What is the BizOMadness Blog?

This blog is devoted to raising critical awareness of psychiatry generally. It is likewise devoted to the antipsychiatry research projects, publications, and related activities of Dr. Bonnie Burstow. Especially foregrounded are The Psychiatry Project, The Madness Project, and "Psychiatry and the Business of Madness". Related to one another, The Psychiatry Project and The Madness Project involve hundreds of interviews, a dozen focus groups, analysis of several hundred documents and their activation, and dedicated periods of institutional observation. The culmination of both as well as of decades of related interviews and activities is "Psychiatry and the Business of Madness" (timely updates on its publication will be provided)--a cutting edge book in which psychiatry is investigated from multiple angles and which begins to tackle the inevitable question: So if we get rid of psychiatry, where do we go from there?

For the Events page to find events related to this research or this book, see

To check out reviews of Psychiatry and the Business of Madness and related publications, see http://bizomadnessreviews.blogspot.ca/

Wednesday, September 30, 2015

Canada -- A Human Rights Violator

In Canada, we pride ourselves on our human rights record. That noted, while this is hardly the only area where we badly slip up, there is one area where we habitually fall into the abuser category with almost no one noticing. Did you know that every single mental health law in Canada contravenes human rights as understood by the UN? Our practice in this area is likewise in contravention. Nor is there any discussion of this infraction. Correspondingly, not only are we doing nothing to remedy it, in the name of promoting "good mental health," we are constantly advancing changes which magnify the violation.  

More particularly, there are a number of instruments of the United Nations which have made rulings that we ignore. To focus in on the most significant, I would draw readers' attention to the Convention for the Rights of People with Disabilities (CRPD; see http://www.un.org/disabilities/convention/conventionfull.shtml), of which Canada is a signatory. We contravene a huge number of articles therein, but I would focus in on two -- articles 12 and 14 -- for their contravention is integral to how we approach what is called "mental health."  

Article 14 reads:

State parties shall ensure that people with disabilities, on an equal basis with others:
      a. Enjoy the right to liberty and security of the person
      b. Are not deprived of their liberty unlawfully or arbitrarily … and that the existence of a disability shall in no way justify a deprivation of liberty.

Given this provision -- and note, we signed this Convention -- every single mental health act in Canada violates our convention obligations for indeed, enabling deprivation of liberty, facilitating involuntary lockup is the mainstay of our mental health legislation. Now people may think that what is happening here is okay because it is done under the auspices of carefully worded laws or because the "mentally illness" area is somehow exempt. The Committee responsible for monitoring compliance, however, is clear that is precisely these laws and the practices thereby authorized that are unacceptable. In this regard, it provides the following guidelines:

Involuntary commitment of disabled people based on health care grounds totally violates the absolute ban placed on deprivation of liberty on the basis of impairments ... The Committee has repeatedly stated that the State parties should repeal provisions which allow for involuntary commitment of persons with disabilities in mental health institutions based on actual or perceived impairment. see http://www.ohchr.org/Documents/HRBodies/CRPD/14thsession/GuidelinesOnArticle14.doc).

And to place this issue on an ethical rather than just a legal footing, even had we not signed such a provision, it minimally should worry us that our everyday practices constitute a human rights violation according to a human rights authority as credible as the United Nations.

Now the violation of Article 14 is cut and dry. Judging Canada's noncompliance with Article 12 is more complicated. Article 12 unequivocally bans all involuntary psychiatric "treatment." That is, it states, "State parties shall recognize that persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life." Enjoying legal capacity on an equal basis, to be clear, means being equally entitled to make one's own decisions, and again, it is precisely depriving people of the right to make their own decisions on matters like "treatment" on the basis of deemed incapacity which is core to our mental health legislation.

Now throughout Canada we have built in very minimalist approximations of human rights protection via a mechanism known as "substitute decision making." People are entitled to appoint a substitute decision-maker to make decisions for them in the event of being deemed "incapable." To be clear, in no way is this in keeping with the UN ruling, as the Canadian officials signing the Convention were well aware. Accordingly, Canada stipulated a reservation on article 12, stating that we understand it to mean that substitute decision-making is allowed. Which led to the Committee responsible for monitoring compliance to provide the following clarification: "The Committee shall ensure that the provision of health services, including mental health services are based on free and informed consent of the person concerned … States have an obligation not to permit substitute decision-makers to provide consent on behalf of persons with disabilities." (article 11)

With this clarification, Canada's reservation "kicked in." As a signatory, it in essence protected us from being forced to truly honour the human right in question. That said, the moral imperative remains. Nor, I would add, is the CRPD the only UN instrument whose rulings on issues like involuntary treatment we as Canadians are defying. In this regard, the U.N.'s Special Rapporteur on Torture, for example, declared the involuntary subjection of people to antipsychotics (major class of psychiatric drugs) a form of torture (see chapter by Tina Minkowitz, in Bonnie Burstow, Brenda LeFrançois, and Shaindl Diamond's Psychiatry Disrupted): And torture, note, is paradigmatic human rights violation.

