Wow, this rocks. Nice piece. Still we have to remember that if any of these drugs really helped all of the people they allegedly help with all the "problems" we allegedly need help with, no one would be wondering about the funding. It still would be unethical but as the nyt doesn't hit on enough, the main problem is that the drugs cause harm which has caused Grassley to look at why the hell they're being used in the first place. Perhaps I should move to Iowa and become a Republican;)

Yes, but Sharfstein also has problems, for example in the same speech you link to in the last paragraph, he says the following:

"Sometimes these fringe individuals and organizations are surprisingly close to the political centers of power. For example, a member of Congress, Representative Ron Paul, is crusading against psychiatric care for children. He claims that psychiatric diagnosis is inherently subjective, that psychiatric treatments frequently ruin the developing brains of children, and that mental health screening in schools has—and I quote—"no place in a free and decent society."

Let me send a message today to Representative Ron Paul, a physician. As President of the American Psychiatric Association, I support a "free and decent society." A society where all youth and their families can obtain care for devastating mental illnesses. A society where parents have the freedom to seek such care without the stigma that you spread with your ignorant attacks. "

End quote. Plentiful rhetoric, but do you really resonate with what he's saying?

:)
Finally! Since I've started researching all this scandal I'm waiting for the day this association, APA, gets what it deserve.
I just hope it will all be forgotten after elections.
It's impossible things keep on going this way.
Perhaps I'll be alive to see some sense on all this scandal.
I only ask: why only one senator? Can't other congressmen see how hideous are all of these?
Many, many docs are lazy like that and it's to the detriment of their patients and their practice.
Good Philip!
They have to have some time to spend the money. They are not lazy. They are just having fun because they work very hard to write the prescription.
can you imagine having to write several prescriptions a day?
I just hope that they have some help of their secretaries and have it all on the computer.
So they only have to sign!
This is one of the few times I come here and do not get infuriated!
thank you Philip!
The dizziness is fading away!
Finally the world is starting to stand still. I didn't realize how terrible i was.
My relation with space was quite disturbed.
Now I'm getting better. It's good to feel gravity!
:)

PS: i didn't go to the doctor earlier because I fear them.
I believe I have reasons enough. Even GPs I fear.
I fear medicine!
I believe it's common knowledge that health is the most important... blah blah blah...

Anyone can email Senator Grassley; give him your thoughts is what I say.

contact Grassley here.

I just LOVE how this is the "first medical society in the U.S. to be the subject of a Senate investigation" according to a commenter on the Carlat Psychiatry blog.

I hope all of the members of the APA have a nice weekend. heh!

The public DESERVES THE TRUTH and Grassley needs to hear from consumers!!

Philip,

Rah, rah, rah, sis-boom, bah…before you jump for joy and wave the flag maybe you ought to first go back to investigating the investigators.

Seems to me I’m still reading about the same ole “Power/Politics/Money Games.”

Maybe you ought to look into and write about the background of former Senator Bill Frist who was an esteemed committee member of Senator Grassley’s panel and take a look at the pharmaceutical money that lined his pockets and the family business. Least we also not forget that Frist as a member of Grassley’s committee was also involved in the Terri Schiavo debacle.

I’m fascinated by these media grabbing witch hunts but let’s also not lose sight that monies have to come from some source to fund these research programs and all institutions and researchers are not necessarily tainted as you might imply or lead one to believe.

Then again, I’m also aware of Grassley’s committee one-sided investigation of a medical device for depression totaling ignoring the professional opinions of a number of leading thought leaders. So much for the skills, abilities, impartiality and untainted nature of the committee and their investigators…

Warmly,
Herb
VNSdepression.com

Philip:
a few points to this well reported posting:

1. I am wary of trusting anything Dr Sharfstein reports or supports, as he was an unspoken advocate for managed care back in the 1990's, perhaps reluctantly, but still a support and even tried to have his own managed care org via Sheppard Pratt in the later '90's. Managed care is a serious hot button issue with me to this day, so his agenda has to be viewed in a cautious manner until proven otherwise. He did have a conference on therapy back in April, so maybe he has seen some light, therefore I hope I am wrong in this view.

