PsychRights and advocacy
The Law Project for Psychiatric Rights, aka PsychRights, is a non-profit organization founded by Gottstein to mount a strategic litigation campaign against forced psychiatric drugging and electroshock. Its mission also includes exposing the truth about these drugs and the courts being misled into ordering people to be drugged and subjected to other brain and body damaging interventions against their will.
In furtherance of this mission PsychRights won five Alaska Supreme Court cases establishing that the state was violating people's rights and then lost one that undid much of the gains.
- Myers v. Alaska Psychiatric Institute , ruling in 2006 that the state cannot constitutionally drug someone against their will unless it could prove it was in the person's best interest and there was no less intrusive alternative available. [4]
- Wetherhorn v. Alaska Psychiatric Institute, [5] ruling in 2007 that the state cannot constitutionally confine someone for being mentally ill unless they cannot survive safely in freedom with the help of family and friends.
- Wayne B. v. Alaska Psychiatric Institute , [6] requiring in 2008 strict compliance with procedural protections before someone can be locked up and drugged against their will.
- Bigley v. Alaska Psychiatric Institute, [7] ruling in 2009 (a) that if a less intrusive alternative to forced drugging is feasible, the state must provide it or let the person go, (b) it was a denial of due process of law not to give the person's lawyer his medical records until the trial on locking him up and drugging him against his will, and (c) the petition to drug someone against their will must include must provide a plain, concise, and definite written statement of the facts underlying the petition, including the nature of and reasons for the proposed treatment, in order that the respondent may prepare to challenge the petition under the Myers [4] factors. This should include information about the patient's symptoms and diagnosis; the medication to be used; the method of administration; the likely dosage; possible side effects, risks and expected benefits; and the risks and benefits of alter-native treatments and nontreatment.
- In Re: Heather R. , [8] voiding and reversing in 2016 an order for an involuntary psychiatric evaluation because the Court did not try to interview Heather R. before issuing the order without notice.
Much of this progress was lost in 2019, when the Alaska Supreme Court decided In the Matter of: Linda M., [9] holding the state could avoid the constitutional prohibition against locking someone up for being diagnosed as mentally ill and dangerous if there is a less restrictive alternative available by causing Soteria-Alaska to close due to insufficient funding, thereby making it unavailable.
PsychRights also developed the Medicaid Fraud Initiative Against Psychiatric Drugging of Children and Youth, based on the United States False Claims Act, also known as whistle-blower or Qui Tam cases, in which any person can file a suit on behalf of the government when improper requests for payment have been made to the federal government, and share in the recovery, if any. The ground for this is most psychiatric drugs prescribed to children and youth on Medicaid are not permissible under Medicaid. In United States rex rel Watson v. King-Vassel, [10] the United States Court of Appeals for the Seventh Circuit held that doctors writing such prescriptions cause false claims.
In addition to co-founding PsychRights, Gottstein co-founded several organizations, including:
- The Alaska Mental Health Consumer Web (with Katsumi Kenaston), which provides peer-support and a drop in center for mental health consumers in Anchorage;
- CHOICES, Inc. (Consumers Having Ownership in Creating Effective Services), which provides peer-run, alternative services, especially the right to choose not to take psychiatric drugs;
- Mental Health Consumers of Alaska (with Andrea Schmook and Barbara Greene), for which he served as a board member for ten years;
- Peer Properties, Inc., which was strictly an owner and operator of real estate, provides peer (mental health consumer) run housing for people diagnosed with serious mental illness who are homeless, at risk of homelessness, or living in bad situations; and
- Soteria-Alaska, Inc., which was dedicated to providing a non-coercive and mainly non-drug alternative to psychiatric hospitalization, under the principles established by the late Dr. Loren Mosher.
