“Jack’s Magic Beans”

• originally written on 16 Dec 2019 for ENG 205

With so much time and effort involved, finding effective pharmaceuticals to treat mental health concerns has shown to have limits. Why after decades of research, new medications, new facilities, and money spent are persons seeking/needing treatment for mental health concerns still not benefiting? This is important because with such heavy emphasis on marketing pharmaceuticals as a treatment for mental health concerns, patients and consumers miss out on safer alternative therapy options developed to truly benefit patients and consumers. This essay will analyze why so many people believe pharmaceuticals are the best/only form of treatment, how marketing of pharmaceuticals has affected culture in mental healthcare, and the change(s) needed in global perception of mental illness that will benefit you, me and our neighbors across the globe.

Everyone knows someone, or is someone who deals with a mental illness, at some point in their life, so the medicines and treatments used affect everyone. T. P. Blackburn, in his book Depressive disorders: Treatment failures and poor prognosis over the last 50 years, explains why physically and chemically affecting the brain is, historically, the most widely accepted form of treatment regarding mental healthcare. But are doctors limited to prescribing just pharmaceuticals? Would an insurer accept non-pharmaceutical therapy prescriptions as a course of treatment? “Consequently, much of the animal research today is framed around physiological and neurobiological phenomena that may bear little resemblance to the disease state. It has long been argued, that the poverty of reliable clinical science feedback needs to be addressed first, which would aid future model development (Blackburn Page 7).” This point interests me because I was alarmed one day to see a patient so numb from the side-effects of their medication(s), that while shaving they slowly began to cut into their cheek with long strokes from their razor blade. The patient wasn’t even aware of their action as proved by the surprised look when a mental healthcare professional quickly grabbed the razor from their hand. I think people should know more about what goes into creating pharmaceuticals used to treat mental illnesses and to ask the question: are doctors prescribing medications based on data proving pharmacology’s effectiveness in treating a mental health concern -OR- because prescribing medication is a function of the culture of our current mental healthcare system.

Medical researchers and mental health professionals argue that medication is the best option for treating mental illnesses because drugs are both funded and recommended most. But what they haven’t considered is this ideology leaves little room for treatments other than pharmaceuticals for a wide range of mental health concerns. In the article, Very Well Mind by Lisa Fritscher, the author argues that recipients of public healthcare are receiving a standardized form of mental healthcare based on a model speaking more to physiological factors as the genesis of a mental illness or disease. This creates a norm of primarily treating the symptoms of a mental health concerns with pharmaceuticals. “A term coined by psychiatrist R.D. Laing, in The Politics of the Family and Other Essays (1971), a medical model is a ‘set of procedures in which all doctors are trained (Fritscher par 1).’ The medical model’s school of thought is that mental disorders are believed to be the product of physiological factors. Simply stated, the medical model treats mental disorders as physical diseases whereby medication is often used in treatment (Fritscher par 2).” Fritscher also states that recipients of public and private healthcare are receiving a standardized form of mental healthcare based on an accepted model promoting physiological factors in the brain as the root of mental illness or mental health concerns. And treatments offered, as a norm, are geared towards addressing the symptoms of a diagnosis. While the FDA, policy makers and American consumers continue to believe this argument, research, development, promotion and prescription of pharmaceuticals will continue to evolve as the best standard of mental healthcare marketed and available for all Americans.

I challenge the idea that marketing in the pharmaceutical industry has patient welfare as the primary concern in mental wellness and healthcare because the purpose of marketing is: to sell; not to prove that something works or truly benefits a consumer. In their article, The New York Times and the ADHD Epidemic by Jonathan Leo & Jefferey Lacasse, authors say the problem with popularizing pharmaceuticals as the answer to mental healthcare concerns is that it leaves little room for therapies other than pharmacological, basically mainlining marketing of “sense-of-self” ideologies directly to public consciousness; consumed without question. “Drug companies were given the means, the motive, and the message to disease-monger ADHD and blow it up out of all proportion. They succeeded beyond all expectations in achieving a triumph of clever advertising over common sense.” -Allen Frances, Chair, DSM-IV, February 12, 2014 (Leo page 3). Authors Leo & Lacasse are obviously pointing a finger at drug companies for marketing a product so heavily that the number of diagnoses of ADHD rose remarkably. There should at least be the question if marketing from pharmaceutical companies actually have patient welfare and mental wellness as their primary concern, because even the New York Times publicly attempted to correct a mistake in openly siding with drug company’s marketing and advertising practices. Marketing and advertising used to sell pharmaceuticals as treatments for mental illnesses are as target-specific and potentially harmful to the public as fake news on Facebook and other social media platforms. In their article, The (Surprising) Impact of Televised Antidepressant Direct-to-Consumer Advertising on the Stigmatization of Mental Illness by Nicolette Rainone, Reshma Oodal and Jeff Niederdeppe, authors outline an established format in advertising used as a standard in marketing pharmaceuticals regardless of the mental health concern portrayed in the advertisement itself. Rainone states,

“Direct-to-consumer advertising (DTCA) for prescription drugs is a controversial practice that is only allowed in the United States (US) and New Zealand (Rainone page 267).”