2. Sorry to say this in this manner, but the APA is a bunch of old, greedy, selfish mother fuckers, who I can't wait to die as soon as possible; there is no negotiation with these entrenched bastards like this group, so death is the only resolution from my experiences, not that I am advocating anything nefarious or illegal, just hoping there is a higher power who believes that the needs of the many outweighs the needs of the very few. Their agenda has almost nothing to do with mine, so they don't speak for me, and if there are inappropriate, illegal, immoral activities going on at the APA that are worthy of investigation and criminal prosecution, it can't happen fast enough for me. which leads me to my last two points,

3. You and your frequent flyers here need to do some investigation into the percentage of psychiatrists who belong to the APA, as I suspect it is less than 50%, so these generalizations that all psychiatrists aid and abet this org needs to be refuted. Some of us are responsible and attentive to the needs of the many, so lumping all psychiatrists with the agenda of the APA is clueless and irresponsible. I'd like to say it another way to some of you (not you specifically, Philip), but I hope some readers who are impartial and somewhat objective will see all the points to this debate, so they'll do their research as well with a clear mind.

4. Finally, Mr Herb's comments in this thread have legitimacy in considering, as related to point 3, as one must be cautious with the zeal and overfocus Grassley seems to have on psychiatry alone. There is a lot of evil out there beyond psychiatry, so it will not surprise me there are special interests at play he (Grassley)caters to that benefits them moreso than the public. Remember, folks, our politicians have their own needs and wants, and they seem to rarely overlap the needs of the constituients that voted these hacks into office in the first place. So watch out, because when you get what you wish for, sometimes hindsight bites you like a great white shark!

Good posting; you should check out what Carlat is looking into of late too!

Herb, which medical device for depression are you discussing?

This is an investigation of the APA not medical devices of which only vested individuals would care to discuss.

Of course Congress is not fully disclosed yet either, that's the beauty of this big picture--It's called opening Pandora's Box.

Pharma money has lined the pockets of our Government agencies, officials and Presidential candidates, that's no secret.

BUT at least Grassley is asking questions that get the general public THINKING!!

Call Grassley's office if you want to whine about him, I'm sure they will take notes.

"You and your frequent flyers here" interesting that is what they call revolving door patients in psych wards.

This is not a generalization of ALL psychiatrists, most of us "frequent flyers" here are smart, intelligent, and understand being a member of the APA is a choice and that not all psychiatrists are members.

Let's stay on task here and remind ourselves that this is an investigation of the APA, and with that in mind, emotions are not part of the invesigation: Grassley wants the paperwork. Good thing he doesn't have to deal with disgruntled psychiatrists, anti-psych crowd, pharma reps, oh you get the picture. I'm sure not all of the phone calls and emails he is receiving are thanking him for having balls!!!

The psychiatric-pharmaceutical drug cartels must be obliterated..

I haven't really had time to look into Grassley like I want, but I suspect this investigation has something to do with or at least some connection to the "mental health" parity testimony and activity.

I'm one of the folks whose life was saved by not having access to mental health care. I bet there are a lot of other folks on the list that discovered through loss of health care coverage for therapy and meds that they were better off without them.

Managed care didn't work and the person who comes up with a real, viable model for delivering real health care will be a hero. The insurance industry, not usually one of my favorites, is doing some cool stuff in terms of presenting info that mental health care doesn't treat real medical problems, doesn't work and thus isn't cost effective. It's not surprising psychiatrists would be opposed to managed care, which cuts off the forever and ever with no results therapy therapists want.

Hmmm, I checked and I was wrong about Grassley. He supports mental health parity. While I don't, I think the fact that he supports this bill proves he's not an anti-psychiatry crusader, which should give him credibiliy with those of you who think anti-psychatiry is bad, wrong, a psychiatric symptom, etc.

Stephany:

"frequent flyers" seemed to originate with people who frequently used airlines, so it seems to be applicable to people who frequent this site. Goes back to my prior comment that I'd be attacked for saying the sky is blue; twist the comment so it attacks patients. Not the intent!

many of the comments here about psychiatrists are generalizations. I'd suggest you reread some of the dialogue that has occurred since I started commenting back in June. I'm a bit surprised you would be one to attack my comments, but oh well.

