First and foremost, do not conflate “Mental Health” with Serious Brain Function Disorders. Mental Health and Serious So-Called ‘Mental Illness’ are increasingly talked about as if they mean the same thing but they do not!
This site has little use for the idea of ‘mental illness’. The reader should not confuse this position with the anti-psychiatry movement that disbelieves in the idea of mental illness and the treatment of it with pharmaceuticals. Due Justice Project believes that ‘mental illness’ is simply a problematic terminology. Part of the reason why the antipsychiatry movement came about is because the medical profession never ‘rescued’ people from having become victims of the psychologization of neurological signs and symptoms after it became clear to competent physicians and neuroscientists that the so-called schizophrenia symptom complex was the product of biological illness as a disorder of neurodevelopment.
We are still living with the catastrophic legacy of Sigmund Freud and the psychoanalytical movement with its bizarre beliefs about psychogenic causation and the miseducation of medical doctors is it relates to functional vs organic “psychosis”. Today, we are in the throes of a crisis of misclassification, of lexicon, and of psychologization and traumatology (operationalized in the construct of trauma-informed). The broader scope of medicine beyond “psychiatry” is still operating under misguided notions of functional neurological disorders.
DJP’s position is that there are psychological and emotional disturbances (i.e. mental health issues) that should be classified differently than severe brain function illnesses, i.e. neurologic disorders, such as “Schizophrenia” and “Bipolar”. DJP’s position is that the medical community needs to rename and reclassify these so-called mental illnesses as idiopathic encephalopathies with other applicable qualifiers. The psychology industrial complex and the biopsychosocial subscribers in the psychiatric community don’t want there to be a distinction made between Mental Health and serious so-called Mental Illness because they have an incapacity to see (cognitively) that there is a distinction.
Advocates in the DJP founder’s network also disfavor the term psychiatric or even neuropsychiatric because these terms lead people to believe (despite the neuro prefix) that these are afflictions of the soul or the spirit…or manifestations of psychological injury or other environmental/psychosocial root causes amenable to psychotherapies and other grossly inappropriate non-medical interventions. We can only push the envelope so far without the leadership of the medical establishment, which thus far, does not even seem to be aware that there is a crisis.
This site has moved away from the term “mental illness” and as much as possible, away from neuropsychiatric. The problem is that the term psychiatric has a great of baggage and sometimes the mission of enlightenment calls for us to respect the powerful connotations attached to certain words in common parlance. Psychiatrists are medical doctors. Medical doctors should be concerned with the evaluation and management of the brain’s semblance of mind -and the semblance of mind concerns the neuro-electro-chemical and physiological functioning of the brain. Medical doctors should not want to call themselves “psychiatrists” given the historical roots of the profession by that name.
According to a wiki entry:
Neuropsychiatry: A branch of medicine that deals with mental disorders attributable to diseases of the nervous system. It preceded the current disciplines of psychiatry and neurology, which had common training, however, psychiatry and neurology have subsequently split apart and are typically practiced separately.
The problem is that when psychiatry branched off, it took neurological illnesses with it! An advocate in DJP’s network shared an account of a running joke between Chairs of the Departments of Psychiatry and Neurology at a prominent medical school – that ‘neurologists take psychiatric diagnoses and move them to neurology as soon as the pathophysiologies or etiologies are understood by researchers’.
That might be a joke but it is also a tragedy. Neurologic symptoms like delusions, hallucinations, command hallucinations/automisms, disinhibitions, neuro-dysmentation, and anosognosia should translate to an implicit diagnosis of an ideopathic neurologic disorder or ideopathic encephalopathy in the absence of a more determinative diagnosis and not be classified as so-called Primary Psychiatric.
A very troublesome cohort of the psychiatry and psychology community thinks that illnesses like “Schizophrenia”, and Bipolar (unlike all of the encephalopathies that can cause neurogenic dysmentation) are in their domain. So-called Schizophrenia is theirs – they retain ownership over it to misconceptualize and mistreat through endless psychoanalytical perturbations.
A faction of that community is even misappropriating neuroscience in order to legitimize their misguided psychosocial ideologies. This commentary does not mean to cast aspersion upon the entire community of psychiatry…remembering the psychiatrists attend medical school and are medical doctors. Within that community there are competent medical doctors who conceptualize SNI in accordance with modern medical science. Too many others in the field continue to be influenced by historical psychoanalytical ideologies. Others believe in a hybrid theory, the biopsychosocial model (which involves nonsensical beliefs about the etiology of psychosis, psychosocial interventions, and CBT). It is ridiculous that there is any such concept as the so-called medical model in this day and age. We don’t speak of the “medical model” of heart disease, or cancer.
