Mad in America: Rethinking Mental Health

Justin Karter is a staff psychologist at Boston College University Counseling Services. He is a recent graduate of the doctoral program in Counseling Psychology at the University of Massachusetts Boston, where he completed his dissertation research on the experiences of psychosocial disability activists in the Global South.

This week on the Mad in America podcast, we are joined by activist and artist Jim Flannery.

Born and raised in suburban Weathersfield, Connecticut, Jim was committed at four mental hospitals across the United States. There he received the best care available in the modern world… torture, which included seclusion, restraints, forced drugging, coercion, and a psychiatric diagnosis.

Later, he turned to the arts to speak out publicly about his experiences with the mental health system through performing stand-up comedy under the pseudonym Flim Jannery and now through music with his new album, "Sorry, It's Not Funny," which will be released on Friday, October 14.

In 2020, Jim began hearing voices, which opened his eyes to what he terms a genocide against neurodiverse people. He shifted his creative efforts towards hip-hop, believing the genre was the best medium to communicate his perspective.

You can hear the new album on the website jim-flannery.com. It’s also on Spotify, Apple Music, YouTube, Pandora, SoundCloud, and Tidal. 

Dr. Diana Rose wears many hats—academic, researcher, service user, and activist. She is a leading figure in user-led research and currently an Honorary Distinguished Professor at the Australian National University. Dr. Rose was previously Professor of User Led Research and Director of the Service User Research Enterprise (SURE) at King’s College. She was also lead in Patient and Public Involvement in several large research programmes at the Institute of Psychiatry, Psychology, and Neuroscience.

Apart from an impressive set of publications, Dr. Rose’s new book Mad Knowledges and User-Led Research is about to hit the markets. In today’s interview, she brings together her vast breadth of experience and depth of knowledge to talk about the challenges service users and survivors of psychiatry face when they take space as knowers and researchers in the Psy-disciplines.

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This week on the Mad in America podcast, we are joined by Dr. Jon Jureidini.

Jon is a child psychiatrist who also trained in philosophy, critical appraisal and psychotherapy. He has a continuing appointment as a professor in the School of Medicine at the University of Adelaide. He heads Adelaide University’s Critical and Ethical Mental Health research group, which conducts research, teaching and advocacy to promote safer, more effective and more ethical research and practice in mental health; and the Paediatric Mental Health Training Unit, providing training and support to medical students, GPs, allied health professionals, teachers and counsellors in non-pathologising approaches to primary care mental health.

He has an international reputation for his work on the evidence base for psychiatry and is a strong advocate for addressing the social determinants of mental health.

Jon, together with co-author Leemon B. McHenry, wrote the book The Illusion of Evidence-Based Medicine published in 2020. The book was followed by an opinion piece which appeared in the British Medical Journal in March 2022.

In this interview, we discuss the issues with evidence-based medicine and what led to the debasement of a system originally conceived to challenge extravagant claims and poor science.

This week on the Mad in America podcast, we are really pleased to be announcing the launch of a new global affiliated site: Mad in Ireland.

Mad in Ireland launches on August the 22^nd and joins our other global sites which include Mad in the UK, Mad in Canada, Mad in Finland and Mad in Brasil amongst others.

Joining me to discuss the launch and the important role that Mad in Ireland will play are Liam MacGabhann, Martha Griffin, Elaine Browne and Harry Gijbels who are part of the team that has been working hard to get the new site up and running.

You can visit Mad in Ireland from August 22nd here: https://madinireland.com

Please help them get up and running by visitng the site and sharing it on social media. Thank you.

Our guest today is Beverley Thomson. Beverley is a writer, researcher and speaker with a focus on psychiatric medication including antidepressants, benzodiazepines and ADHD drugs. She is interested in their history, how the drugs work, adverse effects, dependence, withdrawal and development of patient support services.

For the past 10 years, she has worked with organizations such as the British Medical Association, the Scottish Government and recently the UK All Party Parliamentary Group (APPPG) for prescribed drug dependence. She is currently part of a Scottish Government Short Life Working Group addressing the issue of prescribed drug harm and dependence in Scotland.

We talk about Beverley’s latest book, entitled Antidepressed: A Breakthrough Examination of Epidemic Antidepressant Harm and Dependence published by Hatherleigh Press in 2022. Featuring compelling accounts from people whose lives have been irrevocably harmed by prescribed antidepressants, Beverley’s work provides proof that there is no such thing as a magic pill and that pretending otherwise risks the lives and well-being of those who need help the most.

