Truth-Telling And Consequences

On 1 September 2022, I coordinated an exhibition, ‘Truth-telling & Consequences: Alice in Dunderland Part II’, which I registered as professional development with the ACA. ‘Alice in Dunderland’ was an exhibition intended to highlight and illustrate the role of the arts in dealing with mental health difficulties. As a transpersonal art therapist, I’ve seen that the arts enable us to go to deeper places within ourselves, places that are often impossible to describe in words, places where we bury the deepest hurts, our most painful wounds. This was the rationale behind Alice – that understanding our internal world, and being able to both draw it and draw from it, can keep us from being engulfed and overwhelmed by emotions that are normal responses to being human.

Due to the COVID-19 pandemic, the exhibition was separated into two parts: Alice, the visual component, took place in February while Truthtelling, the storytelling/education forum component, happened in September, seven months later. Therefore, something that was intended to be two parts of a whole was split asunder over both time and space. Alice, held at The Red Tree Theatre in Tuggerah, NSW, was very successful. It was opened by Liesl Tesch AM, local Labor Party member and among the attendees was Emma McBride, Assistant Minister for Mental Health and Suicide Prevention and Assistant Minister for Rural and Regional Health. By September, momentum had been lost and burnout was looming. Truth-telling took place at my own home via Zoom with a very small audience, rather than in The Red Tree auditorium. Unfortunately, especially as the event was meant to present information that would prompt policy change, Liesl Tesch was unable to attend as she had planned to do.

A lot happened in the seven months between Alice and Truthtelling. One of the most significant events was the release of the Moncrieff report on 20 July 2022, titled Depression is probably not caused by a chemical imbalance in the brain. The report authors, Joanna Moncrieff and Mark Horowitz (see Appendix), found no evidence to support the low serotonin/chemical imbalance theory of depression. They stated that antidepressants are no better than placebo, that long-term use is associated with a worsening of symptoms and that many people experience withdrawal symptoms if they try to go off them. My view – both then and now – is that mental health professionals, training organisations, carers and, most importantly, the millions of people taking antidepressants, need to be informed of this watershed report.

Nothing in the Moncrieff report was a surprise to me, nor to any of the hundreds of thousands of psychiatric survivors and mental health professionals critical of psychiatry who have been sharing their negative experiences of antidepressants, psychiatric medications in general and the mental health system as a whole, for decades. I took antidepressants after my mother died, and experienced nightmare adverse impacts and withdrawal symptoms that, at the time, I never imagined were caused by the medications. The akathisia I experienced – very mild in comparison with some people I’ve seen, whose lives have been made almost unliveable – made me think I was going insane. Giant, uncontrollable body shudders and the sensation of millions of microbes crawling under my skin terrified me to the extent that I drove myself to the local psychiatric ward one early morning after yet another sleepless night.

Luckily, the staff were too busy to see me so I hid under a table for a while and then drove home. Hundreds of thousands of others around the world are not as lucky. Many have ended up disabled by their medications, unable to come off them, and are living totally different lives because their diagnoses have altered their sense of self. Many have suicided, some have committed homicide. These stories are available for anyone to read. They can decide for themselves if all these people are lying, which many mental health practitioners seem to think, continuing to discount the truth and very great sadness of these stories. Joey Marino’s story of tardive dyskinesia is a particularly graphic account of the horror life can become courtesy of psychiatric medications (see the link to his story in Resources).

I have been a critic of the biomedical model of mental health as a result of my experience on antidepressants, and from listening to the stories of many people such as Joey Marino, whose lives have been ruined by diagnoses/ misdiagnoses and medications. We all know professionals, carers and/ or consumers who have attempted to bring their concerns regarding these matters to the attention of those who could make changes, but whose concerns have been met with negative consequences. I was dismissed from my position working in foster care when I expressed concern about an ADHD diagnosis, medications and selfharm of an 11-year-old boy I worked with. I viewed it as my duty of care to act as I did – I was fulfilling my moral, ethical, professional and legal responsibility to ensure a child’s safety and wellbeing, particularly considering all I knew about the connections between psychiatric medications and suicide. I, therefore, welcomed the Moncrieff report and prompted discussion about it at the truth-telling event.

The underlying theme of the truth-telling event was that what we believe about mental health and mental illness diagnoses ultimately depends on what we’ve been taught to be true about ourselves as human beings. Psychology and psychiatry are the specialities that purport to explain our internal worlds to ourselves and to those who would care for us. In matters of grief and trauma, of how we help both ourselves and each other and of what the mental health system offers us, there are consequences that are largely dependent on what we, both individually and collectively, believe to be true. Ultimately, though, this is not a theoretical matter; it’s that very practical reality of one human being who is vulnerable and wounded by life seeking help from another who wants to help.

Over the decades, feeling sad, anxious, threatened, afraid or stressed – all of which are normal, human reactions to life – has been medicalised and pathologised. We now seek professional help for what we term depression and anxiety – states of being that can be identified and fixed by medications rather than identified and understood as transient states, then moved through. Many imagine that a diagnosis of depression and/ or anxiety and an accompanying prescription for antidepressants are the logical response to their troubles. We forget that past generations have been through world wars, concentration camps, genocide and the Great Depression, resulting in far fewer mental illness or mental disorder diagnoses than there are today.

There is a poison apple aspect to all this, for both those who are taking antidepressants and those who prescribe them. Many who are currently on antidepressants will reject the Moncrieff report’s findings, because they know the relief the medication brings. They may then go on to base their career and professional reputation on this. Many who are prescribing antidepressants will also reject the findings, because that’s what they’ve been trained to do, even though they have seen side effects and patchy results. Which brings us back to duty of care and ethical and moral decisions. Each individual will decide whether they believe information given in the report, and whether they continue taking the medications or whether they continue prescribing them. Doctors will need to weigh up their professional duty to ‘do no harm’ and decide what to do. This decision making will bring into play knowledge of how the system either rewards or – as in my case – punishes what we hold to be true. Either way, whichever decisions we make, whichever side of the debate we’re on, there will be consequences.

For many, the truth of the Moncrieff report will be too unpalatable to accept. There will be consequences for that, as well. The vast majority of people I know – whether professionals or not – are aware that the mental health system is flawed. Many say it’s broken. None of the information I’ve alluded to is difficult to find; at the time of writing, a Google Scholar search for ‘psych meds suicide’ yields approximately 22,200 results. We only need look and do some critical thinking regarding vested interests, business alliances and origins of research. Most people know someone who is on antidepressants or have been on antidepressants themselves, know at least one person who has suicided, know families where grandparents have brought up grandchildren because of drug or alcohol problems, or know people who are currently suffering and who don’t want to suffer any longer than necessary. Antidepressants are a useful short-term solution for crises. Believing that we have a chemical imbalance in our brains that is genetic and can be fixed with medication is a very different lens through which to see emotional suffering, with very different longterm consequences.

If we accept the fact that our decisions about whether to prescribe or take antidepressants have different consequences for many and for society as a whole, we need to seek better solutions rather than just sinking into helplessness and losing all hope that change is possible. Our future depends on us asking questions and questioning the reality of matters that deeply impact how we see ourselves. It also depends on how we use power and on questioning how power has been used to deceive us and how – or if – we can change this. ■

TRUTH-TELLING AND CONSEQUENCES