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What 60 Minutes Gets Wrong in Report on Mental Illness and Violence


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On Sunday night the television news program 60 Minutes broadcast “Untreated mental illness an imminent danger?” Correspondent Steve Kroft introduces the report by stating: “The mass shooting at the Washington Navy Yard two weeks ago that resulted in the deaths of 13 people, including the gunman, was the 23rd such incident in the past seven years. It’s becoming harder and harder to ignore the fact that the majority of the people pulling the triggers have turned out to be severely mentally ill–not in control of their faculties–and not receiving treatment.”

"60 Minutes" reporter Steve Kroft overstates the degree to which psychiatry can explain and treat mental illness and hence prevent mass shootings like the recent Navy Yard massacre.

I’m a long-time fan of 60 Minutes, which produces the kind of tough investigative journalism that is increasingly rare these days. But “Untreated mental illness an imminent danger?” overstates the degree to which psychiatry can explain and treat mental illness—and hence prevent violent outbursts by the mentally ill.

The problems with the show begin with its basic premise. Contrary to Kroft’s assertion, some mass shooters have received psychiatric treatment–including prescriptions for medications–prior to erupting into violence. The Navy Yard shooter, Aaron Alexis, was prescribed the antidepressant trazodone in August. James Holmes saw a psychiatrist before killing 12 people in a Colorado movie theater last year. According to the Los Angeles Times, police found the antidepressant sertraline and sedative clonazepam in Holmes’s apartment.

As I reported last month, some studies indicate that psychiatric medications, and especially antidepressants, might increase the risk of violence. “Violence and other potentially criminal behavior caused by prescription drugs are medicine’s best kept secret,” says psychiatrist David Healy, who recently created a website, called RxISK.org, to gather data on adverse effects of medications.

Kroft’s discussion of the pros and cons of drug treatment is cursory, at best. He notes that anti-psychotic drugs can make patients “listless or groggy, which is one of the reasons people with severe mental illness often stop taking them.” Kroft says to Mike Robertson, a young man diagnosed with schizophrenia, “A lot of people with your illness say the drugs make them feel worse. They just hate it.” Robertson replies, “Yeah. I can see that with the side effects. But it’s better than having schizophrenic symptoms.”

Viewers hear nothing about other serious side effects of anti-psychotic medications, which range from obesity and diabetes to uncontrollable tremors, or tardive dyskinesia. Nor does Kroft acknowledge that, even disregarding side effects, medications for mental illness do not work very well.

As Harvard psychiatrist Stephen Hyman, a former director of the National Institute of Mental Health, wrote recently, “many individuals with mental disorders remain symptomatic and often disabled despite existing treatments … For some significantly disabling conditions, such as the core social deficits of autism and the cognitive impairments of schizophrenia, there simply are no effective treatments.”

In his 2010 book Anatomy of an Epidemic, journalist Robert Whitaker contends that psychiatric medications may on balance harm more patients than they help. Thomas Insel, director of the National Institutes of Mental Health, recently acknowledged that although anti-psychotics can “safely and effectively help people through the crisis of acute psychosis,” the drugs might “worsen prospects for recovery over the long-term.”

Instead of airing these critical views, Kroft interviews Jeffrey Lieberman, a psychiatrist at Columbia University and adamant proponent of biological theories of mental illness. Lieberman tells Kroft that brain scans of schizophrenics reveal “structural abnormalities.” But according to the National Institute of Mental Health, “No scientific studies to date have shown that a brain scan by itself can be used for diagnosing a mental illness or to learn about a person’s risk for disease.”

Kroft’s primary source is psychiatrist E. Fuller Torrey, who asserts that if mentally ill shooters “were being treated, [mass killings] would’ve been preventable.” By “treatment,” Torrey means detainment in a mental-health facility. For decades, Torrey has advocated legal reforms that would make it easier to hospitalize and medicate patients against their will.

Torrey has one legitimate point: that an unfortunate consequence of the wide-scale closing of state mental institutions a half century ago has been that many mentally ill people now end up homeless or in prison. Kroft interviews Sheriff Tom Dart, who oversees Cook County Jail in Chicago, which houses as many as 2,800 mentally ill inmates.

“The irony’s so deep that you have a society that finds it wrong to have people warehoused in a state mental institution,” Dart says, “but those very same people were okay if we warehouse ‘em in a jail.”

The large-scale incarceration of indigent, mentally ill Americans is indeed a national disgrace. But surely there are better solutions to this problem–and to mass shootings–than rolling back the rights of the ill so many more of them can be forcibly hospitalized and medicated . After all, Dart says that his disturbed, destitute inmates are usually imprisoned for nonviolent offenses such as theft and trespassing.