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In March 2022, a new grief-related disorder was officially adopted into mainstream mental health diagnosis nomenclature. Prolonged Grief Disorder (PGD) is a recent addition to the Diagnostic and Statistical Manual fifth edition text revision (DSM-5-TR). A PGD diagnosis is to be used when a person is grieving too long and too intensely.

In this interview, Kaori Wada, Psychologist, grief researcher, and Associate Professor and Director of Training at the University of Calgary, builds upon her recent paper on the Medicalization of Grief in conversation with MIA Science News Writer and Psychologist Zenobia Morrill. Wada articulates a history of institutional tensions and financial conflicts behind the creation of this new PGD diagnosis. She also discusses the ways PGD could shape how we collectively understand and respond to those grieving.

Wada’s work demonstrates that the creation of PGD was not based on scientific findings but appears to be entangled in long-standing arguments between camps of mental health professionals with different stakes in whether the diagnosis became legitimized. Further, PGD, as with other diagnoses, represents elements of mainstream psychological theory that tend to render deviations from Western cultural norms as “unhealthy.” Is diagnosis needed to provide support and care? If so, those most likely to experience marginalization, violence, and unjust loss are also most likely to be classified as having PGD, a mental illness.

At a time when the world is fraught with tragic loss—owing to causes ranging from political failures, state violence, and the COVID-19 pandemic—grieving has been transformed into a mental health disorder. But the complicated question of what a mental disorder is continues to be glossed over. The opportunity for psychiatric professionals to embrace humility seems to have reverted to the familiar “diagnose-and-treat” response. Will pharmacological intervention become the dominant “treat” response to a diagnosis of PGD?

A new grief disorder is a clear departure, however, from the way grief used to be described in the field as an example of something that is clearly not a mental health disorder, Wada shared. She exclaims: “To me, the medicalization of grief is controversial because it may fundamentally shake up the concept of a mental disorder, [how it has] been defined and understood.”

Wada and Morrill explore what this new PGD diagnosis may mean, reflecting on the ways the “diagnose-and-treat” logic seems to of experiences formerly considered part of the territory of being human. The need to pathologize experiences in order to address them represents a paradox. A new ethical and moral quandary befalls professionals tasked with determining when grief is an illness and when expressions of grief are inappropriate.

Will the public embrace this new disorder? Will the medicalization of grief be resisted? Will a pandemic of PGD diagnoses follow a global pandemic? Wada speaks to the personal and professional influences that shaped these curiosities and her approach to researching how grief is being construed in the mental health field.

Our guest today is sociologist and author, Doctor Andrew Scull. Andrew is a professor of Sociology and Science Studies at the University of California, San Diego, and recipient of the Roy Porter Medal for lifetime contributions to the history of medicine and the Eric T. Carlson Award for lifetime contributions to the history of psychiatry.

The author of more than a dozen books, his work has been translated into more than fifteen languages and he has received fellowships from, among others, the Guggenheim Foundation, the American Council of Learned Societies and the Shelby Cullom Davis Center for Historical Studies.

In this interview, we discuss his latest book, Desperate Remedies: Psychiatry’s Turbulent Quest to Cure Mental Illness, published by Harvard Press in May 2022.

Dirk Wittenborn, the screenwriter and novelist, described the book as "A riveting chronicle of faulty science, false promises, arrogance, greed, and shocking disregard for the wellbeing of patients suffering from mental disorders. An eloquent, meticulously documented, clear-eyed call for change."

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On our last podcast, Mad in the Family covered the effect of climate change and extreme weather events on children’s and mothers’ mental health. This one continues the conversation on environmental links to emotional distress: emerging research showing that pollution in the air and water can affect our minds and emotions, and that children are especially vulnerable, both while they are young and later in life.

Kristina Marusic is a Pittsburgh-based investigative reporter for Environmental Health News, an award-winning, non-partisan organization dedicated to driving science into public discussion and policy. Last fall, EHN collaborated with Allegheny Front on a five-part series, “Pollution’s Mental Toll: How Air, Water, and Climate Pollution Shape Our Mental Health.” They found that residents throughout western Pennsylvania were likely suffering changes to their brains due to pollution in the surrounding environment, even at levels below federal limits.

