REALLY STUPID THINGS
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Modern psychiatry and clinical psychology came out of "treatment" of those who were obviously "nuts." That is, people who heard strange noises, bothered their neighbors with no account disturbances, or who were unreasonably depressed (e.g., suffering from schizophrenia, bipolar, or dysthymic [long-term depression] disorders). The professions of psychiatry and psychology claim great things (e.g., we understand how people tick) and demand great things (e.g., psychologists should be included in all health-care insurance and should be permitted to write prescriptions—after all, mental health is as important as physical health). Attempts have been made to include mental health practitioners in Federal insurance plans. And rather than being made up of witch-doctors—as some allege—the "mental health care" profession claims to rely upon "scientific findings" to devise and carry out its treatments. A basic question, and one that I have mentioned before, is "does all this ‘therapy-stuff’ work?" that is, what happens if we apply the FDA standard of "safe and effective" to the treatment of mental illness? Well, lo and behold, the political body of King County, Washington (where Seattle is located) has demanded just such an accounting—at least in part. There a law has been passed that demands an annual accounting of just how well these "scientific" treatments work. The goal of the politicians was fairly similar to what was sought in the 1850s under the reformer Dorthy Dix. Then, resumption of social functioning was the goal. Now it is "Recovery emphasizes the restoration of self-esteem and on attaining meaningful roles in society." The "restoration of self-esteem" is, of course, a new requirement. Nonetheless, the accounting is in. For 2001, 7,831 patients were treated by the staff of the King County mental health system (at a cost of $90 million or roughly $11,500/patient). The results documented that 6,949 (88.7%) showed no improvement, 597 (8%) showed some improvement, 285 (4%) regressed, and four (.05%) recovered. This is "scientific success"? During the 20th century, under the reforms of Dorthy Dix, mental hospitals that emphasized basket weaving, working in the fields, and listening to preachers had "cure" rates north of 80%. But that was before "scientific" practitioners came along. Look at the numbers above. It seems unlikely that the 8.1% improved or recovered exceeds spontaneous remission! In fact, I have a suspicion that the 8.1% rate is below spontaneous remission. Yet the professionals who managed to "achieve" this outcome, in one of the more progressive locales with one of the most generous budgets, dare to tell us how to live our lives, have our marriages, and—in particular—the correct philosophy of life. We justly scoff at people who pay witch doctors to make dolls of their enemies and pierce those dolls with pins. "How silly," we say, "dolls are not people, and no matter what you do to dolls, it won’t make any difference in the real world." Yet modern witch-doctors—those who extol the primacy of feelings (e.g., do you have good "self-esteem," "do you feel good about yourself") and tout the importance of people "following their hearts"—are magnifying their influence over common thought and social policy. PAL V11N6 (Nov-Dec 2003) |
