According to ‘Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness’, by Anne Harrington, a Harvard professor and renowned historian, the pharmaceutical companies (Big Pharma) have played a prominent role in determining the treatment strategy for mental illness (in the United States (US)), and this is what has led to an increased rise in antipsychotic and antidepressant, as well as other pharmacological use. This article will highlight that Big Pharma knows its influence over the mental healthcare sector and utilizes that to put its profits before its patients (concentrating on US statistics — as that is where Big Pharma mostly festers).

The Problem with Big Pharma:

Every year, new treatments and medications are introduced by Big Pharma to be used by medical professionals. However, while the evolution and progress of new medications may be essential to assisting individuals with mental health, they should not be regarded as the only automatic or unique strategy that offers a solution to individuals with mental distress. Thus, there is a need to ensure that the relationship between health professionals and Big Pharma is irreproachable and transparent.

However, the cooperation between Big Pharma and healthcare professionals has been considered one-sided, involving dubious financial agreements and incentives. Big Pharma provides incentives to prescribing physicians, ranging from tokenistic (but sometimes expensive) goods, free meals, and even overseas holidays, which has been directly associated with an increased medication prescription rate (DeJong et al., 2016). This, along with Big Pharma-funded and led research, has ensured the inextricable link with the mental healthcare sector, yielding results that will always point to pharmaceuticals as the key to mental health.

Drugs have become the core of modern psychiatry, whereby most psychiatrists will end up prescribing at least one medication to inpatients, while others take a variety. Likewise, the same is valid for outpatients, who are also prescribed various psychoactive drugs, including benzodiazepines, antidepressants, and antipsychotics. The patients who receive these drugs will take them for months, years, and even lives. Additionally, most mental health research focuses mainly on drug trials linked with neurological research rather than being holistic and open-minded in testing alternative theories with the same degree of rigor (Moncrieff, 2003).

The establishment of drugs as central to psychiatry is directly linked to Big Pharma, starting from the massive marketing campaigns of the “psychopharmacological era” in the 1950s (Braslow & Marder, 2019). Pharmaceutical companies have transformed themselves from small firms in the 20th century to some of the world's largest corporations, generating more profits than companies in other sectors. In addition, the increased collaboration between Big Pharma and politicians has led to political interference. Americans are estimated to spend over $535 billion on drugs as of 2018, which has increased from 50% since 2010 (Picchi, 2019). Big Pharma has continued to increase prices far beyond the medication inflation rate. Between 2011 and 2015, Big Pharma increased its prices from 40% to 70% (Meller & Ahmed, 2019). In addition, Big Pharma receives substantial tax breaks and government assistance to conduct research despite insisting on exploitative charging (including those receiving welfare).

US taxpayers continue to fund the Big Pharma companies through the National Institutes of Health, which has invested over $900 billion since the 1930s (Meller & Ahmed, 2019). In the period dating 2010–2016, more than 210 new drugs were approved by the Food and Drug Administration, out of which the National Institute of Health funded all their research with over US$100 billion. Besides funding, Big Pharma also received huge tax credits introduced in 1982 (Meller & Ahmed, 2019). The Tax Hikes Act, signed in 2015 by President Barack Obama, made the tax credits permanent. The companies also receive marketing and advertising tax deductions, yet they increased their advertisement costs from US$17.7 billion to US$ 29.9 billion in 1997 and 2016 (Meller & Ahmed, 2019). Despite the tax credits, tax breaks, and subsidies, the Big Pharma companies have hiked their prices at an alarming rate. More than 3,340 drugs were affected following an increase in drugs by Big Pharma (Meller & Ahmed, 2019). As consumers were affected financially, the companies continued to report profits of millions and billions of dollars.

