Threatening letter from a Scientology-front organization

[TheWowEffect]

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A colleague has a received a letter from Citizen Commission for Human Rights International that he is being investigated by them for some sort of violation/complaint. The letter is vague but threatening. It lists various possible abuses and violations that are done by psychiatrists. Has anyone else received or is aware of any such letters being received?

 

[wolfvgang22]

No, but I'd love to see it for the lulz. Maybe retain an attorney to write a vaguely threatening letter back?

 

[675015]

A colleague has a received a letter from Citizen Commission for Human Rights International that he is being investigated by them for some sort of violation/complaint. The letter is vague but threatening. It lists various possible abuses and violations that are done by psychiatrists. Has anyone else received or is aware of any such letters being received?

Congrats to him. That's how you know you've truly made it!

 

[PikminOC]

http://www.cchr.org/take-action/psychiatric-abuse-report-form-former.html
Here's a form anyone can fill out..

 

[Ceke2002]

http://www.cchr.org/take-action/psychiatric-abuse-report-form-former.html
Here's a form anyone can fill out..

You have no idea how much I'm resisting the urge to snark the blanking blank out of that form right now. 😏

 

[Shikima]

http://www.cchr.org/take-action/psychiatric-abuse-report-form-former.html
Here's a form anyone can fill out..

I'm still stuck trying to figure out the difference between a lab test and a blood test.

 

[Promethean]

The less you interact with them the better. They are like hornets. They buzz past you? Great. See if they go away. Only start swatting if you need to, because that might upset the whole nest.

They act like IRL trolls, tossing out provocations to see who is fool enough to engage. They don't actually have the resources to engage in any real "investigation." Oh, the parent organization surely does, but they aren't going to waste money on any such thing. They accomplish much more disruption by threats than they could by action. If they do have any capacity to act beyond sending a mean letter, they would do it and not bother with the warning. Instead, a strongly worded memo is not just an opening salvo, but the entire attack.

Unless you engage. Then there might be lulz in a prolonged campaign of harassment.

:troll:

 

[675015]

I'm still stuck trying to figure out the difference between a lab test and a blood test.

I learned a lot if new information about our field from them the psychiatry quick facts page.

 

[Ceke2002]

The less you interact with them the better. They are like hornets. They buzz past you? Great. See if they go away. Only start swatting if you need to, because that might upset the whole nest.

They act like IRL trolls, tossing out provocations to see who is fool enough to engage. They don't actually have the resources to engage in any real "investigation." Oh, the parent organization surely does, but they aren't going to waste money on any such thing. They accomplish much more disruption by threats than they could by action. If they do have any capacity to act beyond sending a mean letter, they would do it and not bother with the warning. Instead, a strongly worded memo is not just an opening salvo, but the entire attack.

Unless you engage. Then there might be lulz in a prolonged campaign of harassment.

:troll:

Agreed, totally, and of course my previous comment was just me kidding around. I definitely would not engage them, sarcastically or otherwise.

 

[sunlioness]

I kinda want to order my free education package.

 

[birchswing]

From what I've read, the strong disdain for psychiatry was originally less dogmatic and more that L Ron Hubbard's ideas weren't accepted by mainstream mental health organizations at the time, creating in him what seems from the outside like an animosity. In reality, some of their ideas at the lower levels are not dissimilar from a form of psychoanalysis, an idea they would strongly contest.

 

[jettavr6]

Letter from the medical board - Respond. Letter from scientology - Ignore

 

[VMSmith]

I learned a lot if new information about our field from them the psychiatry quick facts page.

I never realized that the entire profession was a sham. I just quit my job, what should I do now, Scientology??

 

[675015]

I never realized that the entire profession was a sham. I just quit my job, what should I do now, Scientology??

Apparently you can't even be a doctor. I mean, they say that if you can't cure a disease you aren't practicing medicine (we all know diabetes and HTN aren't medical issues) and clinical diagnosis are apparently invalid without some sort of lab test.

 

[Shikima]

Apparently you can't even be a doctor. I mean, they say that if you can't cure a disease you aren't practicing medicine (we all know diabetes and HTN aren't medical issues) and clinical diagnosis are apparently invalid without some sort of lab test.

..or did you mean a blood test? I'm still confused.

 

[whopper]

CCHR is a Scientology front group. I've stated this before. If some group wants to make themselves out to be a watch group that gets their hands on bad doctors, fine. So be it.

CCHR, however, is not that. They are a group out to try to screw up anyone in the psychiatric business espousing delusional claims such as Bin Laden was brainwashed into being a terrorist by psychiatrists. (They say we have no real ability to do anything cause we're not a science but we could brain-wash someone into becoming the greatest terrorist of the 21st C)? So if they send a vague threat it could be them just trying to scare some people.

As mentioned above if they claim to be investigating you so be it. They're not a government agency.

CCHR has gotten some psychiatrists out of business by using the legal system or complaining to state medical boards. My response is this. If that person was doing poor care and lost their license, so be it. While I don't like CCHR, I'm not against anyone losing their license for bad practice. I just want the accused to get a fair hearing/trial. CCHR aren't exactly rational-minded complainers. I'm all for supporting groups such as NAMI that want to act as a real consumer advocate for patients.