The fact that we are so far from compliance with international standards should give us pause. Now I am aware that the United Nations determinations may be alarming to some. How can we protect ourselves if we do not lock people up when they are psychotic?, some might wonder. And how can those so "impaired" possibly have the wherewithal to make reasonable choices for themselves? While I cannot adequately address all such concerns in one short article, I would point out that research shows that people deemed mentally ill are no more dangerous than anyone else. Correspondingly, while of course looking out for people in emotional difficulty is a "must," given that the choices made on their behalf have them hooked on brain-damaging drugs, it is hard to believe that on average those deemed "mentally ill" would make any worse choices for themselves than are currently being made for them (not that enjoying basic human rights can ever be contingent on making "good decisions"). And lest people think the CRPD is licensing benign neglect, I would point out the CRPD explicitly specifies that if people need help making decisions, it behooves the state to assist them, much as one might assist a physically disabled person to gain entrance to a building. In other words, the UN is not being naïve or thoughtless here. While I personally would prefer that the state not be the help mechanism but the community itself, providing assistance as needed is transparently part of the Convention obligation.

That said, not only do we do nothing of this nature, we routinely drag people to "hospital" against their will, drug people against their will, and indeed control their every move. Correspondingly, we interpret all objections to such treatment as evidence of "incapacity." Nor are we as a country discussing such issues, never mind making plans on how to bring ourselves into compliance. In fact, quite the opposite, we keep looking for ever new ways to make it easier to violate people's rights. Nowhere is this more obvious than with Ontario's Bill 95.

A piece of legislation which has already received second reading, Bill 95 (http://www.ontla.on.ca/web/bills/bills_detail.do?locale=en&Intranet=&BillID=3316) would authorize a special committee to propose legislation that would further erode the already woefully inadequate rights that psychiatrized people currently enjoy. In the name of ensuring good mental health for everyone, it would make it easier to both commit and to treat involuntarily. For example a change is proposed to what is called the A criteria whereby even a "perceived" danger to self or other that is in no way physical in nature would be grounds for involuntary commitment. And instead of "involuntary treatment" being held in abeyance while the person was under initial observation, it would allow for immediate involuntary treatment (see http://www.ontla.on.ca/committee-proceedings/committee-reports/files_pdf/Select%20Report%20ENG.pdf) Moreover, parental consent for "treating" children would be unnecessary. Additionally, in the name of prevention, it would unleash armies of "mental health professionals" into our schools, all poised to swoop down on youth and deprive them of rights. In other words, it would be intensifying our human rights violation.

As such, it is time for the average citizen to take a long hard look at what is being done in our name. A good beginning is asking ourselves these questions:

How do we feel about Canada being in such profound violation? Why do our elected representatives not attend to the violation? How is it that we have become so comfortable with compulsion and detention that we have lost sight of the importance of basic human rights? Is it really okay to deprive folk of rights just because we are scared of them or for them? How is it that that the most esteemed international body in the world can not only conceive of but actually legislate what the Canadian state appears to find unthinkable?

As you ponder this, I ask you to avoid pat answers like it behooves us to ensure that everyone enjoys "good mental health" for besides that the underlying concepts lack validity, it is precisely such discourse which has landed us in the current untenable situation. 

In ending, I would touch once again on Bill 95. It is clearly promoting an agenda that is a danger to everyone -- but not equally. Who are especially targeted as needing extra help (read: extra intrusion)? Children. Seniors. The Aboriginal community. All of which should sound an alarm.

Which brings me to two final questions: Is the rampant and ever increasing violation of the human rights of vulnerable populations what we want our country to stand for? And do we really think that it is the only way?

(If your answer is no, please contact your elected representatives and make your objection known.)

Thursday, September 3, 2015

Yes, the Tide is Turning Against Psychiatry

The suggestion embedded in this article’s title seems counter-intuitive. How could the tide be turning on psychiatry when the institution has never been so strong? And indeed indicators of its growing strength and tenacity are all around us. The exporting of its model to the global south via the World Bank, the emergence of outpatient committal, the explosion of funding for psychiatric research (see Burstow, 2015). Correspondingly, daily are there calls for most aggressive “detection” and “treatment”  (e.g., Jeffrey Lieberman, 2015). And the mainstream press has never been more closed to truly foundational critiques. That acknowledged, let me suggest that such intensification is common when an old system is in the early days of crumbling.

