Royal College of Psychiatrists lied about psychiatric diagnoses and drugs on BBC

What its president wants will cause more deaths and more patients on disability pension

There is a mental health crisis in the UK where mental health disability has almost trebled in recent decades, and the gap in life expectancy between people with severe mental health issues and the general population has doubled.

Responding to the crisis, the outgoing president of the Royal College of Psychiatrists, Lade Smith, claimed on BBC radio two weeks ago that the pandemic of mental illness, which affects one in eight people, is clearly distinguishable from the mental health challenges we all experience; that it requires medical treatment because “If you don’t get treated, things get worse;” and that effective psychiatric treatments are available that can prevent the chronicity that leads to people going on benefits.

Psychiatry professor Joanna Moncrieff from the Critical Psychiatry Network, of which I am a member, has countered these arguments. I interviewed Joanna about some of the myths in psychiatry in 2023 and below, I shall document further how horribly wrong Smith’s statements are.

The documentation can be found in the links and in my freely available books, “Is psychiatry a crime against humanity?” and “Critical psychiatry textbook.” I write about the latter book on my website:

My book describes what is wrong with the psychiatry textbooks used by students of medicine, psychology and psychiatry. I read the five most used textbooks in Denmark and uncovered a litany of misleading and erroneous statements about the causes of mental health disorders, if they are genetic, if they can be detected in a brain scan, if they are caused by a chemical imbalance, if psychiatric diagnoses are reliable, and what the benefits and harms are of psychiatric drugs and electroshocks. Much of what is claimed amounts to scientific dishonesty. I also describe fraud and serious manipulations with the data in often cited research. I conclude that biological psychiatry has not led to anything of use, and that psychiatry as a medical specialty does more harm than good.

Psychiatric diagnoses are grossly unreliable

Patients with psychiatric diagnoses are not clearly distinguishable from the mental health challenges we all experience; it is just the opposite. Psychiatric diagnoses are unscientific and are based on vague, arbitrary symptoms many of us have from time to time. Therefore, most healthy people can get a psychiatric diagnosis if they look up a psychiatrist or a family doctor for some minor troubles in life.

When researchers interviewed 463 people about 91 key symptoms for psychiatric disorders, they found that all of them experienced thoughts, beliefs, moods, and fantasies that, if isolated in a psychiatric interview, would support a diagnosis of mental illness.

It requires very little to get a depression diagnosis, and if the screening test recommended by the WHO is used on 100 healthy people, about one third will test positive.

When I have lectured for healthcare professionals or a lay audience and have asked them to try the adult ADHD test, it has never failed that between one quarter and one half have tested positive. I reassure them that they shouldn’t worry about this because some of the most interesting people I have ever met have tested positive, including most members of my own family.

I have also tried other tests on healthy people and the results have been surprising for the course participants also for these tests.

Psychiatrists have done a lot to hide the results of observer variation studies where several psychiatrists independently of each other examine the same patients. The science is very hard to find, but two researchers dug it up. The largest study, of 592 people, showed very disappointing results even though the investigators took great care in training the assessors. The agreement between two observers was very poor even for major depression and schizophrenia, two of the most important diagnoses in psychiatry (see my first-mentioned book above, on page 12, for an explanation of what the kappa values from the study mean).

Therefore, we don’t have a pandemic of mental illness, as Lade Smith claimed. We have a pandemic of psychiatric diagnoses, or to be clearer: We are overdiagnosing healthy people hugely and trap them in a system where there is a door in but where the door out is difficult to find and may even be locked.

In 2012, the US Centers for Disease Control and Prevention reported that 25% of Americans have a mental illness. In response to this absurd result, Des Spence, a Scottish family doctor wrote the article: “The psychiatric oligarchs who medicalise normality.”

Spence wrote another article, “Bad medicine: adult attention-deficit/hyperactivity disorder,” that illustrates the institutional corruption of psychiatry:

Psychiatry has … become pharma’s goldmine, with a simple business plan. Seek a small group of specialists from a prestigious institution. Pharma becomes the professional kingmaker, funding research for these specialists. Research always reports underdiagnosis and undertreatment, never the opposite. Control all data and make the study duration short. Use the media, plant news stories, and bankroll patient support groups. Pay your specialists large advisory fees. Lobby government. Get your pharma sponsored specialists to advise the government. So now the world view is dominated by a tiny group of specialists with vested interests. Use celebrity endorsements to sprinkle on the marketing magic of emotion. Expand the market by promoting online questionnaires that loosen the diagnostic criteria further. Make the illegitimate legitimate.

