International Track: MindFreedom 2005 Action Conference Pre-Conference Information

Pre-Conference Information
MindFreedom 2005 Action Conference Washington, D.C., U.S.A.
"Activism for Human Rights in Mental Health: How the Law Can Support Grassroots Action for Human Rights in the Mental Health System."
April 29 to Monday May 2, 2005
American University Washington College of Law

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For a third year MindFreedom had a delegation of members inside the United Nations to help create an international binding treaty on disability and human rights. Celia Brown, board president of MindFreedom, once again led the MindFreedom team of psychiatric survivors which is the only group of its kind of be accredited by the UN as a Non Governmental Organization (NGO) with Consultative Roster Status.

MindFreedom handed out a news release about the results of a meeting between MindFreedom representatives and World Health Organization (WHO) officials in Geneva, Switzerland, in which WHO agreed to MindFreedom’s request to declare a “global emergency” in human rights and mental health.

The United Nations was asked to declare a “global emergency” of human rights violations in the mental health system. When the United Nations held two weeks of meetings starting 23 August 2004 to work on an international treaty about disability and human rights, some of the participants were “psychiatric survivors” who say they have personally experienced human rights violations in the mental health system.

MindFreedom International calls on the UN to echo statements by Dr. Benedetto Saraceno, Director of the World Health Organization’s Department of Mental Health and Substance Abuse in Geneva, Switzerland, who officially declared a “global emergency” in human rights and mental health on behalf of WHO.

Dr. Saraceno said, “I think that, indeed, there is a global emergency for the human rights of people suffering from mental health problems. I insist on the word ‘global’ as people tend to believe that these kinds of violations always occur somewhere else when, in fact, they occur everywhere. A human rights violation is not just a matter of denied access to treatment but also and often consists in treatment itself which is inhumane or simply of very bad quality.”

Led by their president Celia Brown, the team of psychiatric survivors and allies brought up concerns about human rights and mental health during the UN meetings.

1) Undue influence of the pharmaceutical industry: A narrow “medical model” of mental health is globalizing and squeezing out non-drug alternatives. MindFreedom is pro choice, and some members choose to take prescribed psychiatric drugs. But the drug company approach is increasingly dominating the mental health field, and humane non-drug options are often not made available.

2) The rise of involuntary and “direct” electroshock. WHO is asking for an immediate global ban on forced and direct electroshock. The power of the “medical model” is growing, but drugs are expensive and electricity is cheap. That leaves electroshock, which is also known as “electroconvulsive therapy” or ECT. Shock is at times given against the expressed wishes of the subject. In poorer nations, “direct” shock is often done without the use of anesthesia or muscle paralyzing drugs, raising the risk of trauma and broken bones.

3) The rise of coerced psychiatric drugging. There is an international trend to pass laws allowing court ordered psychiatric drugging on an outpatient basis, even of people living peacefully in their own homes.

4) Lack of full informed consent. A number of psychiatric drugs are now linked to structural brain changes, addiction, suicide, and other hazards. Clients, families, and policy makers are seldom informed of these product risks. The public is fraudulently told that science has now proven that mental problems originate from a genetically-caused chemical imbalance. No such evidence exists.

5) Youth and infants are targeted by psychiatric drugs. Some nations are even experimentally drugging youth before they have been diagnosed with any psychiatric disorder in an unscientific attempt to “prevent” mental problems.

6) The voice of psychiatric survivors and mental health consumers is not supported and ignored. Developing nations often have no organized groups.

7) Advocacy and human rights protection programs are scarce or non-existent in many countries, allowing horrendous abuses such as cages, chaining, etc.

8) Alternatives are not supported. Sustainable, empowering, effective non-drug options do not receive adequate funding for programs and research.

Photo: Celia Brown, President of MindFreedom International, leads MindFreedom’s team of psychiatric survivors inside the UN. Celia said, “We are especially concerned that forced treatment is not in the treaty because we believe it’s a violation of a person’s liberty. It was difficult at first but we managed turn around forced interventions based on disability. We need to keep up the pressure. We need MindFreedom members and international sponsor groups to advocate to their governments about ‘no forced treatment.’” In the photo, Celia addresses a protest in front of American Psychiatric Association Annual Meeting in San Francisco.

