November 20, 2007Is America Using Suicide As A Scare Tactic?Recently, I've had a few exchanges with new readers who feel that my criticism of the mental health paradigm in this country is somehow designed to scare people off their meds, or to scare them away from ever taking meds. My usual objection to such silly assumptions (I've had these exchanges before) is that I believe in a free market of ideas and believe fiercely in patients having complete and unfettered access to legitimate information and opinions, so they can make their own darn choices about their health care. It's their bodies and their minds and they deserve accurate information instead of rhetoric based upon distorted statistics. Besides, as a I pointed out to one reader, isn't it possible that one of the totems of mental health care--the argument you can't argue with that you will kill yourself if you are not treated, a line repeated by everyone from pharma marketers to the doc in the neighborhood clinic--could be designed to scare people into taking meds that have very unpredictable outcomes and to scare them into a panic about their fates each time they feel poorly? That reader never answered me, and has likely written me off as a kook (fair enough), but I think I was onto something. Almost any mental health resource will offer the argument that 10 percent to 20 percent of people with depression, schizophrenia or bipolar disorder will commit suicide. But when you look at the numbers, that doesn't exactly pencil out very neatly. Consider: 2 million with schizophrenia (1 percent prevalence amogn US adults) Rounding up, that works out to 30 million people at a 10 percent to 20 percent chance of killing themselves. Obviously, I know some researchers estimate depression and bipolar disorder in America at even higher prevalences. If 20 percent of these folks will kill themselves at some point in their existence, that's 6 million people. We know already that suicides in America average about 30,000 people a year and has for several years, give or take. For 6 million people to kill themselves at a rate of 30,000 people a year--and that's assuming that all 30,000 suicides are a result of schizophrenia, bipolar disorder and depression, and I don't buy that assumption 100 percent--it would take 200 years for that to transpire (this doesn't allow for population growth). If the 10 percent number is used, it would take 100 years. Clearly, both suicide risk assertions don't measure up. You'll never, ever hear that talk from anyone in the mental health establishment however--possibly because they believe these numbers or because they are religious sorts to begin with. But something is clearly wrong with these numbers and the kind of marketing through fear used by researchers, advocacy groups, pharma companies and so on. I'm not asserting that suicide is not a problem--it's a problem and a half and I've written about it extensively--but I've grown very weary of the mental health establishment in this country using these numbers to literally scare people onto their meds. My own casual guesstimate is that suicide rates among the mentally ill likely hover around 5 percent to 7 percent. That's still a sizable problem--one I would like to see solved--but it's not a problem that's going to go away by using false numbers, bad logic and leaning on weak technology (ie, anti-depressants). Because that's just really scary. Anyway, I'm not throwing this out there as an absolute, but in order to generate some thoughts among readers. Think away in comments. Yes, I thought I'd do no more posts for today, but this one sort of had to be written. Posted by Philip Dawdy at November 20, 2007 03:54 AM
del.icio.us
Digg it
reddit
Comments
Where did you come up with the "30,000 suicides per year" figure? Posted by: Jon S. at November 20, 2007 04:34 AMI wonder if your five-to-seven per cent suicide rate among people with bipolar and schizophrenia includes iatrogenically caused suicide by drug reaction? I know the difference, having watched my son have 100% illness-related suicidality as a person with bipolar, and my daughter, who had drug-induced suicidality triggered by both Lexapro and Lamictal - with results lingering for months. We know there at least WERE a goodly number of SSRI suicides as the law firms have been kept busy, and some number of the same with the atypicals. I wonder how