Soteria House: A Haven And Hope Without Drugs

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http://www.cchr.org/doctors/eng/page18.htm

 

SOTERIA HOUSE: A HAVEN AND HOPE WITHOUT DRUGS

by Dr. Loren Mosher

 

 

Dr. Loren Mosher is the director of Soteria Associates in San Diego,

California, and a Clinical Professor of Psychiatry at the School of

Medicine, University of California, San Diego. He is also the former

Chief of the U.S. National Institute of Mental Health's Center for

Studies of Schizophrenia, where he founded and served as the first

Editor-in-Chief of a prominent medical journal, the Schizophrenia

Bulletin.92 He writes:

 

Following a series of enlightening experiences during my psychiatric

residency, I began to believe that psychiatric hospitals were not

usually very good places in which to be insane.

 

As a result, I opened Soteria House in 1971, whose unique social

environment I also designed. There, young persons diagnosed as having

" schizophrenia " lived medication-free with a nonprofessional staff

trained to listen to and understand them and provide support, safety

and validation of their experience. The idea was that schizophrenia

can often be overcome with the help of meaningful relationships,

rather than with drugs, and that such treatment would eventually lead

to unquestionably healthier lives.

 

This project's design was a random assignment, two-year follow-up

study comparing the Soteria method of treatment with " usual " general

hospital psychiatric ward interventions—that relied principally on

drug treatment—for persons newly diagnosed as having schizophrenia and

deemed in need of hospitalization.

 

The experiment worked better than expected. At six weeks

post-admission both groups had improved significantly and comparably

despite Soteria clients having not usually received antipsychotic

drugs! At two years post-admission, Soteria-treated subjects were

working at significantly higher occupational levels, were

significantly more often living independently or with peers, and had

fewer readmissions. Interestingly, clients treated at Soteria who

received no neuroleptic medication over the entire two years or were

thought to be destined to have the worst outcomes actually did the

best as compared to hospital and drug-treated control subjects.

 

Despite many publications (40 articles plus two books in all), without

an active treatment facility, Soteria disappeared from the

consciousness of American psychiatry. Its message was difficult for

the field to acknowledge, assimilate, and use. It did not fit into the

emerging scientific, descriptive, biomedical character of American

psychiatry, and, in fact, called nearly every one of its tenets into

question. In particular, it demedicalized, dehospitalized,

deprofessionalized, and deneurolepticized what Thomas Szasz has called

" psychiatry's sacred cow. "

 

Swiss physicians replicated the experiment and determined that Soteria

care produced favorable outcomes in about two-thirds of patients. In

both Sweden and Finland, researchers have since reported good outcomes

with newly identified persons with " schizophrenia " that involve family

oriented psychosocial treatment programs using minimal or no neuroleptics.

 

" The idea was that schizophrenia can often be overcome with the help

of meaningful relationships, rather than with drugs, and that such

treatment would eventually lead to unquestionably healthier lives. "

 

— Loren Mosher, M.D. Clinical Professor of Psychiatry, 2002