The Zyprexa Papers
In December 2006, during the course of litigation, Gottstein obtained internal documents of the pharmaceutical company Eli Lilly and Company, dated between 1995 and 2004, which showed that the company was aware that psychiatrists were reporting that many of their patients on the neuroleptic (antipsychotic) drug Zyprexa were developing high blood sugar or diabetes. [11]
The memos also showed that Lilly had engaged in off-label marketing schemes, including one called "Viva Zyprexa" which encouraged primary care physicians to prescribe Zyprexa for conditions other than those for which the drug had been approved. [11] [12] United States federal law prohibits drug manufacturers from marketing prescription drugs for purposes other than those for which they have been approved, though individual medical practitioners have latitude to prescribe drugs to any patient they wish. [12]
Gottstein obtained copies of the Eli Lilly memos from a doctor who had served as an expert witness in prior litgation involving Zyprexa, which had resulted in an out-of-court settlement of nearly $700 million with about 8,000 Zyprexa patients. [11] At that time, Lilly succeeded in keeping the documents out of public view by obtaining protective orders to keep the documents under court seal and by requiring plaintiffs to sign confidentiality agreements in order to obtain out-of-court settlements. [11]
However, upon realizing the magnitude of Lilly's off-label marketing effort, Gottstein took the information to the New York Times , which published several articles quoting from the documents. [11] Gottstein further wrote to Lilly's attorneys requesting that the company issue a "Dear doctor" letter to "all health care providers in the United States advising them Zyprexa should not be prescribed to anyone who is not already taking it," noting however that the drug should not be withheld from patients who were currently using it because abrupt withdrawal could cause neuroleptic induced discontinuation syndrome. [11] "It is now clear," Gottstein wrote, "that Zyprexa has no benefits over other neuroleptics, while causing far more cases of diabetes than do other drugs in its class.... This represents a massive health disaster including at least thousands of past and inevitable future deaths." [11]
Eli Lilly responded to the articles in the New York Times by obtaining injunctions against Gottstein, the expert witness doctor from whom Gottstein had obtained the documents, and various advocacy groups, journalists, authors, doctors, and Internet websites to in order to bar them from further dissemination of information from the documents. [11]
At the time of the disclosures, Zyprexa had become Lilly's top selling drug despite having been approved only to treat adults with schizophrenia or bipolar disorder. [11] In 2005, Zyprexa sales amounted to $4.2 billion, thirty percent of the company's total revenues. [12] At the time Lilly denied that links between Zyprexa and diabetes have ever been proven.
Between 2005 and 2007 Eli Lilly settled lawsuits by 28,500 people who took Zyprexa and developed diabetes or other metabolic diseases for approximately $1.2 billion. In March 2008, Lilly settled a suit with the state of Alaska, and in October 2008, Lilly agreed to pay $62 million to 32 states and the District of Columbia to settle suits brought under state consumer protection laws. In 2009, four sales representatives for Eli Lilly filed separate qui tam lawsuits against the company for illegally marketing Zyprexa for uses not approved by the Food and Drug Administration.
In early 2009, Eli Lilly paid $1.415 Billion to the United States Government in False Claims Act (whistleblower) lawsuits over its illegal marketing of Zyprexa. In January, 2020, Gottstein published a book titled The Zyprexa Papers giving his first-hand account of how he obtained the Zyprexa papers, including how Will Hall and a small group of psychiatric survivors untraceably spread the Zyprexa Papers on the Internet and his battles on behalf of Bill Bigley, the psychiatric patient whose ordeal made possible the exposure of the Zyprexa Papers. [13]
20 million people worldwide had taken Zyprexa since its introduction in 1996. [14]
Anti-psychiatry, sometimes spelled antipsychiatry, is a movement based on the view that psychiatric treatment is often more damaging than helpful to patients, highlighting controversies about psychiatry. Objections include the reliability of psychiatric diagnosis, the questionable effectiveness and harm associated with psychiatric medications, the failure of psychiatry to demonstrate any disease treatment mechanism for psychiatric medication effects, and legal concerns about equal human rights and civil freedom being nullified by the presence of diagnosis. Historically critiques of psychiatry came to light after focus on the extreme harms associated with electroconvulsive treatment or insulin shock therapy. The term "anti-psychiatry" is in dispute and often used to dismiss all critics of psychiatry, many of who agree that a specialized role of helper for people in emotional distress may at times be appropriate, and allow for individual choice around treatment decisions.
Olanzapine is an atypical antipsychotic primarily used to treat schizophrenia and bipolar disorder. For schizophrenia, it can be used for both new-onset disease and long-term maintenance. It is taken by mouth or by injection into a muscle.
Eli Lilly and Company is an American pharmaceutical company headquartered in Indianapolis, Indiana, with offices in 18 countries. Its products are sold in approximately 125 countries. The company was founded in 1876 by, and named after, Colonel Eli Lilly, a pharmaceutical chemist and veteran of the American Civil War.
Peter Roger Breggin is an American psychiatrist and critic of shock treatment and psychiatric medication and COVID-19 response. In his books, he advocates replacing psychiatry's use of drugs and electroconvulsive therapy with psychotherapy, education, empathy, love, and broader human services.
The New Freedom Commission on Mental Health was established by U.S. President George W. Bush through Executive Order 13263 on April 29, 2002 to conduct a comprehensive study of the U.S. mental health service delivery system and make recommendations based on its findings. The commission has been touted as part of his commitment to eliminate inequality for Americans with disabilities.