The purpose of this page is to drive home the message that these illnesses are not psychosocial, emotional, or behavioral disturbances in that those distinctly classified disturbances and disorders do not involve neurogenic dysmentation or altered states of waking consciousness. The medical community needs to stop using terminologies such as “mood disorder” and “depression” to describe altered states of consciousness caused by severe brain function illnesses. So-called Schizophrenia is not caused by trauma, abuse, or childhood adversity.
The only issue taken with this otherwise informative article about Delirium (which used to be called ICU Psychosis) is the statement that begins:
“In the ED setting, whether medical or psychiatric…”
If psychiatric refers to Schizophrenia, Bipolar, or any other Ideopathic Psychosis Spectrum Disorder, then these are in fact medical disorders. Also, Delirium involves psychosis (neurogenic dysmentation).
“PSYCHOSIS” IS A TRICKY TERMINOLOGY. Certain mental experiences such as hallucinations, “paranoia”, and bizarre thoughts are characterized as psychotic symptoms, however, psychosis is described as a break or separation from reality. Some people who are experiencing what are referred to as psychotic symptoms recognize that something is wrong – they are still neurocognitively connected to reality. A narrow definition of “psychosis” would exclude people who recognize that they are symptomatic (i.e. they are not yet experiencing the neurological symptom of anosognosia). Psychosis should generically describe an acute brain failure as does encephalopathy. The terminology has been in this murky zone for far too long so the medical community needs to introduce another terminology to define the state of being neurologically detached from reality. The term psychosis should be renamed with a term that is less tinged with freudianism.
Excerpt from the preceeding link:
…Some comments suggested that any definition of “serious emotional disturbance” and “serious mental illness” must include specific language explaining that these are brain diseases with a neurobiological basis. Similarly, suggestions were made to narrow the definitions so that they include only those diagnoses whose etiology has been proven to be neurobiological. Other comments acknowledged that although there is growing scientific evidence suggesting that some disorders (e.g., schizophrenia and mood disorders) have a neurobiological component, it is still not always possible to discern definitively which disorders are exclusively biological in origin.
*Due Justice Project believes that it is high time for the government to exclude psychosis spectrum disorders from their SED definition, exclude emotional, psychological, and behavioral disturbances from their SMI definition, and furthermore, eliminate the age criteria for their SMI definition. We are no longer in that hinterland of 1993. SSA has recently made some strides to get its regulatory and policy language up to date with modern medicine, these classifications need to follow the same path. All of these mental disorders have some neural underpinnings, but, psychosis-spectrum disorders are overrepresented in the criminal justice system (this is acknowledged in the same document from 1993). More resources need to go to the case management of these disorders.
Due Justice Project has replaced SMI with SNI, however, it endorses Treatment Advocacy Center’s Definition of SMI:
“As you can see, the “official” definition of SMI is very inclusive—though I imagine that when people talk about SMI these days—they don’t have the Federal Register definition in mind”
DJP opposes the cobbling together of emotional and psychological disturbances with psychosis-spectrum disorders under the federal definitions of SMI and SED. Reference sources indicate that the SED definition was employed because SMI was considered to be too stigmatizing for children. Once again, those who are most concerned about the dimensions of stigma (negative stereotypes, devaluation, and discrimination) are the ones that participate in stigmatization. Distancing oneself from something that is stigmatized only perpetuates the problem. Moreover, using the terminology SED caused further confusion that continues to percolate to this day. Educators continued to grapple with the fact that SED excluded ‘social maladjustment under the SED or EBD (emotional behavioral disorder). Using SED in place of SMI constitutes socio-politicization of a biological disorder, in similar fashion to the doctor who gives a patient a less stigmatizing diagnosis of Bipolar in lieu of Schizophrenia.
*It is noted by DJP that a white paper which articulated prosecutor associations’ opposition to a ban on capital punishment for people with SMI used this troubling federal definition to support their arguments.
UNDERLYING NEUROPSYCHIATRIC DISORDER, NOT BULLYING IS CAUSE FOR VIOLENCE
People tend to look to psychological reasons for violence in youths. It is therefore, intuitive to see bullying as a causation for school violence. Young people who go on to develop serious neurobehavioral illness often exhibit socially awkward or odd behaviors that tend to attract bullying. This does not excuse bullying, but it is not rational to ignore what is likely to be the substantive cause of mass shootings, stabbings, or other forms of school violence. …This assertion is not a case of blaming the victim.
