Prozac and Psychiatry

January 26, 2005

This lists a section on Prozac

The Hidden Side of Psychiatryby Gary Null, Ph.D.

Mental illness is at an all-time high, with 40 million Americans affected, according to reports emanating from organized psychiatry. But just how accurate is this account? As you will see, people seeking help from the mental health industry are often misdiagnosed, wrongfully treated, and abused. Others are deceptively lured to psychiatric facilities, or even kidnapped. No matter how they arrive, though, once they are there, inmates lose all freedoms and are forced to undergo dangerous but sanctioned procedures, such as electroconvulsive therapy and treatment with powerful drugs, that can leave them emotionally, mentally, and physically marked for life. Some psychiatric patients are physically and sexually abused. Millions more are told that they need harmful medications, such as Prozac and Ritalin, but are not told of the seriously damaging side effects of these.

Add to all this a mammoth insurance fraud - which we all pay for - and what we have, in sum, is the dark side of psychiatry. Millions of individuals are being grievously harmed by the mental health profession, and it's time that we as a society faced this.

Section Index:

Fraudulent Practices in Mental Health Insurance Scams Patient Brokering Bogus and Nonexistent Treatments Abusive Treatments Your Taxes Pay for This Psychiatric Research Inhumane Treatment Involuntary Commitment Electroconvulsive Therapy Deep Sleep Therapy Sexual Abuse

Exploitation of Minorities Abuse of Senior Citizens Prozac: A Second Opinion Worthless Clinical Trials The Medical Industrial Complex Side Effects of Prozac Tardive Dystonia and Tardive Dyskinesia Sexual Dysfunction Biochemical Imbalance DependencyOvercoming Depression Without Drugs

Fraudulent Practices in Mental HealthFraud in the mental health industry goes beyond being a problem; it's more like an all-pervasive condition. By way of introductory illustration, let's look at the recent legal problems of a company that owned several chains of psychiatric hospitals, National Medical Enterprises (NME). As author Joe Sharkey reported in his book Bedlam1,2 in 1993 the FBI completed its investigation of fraud in NME's psychiatric hospitals and raided several NME facilities, in Texas, Colorado, Indiana, Arizona, Missouri, California, Wisconsin, and Minnesota. Sharkey described the extent of the morass into which this enterprise had sunk:

"An estimated 130 lawsuits were filed against NME's psychiatric hospitals by patients. Between 1992 and early 1993, three major suits were filed by insurance companies against NME for insurance fraud. These suits identified more than $1 billion in claims paid to NME's psychiatric hospitals. One month after the FBI raids, NME agreed to pay $125 million to settle two of the large insurance company lawsuits. Soon after, they settled the third suit - bringing the total costs in legal fees and settlements to about $315 million....

"In April 1994, NME paid almost $375 million in fines to the US Department of Justice for violations of Federal law. NME had announced that it would completely divest itself of its psychiatric hospitals and reserved $237 million to cover the write-offs for selling them. All told, NME's settlements and fines have totaled $927 million."

Insurance ScamsThe wrongdoings of NME are not the exception; indeed, insurance fraud seems to be the bread and butter of the mental health industry. Scams occur whenever a psychiatrist or a psychiatric institution bills Medicare, Medicaid, or private insurance companies for work they didn't do, for unnecessary or bogus treatments, or for patients confined against their will. Here are a few examples.

Patient BrokeringConsider this story, carried by the Los Angeles Times in 19943:

"Michael quickly realized that A Place For Us wasn't a place for him. Overweight and suffering from stress, the New Yorker had flown cross country to attend what was advertised as a weight loss clinic in southern California. The airfare was free and the treatment, he was told, was fully covered by his Blue Cross plan. But when Michael reached Los Angeles, he was shocked to see himself booked into a psychiatric hospital in a rundown section of [town] where he was diagnosed as suffering from psychotic depression and bulimia, conditions he denies ever having. Then he was told he couldn't leave. Michael is one of many stories emerging from federal and state lawsuits in Los Angeles in which insurers accuse A Place For Us of enlisting doctors and hospital staff to falsify diagnosis and medical records in order to obtain payment for treatment that, whatever its value to patients, was not covered by their health plans."