 

[splik]

I'm all for supporting groups such as NAMI that want to act as a real consumer advocate for patients.

although NAMI aren't as awful as they used to be they are not really advocating for patients at all, but for families and are essentially an extension of pharma. they have wanted families to be able to have greater access to medical records, even above objections of the designated patient, campaign for more liberal drugging, are in favor of forced drugging and more liberal involuntary hospitalizations are are rotten to the core with drug money. they also continue to peddle this "mental illnesses are brain disorders" message despite all the evidence that this only increases public stigma of mental illness.

in fairness the local groups are much better and provide great resources for people, but NAMI national is something else.

 

[birchswing]

although NAMI aren't as awful as they used to be they are not really advocating for patients at all, but for families and are essentially an extension of pharma. they have wanted families to be able to have greater access to medical records, even above objections of the designated patient, campaign for more liberal drugging, are in favor of forced drugging and more liberal involuntary hospitalizations are are rotten to the core with drug money. they also continue to peddle this "mental illnesses are brain disorders" message despite all the evidence that this only increases public stigma of mental illness.

in fairness the local groups are much better and provide great resources for people, but NAMI national is something else.

I've had mixed experiences with NAMI--though very little contact, and it was a while ago. I have severe anxiety and went to one of the meetings and found that it was more focused on people with other types of mental illness (bipolar, schizophrenia). They showed a video on how people's lives were miraculously changed after taking their medications. It wasn't what I was looking for because I had only gotten worse on medications. I went to a peer group once but it fizzled out. I do think they have more options locally again so I may again check it out. My parents on the other hand, after attending a series of classes for family members, seemed to really get a lot of relief and we were able to relate to each other better. I'm not necessarily against allowing families to be more involved as I feel like families are the social safety net. I think families who have chronically ill children or other relatives should be more supported in some way because they are being tasked with what was previously more of a societal responsibility.

As far as drug money, there's too much of it everywhere. I think human interaction is so huge. I just received bad medical news. I had the rug pulled out from under me. My old anxiety came back. I lost 10 lbs, could barely eat, was shaking, rocking in the fetal position, insomnia, everything. I called my psychiatrist's office. Like usual, I was told I had to wait to my next appointment. She won't talk on the phone. I wanted to know if I could temporarily increase my benzos to get out of a tailspin. Anything. I would be willing to take more Seroquel if she OK'd it even though I hate how Seroquel makes me feel just to stop the shaking. I know when I get like that I have to reset my system somehow. She won't talk until my next appointment. I even used the word crisis, which I don't throw around lightly. Same answer. I called my PCP because I didn't know what to do. He called me back two hours later and just talking to him helped. He looked over the notes of the specialist I had seen who had given me the news, and was even texting me later that night on his observations on it. He's a very rare breed. He stays at the office past the secretaries--literally the last in the buildings. There till 7 PM often. I know it's obsessive perhaps, but I often go back in my mind to my very first visit with a psychiatrist. He didn't have to give me Ativan. I had been living with a secret about my sexuality and I had severe OCD over scrupulosity. My family's dynamic was not great. I needed someone to hear me. He didn't have to give me Ativan.

I always think back to that ad in the 80s that shows the Earth somewhat ominously from outer space, "In a world where certainties are few . . . no wonder Ativan is prescribed by so many caring clinicians." If you look back at some of those drug ads, they are worse IMO than anything Scientology has done to the public. My take on Scientology is this: They are criminal, yes. But the attention given to them is commensurate with their oddity not with the absolute harm done to society. And I don't think everyone that joins is as naive as they make themselves out to be once they leave. Their sales pitch is an offer of expediency. It's get-rich-quick in all ways of life. OK, that's them, a criminal organization. But when you have drug companies (in another ad) saying "The Ativan Experience . . . Now It Can Be Yours" showing a mountain peak, that is criminal behavior that doctors were and some still are part of. They knew back in the 80s what we know now. And I give Scientology more of a pass to be honest in terms of absolute harm because it's a weird company/quasi-military/pyramid scheme invented by a science fiction writer. It's not activity that is being funneled through licensed medical doctors. I get that Scientology does criminal things. I get that they mess with people's heads. I get that they prey on people. If you step back though and look at their place in the world and what they are capable of, good or bad, I think it's very small. I think the biggest problems--the greatest sources of harm--are the ones we accepted a long time ago and don't think to look at objectively. Look at automobile safety. Where's that on the priority list? And that's how it is with medicine, still, in the field of psychiatry. I do think parts of my case were unique, but I still see benzos being used as first-line treatment indefinitely.

 

[whopper]

lthough NAMI aren't as awful as they used to be they are not really advocating for patients at all, but for families and are essentially an extension of pharma.

It may depend on the local chapter. I've seen NAMI help assist families and patients to better doctors that are better community respected.

Though I have heard complaints of this type before and where there's smoke there's likely fire. Again, I'm not against watchdog groups keeping the balance so to speak, but in the police there's a difference between Internal Affairs and some left-wing hippie that thinks that the police doing anything is overstepping. The latter doesn't even properly compare CCHR cause they even make stuff up that's completely not real.

 

[Ceke2002]

I've had mixed experiences with NAMI--though very little contact, and it was a while ago. I have severe anxiety and went to one of the meetings and found that it was more focused on people with other types of mental illness (bipolar, schizophrenia). They showed a video on how people's lives were miraculously changed after taking their medications. It wasn't what I was looking for because I had only gotten worse on medications. I went to a peer group once but it fizzled out. I do think they have more options locally again so I may again check it out. My parents on the other hand, after attending a series of classes for family members, seemed to really get a lot of relief and we were able to relate to each other better. I'm not necessarily against allowing families to be more involved as I feel like families are the social safety net. I think families who have chronically ill children or other relatives should be more supported in some way because they are being tasked with what was previously more of a societal responsibility.