By the way, I'd bet there are people out there who are under the assumption that a psychiatrist has to be a member of the APA to practice. That is why I am commenting; to dispell the myths and misperceptions as best able.

Will Senator Grassley consider the role of pharma funding and its influence over those organizations which "advocate" for those of us dealing with mental illnesses?

Am Psychiatric Assoc will claim how 1. money does not influence clinical dimensions, and 2. money is necessary for research funding, conference funding, journal funding, and CME funding. However, there is a similar field doing very similar things with no such funding: psychology. Psychologists have CME (usually called CEU, however), journals, conferences, etc. Psychologists also have empirically validated, effective treatments for a great deal of the problems that psychiatrists/big pharma are attemting to treat with drugs: sleep problems, social anxiety, panic attacks, depression, ptsd, disobedient children, etc. But psychologists, and the Other APA do all of this with little-to-no $upport from big-pharma.

So, there goes that argument when it is inevitably brought up. If anyone is savvy enough to counter this eventual explanation from psychiatry.

TF I've read every comment you;ve authored here, including the ones where you sign off for the "last time" and yet always return.

I took offense at the 'frequent flyer' phrase based on personal experience inside psych wards: and to assume I would know you equated that phrase to actual flying, and sky is blue analogy--well my assumption based on the fact you are a psychiatrist, I assumed you referenced the psych world phrase (which is an insult btw to patients).

I think your comment that the APA guys are old mother fuckers that need to die was a bit wild considering you are a professional and these are your colleagues...

not attacking you or your comments. i'm blowing off steam re: a highly charged topic the same as you are.

Row1:

I totally agree with your comment, BUT, you did not mention the drive by a minority, yet a sizeable percentage of psychologists, who are pushing for state to state legislation to allow them to have prescribing privileges. So, I don't know where you stand on this issue, but if this poor choice by psychologists goes unchallenged by responsible colleagues in the field, psychology will see this insidious infiltration by big pharma.

I can't believe psychologists are that ignorant to buy into this quick fix mentality when psychology has been the cornerstone for most reliable and credible psychotherapy interventions. But, in my opinion, when they along with psychiatry allowed managed care to dictate interventions by group, including allowing Social Work to become allegedly credible therapists without consistent backround training in therapy, the dulling and diminishing of the reliability of therapy ensued.

Like I have said repeatedly, everyone wants to be a psychiatrist until the crap hits the fan. Pursuing pharmacology rights will be the beginning of the end of psychology as a discipline. Think malpractice rates will be low?

Just my opinion.

I think Senator Grassley is performing a vital service by looking into corruption in the psychiatric-pharmaceutical cabal - whatever his motive may be. There is so much that needs investigating there, and so few who are bothering to investigate, that I think almost any help in shining light on this problem should be welcomed. Even if he is just looking into financial corruption in the industry, and not any of the other abuses, that is better than nothing - and maybe others can build on it later.

Anyway, I think he needs all the encouragement he can get to pursue this, so I submitted a note on his website congratulating him for what he is doing. I'm sure he must be catching some flak from Big Pharma and it's assistant, Big Psychiatry.

Row1, Here's a pretty good counter. Psychiatrists keep getting caught falsifying data, i.e. not reporting or mischarterizing data that disprove their hypotheses. Philip has lots of that sort of thing here. In other words, we are concluding that because we've caught pshrinks holding back data or making it up and they were healvily funded by drug companies who stood to profit from their made up data, psychiatrists made up the data because pharma paid them to. Pharma's defense is easy. All they have so say is, we asked them to do research not to create fake research. That's why the claim of innocence of psychiatrists and their finger pointing to big pharma rings so false.

If it hadn't already come out that the "studies" were flawed, psychiatry could argue that money didn't influence them. Instead they are left with arguments of their own mental inadequacy which is ironic. They can say things like I didn't know that if someone stopped participating in a study because s/he commited suicide we should report that instead of marking them as noncomplaint and not reporting suicide with regards to the study. They could say, we're not good at math, lots of us have learning disabilities, but they are caught with bad studies that don't measure what they claim to measure and data that isn't what they say it is.