One reason why I was so disappointed by “Untreated mental illness an imminent danger?” is that 60 Minutes has produced hard-hitting exposes of the pharmaceutical industry, including Kroft’s 2007 report “Under the Influence.” To redeem itself, I’d love to see 60 Minutes investigate the thesis of Anatomy of an Epidemic that psychiatric medications—far from helping reduce severe mental illness in the U.S.—may be increasing its incidence.

Photo: CBS News.

About the Author: Every week, hockey-playing science writer John Horgan takes a puckish, provocative look at breaking science. A teacher at Stevens Institute of Technology, Horgan is the author of four books, including The End of Science (Addison Wesley, 1996) and The End of War (McSweeney's, 2012). Follow on Twitter @Horganism.

The views expressed are those of the author and are not necessarily those of Scientific American.





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  1. 1. softwarematters 9:16 pm 10/2/2013

    Another outstanding article. Keep up the good work!

    What I find astonishing about the 60 minutes piece is the extremely lousy job that Kroft did researching the material for the segment. Was it really that hard to call Thomas Insel to have different point of view? While it is true that it is increasingly difficult to ignore Bob Whitaker’s work, Tom Insel is as mainstream psychiatry as you can get.

    The prime reason stigma exists is presentations like 60 minutes’ that perpetuate the false notion that if only those like me lost our rights, criminality would be reduced. As John correctly points out, those so called “mentally ill” who end up in jail are there for petty issues. Most murders happen in the inner cities for reasons that, a priori, have nothing to do with “mental illness”.

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  2. 2. madison 1:19 am 10/3/2013

    And high powered guns are readily available even to 12 years olds. Anyone with violent tendencies can play these out because of the milions of guns that the Americans believe is their constitutional right to have.

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  3. 3. sciencejnky 12:03 pm 10/3/2013

    I actually fell for psychiatry’s “low serotonin” scam believing insomnia was a symptom of depression like the depression drug marketing literature says, it kind of made sense. Those “medications” made me feel manic and suicidal like the “black box” warns of. I had to goto a psych ward for observation after going to the E.R for help, the abuse of people in that place was despicable.

    I found out the hard way that all of the classes of psychiatric drugs can and DO cause suicidal, violent, irrational, and/or manic behavior. Among other effects, these drugs cause a neurological condition called “akathesia,” which means that persons who take them can’t sit still and feel like they are jumping out of their skin. They behave in an agitated manner which they cannot control and experience unbearable rage, delusions, and disassociation.

    I think these drugs are why in the old days suicidal people usually just killed themselves, now cause of these psychiatric drugs they lash out at others as well.

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  4. 4. jpdickey 6:52 pm 10/4/2013

    What’s new about 60 Minutes getting it wrong?

    They are in the business of creating sensational stories for the public. They spend a limited amount of time researching each story, and mostly put on only what supports the position they decide to present.

    I have a friend who was once interviewed by 60 Minutes. He spent about 2 hours explaining all the good things his industry was doing, and showing that most of the allegations they put on were wrong. He is very articulate. Four words of his interview made the show: “We could do better.” So a simple acknowledgement that they had not achieved absolute perfection came out sounding like an acceptance of the claims presented in the show.

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  5. 5. jlhayden 2:35 pm 10/6/2013

    The blog post by John Horgan regarding the 60 Minute show, “Untreated mental illness an imminent danger?” completely misses the point of the piece and puts forth some dangerous ideas.

    Mr. Horgan appears to presume that “treatment” of the seroiulsy mentally ill includes nothing more that prescribing medication. Serous mental illnesses are complex brain disorders and require an array of treatments. Effective medications are essential, however, they’re only one component of the comprehensive treatment that is required.

    Dr. Torrey, who was one of the primary sources for the piece, is a fervent proponent of pharmacological treatment for the seriously mentally ill, as I would hope all ethical psychiatrist would be. HOWEVER, Mr. Horgan’s statement regarding Dr. Torrey’s position and work, i.e., “By ‘treatment,’ Torrey means detainment in a mental-health facility. For decades, Torrey has advocated legal reforms that would make it easier to hospitalize and medicate patients against their will” is completely wrong, bordering on libelous. Dr. Torrey and others have advocated for effective treatment in the community, not detainment in a “mental-health facility.”

    To suggest psychiatry “overstates the degree to which [it can] treat mental illness” by putting forth the cases of the Navy Yard Shooter, Aaron Alexis, and the Colorado movie theater killer, James Holmes, is simply preposterous and demonstrates the lack of understanding Mr. Horgan has on the subject. What these cases clearly show is how broken the mental health system (including its laws) is in America, not the impotence of psychiatry. In both these cases, alarms went off but the system was unable to meet the psychiatric needs of these individuals. These were failures of the system, not psychiatry. And, to list the medications that were found in the possession of these individuals as proof they were under psychiatric care for their serious mental illness is laughable. These medications are for depression and anxiety, NOT schizophrenia.