The alliance between psychiatry, the government, and Big Pharma should now be a call for concern as it has severe outcomes. Drugs have dominated the mental health professions such that this has made it difficult for the development of other mental health treatment forms. This is despite research indicating that patients with mental health issues can experience an improvement in their conditions without relying on drugs (Ivanov & Schwartz, 2021). A UK survey found that more than 40% of inpatients lacked recreational and social activities and limited psychological and occupational services (Moncrieff, 2003). Despite alternatives such as cognitive behavioral therapy and family therapy being established as essential treatments, they are rarely used.

In addition, a significant public health problem has been the adverse defects of drugs. According to the Food Drug Administration (2018), a severe drug reaction is present in 6.7% of hospitalized patients, associated with a 0.32% fatality. Over 2,212,000 adverse drug-related hospitalizations account for 106,000 deaths yearly (Food and Drug Administration, 2018). This makes adverse drug reactions the fourth leading cause of death in the US (Food and Drug Administration, 2018). Patients with several mental health problems have been linked to a reduced life expectancy which has received very little attention (Moncrieff, 2003). It was only when a study found out that patients taking antipsychotic medication had a higher death rate compared to those taking medications for other medical conditions in the US, UK, France, Norway, Denmark, Finland, Japan, Italy, Spain, Israel, and Australia (Ralph & Espinet, 2018).

Companies such as GlaxoSmithKline have attempted to prevent the publication of papers about the adverse effects of some of their drugs and failed to warn patients of the discontinuation effects of Seroxat, considered their best-selling. In the end, the company went ahead to win the case 13 years after it was launched (Dyer, 2020). This indicates Big Pharma’s dismal grasp on the industry and the globe. However, you have scandals such as with AstraZeneca, which had to pay $520 million to resolve allegations that it illegally marketed the anti-psychotic drug Seroquel for uses not approved as safe and effective by the US Food and Drug Administration (FDA) (as reported by the Department of Justice). As if AstraZeneca were not already making enough money off the ‘real’ patients, they had to create ‘make believe’ ones. It is appalling.

The Big Pharma industry model heavily relies on returning patients: like a ‘merry-go-round’. Currently, no medications can completely cure disorders such as substance abuse, Bipolar Disorder, Schizophrenia, PTSD, anxiety, and depression; however, it is conceded that many medications do help significantly (and patients should always consult with their psychiatrist on these matters). But without any cure, this urgently propels the need for alternatives to pharmacology to be actively sought and researched by mental health professionals and academics; and furthermore, alternatives that have already been researched and verified as effective treatments should be used!

There are Strong Alternatives to Pharmacology!

Neuroscience

One of the emerging and incredible strides made in treating mental health has been linked to neuroscience (Stein, 2015). This involves understanding how the brain works to develop effective treatment options. Neuroscience can help professionals understand the root causes of a given mental health issue by determining the underlying molecular factors and thus making it easier to focus on research and treatment (Stein, 2015). Ideally, if Big Pharma had the best interests of mentally ill people, one would assume they would be ‘breaking down doors’ to be at the forefront in investing in more humane and effective treatments for mental disorders. However, Big Pharma has cut its research and development budgets within the past ten years by almost 70%, which indicates they want to maintain the status quo where patients continue depending on the medications as they have very little interest in curing them (O’Hara & Duncan, 2016). Because neuroscience is on the verge of providing new long-term treatment models for mental health patients, Big Pharma is quaking at the thought of losing its ‘customers’.

Spirituality and religion

Spirituality has always been considered a core part of many lives of varying degrees. Some people practice Mindfulness, whereas others attend daily Mass — both rituals with roots deep in religiosity. For some, it is considered an individual and private matter, while others, it is expressed in groups. Some even like to spread their Spirituality publicly. Spirituality is thus essential for all people who partake in the various beliefs, even if one has a head injury, mental illness, intellectual disability, or dementia. Spiritual beliefs can thus be equally crucial as healthcare when relieving pain and curing it. Spirituality is considered a journey, and the various encounters, whether bad or good, provide a foundation for learning, developing, and maturing. For some, physical and mental health can be part of that journey.

