MIND GAMES

SNOOPY is suddenly gripped by a wave of anxiety. But it's OK, he
realises, there's a simple way to feel better-lie with your head in
your water dish. "This is hushed up, of course, because it would
completely ruin the drug companies," says Snoopy.

When one of the speakers at the Mind Aid conference showed the Snoopy
strip, the audience laughed. I cringed. I'd gone to New York City not
knowing what to expect, but intrigued by the claim that
neuroscientists and critics of psychiatry would be debating the
biomedical model of mental illness.

Given that in the US some 4 per cent of schoolchildren take Ritalin
and millions of adults take antidepressants daily, it seemed a good
time to start asking how far social problems are being turned into
medical problems. But only about twenty other people turned up, and
they seemed to have already made up their minds. For them, the idea
that mental illness is a "brain disease" is a lie perpetrated by
uncaring psychiatrists colluding with greedy drugs manufacturers to
exert social control over "unacceptable" behaviours. It's a view that
dates back to such sixties dissidents as Thomas Szasz and R. D. Laing,
who argued that schizophrenia and depression are social labels and not
medical diagnoses. So it's not schizophrenic delusions you get, but
"spiritual visions".

The few medical researchers who'd come to the conference clearly
hadn't cottoned on to the Mind Aid agenda. "This conference was a
setup," said Eliot Gardner of the Albert Einstein College of Medicine
in the Bronx, who'd just presented a lecture arguing passionately that
drug addiction was down to biological susceptibility, not moral
weakness. To the audience's delight, the next speaker, Stanton Peele,
ridiculed the role of biology in mental illness, urging that the
disease model is an excuse for not being able to understand human behaviours.

And that set the pattern. Scientific research followed by polemic
against the biological model, followed by wild clapping from the tiny
audience. In between talks, members of the audience would approach
scientists with harrowing tales of misdiagnosis and mistreatment by
their psychiatrists. It was easy to see why they believed psychiatric
drugs were evil: now they were drug-free and doing fine. But as Daniel
Javitt of the Nathans Kline Institute in New York state gently pointed
out to one woman, many people wouldn't do fine. "There are ones left
behind," Javitt said sadly.

I saw one of them later that day, on the streets outside the
conference. He was unkempt and talking wildly to himself. I moved to
the other side of the sidewalk. I have a hard time buying that this
obviously schizophrenic man was experiencing valuable "spiritual
visions". On the other hand, I know someone whose doctor offered her
antidepressants as if her husband's recent death was some curable disease.

The Mind Aid organisers have a good point: psychiatry is bound up with
our social and cultural values. After all, it wasn't too long ago that
homosexuality was deemed a mental illness. So how do we decide who
needs to take psychotropic drugs?

I wish more people had come to the Mind Aid conference to honestly
debate these issues and work out how to preserve health without
compromising humanity.