Michael's story is not an isolated incident. Overweight people are frequent targets of insurance scams. Patient brokers fraudulently advertise 1-800 numbers on television, and people call in thinking that they are talking to health spa representatives. In actuality, they are speaking to sales agents of psychiatric facilities whose only motive is to determine whether or not potential clients have insurance, since the size of their commission depends upon how many patients they can get into the hospital and how long they can keep them there.

It's hard to believe that this is going on in America, but the reality is that, as a result of gross deception by sales agents, people are frequently unaware of the fact that they are about to enter psychiatric institutions. If an unsuspecting party has coverage, the person is flown free to a facility, usually located in Florida or California. A limo awaits at the airport, and the place seems very accommodating until the person actually arrives at the facility and is locked up against his or her will. Once the person realizes what is going on, it's too late. People who become upset and attempt to leave can be threatened or diagnosed as combative.

Civil litigation attorney Randy Lakel works pro bono to represent patients who were voluntarily committed to psychiatric facilities by deceptive patient brokers. He describes a case involving two men from eastern Pennsylvania who were approached by people in the crowd at an Overeaters Anonymous meeting and taken aside.4 The brokers suggested to them that maybe they needed a little extra help, which could be offered by professionals at overeaters' clinics. The men were lured to the institution under false pretenses and then locked up.

Lakel believes that the problem has reached huge proportions: "...There are federal grand juries investigating this. I've also spoken to general counsel from very large insurance companies that have called me up to inquire whether their insurance company was involved in any of my investigations.... The general impression I got from the mention of a grand jury investigation and the general counsel from a large insurance company was that it was not an isolated incident that I was dealing with."

The broken world of patient brokering encompasses more than fat farm fraud; it affects people who might need help with all types of problems. A nine-month investigation of deceptive brokering practices conducted by Florida's St. Petersburg Times was enlightening - and upsetting.5 It was found that patient brokers sometimes share their finder's fees with school counselors who help provide likely young candidates for the brokers' institutions, or with public health workers, union representatives, or police and probation officers who steer prospective patients their way. Finder's fees can be as high as $3000 per patient. Another investigation finding was that patients are sometimes given false diagnoses, for insurance purposes. This is not surprising. The trouble is (on a personal level, and letting alone the issue of massive fraud!) these false diagnoses of mental illness can return to haunt patients throughout their lives. Indeed, according to Randy Lakel, the worst part of the problem is having a psychiatric record for life:

"Once people are committed, it goes on their insurance record. These people...are appalled that they now have a psychiatric record for the rest of their lives. It can interfere with any kind of employment opportunity. One of the people I talked to was a professional in the medical field. In her application, she was afraid that they were going to ask her if she ever had psychiatric commitment. How do you get that off the record? That, from a legal point of view, is clearly a damage."4

A disturbing aspect of patient brokers and referral services is that they are largely unregulated. As the St. Petersburg Times reported,5 in Florida and other states, referral personnel do not need licenses or special training before they can deal with the sick and the troubled. So people with criminal records are among the brokers, many of whom will do whatever it takes to get one more body into a treatment center.

Says Paul McDevitt, a licensed Massachusetts mental health counselors: "These people have no ethics at all. They're morally bankrupt. They're like the grave robbers in old England who provided cadavers for the medical schools. The grave robbers of today are taking the bodies of those so confused as to be dead and shipping them out to treatment centers where they never get well. And the doctors who are the pillars of society are still reaping the benefits and still never asking where the bodies come from."

Bogus and Nonexistent TreatmentsPsychiatric facilities consistently charge consumers for nontherapeutic treatments or services not performed. Adolescent facilities are common perpetrators of this abuse. One Texas hospital, for example, billed insurance companies $40 a day for relaxation therapy. This treatment, which simply consisted of turning on Muzac while teenagers were getting undressed, was actually far more exorbitant when you consider that each patient's insurance company was billed that price for one person turning on the Muzac one time.

