A drug addled nation? Is the 'mental health' of Australians really getting better?
We have an epidemic - it is called psychotropic medication or prescribed drugs 💊.
This blog will discuss aspects of the prescription drug epidemic following the release of the Australian Institute for Health and Welfare (AIHW) data on prescribing of 'mental health' drugs in Australia.
The blog is not intended to be critical of any person taking psychiatric drugs and acknowledges the very real and legitimate distress and despair people experience in their lives.
The blog is describing the influence of diagnosis, and related drugs, as a response to common human experiences, that dominates the 'mental health' industry in Australia. The released data discussed, raises simple and complex questions not least, is them mental health of Australians getting better within the current paradigm or is the current paradigm causing more harm?
For further discussion on psychiatric 'Drugs' by the Humane Clinic see:
The amount of dispensed prescriptions continues to rise, the cost continues to rise (human and financial) and individuals and communities continue to experience understandable distress in their lives, while the smoke screen of a noble medicalization of humane distress 'managed' by the often harmful, potentially neurotoxic drugs that are the primary (and often tertiary) health responses offered, when a person reaches out for connection and support in the so called 'mental health' industry.
The rise of the 'mental health' drug is related to policy, guild interests, financial wealth creators and ideology that began in the 1950's. We now find ourselves reaching out for these drugs in all parts of our society as a fix. But they do not fix anything? They certainly do not fix the fictitious 'disorders' that the 'mental health' system is built upon. They do however, hide the complex and unique dilemmas in the lives of each and every person as members of a connected society.
As we see the emergence of whole new generation of prescribed drugs - psychedelics - we might consider if the 'mental health' systems is the right place for new drugs that may well create relief and hope, but governed by the same structures, may provide the same discrimination of access, necessity to label in order to access and be beholden to the aggressive financial sector for their availability in the 'evidence based' world, not to mentioned the need for a patriarchal oversight.
In truth, Individuals on long term medications die many years younger than the general population - this is not the 'disease' of a 'mental disorder', it relates to the interconnected impact of social inequality, problems in our communities and the impact of medications.
For too many years, the erroneous narrative has been that people with 'severe mental illness' die up to 25 years earlier than the general population. This is erroneous as it denies the impact of adversity and trauma, poverty, racism, interconnected discrimination, determinism and totalitarian ideology and medication.
Summary of prescribed MH drugs data
The recent Australian Institute of Health and Welfare (AIHW) report of mental health prescriptions is alarming.
In 2020-2021 (latest released data), in a county of less than 28 million people, 42.7 million MH drug prescriptions were dispensed.
Summary data can be found here:
https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions
The epidemic broken down
- 1847 MH prescriptions were dispensed per 1000 people
- Almost 1 in 20 ( 4.8%) 5 - 11 year olds were dispensed a MH drug
- Almost 1 in 10 ( 9.5%) of 12 - 17 year olds were dispensed a MH drug
- As the age group rises so does the number of people prescribed
- Between 1 in 5 & 1 in 6 Australians are dispensed a MH drug. In Tasmania this is closer to 1 in 4 people.
- A total of 4.56 Million people were dispensed a MH drug in 2020-2021 (In Australia)
- 17.7 % of the population were dispensed a drug
Drugs and what trends
With the inevitable increase in drugs being dispensed (84.7% prescribed by GP's) what is the drug addled Australian nation consuming?
- 31.2 million Antidepressants prescription
- 3.8 million Antipsychotic prescriptions
- 2 Million psychostimulants
- 3.1 million anxiolytics
Perhaps as aspect of the data that raises concerns is the drugs that have been prescribed at an increased rate.
Rates during the period 2016-17 to 2020-21 have seen Antipsychotic prescriptions increase 164.6 to 168.2 (per 1000 people). Anti depressants prescriptions have increased from 1042.7 to 1216.7 (per 1000 people) and from 48.5 to 78.4 for Psychostimulants, agents used for ADHD. The demonstrates an average annual increase of 0.5%, 3.9% and 12.7% respectively for these drugs.