Of course, intensification itself is hardly an indicator that a reversal is at hand. So how would we know? Examples of possible indicators are: Ever growing critiques from inside and outside the profession, growing discomfort with “anomalies” (in essence, the indicators of a paradigm shift spelt out by Kuhn, 1962). Established moral authorities making unprecedented negative pronouncements about the current state of affairs. The surfacing of more and more tales of corruption and fraud. The rising up of those subjected to it. Each of these signs and more we are experiencing now with psychiatry -- hardly conclusive individually, but taken together, convincing portents of a societal shift.

While psychiatric anomalies have always been with us, note, never have they been so visible. Even as we hear calls for the early detention and treatment of “mental illness” to prevent school shootings, for instance, we discover that the majority of the shooters were on psychiatric drugs. Correspondingly, as the system pushes western ways of handling “schizophrenia” on the rest of the world, World Health Organization studies conclude that the countries with the highest rates of “recovery” are those without the “benefit” of  modern “treatment” (see Robert Whitaker, 2010). As for the dissatisfaction experienced by people in the psychiatric and related professions, just check out the speakers at the 2015 conference of the International Society for Ethical Psychiatry and Psychology (http://psychintegrity.org/plenary-talks/), and you will quickly get a sense of it. Telling likewise is what happened in the years leading up to the release of DSM-5. While their goal, of course, was not "changing” but rather “saving” the current paradigm, well in advance of DSM-5’s release, in what was a historically unprecedented move, the two previous taskforce chairs, Robert Spitzer (2009) and Allen Frances (2009), each came out with hard-hitting critiques of what their colleagues were doing, describing it as once bad science and an exercise in subterfuge—critiques echoed, I’d add, to an unparalleled degree by mainstream media. At the same time, a plethora of radical survivor groups have sprung up. And sites dedicated to deconstructing psychiatry are legion (e.g. madinamerica.com and endofshock.com).

By the same token, proofs of fraudulent trials and fraudulent claims of discoveries abound. Witness David Healey’s (2009) unearthing of the systematic “cooking” of drug trials. Witness the exposés on the Breggin site (http://www.breggin.com/). And note the publishing this year of a book which clearly establishes that the American Psychiatric Association has intentionally misled the public throughout its history -- about “mental illness” being a proven brain disease, for example, about the efficacy of the drugs (Whitaker and Cosgrove, 2015).

Even as these developments unfold, major international organizations have cast doubt on psychiatry both morally and scientifically. Take the aforementioned World Health Organization’s studies. And what is particularly suggestive, in its role as moral compass, two different instruments of the United Nations have declared involuntary neurolepticization a form of torture. Moreover, trace the practical implications of the recently minted Convention on the Rights of People with Disabilities and it becomes clear that it positions a key modus operandi of psychiatry everywhere -- involuntary treatment -- as a human rights violation (a victory, I might add, for which the vintage work of groups like the Center for the Human Rights of Users and Survivors of Psychiatry must largely be credited; for details, see Minkowitz, 2014). All of which, note, paves the way for the current survivor-led campaign to rescind involuntary committal laws throughout North America.

Another salient indicator comes from non-psychiatric medical practitioners and students, for quiet though they remain about it, cogent evidence suggests that their opinion of psychiatry has plummeted. A major study written up by H. Stuart et al. (2015) involving 1057 non-psychiatric medical teaching faculty in 15 countries, for example, shows that the vast majority hold a highly negative view of psychiatry. They find psychiatrists, for instance, too powerful, “unscientific,” and “illogical.” Correspondingly, there is currently a formidable decline in the percentage of medical residents open to specializing in psychiatry. In the UK, for example (once a psychiatric hotbed), less than 5% of medical students choose to enter psychiatry (see Read, 2015).

Indeed, psychiatrists are aware of their faltering reputation. And in what is an unprecedented move, in January of this year a major psychiatric journal (Acta Psychiatrica Scandinavica) devoted a special issue to psychiatry’s “image problem” (Vol. 131; see http://onlinelibrary.wiley.com/doi/10.1111/acps.2014.131.issue-1/issuetoc), with leading figures in psychiatry weighing in -- e.g., current and former presidents of the European Psychiatric Association and the current president of the World Psychiatric Association. What the very existence of this special issue seems to suggest is that so bad is the public image that the upper echelons of the industry are taking alarm. Correspondingly, their response is how regimes of ruling commonly respond when their seemingly unquestionable authority begins to slip away -- for example, portraying themselves as victims and blaming everyone else. Bhugra (2015), current president of the World Psychiatric Association, for instance, lays the blame on the “anti-psychiatry media” -- ironic, given the enormity of the media’s support.