As far as drug money, there's too much of it everywhere. I think human interaction is so huge. I just received bad medical news. I had the rug pulled out from under me. My old anxiety came back. I lost 10 lbs, could barely eat, was shaking, rocking in the fetal position, insomnia, everything. I called my psychiatrist's office. Like usual, I was told I had to wait to my next appointment. She won't talk on the phone. I wanted to know if I could temporarily increase my benzos to get out of a tailspin. Anything. I would be willing to take more Seroquel if she OK'd it even though I hate how Seroquel makes me feel just to stop the shaking. I know when I get like that I have to reset my system somehow. She won't talk until my next appointment. I even used the word crisis, which I don't throw around lightly. Same answer. I called my PCP because I didn't know what to do. He called me back two hours later and just talking to him helped. He looked over the notes of the specialist I had seen who had given me the news, and was even texting me later that night on his observations on it. He's a very rare breed. He stays at the office past the secretaries--literally the last in the buildings. There till 7 PM often. I know it's obsessive perhaps, but I often go back in my mind to my very first visit with a psychiatrist. He didn't have to give me Ativan. I had been living with a secret about my sexuality and I had severe OCD over scrupulosity. My family's dynamic was not great. I needed someone to hear me. He didn't have to give me Ativan.

I always think back to that ad in the 80s that shows the Earth somewhat ominously from outer space, "In a world where certainties are few . . . no wonder Ativan is prescribed by so many caring clinicians." If you look back at some of those drug ads, they are worse IMO than anything Scientology has done to the public. My take on Scientology is this: They are criminal, yes. But the attention given to them is commensurate with their oddity not with the absolute harm done to society. And I don't think everyone that joins is as naive as they make themselves out to be once they leave. Their sales pitch is an offer of expediency. It's get-rich-quick in all ways of life. OK, that's them, a criminal organization. But when you have drug companies (in another ad) saying "The Ativan Experience . . . Now It Can Be Yours" showing a mountain peak, that is criminal behavior that doctors were and some still are part of. They knew back in the 80s what we know now. And I give Scientology more of a pass to be honest in terms of absolute harm because it's a weird company/quasi-military/pyramid scheme invented by a science fiction writer. It's not activity that is being funneled through licensed medical doctors. I get that Scientology does criminal things. I get that they mess with people's heads. I get that they prey on people. If you step back though and look at their place in the world and what they are capable of, good or bad, I think it's very small. I think the biggest problems--the greatest sources of harm--are the ones we accepted a long time ago and don't think to look at objectively. Look at automobile safety. Where's that on the priority list? And that's how it is with medicine, still, in the field of psychiatry. I do think parts of my case were unique, but I still see benzos being used as first-line treatment indefinitely.

I'm sorry for what you're going through. If you ever just need someone to talk to, patient to patient, my inbox is always open.

 

[PikminOC]

From what I've read, the strong disdain for psychiatry was originally less dogmatic and more that L Ron Hubbard's ideas weren't accepted by mainstream mental health organizations at the time, creating in him what seems from the outside like an animosity. In reality, some of their ideas at the lower levels are not dissimilar from a form of psychoanalysis, an idea they would strongly contest.

Look it up. Hubbard wanted psychiatric are. There is his letter out there. He begged for it. When he didn't get it, he started this.

 

[birchswing]

I'm sorry for what you're going through. If you ever just need someone to talk to, patient to patient, my inbox is always open.

Thank you, Ceke. You are one of the most conscientious people I've met on the net.

 

[Therapist4Chnge]

Look it up. Hubbard wanted psychiatric are. There is his letter out there. He begged for it. When he didn't get it, he started this.

Indeed. I read a book about him awhile back (the name escapes me)…and he was a very disturbed guy. He displayed numerous instances of psychiatric disturbance, but he never really sufficiently addressed his problems.

 

[birchswing]

Out of curiosity, I went to scientology.org and to cchr.org. I noticed on scientology.org, there is a clear link very prominently to CCHR with the CCHR logo. And on cchr.org if you click on About, the first thing it says is that it was founded by scientology.

So I'm not sure it can be considered a front organization.

When it comes to drugs, there is shady business that is analogous to front organizations.

I saw a commercial on TV a while ago for Paxil. Except it wasn't for Paxil. It was for Brisdelle, a "non-hormonal treatment for hot flashes."

In fact the web-site for Brisdelle is http://www.nonhormonaloption.com

It says on the site under About, "Brisdelle was specifically studied and FDA-approved to treat moderate to severe
hot flashes associated with menopause and is not approved to treat depression
or any other psychiatric condition."

I understand that's a disclaimer, but I also think it's confusing. Under side-effects it's referred to as an anti-depressant, but elsewhere it's made very explicit that it's a "nonhormonal treatment for hot flashes." Well, so is an ice cube. But you generally call it an ice cube. Nowhere does it say that this is an SSRI.

If you go to deplin.com, there is no clear indication of who makes that drug (medical food as they call it—it's a form of folic acid). There's not even a working link to the prescribing info. Deplin is supposedly a supplement for people who due to dietary deficiencies have depression. It's FDA approved for this. It's in the same vein as Vayarin which is allowed to make the claim by the FDA that it treats ADHD in children who have nutritional deficits that cause this ADHD.