Sandoiu (2018) notes that while divine power may exist, the neurophysiological impacts of spirituality have been accurately and scientifically measured. Idler et al. (2017) found that religious beliefs are positively related to an increased lifespan and assist an individual in coping with diseases. In the neurotheology field, scientists have found that the same brain circuits activated by drugs and sexual activity are also activated by religious experiences (Sandoiu, 2018). Therefore, religion is bound to stay here until the human brain undergoes critical changes (perhaps by evolution). Through neuroscience, it can be vital to explore how spirituality can affect one’s mental and physical health regarding practices and beliefs.

Wojtalik et al. (2018) note that recent developments in cognitive neuroscience are vital to filling the moderate success of a decreasing research funding model for psychosocial and pharmacological interventions aimed and improving mental health. Cognitive neuroscience focuses on understanding the neurobiological mechanism that supports mental behavior and processes. In cognitive neurosciences, the noninvasive methods used in assessing the brain’s structure and functions are referred to as neuroimaging methodologies (Wojtalik et al.,2018). Neuroimaging technologies will thus allow one to determine how the brain’s organization and functions affect human behavior. Through cognitive neuroscience, mental health will be improved, laying a foundation for existing treatments by making them more targeted at core pathophysiology, early intervention, and prevention (Wojtalik, 2018). This is through indicating the brain risk signatures that condition resiliency, thus reducing the onset or even a long-term need to rely on drugs.

This work is already happening, but the pace needs to quicken. Concerning recent research, eminent Neuroscientist Professor Patrick McNamara published The Cognitive Neuroscience of Religious Experiences (‘CNRE’) in 2022. The CNRE text provides an up-to-date review of the neurology of religious experiences, essentially addressing the power of religious experience and how that can affect a person psychologically:

• A new neurobiology and theoretical treatment of ritual and the ritualization process
• Implications of evolutionary genetic and sexual conflict for all key religion and brain topics
• The psychology, neurobiology and phenomenology of mystical states and experiences
• A systematic psychology, philosophy, and neurobiology of self-transformation in relation to religious practices
• A new theory of religious group effects rooted in evolutionary neurobiology and examines its relevance for functions of religion
• Evidence for, relevance to religion of, and an exposition of the new theory of “Theory of Group Mind — ToGM” which stipulates that humans (and brains) aim to cognize both individual and group minds
• Empirical and theoretical work as well as neural correlates of religious language
• The evolutionary background, clinical neurology, and philosophical phenomenology of the relation of schizophrenia to religion and brain topic areas
• Insights of cultural evolutionary models to religion and brain topics
• Insights of the 4E paradigm to examine the extent to which religion and brain processes are embedded, extended, enacted, and embodied
• REM sleep neurobiology and dreams are systematically incorporated into topics on religion and brain

Likewise, compassionate-focused therapies are heavily based on neuroscience principles. The therapies have been designed to help address complex psychiatric-related disorders that do not work with traditional treatment strategies. The focus of compassionate-focused therapies is to target patients who lack compassion towards self-due to feelings of shame or are mostly self-critical (Sommers-Spijkerman et al., 2018). These therapies aid in remodelling self-assurance, reduction of self-critical thinking, reducing genitive effects, and elevating distress tolerance.

Social Anthropology

Social anthropology represents the study of human society and culture across the world. People in social groups will have a flow of patterned activity, which makes social structures and culture abstractions of these activities. These activities include a group’s shared belief system, products, and values. The patterned relationships between people in their social life will form an abstraction of the social structure. Social structure and culture can be jointly termed sociocultural systems as they form interpenetrating abstractions. Therefore, the various values and life across the sociocultural environments globally have shown that individuals can be mentally unhealthy or healthy in several ways. The mental unfitness in one may be expected in another culture, while others consider it a unique gift. Whereas healthy behavior might be unhealthy in another. Nonetheless, any form of social disorganization can lead to mental health disorders. Thus, studying society and cultures would make identifying behaviors linked to disorganization and mental health more meaningful and effective. This provides a bedrock, or foundation, for preventing the behavior and potentially stopping mental illnesses before they occur.

