicide attempts or mortality;” and 3) psychiatric drug treatment has been found to increase suicidal thinking and behavior in children under 18.

The goal of such programs is clear. SAMHSA, acting as a tool of the psychiatric and drug industries, wants Americans to view the world through psychiatric lenses -- to find mental illness in their children, their colleagues, their family and friends. The purpose of the NASC campaign is not to educate Americans about psychiatric theories and treatments but to instill acceptance of psychiatric dogma and psychiatric labeling and thus prepare the way for psychiatric screening and drugging. Always the appeal is heavily weighted to the emotions. The elderly brochure, for example, advises, “If you feel shame because you have a mental illness remember: You are not alone.” SAMHSA will tell us that fear of the mentally ill is part of the stigma, while, at the same time, they will be sowing a subliminal fear that mental illness is lurking around every corner.

The NASC campaign will spread the gospel of chemical imbalances and suggest that the stigma of mental illness is the result of public ignorance and fear. This is a key element of NASC. Americans must be taught to locate the source of the stigma in their own personal failure, not the rampant disease mongering and fear tactics of the psychiatric industry.

The real source of the stigma

The real source of the stigma of mental illness lies in the definition of stigma itself. The dictionary says a stigma is “A mark or token of infamy, disgrace or reproach. A small mark; a scar or birthmark.” The word derives from the ancient word for the mark or tattoo that was carved or burned into the flesh of a slave or prisoner to inform everyone of their shameful status.

The definition of stigma suggests at once the source of the stigma -- psychiatric “marking” -- and how it could be eliminated: Don’t place the mark. The most direct way to end the stigmatization of the mentally ill would be to stop calling them mentally ill and labeling them with specious disorders. After all, there’s no proof they’re ill. There is no lab test that can verify the presence of any psychiatric disorder. We could just get rid of the Attention Deficits, the Major Depressives, the Social Anxieties, the Bipolars and the 370 other labels psychiatrists have invented to alienate and marginalize those who are suffering and convince those who are well that they are ill. We could tell the psychiatric prisoners that their diagnostic cells are a thin illusion, that their experience is part of the infinite variety of human experience. We could tell them they are not other than us, they are not sick, they don’t have bad brains. Life is tough, for a thousand different reasons, and most of us struggle.

If we just put an end to psychiatry’s fraudulent pathologizing of life, the stigma of mental illness would disappear.

Needless to say, this is not the kind of campaign SAMHSA has planned. There’s too much money at stake. For several decades now psychiatrists have been manufacturing stigmas at a ridiculous rate. Psychiatry’s book of stigmas, the Diagnostic and Statistical Manual of Mental Disorders, has expanded from 112 stigmas in 1952 to its current 374, under the guiding hand, the New York Times and others recently (April 20) reported, of “experts” with financial ties to drug companies.

According to the Times, a study in the journal Psychotherapy and Psychosomatics found that “56 percent of 170 experts who worked on the 1994 edition of the manual, called the Diagnostic and Statistical Manual, or D.S.M, had at least one monetary relationship with a drug maker in the years from 1989 to 2004.” A report on the study in the Chicago Tribune noted that, “100 percent of the experts on DSM-IV panels overseeing mood disorders and schizophrenia/psychotic disorders were financially involved with the drug industry. These are the largest categories of psychiatric drugs in the world, racking up 2004 sales of $20.3 billion and $14.4 billion, respectively. Depression is the leading mood disorder.”

It’s a particularly profitable symbiosis. Psychiatrists invent the diseases; the pharmaceutical industry makes the snake oil to treat them. And as we have seen, the purpose of the NASC campaign is to help the experts and drug companies cash in on their cozy relationship, to ensure that Americans accept psychiatric branding and become good customers for the psychiatric/pharmaceutical complex.

The last thing the psychiatric industry wants is for people to have the facts about psychiatry’s invented illnesses and ineffective, damaging drugs. SAMHSA’s campaign will follow a different script, one with more of a “slaves are people too” theme, one which ensures that psychiatric branding is broadly accepted.

A brochure from the ADS center asks that we “remember” that people with mental illnesses “do recover and lead productive lives,” they have the “same needs as everyone else,” they “make valuable contributions to society,” and discrimination “keeps them from seeking help” and “violates their rights.”

In other words, we will be educated about how people become slaves (mentally ill); that it’s not their fault (it’s genetic); that slavery touches all of us, and that, while slaves are different, they should be treated with dignity. Slaves can lead productive lives, they have the same needs as everyone, they make valuable contributions, and you shouldn’t discriminate against them. We’ll be told that psychiatric prisoners are fortunate to have kind wardens who treat them with respect and though the whip is occasionally needed, it’s all in their best interests. Just don’t start thinking that they are normal human beings -- they are slaves, i.e., mentally disordered with damaged brains.

SAMHSA’s campaign will justify and expand the stigmatization that supports the current mental health system, while chiding us to be nice to those who are thereby victimized. It won’t tell us how psychiatrists invent their diagnoses. It won’t tell that psychiatry’s own diagnostic manual admits that psychiatry can’t distinguish one disorder from another or mental illness from mental health. It won’t tell us that psychiatric diagnostic reliability is low. We won’t be informed that, as Harvard psychiatrist Joseph Glenmullen wrote in Prozac Backlash, “We do not yet have proof either of the cause or the physiology for any psychiatric diagnosis. . . . In recent decades, we have had no shortage of alleged biochemical imbalances for psychiatric conditions. Diligent though these attempts have been, not one has been proven.”

The ineffectiveness of psychiatric drugs won’t be mentioned -- nor the stream of warnings that have issued from the FDA and international agencies over the past several years concerning the dangerous and often lethal side effects of antidepressants, antipsychotics and stimulants.

We won’t hear about last year’s study of antipsychotics, published in the New England Journal of Medicine, which found the newer antipsychotics to be no more effective than the older drugs. In the study 74 percent of patients quit the drugs and “[T]he majority of patients in each group discontinued their assigned treatment owing to inefficacy or intolerable side effects or for other reasons.” (Note: They didn’t quit because they “decompensated,” “lacked insight,” or were “in denial.” The drugs were ineffective and intolerable.)

Instead, our government will tell us of the terrible consequence of failing to seek treatment. We’ll be told to get branded -- and encourage our friends and family to do the same - as soon as possible. We’ll be assured that life on the pill plantation is a wonderful thing.

The pitch will touching and benevolent, the unspoken message crystal clear: psychiatric stigmatization is a good thing. Only the ignorant and uncaring fail to embrace it. You’ll be hearing a lot about the stigma of mental illness in the coming months and with good reason. A trillion dollar industry depends on it.

For the past 20 years, Richard A. Warner has been the president of the Citizens Commission on Human Rights of Seattle. He's written several pieces for the Seattle Times and Seattle Post-Intelligencer over the years, been a guest on dozens of local and national radio shows, and testifies regularly at the Washington State capital in Olympia on issues related to mental health. His recent paper on shock treatment can be found at ect.org.