    Mr. Horgan is correct in stating that medications for serious mental illness don’t work for everyone equally and that they have unpleasant, sometimes serious side effects. However, this is true for any medication. What should happen, then, is increased supervision and monitoring by professionals. But what is provided now is less supervision, or in the majority of cases, no supervision at all . . . “prison guards” are not the type of professionals I am referring to. Assisted outpatient treatment (AOT), as is advocated by Dr. Torrey, would provide a mechanism under which such needed supervision could become available.

    Finally, as I won’t go into the dangerous positions provided in the article by others such as Robert Whitaker, Mr. Horgan seems to presume we need only to be concerned about high profile mass killings when judging whether we need to treat the seriously mentally ill. There are many other killings and acts of violence that occur across our country because of untreated or inadequately treated mental illness. Two states, California and New York, have enacted laws named for young women who were killed by seriously mentally ill individuals. Does Mr. Horgan suggest we need similar murders in each state before we can achieve meaningful change in our mental health system at the national level? I certainly hope not.

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  6. 6. softwarematters 11:51 pm 10/6/2013

    jlhayden,

    A few years ago, Szasz wrote a paper criticizing Torrey’s nonsensical ideas both on the social aspects of so called “mental illness” as well as his theories about “viruses causing so called mental illness”. The title is “PSYCHIATRIC FRAUD AND FORCE: A CRITIQUE OF E. FULLER TORREY”. Enjoy,

    http://www.critpsynet.freeuk.com/SzaszHumanistic.pdf

    Torrey’s positions with respect to coercive psychiatry are well known. We don’t need them “distorted” to make them look “benign”. Torrey’s is a program of massive human rights abuses and needs to be assertively opposed.

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  7. 7. jlhayden 1:16 am 10/7/2013

    Softwarematters,

    Szasz had some interesting theories. However, for the most seriously mentally ill the data do not support them. Please read the following to find out what Dr. Szasz might do in real life:

    http://www.huffingtonpost.com/allen-frances/when-is-it-justified-to-f_b_4038218.html

    Regardless of what you think Dr. Torrey’s motive is, ulterior or otherwise, you can not dispute the facts, i.e., the data. Because of serious mental illness, people are dieing daily . . . both the mentally ill as well as innocent bystanders. People with serious mental illness are very much more likely to be incarcerated than hospitalized. Convicted inmates are being released from prisons and jails because authorities are unable to release the seriously mentally ill to their communities due to a lack of services.

    If you have a better alternative to what Dr. Torrey and many others are advocating for, please let us know.

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  8. 8. june conway beeby 6:58 am 10/7/2013

    New scientific discoveries are not usually shared quickly with the public or even with medical professional.

    There are probably good reasons for this but I wish scientific brain research findings could become the exception. We need to heed the scientific facts. But we must hear about and understand them first.

    The assumptions of the naysayers of this CBS well-researched program spout the old myths and misconception that held sway before we had the scientific tools to investigate the chemistry and structure of the brain.

    It is vital that society become fully informed about these biological brain diseases. We must quickly acquire the scientific know how to finally ameliorate the awful symptoms of these diseases–until we find the cure for them. This is do-able only if we understand and use the necessary science.

    This would not only protect society from the tragedies that flow from untreated severe mental illnesses but would also relieve the unbearable suffering of those who have little hope in the social studies that have captured societies’ thinking up to now.

    We have an opportunity to combat this epidemic if we abandon the unscientific hypotheses and learn about the research that has brought humanity the freedom from other chronic diseases.

    May I suggest a visit to the website of The Treatment Advocacy Center to access timely scientific research information.

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  9. 9. stan e m 2:13 pm 10/7/2013

    some mental illness is caused by infections like strep or poor nutrition like magnesium dif.

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  10. 10. softwarematters 3:44 pm 10/7/2013

    jlhayden,

    A “self reported” anecdote of 35 years ago, when Szasz is not here anymore to correct the record, only speaks of Frances’ manipulative nature. This is what Szasz said on the matter 10 years ago during a lecture at the CATO institute,

    http://www.cato.org/multimedia/events/libertarian-principles-psychiatric-practices-are-they-compatible

    Frances is, as most psychiatrists that I have had the non luck of knowing during my life are, a manipulative man. Not surprising that he would resort to this type of misrepresentation, distorting the views of a dead man.

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  11. 11. softwarematters 3:50 pm 10/7/2013

    “If you have a better alternative to what Dr. Torrey and many others are advocating for, please let us know.”

