Friday 5 September 2014

Mental Health Drugs are Big Business

Pharmaceutical companies are big corporations, and they are obligated by law to serve their shareholders and investors by selling as much product as they can, to as many people as they can, for as long as they can, and for as much money as they can. Individuals who may be suffering from some mental discomfort are a ready market for these products.

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The corporation can neither recognize nor act upon moral reasons to refrain from harming others. Nothing in its legal makeup limits what it can do to others in pursuit of its selfish ends, and it is compelled to cause harm when the benefits [for the corporation and her shareholders] outweigh the costs.” –Joel Bakan, “The Corporation”

But it’s complicated, and here’s why. Individuals suffering mental distress are encouraged to see a doctor. The underlying assumptions are that mental distress is a physical condition that can be fixed, or at least treated and mediated, by physical/chemical means, and/or that, as individuals, we are incapable of coping with the slings and arrows of life’s misfortunes without professional help.

Doctors, meanwhile, are busy people. They almost always have their patients’ best interests at heart, but their time is limited and doctor visits are expensive. Typically, patient/doctor contact time might be just ten or fifteen minutes. In that time, the patient needs to explain the problem, the doctor needs to consider treatment options, and then there is just enough time to make a recommendation to the patient. Clearly, there isn’t enough time or expertise allocated here to fix the patient’s stressful job, broken relationship, grieving heart, financial crisis, victimization/abuse, or spiritual emergency (all conditions that often appear at the core of mental distress). But there is time enough to write a prescription, which the patient can fill in his or her own time and take without further ado. Even if the pills don’t work, or are only marginally effective, the placebo effect means the patient is likely to feel better. After all, they came with the doctor’s recommendation, didn’t they? And we trust our doctors.

Pharmaceutical companies are pretty canny. They know doctors are short on time, so they make it easy for doctors to want to promote their drugs by providing supportive literature for their products, free samples for patients to try, advertisements in medical journals, and copies of research studies that demonstrate the benefits of their products. Many even provide quick checklist questions for doctors to use with patients to determine if a particular drug is appropriate. And keep in mind they want their drug(s) to be found appropriate—they are in sales after all. (Unlike other diseases, there are no physical tests that can be run for mental illnesses.)

Further support for drug treatment over therapy or counselling comes from insurance companies and government bodies, corporate-type organizations who also want quick, cheap treatments. And let’s face it, pills are cheap to make and quick and easy to prescribe. So quick and easy and cheap, in fact, that about 20% of the folks in the western world are taking one or more psychiatric medication.

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There’s a lot more to this story, including a fascinating history of how and why we ended up (as a society) believing in bio-medical causes and cures for psychiatric illness, and indeed, how we define psychiatric illness to begin with. Just how do we diagnose this stuff anyway?  (And thereby hangs an interesting tale of commercial evolution!) And do chemical cures work? I have explored those themes in more depth in my new book Reframing Mental Illness, where I also offer some alternative perspectives for both the problem and the “cure”.

If you find this topic of interest, read the book!

Other articles I’ve posted in this blog on the topic of mental health include

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