Other ‘ways’ of doing things that do not fit within our culture, but are proven to be effective in another, must be seriously considered by Western mental health research. To rest on Big Pharma and their profiteering junket is to ‘throw one’s hands in the air’ and say, ‘I could not be bothered’. Other cultures’ treatment of mental health and neurological ailments should be examined.

Treatment from the ‘lived experience’ perspective

Moving on from considering the social anthropological contextualization of mental health and the potential for its use in exploring new ways of treating mental health patients, this final section deals with the treatment by people who have ‘lived experience’ of the same condition they are suffering from — those people are sometimes employed as ‘peer workers’, and this is essential, as the lived experience researchers are increasingly adopting leading roles in conceptualizing and conducting research in mental health:

“The importance of lived experience research in mental health is increasingly recognized and usually conceptualized in terms of three major benefits. First, consumer rights activists, using the slogan of “nothing about us without us” have argued that inclusion in research is a human right and a social justice issue. Second, it can produce better quality research by enhancing methodological sensitivity, data accuracy, validity of results, and overall relevance to service users. Third, people with lived experience have reported deriving benefits from doing research such as satisfaction, skill development, empowerment, and hope” (Honey, Boydell, Coniglio, et al, 2020).

Who better to inform humanity about mental illness than someone who has a mental illness? They are the expert on who they are, how they feel, and what they feel and are often apt at pinpointing the exact nature, or root, of their ailment. The benefits of learning from the wisdom, strategies, challenges, and successes of others — and igniting, sharing, and maintaining a common hope “is also a major benefit of being exposed to the stories and experiences of others in similar situations” (Honey, Boydell, Coniglio, et al, 2020). Those authors then went on to say:

Observing peers who are living well and reading or listening to individual narratives of recovery are important ways in which people learn from each other and derive hope. However, lived experience research has the potential to bring together the stories of a variety of different people to provide a range of ideas and a bigger picture on issues, thus contributing to an individual’s store of resources for recovery.

So, it is a win-win situation: the mentally ill ‘peer worker’ benefits, and the person they are helping. It is an effective model grounded in compassion and empathy.

Conclusion:

So, it can clearly be seen that there are facts indicating mentally ill patients are being taken advantage of by Big Pharma, both financially and morally. Slowly, Big Pharma spread its tentacles throughout the mental health space until it made itself indispensable. Then it rained money. And the more it rained, the more political power it gained. And the more political power it gained, the more entrenched it was in the state, so every mental health facility was virtually a subsidiary of Big Pharma. The pawns are us — the mentally ill. We know the research that does not involve Big Pharma has dwindled away, and therapies that are proven effective and soothing are being ignored altogether. There is a general disinterest.

I have tried to highlight some of those areas that do have people investigating because we are worth more than a virtual bucket to have unverifiable rubbish thrown into it (from the perspective that it is often not fully understood how the drugs operate within a neuroscientific framework). Big Pharma is doling out dangerous concoctions that, although ‘mask’ the illness itself (and are therefore repeatedly prescribed), also cause physiological harm that severely impacts the lifespan.

- Time to speak up.

- Time to make a stand.

- Time to demand the best therapy available for your circumstances.

- There is always another way of looking at things.

WARNING TO READERS: ALWAYS CONSULT YOUR PSYCHIATRIST ON MATTERS SURROUNDING YOUR MEDICATION AND TREATMENT. DO NOT STOP TAKING ANY MEDICATION WITHOUT RECEIVING THE FULL AND PROPER ADVICE

Please reach out to me either on here or on my website: www.newosis.net

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Robert Charles Kavanagh

References:

Braslow, J. T., & Marder, S. R. (2019). History of Psychopharmacology. Annual review of clinical psychology, 15(1), 25–50.