World Health Organization leaders claim to be on our side. But in developing nations the World Health Organization (WHO) is leading the globalization of corporate psychiatry with its disempowerment and human rights violations. One of the 100 sponsor groups in MindFreedom is in India. Here’s a MindFreedom exclusive report from their founder and director.

I live in Pune City, Maharashtra, India. I have been working since 1989 as a researcher and human rights activist to change the mental health system in India.

My mother was labelled with “schizophrenia” in the late 1960s. A mental health institution treated her with drugs and a thousand electroshocks, also known as electroconvulsive therapy or ECT. The shock was done without any anesthesia, which is called “direct electroshock.” She used to run away every time, by stealing money or selling her jewelry. My mother would go and live with the hundreds of wandering people labeled mentally ill in a South Indian temple, called Guruvayur. Every time, my family would have her arrested, tied up and brought back.

My mother was in lock ups, solitary, and given all kinds of abusive modern as well as traditional treatments. Before she died she suffered severely disabling tardive dyskinesia (permanent twitching caused by neuroleptic psychiatric drugs). The so-called modern institutions are still like that in India.

I started my organization in her memory. My childhood days were filled with mental hospitals, electroshock, etc. Center for Advocacy in Mental Health (CAMH) is a group of social scientists, lawyers, psychologists and healers, working towards systems reform in mental health. We are particularly engaged with a highly oppressive law regarding persons labeled as having an “unsound mind” in India. In India, we create alternative models and approaches to mental health which emphasize caring and healing, rather than drugging and shock. For me, being in the developing world, MindFreedom has been one of the two vital sources of information and support. I would like to give more time and effort to MindFreedom’s global efforts.

India is welcoming a globalizing economy and free trade. This has brought in many leading multinational companies, such as Eli Lilly, the drug company. Policy makers, the World Health Organization (WHO) and various well meaning non-governmental organization’s (NGO’s) have been talking about the “great burden of mental disease.” This “awareness” has led to more drugs and more shock.

We say “No” to the globalization of psychiatric oppression and especially the pharmaceutical stranglehold on the psychiatric industry in India. We also say “No” to the barbaric treatments meted out to defenseless and incarcerated people in this country including forced and direct shock and aversion therapy. We also say “No” to the mindless replication of the WHO models.

I have concerns about the WHO role in third world countries on the topic of mental health. WHO data are being quoted far and wide in India, to give visibility to the view that we are suffering from a huge “burden” of mental disorders. The reasons for this “burden” are much less publicized, as the social, economic and political linkages which result in psychological distress are not well studied in India. Most psychiatrists in India don’t care about the social determinants model of health. As a result, the picture painted is very bio-medical. Even in remote areas of India, people mistakenly believe that “depression is a type of mental illness.” This is itself all very depressing.

The few human rights forums in India are taken over by psychiatrists. Now human rights in mental health in India have been reduced to spreading awareness about various types of “mental illness.” What else can you expect if psychiatrists run the human rights discourse? Such persons are comfortable talking about deaths or horror stories within institutions. But they resist discussion on the kind of abuses that can happen in everyday clinical practice: overmedication, cultural stereotyping, electroshock, colluding with the family, colluding with drug companies, paternalism, coercion, etc.

Increasingly in India we have psychiatrists working closely with state authorities to control behaviors of people seen as “problem” populations. In Pune City, discussion of the official national psychiatric society is limited to approving talking about the single drug produced by the company which funded the event. These meetings end up being very opulent food and booze sessions.

The psychiatric association conferences are also like that. Doctors and their families get airfare, free busing, local hospitality in plush hotels, and various other freebies. As there is no consumer pressure to act responsibly, drug companies are having a great time here in India.

There are serious worries about the WHO data and how it is being used in India. We have a whole range of experts now saying that poor people are susceptible to mental illness. This data is going to lead to mass psychiatrization of our poor. Our poverty alleviation programs will soon be flooded with psychiatric drug prescriptions, when what such people need are healthy food, safe environments, social security, jobs and housing. In conflict-filled places like Kashmir drug companies are doing very highly profitable business selling directly to consumers.

