Well, it’s here upon us once again… May is Mental Health Month. Awareness of mental health issues is vital to reducing the stigma attached to mental disorders nowadays. Mental disorders are not purely biological illnesses, despite what some doctors will say, nor are they purely psychological illnesses. Based upon all of our best research and knowledge to date, it appears all mental disorders have three common, equally-important factors:
- Biology – This includes theories of “drug imbalances” in the brain, genetics, etc.
- Psychology – Includes personality factors, developmental factors, etc.
- Social – Includes environmental factors, social and work relationships, etc.
For most people, treating a mental disorder will include a combination of these factors, usually in two different people: someone to prescribe a medication to help the biology (general practitioner, psychiatrist, etc.) and a psychotherapist to help the other two factors (psychologist, clinical social worker, marriage and family counselor, etc.). While a small minority of people can probably be helped with only one of these treatments, most will respond best to both kinds.
What should you take away from all of this? That no matter what treatment you receive, mental illness is not your fault. Many people view mental disorders, still, as a personal weakness. Nothing could be further from the truth. These disorders will affect one out of every 4 adults in his or her lifetime, so this is something that needs to be better understood and dealt with realistically in today’s society. Tomorrow, it could be you or someone close to you that suffers from one of these disorders… Keep an open mind.
One of the most enlightening and sad displays of capitalism at its best and worst was observed in the past week. I attended my first American Psychiatric Association annual convention, this year held in New York City. As a psychologist, I don’t often get to other profession’s conventions, since there are pretty clear professional divisions. But this year, because of a product my company is going to be releasing this summer mainly targeted toward psychiatrists, I had the opportunity to see the psychiatrists’ convention. Wow.
First, the American Psychiatric Association has little to no clue. Almost every other major convention in the United States issues electronic credit card-like cards which have identifying information (name, address, phone) of each attending member. This makes it easy for vendors to quickly swipe the card through a card-reader and get that information. Coming from a vendor perspective this year, I see the flexibility and convenience of such a system. The American Psychological Association uses such a system also to allow attending members to check an electronic computerized messaging system they sponsor. It’s easy, fast, and convenient. Without it, psychiatrists had to sit there and write out the same information, time and time again, whenever they wanted additional information from someone. What a pain in the ass!
Second, the drug companies are RIDICULOUS. If you saw how they market to professional doctors, you’d be as sickened as I was walking around the exhibitor’s hall. Risperidol, a drug marketed for manic-depression among other things, had one of the most tackiest displays, with a mini roller coaster setup over the top of their booth, which actually ran all day with a little man in it. I guess it was supposed to symbolize the ups and downs of what patients feel if not on their medication. Give me a break!
Effexor, a poorly-tolerated (at least in the hundreds of people I’ve known who’ve tried it) medication for depression, has the second tackiest display. Their booth was set up as a house, with display tables taking the form of barbeques, outdoor patio furniture, etc. In the house’s “dining room,” they had set up a robot family which went through a scripted melodrama. Reminded me of Disney’s “A Small World” display… Except this was 100 times worse. Luckily, I noticed very few doctors who watched the display very closely.
One pharmaceutical company was there to promote a drug which hadn’t even received FDA approval yet and which they couldn’t even discuss! They were so sure they would receive the approval, though, they were at an APA show a year ahead of time to market their name and hand out pads of papers (with their name on it, naturally). This is both a sad commentary on the joke which passes for FDA approval nowadays and the strength of pharamceutical companies’ influence on psychiatrists. Or at least attempted strength.
Sure, there were a lot of tastefully done, well-laid out booths which were matter-of-fact and handed out relevant literature without a lot of hubaloo. Luvox and, surprisingly, Prozac, both had no-nonsense booths which did the job they were supposed to do — allow psychiatrists access to useful information without trying to tug on their emotions or other ridiculous, un-scientific means. Marketing needs to learn to be more sensitive to these issues. Would you ever expect to see such displays at a surgeon’s convention??
Which brings me to one last observation about psychiatrists themselves. Drug companies wouldn’t go to such absurd and offensive lengths if they weren’t allowed to. The APA has the power to limit booth displays and handouts to remain in good taste and they should excercise that right. Psychiatrists should also stop slobbering over the freebies handed out by the companies. You’d think that someone making upwards of $100,000 per year wouldn’t have the time or need to stand in a half-hour line to get a free umbrella. And yet, for every day the exhibit hall was open, this was by far the longest line for a freebie for a company I can’t even remember (or remember its purpose). I saw many psychiatrists grab at these freebies time and time again, as though they were worth being rude to other human beings for, or their livelihood depended upon getting that one more free pen or mouse pad or flashlight.
Hey, I’m all for getting free stuff, as much as the next person. But please… I wish psychiatrists wouldn’t waste their time standing in line for such a freebie when they could be attending another lecture (the reason they have the convention in the first place), networking with colleagues, or the like. I’m not saying psychologists or any other profession is much better (although we don’t have the drug companies marketing to us like they do), but we should retain some self-respect and decency about us when viewing these kinds of displays of silliness.
Anyway, the point? The point is that pharmaceutical companies have a huge stake in trying to get a psychiatrist of general physician to prescribe their drug to you over another. And in trying to influence the psychiatrist’s prescription routine, they will go to extraordinary and ridiculous means sometimes, especially at their annual convention. What I haven’t mentioned here is the drug company-sponsored dinners and the like every night, too. Psychiatrists protest, “Hey, these silly things don’t influence our objective stance in prescribing the best medication for a particular person at any time.”
Marketing departments of these pharmaceutical companies wouldn’t be spending millions of dollars every year on advertising if this were true for most psychiatrists. There’d be little need for expansive and expensive displays every year at the annual APA convention, and even less need for freebies, paid-for dinners, and elaborate demonstrations. All the information an objective psychiatrist needs can be easily found in the research literature.
From the last two editorials…
I have launched three new mailing lists which address drastically different issues, but which I wanted to mention here. They are:
- RESEARCH – Psychology of the Internet: Research & TheoryThis list is open to anyone who is interested in discussing the psychology of various on-line phenomenon, such as “flame wars,” relationships, support groups, “Internet addiction disorder,” etc. I began it to help researchers and interested individuals discuss the psychology of what goes on on-line.
- SELFHELP – Leaders in SelfhelpThis list was created to allow forum leaders, mailing list owners, and other individuals in a leadership role in mutual self-help support groups have a place to discuss issues that appear time and time again in these types of groups, such as suicidal crises, emotional support, how to handle a “flame war,” relationships, etc. It is meant only for forum leaders.
- WEBPSYCH – WebPsych PartnershipThe WebPsych Partnership is a new organization recently created to help increase coordination, cooperation and communication among those in the psychological, psychiatric and mental health fields who author or maintain Web sites devoted to these topics. It offers quality guidelines for members to follow, as well an opportunity to exchange ideas and links, and discuss how to reduce redundancy of resources. Only those who host such a Web site should subscribe to this mailing list, after reading the WebPsych Partnership Web page at: http://www.ismho.org/webpsych/.
I hope these new mailing lists are helpful to the on-line community.
If you want the whole shi-bang of over 3,500 separate resources that have to do with psychiatry and mental health online, then you might want to visit Psych Central. It’s the largest and most comprehensive site of its kind in the world and we’re looking to build upon it in the upcoming years, acting as a super guide to mental health online. If you didn’t find what you needed here, look there next!
That’s it for this time… As always, keep in good mental health!