Do people with psychiatric diagnoses need drugs?

Lade Smith claimed that if people are not treated, things get worse, and “effective psychiatric treatments” can prevent the chronicity that leads to people going on benefits.

Again, the truth is the exact opposite. Not a single psychiatric drug is beneficial in the long run and the same applies to electroshock. Science journalist Robert Whitaker has shown (see page 8 in his book, Anatomy of an epidemic, 2^nd edition) that the rate of disability pensions follows the usage rates for depression pills closely in all the countries he has examined, and that after SSRIs came on the market, a 35-fold increase in disabled mentally ill children in the USA was seen in just 20 years.

Depression is best treated with psychotherapy, which can halve the occurrence of a new suicide attempt in people admitted after a suicide attempt whereas depression pills double suicides, with no age limit - it is not an effect restricted to minors and young people, as it is often said.

Psychiatry does not need more funding

The eternal mantra among the psychiatric leaders is that their specialty needs more funding, which Lade Smith also said.

There is none so blind as she or he WHO WILL NOT SEE. The Royal College of Psychiatrists is harming the patients, and it is shameful to suggest more of the same, as if this could somehow clean up the mess the psychiatrists have created. More money will only make matters worse because more diagnoses will be made and more patients will be treated with drugs, they often find it very difficult to come off again because of serious withdrawal symptoms, which psychiatrists usually interpret as if the disease has come back.

A popular saying is that madness is doing the same thing again and again expecting a different result. I have argued, and this is not a joke, why I think psychiatrists are generally more mad than their patients and why psychiatry is the only medical specialty that survives on lies. Not a little lie here and there but big lies with lethal consequences. It should never be forgotten that psychiatric drugs are the third leading cause of death, after heart disease and cancer, and that millions of people are being permanently harmed by psychiatric drugs every single year.

What do we need?

As the massive use of psychiatric diagnoses and drugs so clearly make everything worse, the World Health Organisation and the United Nations have recently called for systematic mental health reform emphasising psychosocial interventions.

There have also been calls to scrap the entire diagnostic system and to focus instead of the issues patients have. As one commentator put it after the appearance of the DSM-5 diagnosis manual: “Real sciences do not decide on the existence and nature of the phenomena they are dealing with via a show of hands with a vested interest and pharmaceutical industry sponsorship.”

The US National Institutes of Mental Health has abandoned the use of the DSM as a research tool and in 2013, its president, Thomas Insel, explained why:

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. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.

There is much overlap in the criteria for different diagnostic categories, which often results in a “comorbidity” label, although the patient does not have several “diseases.” We would not accept this in any other branch of medicine. Indeed, prominent psychiatrists including Thomas Insel, his predecessor Steven Hyman, and Allen Frances, chairman for the DSM-IV diagnosis manual, have acknowledged that psychiatric disorders have never been validated as discrete illnesses. Hyman has even admitted that diagnoses are “an absolute scientific night mare. Many people who get one diagnosis get five diagnoses, but they don’t have five diseases – they have one underlying condition.”

Another reason why many patients get several diagnoses is that the drugs they receive cause harms that fit very well with the arbitrary criteria for additional diagnoses. It is therefore not possible to judge if a patient in treatment for depression or ADHD has developed bipolar disorder or is suffering from drug harms.

Allan Frances has explained that diagnostic categories are constructs, not diseases, and are descriptive, not explanatory. As an example, to get an ADHD diagnosis does not explain anything even though patients and psychiatrists often think so, failing to understand that this is circular evidence, a tautology. When I lecture, people may say they have ADHD. I reply they can have a dog or a car but not ADHD, which is just a name. When we give a certain behaviour a name, we cannot say that a person behaves this way because he has ADHD.

Tautologies are also prevalent in the media. Even websites critical of overdiagnosis may convey information like, “Mental disorders are the leading causes of ill-health and disability worldwide.” Not so. People suffering from deprivation, poverty, unemployment, and abuse suffer ill health and disability; they are not attacked by a psychiatric monster, e.g. an imaginary disease called depression. They become depressed because they live depressing lives.

We must realise that psychiatry should no longer be a medical discipline led by doctors. As psychiatrists have an extreme focus on drugs, we need a totally new institution, which should not be led by psychiatrists but by people who are educated to offer psychosocial interventions.

Finally, we need a little honesty from leading psychiatrists. It is very hard to find because they know that if they tell the truth, the house of cards of psychiatry would tumble down. Which it should.