    Sure, FREEDOM. I speak from the perspective of having been civilly committed in a European country that has the laws that Torrey wants (so called “need for treatment” standard). The reality wouldn’t be pretty. In fact, even in an American context we know how the reality would look like. That’s what existed in the US before the current protections against psychiatric abuse were enacted: people betrayed by their so called “loved ones” when they do not conform to whatever those “loved ones” expect from them.

    Thanks, but no thanks. If anything, we need to elevate the standard for civil commitment on the grounds of “dangerousness” from “clear and convincing evidence” to “beyond reasonable doubt”. Only then there will be true justice for those of us survivors of psychiatric abuse.

    I think that you should submit yourself to a Rosenhan experiment type of challenge to understand the evilness of the Torrey proposal.

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  12. 12. softwarematters 3:53 pm 10/7/2013

    june,

    A TAC representative spewing propaganda is nothing new, like

    “It is vital that society become fully informed about these biological brain diseases.”

    Excuse me, which of them has been shown to be a “brain disease”? This is what the director of the NIMH had to say recently about DSM labels,

    http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml

    “The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.”

    TAC has been censoring people at their Facebook page that present this critical point of view. I am not surprised that you say such ridiculous statements. You obviously have developed some kind of “group think” at TAC that makes your arguments vulnerable to critical thinking.

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  13. 13. jlhayden 1:04 am 10/8/2013

    softwarematters,

    So I am clear, your preference for those who have demonstrated difficulty with living independently in the community through repeated hospitalizations, arrests/incarcerations, and the like, which are the criteria for Assisted Outpatient Treatment (AOT), your vote is for allowing them continued “freedom” to:

    -be confined in emergency rooms, often time restrained to their beds: http://seattletimes.com/html/localnews/2021968893_psychiatricboardingxml.html

    -be “treated” with pepper spray in state prisons: http://www.latimes.com/local/la-me-ff-prisons-mentally-ill-20131002,0,7763239.story

    -Sculpt with their own feces in federal prison: http://www.coloradoindependent.com/144266/emergency-motion-seeks-to-head-off-another-adx-suicide

    -Enjoy “three hots and a cot” in their local jail: http://www.npr.org/2013/09/15/222822452/what-is-the-role-of-jails-in-treating-the-mentally-ill

    -commit suicide-by-cop and take out a family member as well: http://www.prisneyland.com/2013/08/24/chaos-on-mellow-lane-as-mentally-disturbed-man-kills-mother/

    So we are clear, this is the “freedom” you’re advocating for? This is your solution?

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  14. 14. softwarematters 9:45 pm 10/8/2013

    jlhayden,

    “So we are clear, this is the “freedom” you’re advocating for? This is your solution?”

    Yes, and I have vested interest here. Having been civilly committed under a “need for treatment” standard, I prefer death and jail to another so called “involuntary treatment”.

    See, for me is personal. You’d sure change your mind if you had spent a day restrained, treated like a criminal without being one, hah had your life suspended “indefinitely” because a psychiatrist wanted to and had been forcibly drugged with poisonous so called “medicines” that almost left me without kidneys and liver.

    I despise everything that Torrey represents with a passion and I will fight his program of human rights abuses with every bit of my soul. As an American, I have the rights that that European country denied me.

    One of the advantages of being treated as a criminal defendant is that there are statutory protections against unfair incarcerations. The time you can be put in jail is also limited (except for the most grave crimes). Legislators/judges can be fired from office if they overreach. Who’s going to fire the quacks at the APA? Or Torrey, who got money from a wealthy investor to spew his propaganda? Even with these protections, abuses happen. And socially speaking, having been labeled puts you in a much worse position that having been jail.

    Please be courageous and take the Rosenhan challenge. For some reason, I haven’t gotten any takers among those like you who defend human rights abuses in the name of psychiatry :D .

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  15. 15. Barugna 12:48 pm 10/20/2013

    You left out the excellent, scholarly and critical work that Marcia Angell, MD (former editor of New England Journal of Medicine) has published by way of essays and reviews of books on the subjects of psychiatry, psychopharmacology and mental illness. She wrote one about antidepressants which was highly critical of the industry, the prescribers and the drugs as well as the theory that neurotransmitter misalignments precede and cause depression (as opposed to being correlative with or resultant from depression).
    “In treatment” (in the sense of regular weekly or monthly interactive consultations with a professional) could also help prevent some crimes by identifying exacerbations of a mental disorder in time to effect control or change or redirection, even if it meant some temporary loss of freedom for the affected person.
    Ultimately though the ‘mental illness’ is perhaps more a ‘societal illness’ of love for guns, shooting and personal righteousness instead of lawfulness (like presidents who lie about the need for war).

    Link to this

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