these numbers parse out...50% from the illness, 50% from the drugs? Posted by: Sprrpwgi; at November 20, 2007 05:48 AMI agree they scare us onto meds, and I think I'd sooner buy the 5-7% but the statistic I'm most curious about is attempted suicides. I know that's harder, almost impossible to track. The 30,000 a year if attempts were included would jump significantly I suspect. Triple perhaps or more? I mean I know a fair amount that weren't successful. Cough cough. That percentage might be more of a number that would scare people onto meds or to stay on them. I know I'm scared to come off my meds due to suicidal ideation that still persists off and on while on medications, but now it's manageable. The lithium has what like a 9 times reduction of chance of suicide? Posted by: Nathaniel at November 20, 2007 06:01 AMYour guesstimate is pretty good. Here are data for suicide in patients with depression. The old number one still sees thrown around of 15% lifetime suicide risk is no longer accepted. ________________________________________ Authors Bostwick JM. Pankratz VS. Institution Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA. bostwick.john@mayo.edu Title Affective disorders and suicide risk: a reexamination.[see comment]. Comments Source American Journal of Psychiatry. 157(12):1925-32, 2000 Dec. Abstract ________________________________________ that comes from the cdc/natl ctr for health stats. Posted by: Philip Dawdy at November 20, 2007 09:46 AMYou need to weigh suicides or attempted suicides while on meds against the self-damaging behavior (not necessary physical self-damage) that occurs with the subjects who are not meds but who ought to be. I define self-damaging behavior broadly to include bad judgment, failure to appreciate harm to oneself, etc. Posted by: Red Rover at November 20, 2007 03:14 PMRed Rover, I really don't think we can consider "bad judgement" to be a symptom of mental illness. Ditto "failure to appreciate harm." What about the smokers? Kentucky Fried Chicken diners? Gamblers? Fat people? People who drive too fast? Don't wear seatbelts? This is Big Pharma's wet dream: 100% of the population being diagnosable. Posted by: Francesca Allan at November 22, 2007 08:12 AMPost a comment
|
Patient Blogs. Sites.
The Trouble With Spikol
Icarus Project Blog John's Bipolar Stories Seroxat (Paxil) Sufferers Stand Up! Seroxat (Paxil) Secrets The Bipolar View Writhe Safely soulful sepulcher Electro Boy Spiritual Emergency Mental Nurse Deborah Gray Mental Mommy The Splintered Mind bipolar.and.me Nurse Ratched Psych Person Trick Cycling for Beginners depression introspection Salted Lithium Living With A Purple Dog Polar Trippin' Mercurial Scribe Bipolar Chicks Blogging Bipolar Blast Off Label Jung At Heart Graphic Truth Joysoup Apesma's Lament Soapy Water Outlaw Psychiatry Empirical Insanity Patient Anonymous Beyond Blue Psych Survivor Postpartum Progress The Happiness Project Finding Optimism The Gimp Parade Midlife and Treachery Secret Life of a Manic-Depressive Psych Tech Going Through Hell
Doctor Blogs. Sites.
Clinical Psych
World of Psychology CorePsych The Last Psychiatrist Carlat Report Blog Intueri Emotional Well-Being Scientific Misconduct Aaron Beck Cognitive Therapy Today Treatment Online Shrink Rap David Healy Dr. Dork NHS Blog Doctor Dr. X's Free Associations Dr. Sanity Anxious Mind Everyone Needs Therapy Counselling Resource
Activists. News.
Charlottesville Prejudice Watch
The Icarus Project MindFreedom AHRP Blog SSRI Stories Healthy Skepticism Psych Rights Treatment Advocacy Center Peter Breggin Schizophrenia News eDrugSearch Blog Nuts R Us News Disapedia WSJ Health Blog
Social Networking. Forums.
Mood Garden
Paxil Progress Crazy Boards Forums Psych Central Forums Icarus Project Forums DepressionTribe MySpace Bipolar Group Bipolar World Pendulum.org Bipolar Planet About.com Bipolar
Science. Big Pharma. Ethics.
PharmaLot
Pharma Gossip Science Blogs Mind Hacks GoozNews Integrity in Science Neurophilospohy bioethics.net Drug Wonks Pharma Marketing Blog Pharma's Cutting Edge On Pharma Health Care Renewal
Current Affairs
Buzz Machine
To The People Andrew Sullivan Michelle Malkin Daily Kos Reason's Hit&Run The Agitator Press Think Jim Romenesko Rough Type Gawker The Graphic Truth Tail Rank Huffington Post Instapundit Little Green Footballs Talking Points Memo MoJo Blog
Seattle Stuff
Smoking. Stuff.
|