My research shows that Deplin is made by Pamlab. Pamlab is owned by Nestle. A division of Pamlab called Red River Pharma manufactures 4 different medical foods, one of those is Deplin.

When you go to Deplin.com, why doesn't it say Manufactured by Red River Pharma, Pamlab, or Nestle? Why not link back to the main company so that a customer can see who is making the product and their portfolio?

Maybe it's because Red River Pharma sells nearly identical products in Metanx (folic acid and B vitamin metabolites) for diabetic neuropathy, Cerefolin NAC (which has no prescribing info and doesn't even list an active ingredient but is likely similar to the others, used to treat alzheimers; edit: looked up outside their site, it seems to be a basic repeat of Metanx), and NeevoDHA (the same exact product as Deplin but for women who are pregnant and have an MHTFR gene issue).

These are all FDA approved products, but there is tomfoolery afoot. If an ingredient is GRAS (which a medical food is required to be), why does it have to be a prescription? Why would a company sell it under 4 different trade names without acknowledging this more openly? What are they hiding? If I were a pregnant woman, what is my reason for taking Deplin instead of NeevoDHA? What if I took Deplin for my depression and NeevoDHA for the health of my baby and didn't even realize I was effecitvely taking the same drug twice?

Why is Paxil being sold for f*cking hot flashes when in 2015 we have air conditioning and fans?! And it's being sold as if it's not low-dose Paxil; "it's a non-hormonal treatment option." Anything that could make you cooler and that isn't a hormone is a potential non-hormonal treatment option. A hammer is a non-hormal treatment option. Hit yourself on the head enough and you won't remember you're hot (is that the same mechanism as Paxil?). To me, that is more obfuscation than cchr being an organization within scientology. I think most people who know about cchr know it's a scientology organization. Their web-site and materials have the bombast of a donald trump presidential run; it's not exactly subtle

 

[Ceke2002]

I must admit watching american TV when I have a stream available is like stepping into another world when it comes to seeing adverts for pharmaceutical medicines. I mean you guys just come straight out with it..."Hey check out this medication, here's the name of it, exactly what it treats, we'll list the side effects at the end when we've shown you some pictures of happy people frolicking through meadows".

In contrast, here are a couple of Australian adverts for Pharmaceutical Companies/Medicines. These are both from Pfizer.

 

[Ceke2002]

Thank you, Ceke. You are one of the most conscientious people I've met on the net.

Thank you, I do try, and you're very kind.

 

[birchswing]

I must admit watching american TV when I have a stream available is like stepping into another world when it comes to seeing adverts for pharmaceutical medicines. I mean you guys just come straight out with it..."Hey check out this medication, here's the name of it, exactly what it treats, we'll list the side effects at the end when we've shown you some pictures of happy people frolicking through meadows".

In contrast, here are a couple of Australian adverts for Pharmaceutical Companies/Medicines. These are both from Pfizer.

We have these ones, too, which I assume they use when they want to avoid having to list the side effects. Sometimes they try to advertise themselves as educational resources directing you to a web-site, which then ultimately presents the drug as the treatment option.

 

[Ceke2002]

We have these ones, too, which I assume they use when they want to avoid having to list the side effects. Sometimes they try to advertise themselves as educational resources directing you to a web-site, which then ultimately presents the drug as the treatment option.

Here it's done because pharmaceutical companies are not allowed to market prescription medicines direct to the public. Even on the websites the ads direct you too it still won't mention any medication by name, and will also list non medication options for treatment to discuss with your Doctor. I mean everyone knows if a pharmaceutical company is putting up an advert or website saying 'If you suffer from X condition then speak to your Doctor about treatment options' that one of those options is going to be medication, but the consumer/patient still has to actually speak to their Doctor to find out anything further.

 

[hamstergang]

Why is Paxil being sold for f*cking hot flashes when in 2015 we have air conditioning and fans?! And it's being sold as if it's not low-dose Paxil; "it's a non-hormonal treatment option." Anything that could make you cooler and that isn't a hormone is a potential non-hormonal treatment option. A hammer is a non-hormal treatment option. Hit yourself on the head enough and you won't remember you're hot (is that the same mechanism as Paxil?).

Well, presumably, Paxil is being marketed for hot flashes because it was demonstrated to be effective and safe. Hot flashes, by the way, are not just some minor annoyance easily solved with air conditioning. You obviously just lack the understanding/appreciation of them much as you do with Paxil, which is to be expected of someone without medical training. But the strength of your opinion on this does not match that lack of understanding. And none of this is actually related to this thread. Seems you just used a topic here as a way to tangentially get out your anti-psych sentiment, which seems to me to be half the reason you're actually on this forum.

 

[Armadillos]

Well, presumably, Paxil is being marketed for hot flashes because it was demonstrated to be effective and safe. Hot flashes, by the way, are not just some minor annoyance easily solved with air conditioning. You obviously just lack the understanding/appreciation of them much as you do with Paxil, which is to be expected of someone without medical training. But the strength of your opinion on this does not match that lack of understanding. And none of this is actually related to this thread. Seems you just used a topic here as a way to tangentially get out your anti-psych sentiment, which seems to me to be half the reason you're actually on this forum.

One of my favorite GYN attendings in medschool was this awesome super old school doc who had been practicing forever. He always used to say if he watched his colleagues he immediately knew if they or their spouse had started going through menopause because they suddenly started taking their pts hot flashes seriously. "Hell on earth" he would say

 

[Igor4sugry]

A colleague has a received a letter from Citizen Commission for Human Rights International that he is being investigated by them for some sort of violation/complaint. The letter is vague but threatening. It lists various possible abuses and violations that are done by psychiatrists. Has anyone else received or is aware of any such letters being received?

