December 12, 2005

Calls for Mental Illness Treatment Reform

Following is an excerpt from a good editorial out of Australia that touches upon universal issues:

Mental illnesses issues need reform


POPULAR views are that the greatest health threats to the economic and social future of Australia are either bird flu or the ageing of the population. One rarely reads that 27 per cent of all health-related disability is due to mental illness or that a staggering 60 per cent of disability among 15 to 34-year-olds is due to depression, anxiety, alcohol and substance abuse, manic-depressive illness (bipolar disorder) or schizophrenia.

As a parent of teenage girls, when I'm asked what most worries me most I state some key facts.

First, 75 per cent of adult mental health problems start before the age of 25.

Next, less than 40 per cent of adults with mental health problems access any help, with younger people being the most poorly served. Of those that do get help, over 80 per cent of services are provided by family doctors who often function without support from private psychiatrists or psychologists or public mental health services.

The recent release of the report "Not For Service: Experiences of Injustice and Despair in Mental Health Care in Australia" by the independent Mental Health Council of Australia has again focused national attention on the lack of access to basic medical, psychological and social services for those with mental illness. As every family in Australia will at some time face this problem, we should all be greatly concerned. Despite a decade of promises by all governments to lift the quantity and quality of mental health care, very basic failures in the system occur on a daily basis.

Even though I am someone with inside knowledge and connections, I'm worried that if a close relative of mine becomes mentally ill we will struggle to access basic services. By contrast if one of my girls develops a breast lump, I am very confident that I will be able to access the best care that medicine can deliver. Most importantly, I'm sure that no one will tell us to go away and come back when the lump is bigger or has spread outside the breast. In mental health, however, people are turned away daily on the basis that their problem is not yet life threatening. As a Victorian man reported to our enquiry, when he sought urgent help, he was simply classified by the system as "not for service".

Quite contrary to some political commentary, our report does not simply call mindlessly for massive increases in expenditure. It does not criticise those professionals who deliver services. It does highlight the key issue of the need to support those persons with illness, as well as their families, to live productive lives in our community. Two other key features of the report deserve attention. First, we asked the community to name its top priorities and to detail the extent to which those priorities were being implemented in their local area. Second, we have outlined a roadmap of key strategic directions, emphasising rapid uptake of the most cost-effective interventions available.

Source: Professor Ian Hickie is executive director of the Brain and Mind Research Institute at the University of Sydney and was co-Author of the Not for Service Report. The Australian newspaper


unless you're in immediate danger of harming yourself or someone else, you don't have a whole lot of hope of being able to get public sector mental health treatment in australia.

Posted by: melanie at December 13, 2005 08:04 PM

Bird flu, ageing and mental illness are all potentially treatable with Diet, Inositol and Fishoil!

PS. ADHD and Adult ADD, which often cause depression, substance abuse and antisocial behaviour, can be traced to maternal consumption of refined vegetable oils in pregnancy: steam-refined oils are low in Vitamin E, and cause oxidation of nerve cell membranes in the fetal brain.

Two trials have shown Fishoil fatty acids to be effective in children with ADHD, but about one third of ADD cases are also anxious, and so will need to increase their Inositol intake as well. Since refined food oils appear to cause both ADHD and Alzheimer's disease, both disorders will cease to occur when food oil refiners are legally required to make good the current 30% loss of Vitamin E, incurred during steam deodorization.

[Edited for brevity by editors]

Posted by: Dr Robert Peers at December 15, 2005 05:53 AM

Dear Dr. Roberts - as can be seen in the Pubmed summary on Inositol in animal models (below) - the research is far from conclusive on these compounds you are talking about and a lack of human studies suggests that it would be extremely premature to be promoting them in the manner that you are. If I were you I'd be concerned about potential legal liability should someone go off their meds and follow your advice. Please stop your posts on this subject until you have solid, double blind, human studies from reputable universities to share with us. Until we see those studies, we are highly skeptical of the claims you are making.

J Affect Disord. 2001 Jan;62(1-2):113-21. Related Articles, Links

The effects of inositol treatment in animal models of psychiatric disorders.

Einat H, Belmaker RH.

Ministry of Health Mental Health Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheva, Israel.

Clinical trials indicate that inositol may be effective in the treatment of patients with depression, panic disorder and obsessive compulsive disorder (OCD), but not in the treatment of patients with schizophrenia, Alzheimer's disease, ADHD or autism. This spectrum of clinical action parallels that of serotonin selective reuptake inhibitors (SSRIs), but inositol is a precursor in the phosphatidylinositol cycle, a second messenger system distal to the receptor for 5HT-2. To study its mechanism of therapeutic action there is a need to test inositol's activity in animal models of psychopathology. In rats, chronic inositol was demonstrated to increase activity levels, reduce immobility time in the forced swim test and in the reserpine-induced hypoactivity models of depression, and reduce anxiety-like behaviors in the elevated plus-maze. The reduction in anxiety-like behaviors appears to be related to baseline levels of activity. Inositol treatment was not observed to have any effect on amphetamine-induced hyperactivity, apomorphine-induced stereotypy, or on the performance of memory tasks by monkeys. Clinical controlled trials of inositol in patients with depression, panic disorder, and OCD were small, and positive psychoactive effects in animals clearly strengthen the case for further clinical trials and potential for general therapeutic use in humans.