That noted, if the tide is turning – and, as shown, it is -- the question is how far? And what form will the change take? At the moment, despite critiques which demonstrate psychiatry’s utter invalidity, the primary discourse is reformist. This news is worse than it appears, for throughout the centuries, in the long run, reform agendas have only served psychiatry. Temporarily, for sure, they create a modicum of improvement, like with “moral management.” Nonetheless, as shown by Burstow (2014), each and every tempering of psychiatry under a reform agenda has culminated in the return of biological psychiatry with a vengeance. As such, despite good intentions—and I am in no way doubting the intentions and hard work of most of the people involved -- all “reformism” ultimately succeeds in doing is losing the momentum.

That said, at this point, many movement people are keenly aware of this dynamic. Correspondingly, we are seeing a renewed interest in psychiatry abolition, especially versions committed to societal rebuilding. The reception which I have been receiving among psychiatric survivors – and survivors, after all, is where the resurgence of subjugated knowledge must come from -- is suggestive in this regard.

Significantly, up until a few years ago, there was but muted interest in psychiatry abolition within survivor circles. What I am seeing now, conversely, is an abundance of posts of the ilk “If antipsychiatry is what Bonnie says it as, then I am antipsychiatry.” Additionally, more and more antipsychiatry websites are popping up. The point is, antipsychiatry -- and not just any type but one of a visionary nature -- is markedly on the rise.

And indeed, a visionary antipsychiatry is precisely psychiatry’s worst nightmare—hence the current barring of foundational critiques by the mainstream media and hence psychiatry’s worried references to “antipsychiatry.” Simple reform, as history shows, is inevitably coopted. And critique alone can easily be dismissed. A true revolution -- one involving reclamation -- is a whole different matter.

In ending, let me invite those in the Toronto area interested in continuing this conversation to come to my book launch on September 18 (5:30, Floor 12, 252 Bloor West). And more generally, let me ask all readers: Is a coercive, invalid, and damaging “system” really the best we can do? What makes setting our sights on but tempering it and/or but adding “alternatives” the “practical” option?

And now that the tide is turning, what can the average citizen do so that this time round, we as a society do not “squander” the moment?

(for this and related articles, see http://bizomadness.blogspot.ca).


Bhugra, D. (2015). To be or not to be a psychiatrist? Acta Psychiatrica Scandinavica, 131, 4-5.
Burstow, B. (2014). Liberal “mental health” reform: A fail-proof way to fail. Mad In America. November 17 (http://www.madinamerica.com/2014/11/liberal-mental-health-reform-fail-proof-way-fail/)
Burstow, B. (2015). Psychiatry and the business of madness. New York: Palgrave Macmillan.
Frances, Allen (2009). A warning sign on the road to DSM-V. Psychiatric Times. June 26 (http://www.psychiatrictimes.com/articles/warning-sign-road-dsm-v-beware-its-unintended-consequences).
Healey, D. (2009). Psychiatric drugs explained. London: Elsevier.
Kuhn, Thomas (1962). The structure of scientific revolutions. Chicago: University of Chicago Press.
Lieberman, J. (2015). How to halt the violence. The New York Times. August 28  (http://www.nytimes.com/2015/08/29/opinion/how-to-halt-the-violence-treat-mental-illness.html?smid=fb-share).
Minkowitz, T. (2014). Convention on the rights of people with disabilities and liberation from psychiatric oppression. In Bonnie Burstow, Brenda LeFrançois, and Shaindl Diamond (Eds.). Psychiatry disrupted (pp. 129-144). Montreal: McGill-Queen’s University Press.
Read, J. (2015). Saving psychiatry from itself. Acta Psychiatrica Scandinavica, 131, 11-12.
Spitzer, R. (2009). DSM transparency: Fact or rhetoric. Psychiatric Times. March 6 (http://www.psychiatrictimes.com/articles/dsm-v-transparency-fact-or-rhetoric).
Stewart, H. et al. (2015). Images of psychiatry and psychiatrists. Acta Psychiatrica Scandinavica, 131, 21-28.
Whitaker, R. (2010). Anatomy of an epidemic. New York: Broadway Paperbacks.
Whitaker, R. and Cosgrove L. (2015). Psychiatry under the influence. New York: Palgrave Macmillan.