The increases in Antipsychotics may demonstrate the continued use of the the ideology developed from the out of date theory of 'schizophrenia', whilst the continued increase of the Anti depressant prescriptions is consistent with the largely failed anti stigma campaign that have tried to create a narrative that the level of 'mental disorder' in society is so high it is normal. This begs the question - What is normal? and - If normal is distress and sadness, do we need drugs for this or do we need to address the underlying factors that have created sadness in our communities?
Finally, the 12.7% increase in Psychostimulants is not only an alarming jump in itself, but the number and rate of children being prescribed these drugs is concerning. Below I have discussed the evidence based guidelines relating to ADHD as an example of how the MH industry creates narratives to satisfy the need for an answer. In turn leading to increased number of prescriptions, despite no reasonable evidence to support that narrative. This is a modern version of the psychiatric drug proliferation since they were first used under what has become the modern 'mental health' system.
We might ask a simple question here - Do we want our children and future generations to be given potentially neuro toxic and harmful drugs at increase rates? If not, we may need to consider alternatives - now!
A little extra - NB. COVID 19 is not a mental illness!
And whilst no one could get to see a doctor during COVID in 2020- 2021( first quarter) the rate of mental health perceptions rose by 23%. Please note, COVID 19 does not cause 'mental illness', it may lead to distress, as many social determinants are impacted significantly on people - especially those already facing most disadvantage in society).
Building narratives to support drug prescriptions in 2023 (not a good thing)
Along side the rise of prescribing MH drugs is the building (false)narrative that many of our children, and adults, are not in fact responding to their environments, distress, trauma, a changing world - they are 'sick'. When we begin to see children and young peoples behaviour as abnormal, we might ask - what is going on in their homes, schools or communities? What are the generationally driven changes accepted and not accepted in behaviour change in our communities? How do can we begin to understand that the next generation are expressing distress at the world they are growing up into?
But as a society we are not asking those questions. We are investing in developing more simple ways for children (and adults of course) to be considered 'disordered', sick, broken etc. This is based in the diagnosis and drug based model.
The mythology of the 'mentally ill' ,that created the fictitious diagnostic system, underpins this idea of an 'ill' child / person and the faulty chemicals in their brain (the only faulty thing going on here is the idea of the faulty brain).
Built on these fictitious diseases/disorders labels, in recent times we have seen the release of ever more accessible 'diagnose and drug' approaches here in Australia. At times, the social media world is alive with requests for details of the first available professional that could assess and diagnose a child or a family member. We can understand the distress and desperation of a person or their family member as any 'treatment' funding is tied to the label, and here demonstrates the deep rooted narrative of 'disorder' throughout the layers of our society - despite not evidence to support that.
This social media 'something wrong with me' or 'something wrong with someone else' approach has led to ever increasing number of quick fixes and the 'mental health' drugs are one easily available tool with the profits racking up to the powerful organizations, while the outcomes of people get worse. This is supported by medical fraternity, governments, academic institutions and even advocacy groups, despite the psychiatric survivor movement having origins in emancipation from this very situation some 60 years ago!
However, there is no evidence to support the 'brain disorder' ideology and labels that perpetuates the 'mental health' industry, an industry that uses a risk and fear (prejudice) based framework to create an 'us and them' scenario. But there is not 'us and them'. No one is unaffected by the experiences of living and the responses to different experiences of living are all understandable, and legitimate responses to situations that make up the experiences of living.
ADHD is one label that is gathering pace here in Australia. The AIHW data demonstrates stimulant drugs is rising accordingly: For many the drugs come with the label (and funding). This is true of all the 'disorder' labels of course. The are no tests to demonstrate any of the 'disorder' labels - there is simply opinion. For a brilliant description of how we have arrived at our 'diagnostic' and drug led model you can watch James Davies video on the origins of the DSM (diagnostic manual) or read his book: Cracked: Why Psychiatry is Doing More Harm Than Good
To give an example of how we develop 'evidence' and perpetuate the simplicity of 'diagnosis' and then drugs, I have summarized the levels of evidence (Type of evidence) , certainty of evidence (certainty) and strengths of recommendations based on evidence (strength) of evidence in relation to diagnosis of ADHD in the recently released Australian Evidence Based Clinical Practice Guideline For Attention Deficit Hyperactivity Disorder (ADHD) (2022).