DeJong, C., Aguilar, T., Tseng, C. W., Lin, G. A., Boscardin, W. J., & Dudley, R. A. (2016). Pharmaceutical industry–sponsored meals and physician prescribing patterns for Medicare beneficiaries. JAMA internal medicine, 176(8), 1114–1122.

Dyer, C. (2020). GSK wins legal case over withdrawal effects of paroxetine after 13 years and£ 9.33 m in costs. BMJ. 370:m2799

Food and Drug Administration. (2018). Preventable Adverse Drug Reactions: A Focus on Drug Interactions. U.S. Food and Drug Administration. Retrieved 29 July 2022, from https://www.fda.gov/drugs/drug-interactions-labeling/preventable-adverse-drug-reactions-focus-drug-interactions#:~:text=These%20studies%20estimate%20that%206.7,a%20fatality%20rate%20of%200.32%25.&text=If%20these%20estimates%20are%20correct,causing%20over%20106%2C000%20deaths%20annually.

Harrington, A. (2019). Mind fixers: Psychiatry’s troubled search for the biology of mental illness. WW Norton & Company.

Idler, E., Blevins, J., Kiser, M., & Hogue, C. (2017). Religion, a social determinant of mortality? A 10-year follow-up of the Health and Retirement Study. PloS one, 12(12), e0189134.

Honey, A., Boydell, K.M., Coniglio, F. et al. Lived experience research as a resource for recovery: a mixed methods study. BMC Psychiatry 20, 456 (2020). https://doi.org/10.1186/s12888-020-02861-0

Ivanov, I., & Schwartz, J. M. (2021). Why Psychotropic Drugs Don’t Cure Mental Illness — But Should They?. Frontiers in Psychiatry, 133.

McNamara, P. (2022). The cognitive neuroscience of religious experience (2nd edition). Cambridge University Press. ISBN 978–1108833172

Meller, A., & Ahmed, H. (2019). How Big Pharma Reaps Profits While Hurting Everyday Americans. Center for American Progress. Retrieved 29 July 2022, from https://www.americanprogress.org/article/big-pharma-reaps-profits-hurting-everyday-americans/.

Moncrieff, J. (2003). Is psychiatry for sale. An examination of the influence of the pharmaceutical industry on academic and practical psychiatry.

O’Hara, M., & Duncan, P. (2016). Why ‘big pharma’ stopped searching for the next Prozac. The Guardian. Retrieved 29 July 2022, from https://www.theguardian.com/society/2016/jan/27/prozac-next-psychiatric-wonder-drug-research-medicine-mental-illness.

Picchi, A. (2019). Big Pharma ushers in new year by raising prices of more than 1,000 drugs. Cbsnews.com. Retrieved 29 July 2022, from https://www.cbsnews.com/news/drug-prices-oxycontin-predaxa-purdue-pharmaceuticals-boehringer-ingelheim/.

Sandoiu, A. (2018). The neuroscience of religious and spiritual experience. Medicalnewstoday.com. Retrieved 29 July 2022, from https://www.medicalnewstoday.com/articles/322539#_noHeaderPrefixedContent.

Sommers-Spijkerman, M., Trompetter, H., Schreurs, K., & Bohlmeijer, E. (2018). Pathways to improving mental health in compassion-focused therapy: Self-reassurance, self-criticism and affect as mediators of change. Frontiers in psychology, 9, 2442.

Stein, D. J., He, Y., Phillips, A., Sahakian, B. J., Williams, J., & Patel, V. (2015). Global mental health and neuroscience: potential synergies. The Lancet Psychiatry, 2(2), 178–185.

Wojtalik, J. A., Eack, S. M., Smith, M. J., & Keshavan, M. S. (2018). Using cognitive neuroscience to improve mental health treatment: A comprehensive review. Journal of the Society for Social Work and Research, 9(2), 223–260.