Bruce Wiseman is president of the Citizens Commission on Human Rights, an organization that champions mental health consumer protection.6 He can provide a plethora of examples of how psychiatrists rip off the system. Wiseman tells of a Texas psychiatrist who was known for his hundred-dollar handshake. All he would do was walk by the beds of various patients, shake hands with them, and then bill each person's insurance company a hundred dollars. Another investigation discovered that charges for nutritional counseling were to cover the person going to lunch. Insurance companies are also charged for individual therapy when a group of people are placed in a room together and told to scream at each other for a couple of hours. These would be a little bit funny if they weren't so devastating in terms of what they do to insurance premiums and our taxes."7

Wiseman states that psychiatrists collect $600,000 to 900,000 a year on bogus or nonexistent treatments. "We have plenty of cases where they just bill the insurance company or the government for treatment that was never given. They don't even see the patient and they send the bills in."7

Abusive TreatmentsThe scenario worsens when you consider that economic exploitation is often coupled with physical abuse. Wiseman tells how an adolescent facility in Reno tormented a 15 year-old boy and then billed his parents' insurance company $400,000:

"They would drug this kid with Haldol, a so-called antipsychotic drug, until he was in a stupor, and then tie him in four-point restraints. They would tie his hands and feet to the bed, and then tickle him until he was hysterical. For that "treatment" this child's parents' insurance company was billed $400,000, and the insurance company paid it! If anyone else does to a child what the psychiatrist does, it is called child abuse. But here the insurance company pays almost half a million dollars for it. This is the kind of treatment and insurance fraud that exists.

This is not an isolated incident, Wiseman explains, but typical of what goes on: "In the Reno facility, children are subject to frequent take-downs. If a kid 'smarts off' or jumps the guards, he or she is physically abused. One patient in a Texas hospital had her legs strapped to a chair for four hours because she was moving her legs. They called it purposeful exercise, which she was not supposed to do. Kids are made to stand and look at a wall for 16 hours a day for months on end. There is also sexual abuse regularly going on in these hospitals."8

Nickie Saizon, who regrettably placed her son in a psychiatric facility, says that routine punishments were called treatment. Her insurance company was billed exorbitant amounts for these procedures:

"If they punished them with a time out, they had to sit in a chair in the hallway all day without moving. They charged $37.50 for that. When the kids would get mad and angry, they would have a nurse and counselors surround the kids and tell them, 'Get mad, get it out, have your fit.' They would keep on until they got mad and really started having a big fit. Then they put them down on the floor, held them there, and cut their shirt off. For that they charged $45. Then they put them in a room which they call a think tank. The room is bare and empty. There is no carpet, no chairs, nothing. They have to go in there and think over how they should have handled the problem.... They charged $87.50 for this room. Every time you turned around there were hidden costs.9

Wiseman believes that people would be outraged to learn what really goes on in these institutions: "The general public isn't aware of it, but one would be hard pressed to walk into any psychiatric hospital and not weep at the 'treatment' that occurs in these places."8

Your Taxes Pay for ThisIn the final analysis, fraudulent insurance practices hurt taxpayers since the maintenance of moderate insurance rates becomes virtually impossible. Consider these figures. The American public is swindled out of $42 billion a year. That's $3 billion a month, $800 million a week, $116 million a day, $4 million an hour, $80,000 a minute, and $1300 a second.

The federal government and the insurance industry are finally waking up to the problem and starting to fight back. In 1993, seven of the largest insurance companies sued one of the largest psychiatric hospital chains, National Medical Enterprises, for $750 million. In addition, every attorney general now has an assistant attorney general to oversee health care fraud prosecutions. As a result, some progress has been made. Wiseman states:

"Psychiatrists make up 8% of doctors, but 18% of those health care practitioners that have been kicked out of the Medicare system for fraud. Last year, $411 million was paid to the government in fines and penalties for health care fraud and 90% of that was paid by psychiatrists or psychiatric institutions."7

Although this is a start, it is Wiseman's belief that to truly resolve the problem the public must become more informed about what's going on, and insist on putting an end to the corruption.

Psychiatric ResearchEach year, hundreds of millions of tax dollars are wasted on pointless research conducted by the National Institutes of Mental Health (NIMH). For instance, these are examples of the types of studies they are funding under the guise of learning more about sexual behavior: a four-year study of horses masturbating, an eight-year study of castrated quail, a four-year study on the nasal cavities of hamsters during intercourse, a two-year study on the sexual preference and behavior of prairie moles, an 11-year study in which female pigeon genitals were stimulated to measure how hormones affect sexual behavior, a 9-year study of maternal licking of the genital region of male versus female ferret babies, a 9-year study on the sexual behavior of lizards, a 23-year study of sexual odors and social factors that affect male Asian monkeys, and a 23-year study on the sexual behavior of male rats as a biological basis for human behavior.

To study the effects of drugs, a 13-year study was undertaken in which rats were given hallucinogens, such as LSD,

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