What We are Up Against in Our Fight For Improved Psychiatric Care

By Marvin Ross

Despite our best efforts and the science that is emerging on the causes of mental illness and its successful treatment, we continually face opposition. That opposition touts arguments opposed to medication, hospitalizations, labeling as illnesses and the list goes on. Chemical imbalance and the value of anti-depressants as an explanation and treatment for depression has long been under attack.

Thanks to the work of James C Coyne, we now get a peak into the marketing strategy of these contrarians. Coyne is a psychologist and professor emeritus in Medicine from the University of Of Pennsylvania and  was ranked #200 in a 2014 list of the most eminent psychologists of the post-World War II era. He has always poked holes in shoddy research and continues that role in retirement. His most recent interest is British psychiatrist and academic Joanna Moncreiff, a leading figure in the Critical Psychiatry Movement and how she has been able to spread her message.

Moncreiff recently published a critical review of the chemical imbalance concept of depression in the prestigious journal Molecular Psychiatry. Her conclusion was that “serotonin theory is dead and so depressed persons should avoid meds.”

Coyne critiqued that paper in August and concluded with:

On Twitter, they consistently portray psychiatrists as evil cryptoNazi miscreants who believe in eugenics and who deceive patients and poison them with drugs that are not only ineffective but dangerous. Psychiatrists are further ridiculed if they protest this portrayal is unfair or if they insist that they do not and never have subscribed to the notion that treatment of depression involves eliminating a chemical imbalance.

There is no sense of the nuance and humility required by scientific rigor in antipsychiatry groups’ Twitter attacks. Only wild-eyed social media radicals can be so certain in a world of uncertain scientific findings.

The Moncreiff article, however, was extensively read and that is what the subject of Coyne’s follow up article deals with.

As anyone who has tried to read a research or academic paper knows, the articles are behind a paywall. Journals make money through very high subscription fees to universities, drug companies and the sale of reprints. Unless you have a university affiliation with an institution that can afford those rates and can access them through the library, you are out of luck. The vast majority of the media read about research from the press releases and report on the findings from the press release and their interviews with the researchers. Good medical reporting requires that the journalist also talk to an expert in that field not associated with the research to comment and to add some objectivity. That doesn’t often happen.

Recently, some journals like Molecular Psychiatry have had open access but charge the authors to publish their articles in it. The higher the circulation and the more prestigious the readers, the more they charge. In 2021, Molecular Psychiatry charged authors over $11,000 US.

Coyne found that Moncreiff’s audience was enormous. He described it as “like nothing the network or most laboratories had ever seen, reinforcing the claim that the review was a real coup, a victory in the war of antipsychiatry against psychiatry, analogous to the blowing up of the bridge linking Crimea to the Russian mainland.”

As of October 11, the article was accessed 740,000 times with 8247 tweets, 621 news outlets and 11 wikipedia pages. Rarely was there a critical response. On twitter, the public outnumbered scientists, healthcare professionals, and science communicators five to one. Many of the twitter accounts were associated with those claiming to be damaged by psychiatry while the larger twitter accounts tended to be from right wing commentators who are also anti-vax and conspiracy theorists.

I highly recommend that you read the full article as I’ve only touched on the high points and there is a great deal more in it. You might also like to sign up to get on his mail list for further substack articles by him.

My question is how do we make inroads against such successful misinformation? I’m not sure we ever will. The purveyors of alternative reality really do a first rate job of spreading their information and we have to learn how to do the same. Some of you who’ve known me for a long time may remember my involvement is exposing the vitamin scam we called Pig Pills. That started over 20 years ago when a couple of Alberta entrepreneurs began hustling vitamins they claimed cured a bipolar like ailment in pigs. See Pig Pills Inc Bad research at the University of Calgary using those pills was shut down by Health Canada and the US Office of Human Research Protection in the US condemned the Calgary partners at the University of Utah but the media loved it and gave them tremendous publicity. People went off proven meds for the vitamins at considerable financial cost and, in many cases, with disastrous outcomes.

Just last month, I received an interview request from a prestigious news magazine interested in that work thinking that it was novel, groundbreaking and legitimate.

In my lifetime, we’ve gone from hailing the development of polio vaccines as a modern miracle to the present time when a significant number of us look upon age old public health practices and new vaccines as a conspiracy of Bill Gates and the World Economic Forum. But then, maybe what I write is influenced by having full covid immunity including the latest bivalent vaccine. The chips Gates implanted in me are doing their job.

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