They came out of the woodwork for the APA in Toronto few weeks ago (particularly on Saturday morning). Chanting to stop APA from hooking kids on drugs.

 

[birchswing]

Well, presumably, Paxil is being marketed for hot flashes because it was demonstrated to be effective and safe. Hot flashes, by the way, are not just some minor annoyance easily solved with air conditioning. You obviously just lack the understanding/appreciation of them much as you do with Paxil, which is to be expected of someone without medical training. But the strength of your opinion on this does not match that lack of understanding. And none of this is actually related to this thread. Seems you just used a topic here as a way to tangentially get out your anti-psych sentiment, which seems to me to be half the reason you're actually on this forum.

A drug is not marketed because it is effective and safe; that's requisite in theory but not motivation. It's marketed because a company thinks it's worth pursuing its time on that product to make money. Brisdelle in particular is being sold in this way because the company that markets it can charge much more for it than generic Paxil. If it's common knowledge among the medically trained (which you pointed out I am not) that Paxil treats hot-flashes, then there's no medical justification for coming out with a new product that is the same product. Yes, they had to do a trial, but this must have already been a known off-label use for anyone to conduct a trial to begin with. If products were marketed because they're effective and safe then there wouldn't be shortages of life-saving medications or ones that are really effective but not profitable. The fact that you can't buy mebendazole in the US is pretty strange if you're going by the measure of what is safe and effective. Products are marketed because of perceived demand and how much people will pay for them.

I do get hot flashes, BTW, from Seroquel, and I have to be careful about being in warm environments because of Seroquel. I suffer much worse than that, though. (I'm also on Paxil, and it hasn't done much to help me mitigate the effects of Seroquel-induced hot flashes.)

As for me derailing anything, if you look at any of the threads on this forum, they don't end the way they begin.

I don't have "anti-psych" sentiment. Brisdelle has nothing to do with psychiatry, other than that a pharmaceutical company is re-marketing an existing psychiatric drug. Brisdelle is a ridiculous product of the times. The people you should be upset with are those who are making a buffoonery of the field of medicine, whether its repackaging antidepressants as if they're entirely different products, selling botulism with the intended effect of paralyzing a person's face for cosmetic reasons, or selling glaucoma medications with the medical indication of "too short of eyelashes." They're all useful medications useful indications, but not the ones you see them advertised for.

As much as you said that I sidelined the conversation, the conversation was about front-groups. And someone else brought up drug money. My point is that marketing Brisdelle as if it's not Paxil is analogous to what it's being claimed Scientology does with the CCHR (that it's a front group). It's analogous to what Nestle does with all the various forms of folic acid it sells in varying prescription brands.

I stand by what I said. Marketing by pharmaceuticals has done more absolute harm to society than Scientology. Nestle alone has done damage to the developing world by promoting its infant formulas which end up being mixed with polluted water over the promotion of breast-feeding which is inherently safer in most cases.

I don't put a lot of stock in people who speak for me or claim to understand my intentions. I also don't put a lot of stock in appeals to authority. Medical training gives you a lens, which can be helpful or limiting. It's not something that ends a conversation.

 

[whopper]

Chanting to stop APA from hooking kids on drugs.

That's an issue where I'm actually not completely disagreeing with them. A broken clock is still right twice a day. Some kids do need psychotropic meds but I also think psychiatrists need to be afforded extra time and evaluation before they medicate a kid.

Almost every freaking kid I've seen with conduct disorder gets a med and I'm not aware of much research showing it actually makes a significant difference in that disorder. So many guys I see in the jail were on antipsychotics as kids despite that it did them no good and even made them feel pathologized and discouraged they take responsibility over their bad behavior.

I've gotten a lot of guys in the jail around age 18 on antipsychotics with no psychotic signs and I simply just stop their meds. A lot of them get angry with me because they're pursuing disability or are already on it for schizophrenia or bipolar disorder. And then 6 months later still not being on meds guess what? They're fine! Well a bit antisocial, but fine!

 

[Nasrudin]

That's an issue where I'm actually not completely disagreeing with them. A broken clock is still right twice a day. Some kids do need psychotropic meds but I also think psychiatrists need to be afforded extra time and evaluation before they medicate a kid.

Almost every freaking kid I've seen with conduct disorder gets a med and I'm not aware of much research showing it actually makes a significant difference in that disorder. So many guys I see in the jail were on antipsychotics as kids despite that it did them no good and even made them feel pathologized and discouraged they take responsibility over their bad behavior.

I've gotten a lot of guys in the jail around age 18 on antipsychotics with no psychotic signs and I simply just stop their meds. A lot of them get angry with me because they're pursuing disability or are already on it for schizophrenia or bipolar disorder. And then 6 months later still not being on meds guess what? They're fine! Well a bit antisocial, but fine!

That's orders of magnitude easier to say looking at adult criminals rather than contending with the full court press of parents, school officials, counselors, psychologists, and all the other kings men trying to get you to do SOMETHING....ANYTHING....for the problem child in question.

 

[heyjack70]

That's an issue where I'm actually not completely disagreeing with them. A broken clock is still right twice a day. Some kids do need psychotropic meds but I also think psychiatrists need to be afforded extra time and evaluation before they medicate a kid.

