Reply to an article in Socialpolitik

In their article Pebbles Karlsson and Martin Ambrose Schalling suggest that “antipsychotics and lithium should be made free” (Socialpolitik, 3, 2016).

At first, we believed that we have misinterpreted them – do they really mean that psychotropic drugs should be made even more available on the market? This despite the fact that we in Sweden and other parts of the Western world have been able to record an almost exponential increase in the use of such drugs, while the number of people who are forced into early retirement due to mental disorders at the same time has increased significantly?

Research demonstrates that people do not have a better recovery rate when using antipsychotics, but rather the opposite (Seikkula 2006, Harrow 2012, Wunderink 2013 Aderhold,2014 Whitaker, 2016, Gøtzsche,2016).

Karlsson and Ambrose Schalling state in their article that people with severe mental illness have up to 20 years shorter life expectancy than the average citizen. This is a fact that also we, unfortunately, are familiar with, but we do not share the view of the reasons behind this, nor the notion that the best solution would be even greater access to antipsychotics. Studies show that treatment with antipsychotics is a contributory factor to the short life span of these patients (Gøtzsche 2016).

We would have wished that Schalling, as chair of Psykiatrifonden, instead had drawn the readers’ attention to the non-functioning psychiatric care system, that still in 2016 to an appallingly high degree lacks alternative to hospitalization with early diagnosis and prescription of psychotropic drugs as almost the only action.

We still lack, with very few exceptions, early psychotherapeutic interventions, continuity, availability, time, sustainable thinking and action, contact with networks and, more than anything, a focus on the person involved and his or her experiences and needs.

We also would have wished that the writers had noted that strong drugs are prescribed without a rigorous, continuous follow-up and without a plan on how these drugs should be cut down and ultimately removed from the treatment. This is actually one of the major differences between diabetes and psychosis: the former is a chronic disease (where insulin has a specific action), but this is not the case with the latter and it should therefore not be treated as such.

The authors refrain (apart from half a line in the article) from discussing all the side effects that are associated with antipsychotics and most likely are a significant reason why people stop taking them.

Proven experience and international research report severe side effects, both physical and mental, of these drugs. This huge problem deserves more attention and more research, independent of the psychotropic drugs industry and not as today, closely linked to it (Whitaker and Cosgrove 2015).

Much remains to be done to alleviate human suffering and prevent people from getting caught up in a psychiatric dependency. As humans we are social and relational beings, and we need to adapt healthcare institutions and organizations accordingly.

We welcome the authors and not least the organization Schalling represent, Psykiatrifonden, to future talks and a joint action to create alternatives to the currently highly dysfunctional psychiatric health care in our country.

Carina Håkansson, PhD, founder of the Foundation Extended Therapy Room, Sweden
Birgitta Alakare, psychiatrist, Finland
John Read, professor of psychology, UK
Olga Runciman, psychologist, Denmark
Peter Gøtzsche, professor, Cochrane Institute, Denmark
Jaakko Seikkula, professor of psychotherapy, Finland
Hanna Lundblad, social worker, Sweden
Will Hall, research student, USA