Publication Types:

Posted by: szadmin at December 15, 2005 09:31 PM

Another paper - where Inositol was tested in people who had schizophrenia - and no result. The balance of the evidence seems to me - to be negative.

Eur Neuropsychopharmacol. 1994 Dec;4(4):487-90. Related Articles, Links

CSF inositol in schizophrenia and high-dose inositol treatment of schizophrenia.

Levine J, Goldberger I, Rapaport A, Schwartz M, Schield C, Elizur A, Belmaker RH, Shapiro J, Agam G.

Abarbanel Mental Health Center, Bat Yam, Israel.

Inositol is a key metabolite in the phosphatidylinositol cycle, which is a second messenger system for serotonin-2 receptors that have been implicated in the pathophysiology of schizophrenia. Cerebrospinal fluid inositol levels were measured in 20 schizophrenic patients and 19 age- and sex-matched controls and no difference was found. However, the patients were all neuroleptic-treated. A controlled double-blind crossover trial of 12 g daily of inositol for a month in 12 anergic schizophrenic patients, twice the dose given before in schizophrenia, did not show any beneficial effects. However, the number of patients studied was small and the length of time of inositol administration may not have been sufficient.

Publication Types: Clinical Trial

Posted by: szadmin at December 15, 2005 09:34 PM

The high standard of evidence that your web site requires for innovative or unusual new treatments for "mental illness" is commendable.

However, in the case of Inositol, this high standard has not been accompanied by attentive reading of my post, for in digging out Inositol abstacts, you have unfortunately not followed my simple suggestion, that a "solid, human, placebo-controlled trial from a reputable university" can easily be found on Google->Inositol->Page 1->Inositol In Psychiatry.

This landmark Israeli trial of Inositol in anxiety-relared disorders, conducted in 1997, involved small patient numbers, but showed conclusive benefit from Inositol supplementation, that is likely to be seen in larger trials (planned, for example, in S Africa).

Please note that this study was of a much higher scientific standard than Dr John Cade's 1949 landmark trial of Lithium in mania, which was merely an open trial in a few patients, with no placebo or control group (Med J Aust)!

The same Ben Gurion University group has shown, again with placebo and controls, that Inositol is effective in eating disorder, and twice as effective as the drug fluvoxamine in reducing panic attack frequency.

In defence of Inositol-a natural food ingredient with no side effects- it must be said that psychiatric drug treatment of anxiety, using benzodiazepines and SSRI drugs, has poor results (benzos are addictive; SSRIs are very slow to take effect, and have nagging side-effects, especially on libido).

[Edited by editors for brevity]

Posted by: Dr Robert Peers at December 17, 2005 03:34 AM

My Apologies!

I meant to say, in the second paragraph of my second post above, that you had not paid close attention to "my posts" (plural): it was in my comment on Schizophrenia And Stress (News Blog, 12 Dec) that I gave the Google->Inositol lead, not in my first post above.

Your editors are therefore excused for not being aware of the "Inositol In Psychiatry" paper, accessible on Page 1 of Google->Inositol, which shows quite clearly that Inositol treats anxiety disorders with significant benefit, in a "solid, human, double-blind trial at a reputable university".

Once again, my apologies for this error.

Posted by: Dr Robert Peers at December 17, 2005 07:45 AM

Dr. Peers - its nice that your inositol has shown in some early, small trials some effectiveness in treating anxiety.

However we are a schizophrenia-focused web site - and so please place such posts on Anxiety-focused web sites, and not on this one.


Posted by: szadmin at December 18, 2005 03:03 PM

Social Anxiety is a potentially debilitating fear of social situations. It is generally considered to be the most common psychological problem, and encompasses a wide range of phobias and anxieties having to do with social situations. Social Anxiety Disorder (SAD), if left untreated, can degenerate into worse psychological issues, like agoraphobia or substance abuse, as people try to deal with their issues through avoiding them.

Posted by: Anxiety Treatment at January 27, 2006 02:06 AM

Many things can be shown to correlate with schizophrenia. In each case the advocates of the modality have not eliminated Subliminal Distraction exposure.

SD was discovered when it caused mental breaks for office workers. The cubicle was designed to deal with the vision startle reflex to prevent this exposure. The mental breaks stopped where cubicles are used after 1968.

Through Qi Gong and Kundalini Yoga low-level long-term exposure can be shown to create an altered mental state that resembles schizophrenia.

Examining daily activities for exposure and changing behavior to stop exposure should help slow the effects of a diagnosis of schizophrenia.

This costs nothing, does not require medication or treatment of any kind. It will not interfere with any treatment you now have.

Recent onset or first psychotic episodes will stop within a week or so. There are examples of exposure that show that.

Long term sufferers will not have an immediate result. But eliminating exposure will eventually help.

Posted by: L K Tucker at April 12, 2008 05:10 PM

Post a comment

Please enter this code to enable your comment -
Remember Me?
(you may use HTML tags for style)
* indicates required