Almost every freaking kid I've seen with conduct disorder gets a med and I'm not aware of much research showing it actually makes a significant difference in that disorder. So many guys I see in the jail were on antipsychotics as kids despite that it did them no good and even made them feel pathologized and discouraged they take responsibility over their bad behavior.

I've gotten a lot of guys in the jail around age 18 on antipsychotics with no psychotic signs and I simply just stop their meds. A lot of them get angry with me because they're pursuing disability or are already on it for schizophrenia or bipolar disorder. And then 6 months later still not being on meds guess what? They're fine! Well a bit antisocial, but fine!

Can you imagine if parents brought in a violent kid and he did not get an antipsychotic? Then attacked someone. Why didn't that psychiatrist do something to stop him from his willful behavior? My biggest pet peeves in medicine are drug reps and the fashionable diagnosis of bipolar. It really pisses me off in children who get put on antipsychotics when they're really conduct disordered.

 

[Ceke2002]

They came out of the woodwork for the APA in Toronto few weeks ago (particularly on Saturday morning). Chanting to stop APA from hooking kids on drugs.

Hahaha, OMG, not sure if it was the same affiliation but we had someone barrel into a Pagan/Wiccan discussion group several months back to try and rally us all into chanting up an international cone of power for the expansion of a global consciousness against unnecessary Psychiatric medications. Considering the group is not one of your stereotypical crunchy granola new age type affairs, and several members are on Psychiatric medication which they credit with saving their lives, and allowing them to function, let's just say a dog pile ensued. 😉

 

[hamstergang]

A drug is not marketed because it is effective and safe; that's requisite in theory but not motivation.

You asked why Paxil was being used for hot flashes when we have fans and air conditioning, and I explained that it was because Paxil was presumably demonstrated to be safe and effective for hot flashes. The motivation of the drug company of course plays a role in getting the studies done and the marketing and all that, but the reason Paxil is getting used is because it works (again, presumably. I haven't seen the studies myself nor have I claimed to have any knowledge on the use of Paxil for hot flashes).

As much as you said that I sidelined the conversation, the conversation was about front-groups. And someone else brought up drug money. My point is that marketing Brisdelle as if it's not Paxil is analogous to what it's being claimed Scientology does with the CCHR (that it's a front group). It's analogous to what Nestle does with all the various forms of folic acid it sells in varying prescription brands.

I don't get how you can make this point again without seeing what it is that you're doing. Someone claimed CCHR was a front for Scientology. You said, no it's not, but look here at what drug companies are doing! It has no relevance what the drug companies do to whether or not CCRH is a front for Scientology. Talking about Paxil and Nestle does nothing to advance your point or explain yourself wrt CCRH.

Which is why I was left to wonder why you even bothered to talk about Paxil if it had nothing to do with the conversation. Either you had a beef with Paxil (and despite your claims, your posts as a whole skew rather anti-psychiatry), or you didn't realize your argument didn't flow logically, or what else could there be?

 

[whopper]

trying to get you to do SOMETHING....ANYTHING....for the problem child in question.

You can't medicate someone based on pressure from others. You need to do it based off of a competent evaluation. There is a difference between medicating someone based on pressure and medicating based on actual information that lends to a credible diagnosis.

I'm not a child psychiatrist, but I have been in several situations where I have been given angry letters by lawyers, other physicians (not psychiatrists) and care-takers demanding I medicate someone. I've testified in court that someone had no psychosis or bipolar disorder despite that 10 other psychiatrists diagnosed the person with the disorder. In that particular case the other psychiatrists even admitted they didn't think the person was psychotic or manic but just put in that diagnosis for billing purposes.

I still don't medicate the person.

There is an argument to medicate off-label. E.g. a guy flies off the handle in anger. Maybe an SSRI or low-dose antipsychotic could help. Ok. I get that. I still don't like it but sometimes meds can help. In cases like this you don't fudge. You write down in the chart what's going on and don't fraudulently claim the guy has bipolar disorder when you know he doesn't meet the criteria of it and say it's off-label, and inform the patient including the risks, and only give the medication if the patient agrees with the plan.

If child psychiatrists are medicating out of pressure from parents, that just reinforces my current stance where I'm not disagreeing with the Scientologists on this issue.

 

[smalltownpsych]

That's orders of magnitude easier to say looking at adult criminals rather than contending with the full court press of parents, school officials, counselors, psychologists, and all the other kings men trying to get you to do SOMETHING....ANYTHING....for the problem child in question.

Hey! Tell those psychologists to knock it off. Conduct disorder needs to be treated by multi-systemic therapy and sometimes anti-depressants as depressed mood can be a contributing factor to the behavior. The only way to help these kids is to have firm limits and expectations and all adults and institutions involved on the same page. The psychologists should know better. 😛

 

[whopper]

And you basically form the opinion that this person is bulldung and you have no professional respect for them.

I got a guy on the unit right now that I'm going to kick out. He's making sexual advances on a child. There is no accepted treatment for pedophilia. There are some studies with CBT for this issue but it's not an "accepted" treatment. There are studies with chemical castration-it's dangerous (e.g. high risk of blood clots), the patient doesn't want it, and I can't force it. His family is all ticked off with me for kicking him out.

And guess what? I'm still going to kick him out. Pressure to keep him in? Yes.

I'm still kicking him out. Of course with Tarasoff warnings, a referral for CBT and consideration if he wants for chemical castration and all but he's going out. I already told the family I don't have a magic pill for this.

If you medicate based on pressure from others, what are you going to do when someone tries to bully you into giving out Xanax, stimulants, and Marinol?