Prior to joining EHN in 2018, Kristina covered issues related to environmental and social justice as a freelancer for a wide range of digital media outlets including The Washington Post, Slate, Vice, Women’s Health, and MTV News, among others. Her reporting on environmental health for Public Source won first place in the Keystone Society of Professional Journalists’ Spotlight contest in 2017. Kristina holds an MFA in Non-Fiction Writing from the University of San Francisco and a bachelor’s degree in Creative Writing from Hofstra University. She is the co-founder and chair of the Pittsburgh chapter of the Association of LGBT Journalists.

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If you find this podcast valuable, rating it 5 stars and leaving a review on iTunes, Spotify or Facebook helps us to get the word out about these important conversations. Thank you.

Our guest today is Jessica Taylor, author of Sexy But Psycho: How the Patriarchy Uses Women’s Trauma Against Them, which was published in March by Little, Brown and quickly hit the London Times bestseller list. Based in England, she is a chartered psychologist with a PhD in forensic psychology and more than a dozen years of experience working with women and girls subjected to abuse and other trauma.

She's the founder and CEO of VictimFocus, a trauma-informed UK organization that challenges the blaming and gaslighting of victims—and advocates for change in how they're treated. She's also the author of the 2020 book Why Women Are Blamed for Everything: Exploring Victim Blaming of Women Subjected to Abuse and Trauma. 

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If you find this podcast valuable, rating it 5 stars and leaving a review on iTunes, Spotify or Facebook helps us to get the word out about these important conversations. Thank you.

On the podcast this week, we hear from Dr. Niall McLaren. Niall, known to many as Jock, is an Australian psychiatrist who worked for 25 years in the remote north of the country. Also an author, Jock's latest book is entitled Natural Dualism and Mental Disorder, the Biocognitive Model in Psychiatry, and it was published in December 2021.

Recently retired after 47 years, Jock joined me to talk about his experiences working in psychiatry and explains why the models that purport to guide psychiatric diagnosis and treatment are not what they seem.

Tara Thiagarajan is founder and chief scientist of Sapien Labs, a nonprofit organization that runs the Mental Health Million Project and its annual Mental State of the World Report, which uses an online survey to track mental wellbeing among internet-enabled populations around the world.

The 2021 report, just published, was the project's second annual effort. Authored by Thiagarajan and lead scientist Jennifer Newson, it surveyed more than 233,000 internet users in 34 countries. The overall objective, write the authors, is to “provide an evolving global map of mental wellbeing and enable deep insights into its drivers.”

Its results have considerable implications regarding mental health and the factors that contribute to it.

In this interview he talks about how the psychiatric discourse has left the clinic and entered workplace, how the DSM has been feminized to the detriment of women, how and why the ADHD diagnosis has shifted shape, and lastly, how the global move towards “mental health” and away from “mental illness” might not be positive or benign.

Note: To find out more and to register for the 26th International Network Meeting for the Treatment of Psychosis 2022, click here.

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May is Maternal Mental Health Month, and although we tend to hear a lot about postpartum depression, as our guest today has pointed out, perinatal distress is really a spectrum of reactions. Childbirth and new parenthood are major life transitions that involve many physical, psychological, and practical changes. These changes may interfere a little or a lot in a mother’s ability to function optimally and, in turn, affect her relationship with the child and the child’s development. Today’s global crises, including climate change, the pandemic, and war, can add an additional layer of stress so normalizing the experience is more important than ever.

Our guest is public health expert Jennifer Barkin, Ph.D., M.S., a Professor and Vice Chair of Community Medicine and Obstetrics and Gynecology at the Mercer University School of Medicine in Georgia. A biostatistician and psychiatric epidemiologist, Dr. Barkin was formerly an analyst at the University of Pittsburgh’s Epidemiology Data Center, where she designed the Barkin Index of Maternal Functioning (BIMF), the first patient-centered wellness assessment tool focusing on mothers’ daily lives during the first year after giving birth.  She is a peer reviewer for journals including Archives of Women’s Mental Health and serves on the Board of Directors for Postpartum Support International, Georgia Chapter.

The Visible Hands Collaborative in Pittsburgh, Pennsylvania is run by Alice Fox Thompson and Kenneth Thompson. Together, the father and daughter team is bringing a novel form of community healing developed in Brazil, called Integrative Community Therapy (ICT), to the United States for the first time.

Alice Fox Thompson is currently in her fourth year of medical school at Geisinger Commonwealth School of Medicine. Before medical school, Alice worked in community organizing and advocacy. She is interested in solidarity-based approaches to community and population mental health.

