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Commentators

Raj Persaud: A dangerous war on psychiatry

The public's fear of psychiatric drugs has itself become a serious public health problem

The Independent
30.6.2005

Tom Cruise denounced psychiatry as a "pseudo science" this week when questioned by the American NBC-TV host Matt Lauer about his stance against anti-depressant drugs. The actor had criticised Brooke Shields for taking drugs for post-natal depression, which in turn has drawn a rebuke from the American Psychiatric Association. In response to Cruise's comments, it stated that: "It was irresponsible for Mr Cruise to use his movie publicity tour to promote his own ideological views."

The Association, which represents more than 36,000 physicians specialising in the diagnosis and treatment of mental illness, challenged Cruise's assertion that psychiatry lacks scientific merit. "Rigorous, published, peer-reviewed research clearly demonstrates that treatment [of mental illness] works," they asserted.

Cruise's comments come as no surprise to many psychiatrists, not because much of his recent behaviour has been found so strange by the press, but more because it is widely reported he is a follower of the Church of Scientology, which is virulently against psychiatry. The "war" against psychiatry was integral to the mission of the founder of Scientology, Ron Hubbard, since his first book, Dianetics, in 1950, and continues to this day. Hubbard indicated as far back as the 1960s that one of the key enemies of Scientology was the profession of psychiatry. This small but internationally connected group, Hubbard claimed, was behind the "lies and slander" that both the press and government agencies received about Scientology.

But Hubbard went further and argued that psychiatry was not just a threat to Scientology but was a vehicle to undermine and destroy the West through purveying techniques like electric shocks and brain operations. Hubbard believed that psychiatrists had sought to obtain power by becoming the contemporary "confessors" and counsellors of not just the ordinary person but also the politically powerful.

Psychiatrists took on the classic characteristics of evil in a cartoon printed in the first International Edition of Scientology's publication, Freedom, where a front-page drawing depicted eight psychiatrists as horned, goateed, tailed, and cloven-hoofed devils injecting "patients" with drugs, and performing electric shock and lobotomies. Since psychiatry is Scientology's alleged cosmic enemy, his followers want to see the profession destroyed, and its functions in society replaced by Scientology.

The specific social action group designed to eliminate psychiatry through political and press lobbying is the Citizens Commission on Human Rights, whose efforts are co-ordinated worldwide under Scientology's Office of Special Affairs International. Its efforts to portray psychiatry in a negative light has led CCHR to support the rights of patients, occasionally uncovering instances of questionable, if not calamitous, psychiatric care. In 1981, for example, Scientologists received national attention in Canada for exposure of the demonstrably detrimental effects of institutionalisation upon a psychiatric patient, Henry Kowalski, who was confined with the criminally insane while receiving unpleasant drug treatments and electric shocks.

While patients have occasionally benefited from the Church of Scientology publicising examples of poor psychiatric care, this doesn't mean that the general thrust of Scientology's case against psychiatry stands up. They appear to be reflexively against medication and other scientifically supported treatments which often are needed and are indeed life-saving.

Some psychiatric patients in the US and Canada recently became so convinced about the alleged dangers of psychiatric treatments, as a result of Scientology's campaigns, that they stopped taking their medication. US psychiatrists have concluded that the public's fear of psychiatric drugs has itself become a potentially serious public health problem, as people begin to avoid and fear treatment.

The most irresponsible aspect of Cruise's comments, as well as the approach of Scientology, is not so much their criticism of psychiatry as their failure to provide a valid alternative response to major mental illnesses. What are the treatments they advocate? Do they run centres for the clinically depressed where they take legal responsibility for their care? And do they publish data proving the effectiveness of their methods?

Cruise should outline what treatments he would recommend and show us the evidence that they work. Otherwise, he is just launching a War of the Worlds in his provocative comments. This may make good film publicity, but it does no service to the mentally ill.

The writer is Gresham professor for public understanding of psychiatry

Letters

4.7.2005

Mental illness: pills are not enough

Sir: Raj Persaud (Opinion, 30 June) valiantly defends psychiatry against the anti-medication stance taken by the Church of Scientology. It is true that medication can significantly improve the lives of people with mental disorders. But at the same time many patients have to put up with appalling side effects (a major reason why some patients stop taking the pills). For others, medication results in no therapeutic benefit.

The real problem facing mental-health services at the moment is not the lack of medication options but the lack of alternative, evidence-based interventions, most notably talking therapies. These are shown to be widely effective but there are long waiting times for referrals and too few practitioners.

At a time when the Government is proposing a new Mental Health Act that will allow the compulsory treatment of some mental-health patients in the community (overwhelmingly through medication), we need to fast track the development of effective alternatives to pills and injections for people with mental-health needs.

SIMON LAWTON SMITH SENIOR POLICY ADVISER, MENTAL HEALTH, KING'S FUND LONDON W1

Letters

5.7.2005

Psychiatry helps

Sir: The Royal College of Psychiatrists welcomes Raj Persaud's thoughtful and informative editorial (30 June). The Church of Scientology has always been vehemently opposed to orthodox psychiatry and it has always been fruitless to respond or to enter into any dialogue with them in relation to their claims. Whilst we respect the rights of people to have their own views, to frighten and deter people from seeking help when they desperately need it is dangerous. Psychiatry has helped millions of people with its treatments and therapies, which are closely regulated like all medical professions.

DR TREVOR TURNER VICE-PRESIDENT, THE ROYAL COLLEGE OF PSYCHIATRISTS LONDON SW1

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