 

[smalltownpsych]

And you basically form the opinion that this person is bulldung and you have no professional respect for them.

I got a guy on the unit right now that I'm going to kick out. He's making sexual advances on a child. There is no accepted treatment for pedophilia. There are some studies with CBT for this issue but it's not an "accepted" treatment. There are studies with chemical castration-it's dangerous (e.g. high risk of blood clots), the patient doesn't want it, and I can't force it. His family is all ticked off with me for kicking him out.

And guess what? I'm still going to kick him out. Pressure to keep him in? Yes?

I'm still kicking him out. Of course with Tarasoff warnings, and all but he's going out.

If you medicate based on pressure from others, it raises the question in my mind that you may be giving out Xanax, stimulants, and Marinol to anyone who raises a voice at you.

Bulldung! Love it! I always liked bull-puckey. We should have a smiley for that.

It is difficult to deal with the pressure to "do something" and I love the example you provide. Iwould say that it is a legal issue not a treatment issue. The more common one I get is the suicidal when drunk types whose family members want us to "do something". Not only that, but the other docs can't believe that we are going to discharge them because "they'll be right back again". Since everyone feels something has to be done and we don't have a psychiatrist the PMHNP says they have "a touch of Bipolar" writes a script for some anti-psychotic and we send them on their way and everyone feels something has been done.

 

[whopper]

Been there. Had an alcoholic, sobered him up. Even got him into a good rehab. The guy left the rehab and got drunk again. His sister wanted him hospitalized for life. I told her it violated the constitution and I had no legal power to do this. I said it of course very very nicely. Of course I wanted the guy to do well.

The 5th time she tried to inappropriately hospitalize him (e.g. had the cops sent to his house, he was sober but the cops picked him up anyway and brought him to the hospital), I told the sister, "Have you ever heard of conspiracy to commit a crime?"
Her: Yes
Me: It's when someone tries to get someone else to do something illegal
Her: Ok.
Me: You trying to get me to force your brother to stay in the hospital despite that he's sober at this moment violates your brother's constitutional rights. This it illegal because it violates the CRIPA ACT. Technically it is conspiracy to commit a crime. Please don't do this. I will have to inform the police.

She stopped bothering us though she may have started this vicious cycle with another hospital in the area.

 

[Nasrudin]

I'm not a child psych either...which is my point...unless you're there when all the outpatient, 9-5 weekday, citizens of the psych/school world have tapped out and you have to make decisions on acute care or what would keep a kid out of the hospital or what might work in a pinch as the family situation is blowing up and there's maybe violence involved and multiple parties to consider...you don't know why say an antipsychotic was tried.

I think there's a decadent level of Monday morning quarterbacking going on in these situations.

I mean look. If you're an outpatient therapist and your kid and his family is blowing up...by all means...send them to the scientologists. Better them than me trying to figure out this BS at 2am with a child psych fellow on the phone and bunch of upset people looking at me like I'm their last hope. God bless them for they know not what they except of an intern.

Maybe an antipsychotic has a role to play off label in these situations.

I just can't stand Monday morning quarterback types. So I'm simply saying we weren't there so don't rush to judgment.

 

[whopper]

Monday Morning Quarterbacking.

I get it. It's easy to point out the mistakes after the fact and the tension is all over.

I can tell you that I've run a psych ER as an attending for years and I pretty much never medicated a kid that showed up to the ER unless it was grossly apparent the kid was psychotic and there was no substance abuse involved.

Otherwise I just referred to other treatments. E.g. fish oil, outpatient providers, etc.

I documented that while there was something serious such as violence there is not enough evidence to justify a dx of psychosis and if it's conduct disorder there are no meds that are approved so we'd then go through a formal conduct disorder treatment route of social interventions.

The real problem I had that paralleled what you're talking about is when the caretakers would bring in someone with intellectual disability that couldn't advocate for themself and is on medication polypharmacy. We all know that some outpatient providers sometimes medicate people with low IQs in structured home-care into oblivion. So when they tell me the guy is psychotic because of a behavior that is not clearly psychosis (e.g. he broke a table) that's where I'd be in the very unsavory position on trying to figure what to do with this person.

What I did have as a weapon was in the Cincinnati area we did have some good DD people that could give us the real story but sometimes they couldn't pull through, and other times we got people from other counties outside of our network of trusted information sources.

And in a psych ER you could hold the person there for several hours while you could observe them there. Often times, if the person showed no violence, is fairly cooperative, etc, in the ER for say about 12 hours I'd discharge. Then there's some people you still can't tell because they may have acted extremely odd.

This game is highly different per area. In St. Louis I don't have a trusted network I can contact. I can see a situation where there is pressure to medicate but if you're in a residency program and this is happening I recommend you talk to the attendings and tell them that there is a palpable pressure for this and this is harming your ability to make a treatment decision you believe in.

And I can also say this, where I did residency I knew plenty of attendings that caved into pressure or blatantly just gave bull$hit diagnosis that I could tell they didn't even believe in to make the day go easier. So if you're in that position you really can't do much cause you can't over-step the attending.

 

[PikminOC]

The only way to help these kids is to have firm limits and expectations and all adults and institutions involved on the same page. The psychologists should know better. 😛

They're too busy trying to obtain prescribing rights for themselves...

And I get the sarcasm.

 

[PikminOC]

And you basically form the opinion that this person is bulldung and you have no professional respect for them.