“In spite of the high prevalence of mental illness, having one is highly stigmatized in the US and elsewhere. Stigma is defined as an ‘attribute that is deeply discrediting’ and that reduces the bearer of stigma ‘from the whole and usual person to a tainted, discounted one’ (Goffman 1963, p. 3). More recent conceptualizations argue that stigmatization involves at least four elements: (1) labeling, in which individual differences between the non-stigmatized and the stigmatized individual are articulated and labeled; (2) stereotyping, in which the dominant culture links the labeled individual with negative characteristics; (3) categorization and social distancing, in which distinctions are made between the in-group (which does not include the person with the stigmatized condition) and an out-group (which includes the person with the stigmatized condition); and (4) status loss and discrimination, in which a person with a stigmatized condition or identity experiences a loss of status or discrimination, which in turn leads to unequal outcomes on a variety of social characteristics (Link and Phelan 2001)(Rainone page 268.)”

As part of any truly well-told story, based on the format of information made available to the viewer in the advertisement, viewers are likely to see something of themselves in, or be persuaded by a character, in an advertisement promoting “a better life-alternative”. Viewers are likely to believe they are in need of a product that will help a newly self-diagnosed mental health issue based on the symptoms and characterization of a mental illness portrayed in the advertisement. This person is also likely to inquire if the medication in the advertisement will help them. Although mental illnesses are defined in a wide array of “disorders,” advertisements for pharmaceuticals to treat a mental illness follow a standardized visual setup or walk-through regardless of a mental illness diagnosis itself.

Another consideration in mental healthcare to be made is: inpatient/outpatient services usually employ more nurses and supportive staff than doctors. If the environment inside a treatment facility is as toxic as the environment attached to the source of a patient’s mental health concern(s), the quality of therapy will contribute negatively to patient welfare and safety. In his article, Encounters With the ‘Dark Side’: New Graduate Nurses’ Experiences in a Mental Health Service by Michael Hazelton, the author speaks to a culture of care behind mental healthcare, in both public and private facilities, playing a huge factor in the success or destruction of a person treated for mental health diagnosis. “While lack of rehabilitation, housing and community support services have been blamed for policy shortfalls, there is also concern that mental health services may impede rather than facilitate recovery from mental illness (Hazelton, page 172).” Mental health affects all of us in one way or another at some point in our lives. Doctors are sworn to do no harm, yet a health concern that affects everyone has been marketed to make a profit, and in doing so has caused harm to a massive number of patients seeking help.

Works Cited

• Blackburn, T. P. “Depressive disorders: Treatment failures and poor prognosis over the last 50 years.” Pharmacology Research & Perspectives, 7 nov. 2019. [s.l.], v. 7, n. 3, p. 1–20, 2019. Disponível em <http://search.ebscohost.com.libraryaccess.sdcity.edu/login.aspx?direct=true&db=a9h&AN=136670094&site=ehost-live>.
• Fritscher, Lisa. “Medical Model Use in Psychology”, Very Well Mind, 18 Oct, 2019 https://www.verywellmind.com/medical-model-2671617
• Hazelton, M. et al. “Encounters with the ‘dark side’: New graduate nurses’ experiences in a mental health service.” Health Sociology Review, [s. l.], v. 20, n. 2, p. 172–186, 2011. DOI 10.5172/hesr.2011.20.2.172. Disponível em: http://search.ebscohost.com.libraryaccess.sdcity.edu/login.aspx?direct=true&db=a9h&AN=74485085&site=ehost-live. Acesso em: 9 dez. 2019.
• Leo, J.; Lacasse, J. “The New York Times and the ADHD Epidemic.” Society, [s. l.], v. 52, n. 1, p. 3–8, 2015. Disponível em <http://search.ebscohost.com.libraryaccess.sdcity.edu/login.aspx?direct=true&db=a9h&AN=100710983&site=ehost-live>. Acesso em: 18 nov. 2019.
• Rainone, N.; Oodal, R.; Niederdeppe, J. “The (Surprising) Impact of Televised Antidepressant Direct-to-Consumer Advertising on the Stigmatization of Mental Illness.” Community Mental Health Journal, [s. l.], v. 54, n. 3, p. 267–275, 2018. Disponível em: <http://search.ebscohost.com.libraryaccess.sdcity.edu/login.aspx?direct=true&db=a9h&AN=128379009&site=ehost-live>. Acesso em: 18 nov. 2019.