There is no regulation whatsoever of research or practice. Our human rights and regulatory systems far too weak to take on this assault by psychiatric commerce.

Against this scenario, we cannot expect the WHO models to be implemented without serious human rights violations, however well intentioned WHO may be. The WHO regional offices have been active in all this mental health work for a while now in India. However, no where has WHO made any attempt to involve consumers or consumer forums or even social justice forums. No authority in India has tried to alert or foster consumer leadership in this area. WHO has seen it sufficient to deal with psychiatrists, psychiatrists, and more psychiatrists in the Indian subcontinent.

Psychologists, counselors, advocates, case workers are nearly absent in India. Their numbers are far, far below the required numbers.

Already, there is some damage happening with an increased “awareness” about people diagnosed with Post Traumatic Stress Disorder (PTSD). While trauma models can be robust, what is utilized in Indian practice is the shock and drug model. It is argued that these are the cheapest and most effective forms of treatment.

Some well known psychiatrists are today advocating the use of shock without anesthesia, or “direct ECT.” They say that in a poor country, where laboring people must get back to work the next day, ECT must be given as the first option, even if anesthesia is not available. Instead of spending more resources and imagination in thinking up creative community based options, these doctors are doing serious damage to mental health in India by promoting an obsolete and barbaric practice.

As psychiatrists leave the country in busloads, looking for greener pastures in the USA and UK, we are left with more ECT machines and the most hazardous form of ECT.

We are doing a campaign against direct ECT. There is a resurgence in professional advocacy for this practice, and the lobby is quite large. I suspect that there is a link to globalization. In India, there is no regulation, policy or law about ECT, therefore it is rampantly abused. They have given direct ECT to pregnant women, children and the elderly. The international user community will hopefully respond to this issue.

We are among the very few organizations in India which has openly protested direct ECT. We plan to give the issue as much publicity as possible. We say that those given direct ECT should be seen as victims of torture. Their fear and terror are evidence of trauma.

To implement the WHO models, you need to have some basic ideas about user rights, good practice, etc. Here, such concepts do not exist as the Indian Psychiatric Society has not set up any standards of practice. Even our paan waalas in the corner shop selling cigarettes and sweets extend courtesies and information about their trade. I emphatically reject the highly literate, well paid professionals who don’t even extend this minimum courtesy. I hold the IPS responsible.

Some private doctors were even practicing insulin coma shock in our small city. Recently, a psychiatrist was arrested in North of India for issuing false certificates of mental illness upon a payment of 10,000 rupees (approximately $200 US) per certificate. With this certificate, it becomes easy for husbands to dump their wives.

Those speaking on behalf of persons labeled with mental illness are very few in number. We are easily silenced. We keep with it in the hope that some day our turn to speak will come.

Photo: Bhargavi Davar, Director, Center for Advocacy in Mental Health in India, a sponsor group in MindFreedom. She is seen here in Denmark at the WNUSP conference.

Photo: Electroshock survivor Lynda Wright helped start MindFreedom’s Zapback Campaign against electroshock violations. Pictured here at the Lied Center MindFreedom Strategy Summit, Lynda is now a counselor in Hawaii.

Photo: Dr. Benedetto Saraceno is a psychiatrist from Italy who is now Director of the World Health Organization’s Department of Mental Health and Substance Abuse. Dr. Saraceno brought in several MindFreedom representatives, including MindFreedom director David Oaks, for two days of meetings with him and his staff in October 2003 at WHO headquarters in Geneva, Switzerland. At MindFreedom’s request he declared a “global emergency” of human rights violations in mental health. In a follow-up interview with MindFreedom he called for a ban on forced and “direct” shock. He said, “involuntary electroshock or electroshock without anesthesia should be banned and should be considered unacceptable.” One year later is WHO following through?

Photo: Queen Radia encourages the MindFreedom Counter-Conference to embrace MAD PRIDE. See article on page 9.

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