Kenneth Thompson is a psychiatrist trained at the Boston University School of Medicine. He has served as faculty at Yale University and the University of Pittsburgh and has been the director of many different psychiatric clinics. Ken currently serves as the Chief Medical Officer of the Pennsylvania Psychiatric Leadership Council, a unique state-level education policy and advocacy organization that he helped found.

Ken’s focus as a psychiatrist has always been on social medicine and community psychiatry, having written, consulted, and lectured extensively on issues of public service, whole-person treatment, primary health services, health equity, democracy, human rights, and more.

In this interview, Alice and Ken describe how they both came to Integrative Community Therapy and what they've learned in adapting it to their context in the Visible Hands Collaborative in Pittsburgh. They also discuss the connection between the emotional literacy and community support developed in their groups and broader processes for political change and social justice.

Executive Director Jahmil Roberts and Advocacy Director Yana Calou from the Trans Lifeline work towards connecting trans people to the community support and resources they need to survive and thrive. Trans Lifeline is a grassroots hotline and microgrants 501(c)(3) non-profit organization offering direct emotional and financial support to trans people in crisis – for the trans community, by the trans community. Their hotline is a peer support phone service run by trans people for trans and questioning peers and does not contact police without consent. The Cops out of Crisis initiative, which you can learn more about here, does advocacy work based on the negative impact of non-consensual law enforcement intervention and forced hospitalization on those in marginalized populations. The Trans Lifeline envisions a world where trans people have the connection, economic security, and care everyone needs and deserves – free of prisons and police.

This is the third and final interview in a series of conversations being conducted around the issue of hotline tracing and intervention. The first interview was with Vanessa Green, founder of Call the Blackline and the second was with Sera Davidow from The Wildflower Peer Support Line. It is part of Mad in America’s Suicide Hotline Transparency Project, which was born out of the belief that creating transparency and public access around suicide hotline intervention and call-tracing policies should be a priority. This project includes a directory of lines that do not trace or intervene without consent, a public poll, survivor interviews, and an open call for art. Please visit the project page to find out how you can participate.

He received his PhD at the University of Pennsylvania and taught at the New School for Social Research in New York City before returning to Australia. His books include Psychology in the Bathroom, Introduction to Personality and Intelligence, Yearning to Breathe Free: Seeking Asylum in Australia, and Introduction to the Taxometric Method.

In addition to his academic writing, Nick regularly contributes to The Conversation, Inside Story, and Australian Book Review. He has also written for TIME, The Monthly, The Guardian, The Washington Post, The Australian, and two Best Australian Science Writing anthologies. Nick is a Fellow of the Academy of the Social Sciences in Australia, the Society for Personality and Social Psychology, and the Association for Psychological Science.

In this interview, he discusses inflating concepts around harm and their effects on ourselves, our experience, and society at large. He also talks about his work on stigma and biogenetic explanations of mental disorders, calling it a mixed blessing.

In this interview, MIA speaks with Allan Horwitz and Sarah Fay about the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) and its impact on our society and our personal lives.

Allan Horwitz is an Emeritus Professor of Sociology at Rutgers University. He is the author or co-author of 11 books, a number of which have focused on the DSM and how the successive iterations of that manual have shaped societal thinking about mental disorders. His most recent book is DSM: A History of Psychiatry’s Bible.

Sarah Fay is a writer whose essays and articles have been published in the New York Times, the Atlantic and numerous other national publications. Her memoir, Pathological: The True Story of Six Misdiagnoses was published in March. She is also the founder of Pathological: The Movement, a public awareness campaign “devoted to making people aware of the unreliability and invalidity of DSM diagnoses, and the dangers of identifying with an unproven mental illness.”

Sera Davidow is a filmmaker, activist, advocate, author, and mother of two very busy kids. As a survivor of physical, sexual, and emotional abuse as a child and relationship violence as an adult, Sera has faced many challenges throughout her own healing process, including many ups and downs with suicidal thoughts, and self-injury. At present, she spends much of her time working as Director of the Wildflower Alliance (formerly known as the Western Mass Recovery Learning Community), which includes Afiya Peer Respite, recently recognized by the World Health Organization (WHO) as one of about two dozen exemplary, rights-based programs operating across the world. She also serves on several boards including the Massachusetts Disability Law Center (DLC) Board of Directors, the DLC’s Council Against Institutional and Psychiatric Abuse (CAIPA), as an advisory board member for the National Center on Domestic Violence, Trauma, and Mental Health (NCDVTM), and as a founding Board member of Hearing Voices USA. You can learn more about Sera and her work in an April, 2018 article in Sun Magazine.