You raise an interesting point about psychology. I don't know of any studies that emprically validate the effectiveness of psychotherapy, but that doesn't mean there aren't any. Are you refering to specific studies? If so, which one or ones?

And I warn you, most psychological studies can be discounted because of history threat, maturation threat and testing threat. These are not the only empirical validity problems a instrument attempting to measure the effectiveness of non drug talk therapies, but they are the key ones I undersand. The problem, as always, is the subjectiveness of what is being measured. You do raise a good point about psychological research being possibly indenpendnat of drug companies and that effecting the potential differences in results and in what psychologists attempt to measure, as opposed to what psychiatrists attempt to measure, of what is decided worthy of studying in the first place.

Unfortunalty most Psychologist today are medicated on psychotropic medications themselves. To think they aren't influenced by pharma already is a big mistake. I believe Psychologists should be required to tell patients they are medicated before providing any therapy as their judgements have been altered. It's just not fair to a clients to be treated by someone who has yet to deal with their own issues.

Stephany:

I only replied back to you in this posting thread as I was not expecting you to be challenging something that I felt were straight forward points, even though just my opinion.

As to the MF comment, you seemed to relate in a posting at Carlat's site a couple of months ago when I made a bit less disparaging comment about my older colleagues that you appreciated it, so if wasn't you, sorry for the mistake. However, I have worked in this field for 15 years and had been under the unfortunate tutelage of several supervisors who were entrenched in the system while in my training for 4 years prior, and the level of patronizing, entitlement, and in my opinion abusiveness by these "people" to trainees and non-colleagues really turned me off in respecting and appreciating their alleged seniority. Most, BUT NOT ALL older psychiatrists have come from a training mind set of patriarchial and controlling attitudes that send a very clear message to others of "do what I say, not what I do, and I don't give a damn if you don't like what I say or do."

"People" like that cannot be negotiated with, so I just hope the natural course of life moves faster to minimize having to deal with them. I don't see many psychiatrists over the age of 65 retiring of late, and if my opinion and experience with how this age group operates has any validity, I stay away from them. But, these are the guys who run the APA, the ABPN (Psychiatry Board for Certification, which by the way has excluded physicians who are board certified prior to 1994 from needing to go through the $1600 recertification process every ten years, so what does that say), and I'll bet have a sizeable input into the DSM process (but not the majority, in this example less are supportive of this biochemical model BS than newer docs). Sort of what we see in the way our older politicians run this country--"I know better what to do, so shut up and let me do what I want".

So, I responded to you here to let you know that I sense you are more objective about issues, and you know where I am from as a psychiatrist and a person, and I am not going to let pervasive negativity go unaddressed here as I value this site as a source of information for others who are not "regular commenters"; the regulars I get a sense of where they are coming from.

By the way, I haven't been commenting at Carlat's site so much of late, so yes, I have been inconsistent about staying away, because I feel the issues responsibly and fairly need to be examined through the exposure of different viewpoints such matters have. Not that I am right, just that I am not agreeing with what others say by my silence. In my opinion, too many bashers and too little responsible supporters leave a poor perspective to judge an issue or topic.

So, for what it is worth, sorry I replied here prior, but I hope this will provide some clarification. Thank you for your input.

TF thanks for the clarification, I have appreciated your outspoken viewpoints and look forward to more discussion in the future.

Great info. Thanks!

On a side note, something is going on behind the scenes with pharma co. and docs. Two relatives are phama reps. They just recieved word of NO MORE FREE DINNERS FOR DOCTORS!
In my state, WV, the pharma co. hands are being removed (slowly, but surely) from the doc pockets.

The only negative to this is that uninsured people (like me) can no longer get samples of our meds for free. It's back to paying ridiculous amounts for scripts that are needed. Still, I think I'd rather pay an exhorbant amount at the pharmacy than have what meds that I am prescribed be strongly influnced by perks given to crooked doctors.

I for one think that what Sen. Grassley is doing is great. Regardless of his own political ties and what not, this action is opening public eyes. I do not think that ALL psychiatrists are out to get the public, however there is a growing trend of drugging without proper consideration that needs to be addressed and if the push is coming from the drug companies then great, this should make them back off a little.
Great article. I read the Times article and am interested in seeing if this goes anywhere or is allowed to be buried.