Well, if you’ve been involved in the mental health field for any amount of time, you knew it was only a matter of time. U.S. Senator Charles Grassley first focused on the low-hanging fruit — researchers with unreported conflicts of interest (usually unreported money) from pharmaceutical companies, the same companies they conducted drug research for. Now he’s examining nonprofits in mental health, and first up is the National Alliance for Mental Illness (NAMI).
Senator Grassley has made clear that this isn’t a witch-hunt as much as a desire to get to the bottom of how the pharmaceutical industry funds its practices that makes it products so popular and widespread. It’s not about receiving money from pharmaceutical companies per se’, but rather being upfront and transparent about your funding.
The problem with the National Alliance for Mental Illness and Mental Health America (formerly known as the National Mental Health Association), among others, is their simple lack of transparency about their funding sources. NAMI, for instance, doesn’t break out its donations by source. If it did, I suspect we’d see that somewhere between 30 to 50 percent of its donations come from pharmaceutical companies, affiliated companies, or individual employees and management from within pharma. For other nonprofits, I would expect similar percentages.
The long-held secret of these national nonprofits doing important advocacy and policy work in mental health is simply this — without the pharmaceutical monies they receive, they probably wouldn’t exist today. They are dependent upon them and some of them would rather you not know how dependent upon them they really are.
Does such money buy influence? Well, with NAMI, the answer appears to be an unequivocal “Yes.” NAMI has long pushed that severe mental illness — like depression, schizophrenia and bipolar disorders — are pure neurobiological medical diseases (or as they call them, “biologically based brain disorders”).
The primary treatment method pushed by NAMI national? Medications, of course. For instance, in their consumer article about depression, 84 percent of the article is devoted to medications and only 10 percent mentions psychotherapy.
Meanwhile, research has shown that for most people, a person will have to go through 3 or 4 different antidepressant medications before finding one that works (over the course of months). Studies have also shown the effectiveness of psychotherapy techniques for all types and severity levels of depression. You’d think a treatment shown to be equally effective in treating depression would receive equal amount of emphasis in a treatment article.
But not at NAMI. Here’s a wonderful example from their 2002 brochure, “Understanding Major Depression:”
The development over the past 20 years of antidepressants and mood-stabilizing drugs has revolutionized the treatment of clinical depression, particularly for those with more serious or recurrent forms of the disorder. Biological treatments are dramatically effective, and between 70 percent and 80 percent of people with biological depression will get significant relief from medication — whether the depression is mild or severe, recent or long-term.
Wow, “biological depression,” huh? And what’s the test for “biological depression” versus regular depression? Oh, the brochure doesn’t mention that the official diagnostic manual makes no differentiation between the two (and neither do most researchers — it’s a marketing distinction, not an empirical one). Six sentences in that entire 18-page brochure talked about psychotherapy. Six. ECT had nearly as much air time.
NAMI, Mental Health America, and all you other mental health nonprofits who don’t make such information public… It’s time to come clean about your pharma ties. And better to do it on your own, publicly, independently, before Senator Grassley’s office comes a callin’. You do good work, but you can’t hide your major funding sources any longer. (Kudos go to Depression and Bipolar Support Alliance (PDF) for breaking out their donors in their annual report.)