Summary of how the evidence and justification for the guidelines is constructed
Type of evidence:
EBR - evidence based recommendation based on some for of systematic or structured evidence
CCR - Insufficient evidence was available for the EBR category so a group of wrote a narrative review (no evidence)
CPP - No evidence so people made up an answer based on their opinions.
Summary of recommendations based on ('evidence' as described above)
High - confident the true effect (of evidence) lies close to estimate of effect
Moderate - moderately confident " " " "
Low - limited confidence of the true effect of the evidence
Very Low - little confidence in the true effect of the evidence - in fact true effect is likely to be 'substantially different' to the 'evidence'.
Strength (grade) of recommendations for Evidence Based Recommendations
**** - Strong recommendation
*** - Conditional recommendation
** - Conditional recommendation for evident or other (!)
* - Conditional Recommendation against the evidence
The section 'Diagnosis' in the guidelines, that informs the so called evidence base that support the labelling of common human experiences ,and then the drugging of children and adults labelled with ADHD we might what is the 'evidence'? So what is the evidence to support the 'Evidence based guidelines' in the section on diagnosis?
NONE!!!! There is no systematic evidence even offered.
All category's in the diagnosis section are supported by evidence, made up entirely from CCR and CPP (this means opinions with no validating data - systematic or structured evidence to support the opinions).
When we move onto considering the other two aspects of the 'evidence' - strength and certainty of the evidence we find N/A in every section. So even the structure of the 'evidence' in the guidelines doesn't support the idea that this is any meaningful evidence of strength or certainty in the evidence of diagnosis. This is a guideline published in 2022, stated as evidence based, but the primary process of how to diagnosis the 'condition' has no evidence to support it.
The phenomena of taking public despair and and popular ideas (planted by powerful ideological institutions) as a rationale for diagnosing 'mental disorders' contributes to an increase in numbers of children and others being diagnosed and therefore the increase in psychiatric drug prescriptions.
Is Australia a psychiatric drug addled nation? Yes (to some degree). More that 1 in 6 people are given a drug to change there behaviour towards being 'normal'. Our future generations are being prescribed neurotoxic and mind altering drugs as increased rates, while we accept evidenced based guidelines with no evidence - this sounds rather addled.
Is the 'mental Health' of Australians improving with the increase in numbers of prescription drugs for 'mental health'? No. The number of people accessing services continues to rise, suicide numbers are not lowering, health budgets continue to blow out and not meet the demand and the underlying determinants based in oppression and power are not being meaningfully considered through the smoke screen of 'diagnosis' and prescription drugs.
We need to act sooner rather than later if we are to begin to bring communities together, address violence and harm in our societies and challenge prejudice (especially race and gender related) that leads to oppression of marginalized groups who look to a broken systems operating under systems of patriarchy to provide answers that the very system is invested in maintaining.
The data discussed on 'mental health' prescription raises many questions, not least the idea of people making informed consent and without knowledge of what drug, for which 'disorder' and what might be the long term consequences? Further more, what are we even talking about when we say 'mental health'? Who is governing the narrow band of ideas and responses that generate funding, services models and ultimately empowerment or lack there of in our communities? If the ever increasing influence of psychiatric drugs has the powerful messages of confirming fictitious 'disorder' labels, has the psychiatric drug juggernaut actually become a barrier to reform and change in the way we respond to understand, contextualize and compassionately respond to distress? Perhaps this recent data in Australia, and likely mirrored around the world, could be literature of emancipation if we see the important message and question the status quo.
We have an epidemic - it is called psychotropic medication or prescribed drugs.
Do we want to address the epidemic? The difference between this and other recent epidemics or pandemics, is that we could all agree to end this epidemic and it could have unifying, community connecting, reducing of prejudice and euphoric consequences of empowerment, moving away from 'us and them' towards 'us' - people supporting one another to acknowledge and support the realities of distress in our experiences of living through compassionate, connection and equality based ideas of same not difference.