MindFreedom International is an international coalition of over one hundred grassroots groups and thousands of individual members from fourteen nations. Based in the United States, it was founded in 1990 to advocate against forced medication, medical restraints, and involuntary electroconvulsive therapy. Its stated mission is to protect the rights of people who have been labeled with psychiatric disorders. Membership is open to anyone who supports human rights, including mental health professionals, advocates, activists, and family members. MindFreedom has been recognized by the United Nations Economic and Social Council as a human rights NGO with Consultative Roster Status.
Bruce E. Levine is an American clinical psychologist, often at odds with the mainstream of his profession, in private practice in Cincinnati, Ohio. He has been in practice for more than three decades. Levine writes and speaks widely on how society, culture, politics and psychology intersect.
Robert Whitaker is an American journalist and author, writing primarily about medicine, science, and history. He is the author of five books, three of which cover the history or practice of modern psychiatry. He has won numerous awards for science writing, and in 1998 he was part of a team writing for the Boston Globe that was shortlisted for the 1999 Pulitzer Prize for Public Service for a series of articles questioning the ethics of psychiatric research in which unsuspecting patients were given drugs expected to heighten their psychosis. He is the founder and publisher of Mad in America, a webzine critical of the modern psychiatric establishment.
The Soteria model is a milieu-therapeutic approach developed to treat acute schizophrenia, usually implemented in Soteria houses.
The psychiatric survivors movement is a diverse association of individuals who either currently access mental health services, or who are survivors of interventions by psychiatry.
Loren Richard Mosher was an American psychiatrist, clinical professor of psychiatry, expert on schizophrenia and the chief of the Center for Studies of Schizophrenia in the National Institute of Mental Health (1968–1980). Mosher spent his professional career advocating for humane and effective treatment for people diagnosed as having schizophrenia and was instrumental in developing an innovative, residential, home-like, non-hospital, non-drug treatment model for newly identified acutely psychotic persons.
Judi Chamberlin was an American activist, leader, organizer, public speaker and educator in the psychiatric survivors movement. Her political activism followed her involuntary confinement in a psychiatric facility in the 1960s. She was the author of On Our Own: Patient-Controlled Alternatives to the Mental Health System, which is a foundational text in the Mad Pride movement.
The Citizens Commission on Human Rights International (CCHR) is a nonprofit organization established in 1969 by the Church of Scientology and psychiatrist Thomas Szasz, headquartered in Los Angeles, California. Its stated mission is to "eradicate abuses committed under the guise of mental health and enact patient and consumer protections." Many critics regard it as a Scientology front group whose purpose is to push the organization's anti-psychiatric agenda.
The Critical Psychiatry Network (CPN) is a psychiatric organization based in the United Kingdom. It was created by a group of British psychiatrists who met in Bradford, England in January 1999 in response to proposals by the British government to amend the Mental Health Act 1983. They expressed concern about the implications of the proposed changes for human rights and the civil liberties of people with mental health illness. Most people associated with the group are practicing consultant psychiatrists in the United Kingdom's National Health Service (NHS), among them Dr Joanna Moncrieff. A number of non-consultant grade and trainee psychiatrists are also involved in the network.
The Law Project for Psychiatric Rights, or PsychRights, is an Alaskan organization that seeks to "end the abuses against people diagnosed with mental illness through individual legal representation." The organization is especially focused on fighting involuntary medication and the forced use of electroshock therapy. It contends that the involuntary treatment system operates largely illegally, in that requirements such as the "less restrictive alternative" requirement are often not followed. PsychRights has mounted legal challenges in Alaska, Massachusetts, Minnesota, New York, and other states.
The following outline is provided as an overview of and topical guide to the psychiatric survivors movement:
Stefan Philip Kruszewski is an American clinical and forensic psychiatrist, active as a whistleblower in medically related cases. He is principal in the company which bears his name, Stefan P. Kruszewski, M.D. & Associates, P.C. in Harrisburg, Pennsylvania.
Peter Lehmann, D. Phil. h.c., is an author, social scientist, publisher, and an independent freelance activist in humanistic anti-psychiatry, living in Berlin, Germany.
David William Oaks is a civil rights activist and co-founder and former executive director of Eugene, Oregon-based MindFreedom International.
Flumezapine is an abandoned, investigational antipsychotic drug that was studied for the treatment of schizophrenia. Flumezapine failed clinical trials due to concern for liver and muscle toxicity. Flumezapine is structurally related to the common antipsychotic olanzapine—a point that was used against its manufacturer, Eli Lilly and Company, in a lawsuit in which generic manufacturers sought to void the patent on brand name olanzapine (Zyprexa). Although flumezapine does not differ greatly from olanzapine in terms of its structure, the difference was considered to be non-obvious, and Eli Lilly's patent rights on Zyprexa were upheld.