I got a guy on the unit right now that I'm going to kick out. He's making sexual advances on a child. There is no accepted treatment for pedophilia. There are some studies with CBT for this issue but it's not an "accepted" treatment. There are studies with chemical castration-it's dangerous (e.g. high risk of blood clots), the patient doesn't want it, and I can't force it. His family is all ticked off with me for kicking him out.

And guess what? I'm still going to kick him out. Pressure to keep him in? Yes.

I'm still kicking him out. Of course with Tarasoff warnings, a referral for CBT and consideration if he wants for chemical castration and all but he's going out. I already told the family I don't have a magic pill for this.

If you medicate based on pressure from others, what are you going to do when someone tries to bully you into giving out Xanax, stimulants, and Marinol?

Sounds like you work at a bigger place where your malpractice is covered and the place has deep pockets to fight cases.
In PP, not so much. I did try to treat a sex offender with fluoxetine OP. He is back in jail.

 

[birchswing]

You asked why Paxil was being used for hot flashes when we have fans and air conditioning, and I explained that it was because Paxil was presumably demonstrated to be safe and effective for hot flashes. The motivation of the drug company of course plays a role in getting the studies done and the marketing and all that, but the reason Paxil is getting used is because it works (again, presumably. I haven't seen the studies myself nor have I claimed to have any knowledge on the use of Paxil for hot flashes).


I don't get how you can make this point again without seeing what it is that you're doing. Someone claimed CCHR was a front for Scientology. You said, no it's not, but look here at what drug companies are doing! It has no relevance what the drug companies do to whether or not CCRH is a front for Scientology. Talking about Paxil and Nestle does nothing to advance your point or explain yourself wrt CCRH.

Which is why I was left to wonder why you even bothered to talk about Paxil if it had nothing to do with the conversation. Either you had a beef with Paxil (and despite your claims, your posts as a whole skew rather anti-psychiatry), or you didn't realize your argument didn't flow logically, or what else could there be?

Out of the options you presented, I pick option 2 (my argument didn't flow logically).

Sounds like you work at a bigger place where your malpractice is covered and the place has deep pockets to fight cases.
In PP, not so much. I did try to treat a sex offender with fluoxetine OP. He is back in jail.

I think there are support groups for this in countries other than the US. Canada and Germany come to mind as examples.
Found this one:
https://www.dont-offend.org (German)
I remember an article a while back on the PSAs they run in Germany to people with pedophilia who haven't offended. They offer free counseling. This might be the same organization. Seems better than our system in that we don't have a preventative system at all. I can't find a link to info on the organization in Canada, but as I recall it was some sort of group in the vein of AA.

EDIT:

This was the ad from the article:



Can't imagine that running on US television, but something like it should.

 

[smalltownpsych]

They're too busy trying to obtain prescribing rights for themselves...

And I get the sarcasm.

Yeah. I have seen too many of my colleagues get on board with the push for medication to control behaviors and I don't see any reason to think that if we get prescription privileges we will be any better at resisting this pressure than psychiatrists. One of my least favorite statements I hear is "they just need to stay on their medications" as applied to the non seriously mentally ill patients when the truth is more that the patient needs to stop using drugs and alcohol and learn that if you don't do what you are supposed to do in life, then you will fail. Many of the frequent flyers didn't learn that in school and still haven't learned it. Fortunately, I get a lot of people in my outpatient practice that recognize that their approach to life is not working and want help learning how to succeed. They have been sold the message that they can have a better life from medications for way too long and are ready to take responsibility for their own well-being.

 

[whopper]

I did try to treat a sex offender with fluoxetine OP. He is back in jail.

Nothing wrong with a try of SSRIs given that the side effect profile is relatively not bad and it could cut sex drive.

Sounds like you work at a bigger place where your malpractice is covered and the place has deep pockets to fight cases.

This wasn't the point of the post. The patient doesn't want a treatment. The patient isn't seeking treatment. In PP the patients are almost always there of their own volition though maybe they could be there due to a guardian. In my patient's case this isn't PP. It's inpatient.

You can't force treatment that the patient doesn't want it while he has capacity especially when there's no approved treatment for his problematic behavior.

It isn't about deep pockets. Do you keep patient in an inpatient unit against their will when there's nothing for you to treat and they don't want to be there?

If anything you ought to be gunning for having deep pockets and good insurance for holding someone against their will that violates their constitutional rights as would be the case in the one I mentioned if I were to hold him there based on pressure from his family.

One more thing I didn't clarify. The minor this guy is pursuing is 16 years old so it's not pedophilia. It's hebephilia. Hebephilia, however inappropriate, is not a mental illness. I wrote the word "child" that most would not apply to a 16 year old so I should clarify.

http://www.jaapl.org/content/39/1/7...10be1c18123979c5596b5d33&keytype2=tf_ipsecsha

If you medicate inappropriately, you ought to be making sure your malpractice is well covered for practicing outside of reasonable/standard of care and raising the risk of side effects from those inappropriate treatments.

They're too busy trying to obtain prescribing rights for themselves...

Most psychologists I know don't want prescribing rights. I recommend not to lump all of our colleagues in that field into a big clump for us to paint as an enemy.

 

[splik]

Most psychologists I know don't want prescribing rights. I recommend not to lump all of our colleagues in that field into a big clump for us to paint as an enemy.

Indeed. no good psychologist wants prescribing privileges (it is a privilege and not a right). there is a strong movement amongst psychologists against RxP actually despite there being a vocal minority that want it.