A system that finds out

By Scott Christiansen
Anchorage Press
Published/Last Modified on Wednesday, May 6, 2009 5:38 PM AKDT

“Anchorage doesn’t have enough of these,” Jim Gottstein said, as he led Flashlight to the rooftop deck above his small, somewhat cluttered, law office downtown. The rooftop, he says, is a great place to watch the Blue Angels when they perform at Elmendorf Air Force Base. Gottstein says he’d stress out if he were to attend the air show on the base, because the throngs of people the show attracts.

Gottstein is the attorney who made headlines nationwide after leaking some documents he calls “the Zyprexa papers” to the New York Times. The documents came from a civil suit against drug manufacturer Eli Lilly. They reportedly showed Lilly officials knew their best-selling psychiatric drug, Zyprexa, could raise blood sugar and lead to diabetes. The drug company denied the link and sought a court injunction against Gottstein so he wouldn’t talk about what he calls “the Zyprexa papers” anymore.

On the rooftop Gottstein dons a pair of Ray-Bans and declines to have his picture taken. Even though he’s argued three patients’ rights cases before the Alaska Supreme Court, he doesn’t look very lawyerly. He’s dressed in a blue tropical-print shirt, white jeans and sneakers, as if ready for a barbeque.

Next week Gottstein will be presenting at a conference called the Alaska Mental Health Recovery Conference, a two-day event at the Sheraton Anchorage hotel sponsored by Alaska Mental Health Trust and hosted by Alaska Peer Support Consortium, a statewide network of behavioral health organizations. He will be talking about what mental health agencies can do to change the system, a system he has attacked in court for prescribing drugs too often and for ignoring patients’ rights when the state seeks to lock them up against their will.

Much of what Gottstein knows about psychiatric care is from research, but he also has personal experience. His legal career was interrupted in 1982 by a spell of psychosis. He was 29 years old and was committed to Alaska Psychiatric Institute and given an anti-psychotic called Thiordizine. He’s written about the experience, recalling that when he was asked to a sign voluntary commitment statement he was given a choice: sign the paper or the state would seek involuntary commitment in court. He signed, but it didn’t feel voluntary. Some API staff members told him he wouldn’t likely practice law again.

That’s the sort of attitude that motivates Gottstein to fight for change in the mental health system. We have a system that’s too quick to prescribe drugs, he says. We’re also too quick to write off people with mental illness as incurable, and too quick to diagnose and drug children. “We recognize as ‘pathologies’ things that are really just variations of normal,” he says. “Why not just recognize them as people, you know, variations of people.” 

Gottstein does much of his work pro bono, through a nonprofit he founded called The Law Project for Psychiatric Rights.  One current lawsuit claims Alaska’s Office of Child Services has a system that reaches for the prescription pad too quickly, without first looking for other ways to help children in state custody.

Of course, those children are in state custody to begin with because their original home was deemed too dangerous. Gottstein acknowledges that, but says it doesn’t automatically mean the child needs medication. “These children are legitimately upset,” Gottstein says. “It’s really because they are bothering the adults in their lives that they are being diagnosed.” The Law Project, he adds, has put the OCS case as its top priority.

Next week’s conference isn’t all about psychiatric drugs or debating over when they should be prescribed, says conference program director Eliza Eller of Alaska Peer Support Consortium. “The conference is not anti-medication at all,” Eller says. “Our main focus is that recovery happens all the time and that peer support, from people who have been through the experience, can be tremendously inspiring. I would say that peer support is a huge component of recovery because hope is a huge component of recovery.”

The conference will feature Yvonne Sanders-Butler, a school principal from Georgia who established a “sugar free zone” and recorded rising tests scores and fewer behavioral problems as students’ health improved. Journalist Robert Whitaker will also speak at the conference. His book Mad In America tries to make sense of low recovery rates for mental illness in the U.S. and lays the problem at the feet of the medical establishment—drug companies, doctors and institutions.

Eller expects at least 200 attendees, many of them professionals in behavioral health, but also educators and “mental health consumers”—the field’s jargon for patients and their families. 

On the rooftop, Gottstein tells Flashlight that the degree to which children are prescribed drugs is “an emergency” and says there’s little proof it’s even safe. Still, he says, he isn’t suing for a completely drug-free mental health system: “I don’t say that the drugs should never be used. What I say, and what Bob (Whitaker) says, is that they should only be used selectively.”

What’s needed, he says, “is a system that finds out” who needs medications. “Because some people find that the drugs do work, and you know what? They take them voluntarily.”



Daniel Haszard wrote on May 7, 2009 1:30 AM:

" Lilly Zyprexa use by Children.

Zyprexa,as well as the other atypical antipsychotics, are being prescribed for children, even though this is an unapproved, off-label use. Eli Lilly has been charged in allegedly pushing the drug for children in more than one state.

A report by Dr. Cooper at Vanderbilt University states that 2.5 million children are now taking atypical antipsychotics. Over half are being given them for Attention Deficit Hyperactivity Disorder. Perhaps it is statistics like these that caused the FDA to finally require warnings on the labels of the ADHD drugs.

Daniel Haszard "

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