One of the causes of paroxysmal type violence is visual hallucinations. A person who is in a disordered state of waking consciousness can see horrific, terrifying images in the mind’s eye in place of the real imagery in the visual field. A person can be triggered to defend themselves against a frightening image produced by the brain. more….
As it has been said in other commentaries on this site, hallucinations do not fully explain why someone would attack a terrifying, grotesque figure produced by the brain. Most of us would flee in terror if confronted with such an image. What is different in the case of someone with SMI is that there is another complex factor involved, that is, consciousness disorder. A person in an abnormal state of waking consciousness will exhibit bizarre behaviors, even behaviors similar to those that are seen in arousal disorders (parasomnias).
Consider that the criminal justice system convicts and punishes people who have defended themselves while in this medical condition.
DJP wants to restate comments made on the blog page about trauma and abuse as they relate to mental health. Clearly, trauma and abuse, especially when experienced by children can have devastating and long-lasting effects on psychological health. These traumas can lead to situational depression, substance abuse, and other tragic consequences. It is also known that there is a strong mind-body connection between psychological and physical health. Acute stress and psychological traumas most likely can alter brain function. There is a strong relationship between military combat trauma and mental health issues, i.e. PTSD, however, there are controversies associated with the PTSD construct…also, instances of misdiagnosis of prodromal symptoms and other phases of psychosis-spectrum disorder. Individuals with genetic risks may respond abnormally to certain stressors. DJP does not subscribe to the trauma/abuse causation theory of psychosis-spectrum disorders. Traumatologists have stretched the diagnostic criteria for PTSD and have co-opted the construct in order to undergird the ideological contortions of other disorders. (Links to articles about the PTSD controversies will be added to the topics menu page.)
***One day in the distant future, the traumagenic theory of psychosis-spectrum illness may be known as “a strange belief” and the epigenetic/transgenerational trauma theory (that traumatologists have used to face down evidence of genetic root cause) may be characterized as a confabulation.***
“The chemicals win in these situations. The illness wins. It’s not about killing ourselves. It’s about an illness killing us.
That is a different kind of suicide”
Dr. Insel said in the interview that his motivation was not to disparage the D.S.M. as a clinical tool, but to encourage researchers and especially outside reviewers who screen proposals for financing from his agency to disregard its categories and investigate the biological underpinnings of disorders instead. He said he had heard from scientists whose proposals to study processes common to depression, schizophrenia and psychosis were rejected by grant reviewers because they cut across D.S.M. disease categories.
“They didn’t get it,” Dr. Insel said of the reviewers.
Exploring other neurological disorders, e.g. Seizures Disorders, Autism, Parasomnias -Considering how Schizophrenia and Delusional Disorder (Psychosis) overlap with other disorders that transiently or chronically cause (neurological) disorder of waking consciousness and violent behavioral symptoms. The most grave symptoms of Schizophrenia are neurological – not psychological.
Excerpt from Psychosis vs Criminal thinking:
Post deinstitutionalization: Between 1988 and 2008, the proportion of Vermont state hospital admissions accounted for by forensic patients increased 50 percent; in Massachusetts, 281 percent; in New York, 309 percent; and in Pennsylvania, 379 percent.
Violence as a symptom of neurological or brain dysfunction is almost always controversial. Human beings are conditioned to have difficulty accepting that biological defect or malfunction, rather than ‘evil (as some type of “disembodied” force controlling the mind and body) can be the cause for violent behaviors.
Research papers on almost any disorder affecting the brain will frequently insert the obligatory qualification that violence in association with the subject disorder is controversial. Whether the disorder is Autism, or traumatic brain injury (TBI), or seizure disorders, there will be skeptics and combatants against any association with violence (Although, in the case of these disorders, the violence may be paroxysmal rather than that which is indicative of pre-meditation…such as violence arising from sustained delusions…predatory or defensive aggression). Concessions will almost invariably be granted to skeptics: Individuals with medical or scientific credentials, stakeholders who are consumed with fighting stigma, and other operators who are driven by powerful prosecutorial proclivities. Violence is, of course, and rightfully, the most highly stigmatized type of human behavior. No one wants it to be beyond our control, even in the case of severe neurobehavioral illness.