A Retort to President Bush on Mental Health

Remarks by President George W. Bush on Mental Health
Albuquerque, New Mexico
April 29, 2002

with indented and italicized responses by Douglas A. Smith   (revised 5/24/2002)

Millions of Americans, millions, are impaired at work, at school, or at home by episodes of mental illness.  Many are disabled by severe and persistent mental problems.  These illnesses affect individuals, they affect their families, and they affect our country.

'Mental illness' is an erroneous concept, and not only because it is a semantic impossibility.  An 'illness' or 'disease' is physical.  'Mental' means non-physical.  As psychiatrist E. Fuller Torrey wrote in his book The Death of Psychiatry in 1974 (before he joined the ranks of biological psychiatrists): 'The very term ['mental disease'] is nonsensical, a semantic mistake.  The two words cannot go together except metaphorically; you can no more have a mental 'disease' than you can have a purple idea or a wise space' (Penguin Books, p. 36).  Similarly, there can no more be a 'mental illness' than there can be a 'moral illness.'  The words 'mental' and 'illness' do not go together logically.  Mental 'illness' does not exist, and neither does mental 'health.'  These terms indicate only approval or disapproval of some aspect of a person's mentality (thinking, emotions, or behavior).

As many Americans know, it is incredibly painful to watch someone you love struggle with an illness that affects their mind and their feelings and their relationships with others. We heard stories today in a roundtable discussion about that -- what the struggle means for family.

Many if not most people forced into psychiatric 'treatment' (or mistreatment) are forced by others in their family.  The notion that families necessarily do what is best for their 'loved ones' is a myth.

Remarkable treatments exist, and that's good.  Yet many people -- too many people -- remain untreated.  Some end up addicted to drugs or alcohol.  Some end up on the streets, homeless.  Others end up in our jails, our prisons, our juvenile detention facilities.

Psychiatry's treatments are indeed remarkable - remarkably bad, and remarkably harmful.  Neuroleptics (also called major tranquilizers) tricyclic and SSRI antidepressants, electric shock treatment, and psychosurgery, all cause brain damage.  Many people don't behave as they are expected to and become homeless or violate the law and are put in prisons of one sort or another, but none deserve the harm inflicted on them by psychiatry's modern biological 'therapies.'

Our country must make a commitment: Americans with mental illness deserve our understanding, and they deserve excellent care.  (Applause.) They deserve a health care system that treats their illness with the same urgency as a physical illness. (Applause.)

Our country must make a commitment: a commitment to the liberty of all law-abiding Americans.  Americans who are called mentally ill who do not violate the law in any way deserve liberty the same as everyone else.  We must stop using mythological conceptions such as mental illness to justify incarcerating law-abiding but eccentric or annoying people, or people who choose to live differently than we would like them to, in the prisons we call mental 'hospitals.'  We must begin a new era of tolerance towards people who are weird or different or emotionally troubled or obnoxious but who do not violate the rights of others.

To meet this goal, we've got to overcome obstacles, and I want to talk about three such obstacles this morning.  The first obstacle is the stigma, the stigma that often surrounds mental illness -- a stigma caused by a history of misunderstanding, fear, and embarrassment.  Stigma leads to isolation, and discourages people from seeking the treatment they need.  Political leaders, health care professionals, and all Americans must understand and send this message: mental disability is not a scandal -- (applause) -- it is an illness.  And like physical illness, it is treatable, especially when the treatment comes early.

The stigma that comes with receiving psychiatric treatment is a legitimate and powerful reason everyone who wants to live a good life in the future would be well-advised to avoid it.  It also is a legitimate and powerful reason we should not encourage other people to seek psychiatric 'help' and should not force it on them.  Since so-called mental illness has no biological cause and is not a true illness, it cannot be 'treated.'  The assertion that early mental health treatment is particularly effective is a myth that is used to persuade people who are not in severe distress to nevertheless patronize mental health professionals who need patients to earn profits.

Today, new drugs and therapies have vastly improved the outlook for millions of Americans with the most serious mental illnesses, and for millions more with less severe illnesses.  The treatment success rates for schizophrenia and clinical depression are comparable to those for heart disease.  That's good news in America, and we must encourage more and more Americans to understand, and to seek more treatment.

Today's psychiatric drugs are a disaster that have brought an epidemic of neurological disease on psychiatric patients, including dementia and movement disorders such as tardive dyskinesia and dystonia and other consequences of their both neurotoxic and generally toxic nature.  Psychiatry's electroconvulsive 'therapy' and psychosurgery damage the brain even more quickly.  The so-called anti-anxiety drugs or minor tranquilizers (benzodiazepines) cause addiction and severe withdrawal reactions without effectively alleviating the emotional reactions such as anxiety that motivated their use in the first place.  Urging people to seek these 'therapies' is stupid and outrageous.  Perhaps psychiatric treatment is indeed as effective, or as ineffective, as treatment for heart disease, since heart disease is the #1 killer of Americans, which it wouldn't be if treatment for it were particularly effective.

The second obstacle to quality mental health care is our fragmented mental health service delivery system.  Mental health centers and hospitals, homeless shelters, the justice system, and our schools all have contact with individuals suffering from mental disorders.  Yet many of these disorders are difficult to diagnose.  This makes it even harder to provide the mentally ill with the care they need.  Many Americans fall through the cracks of the current system.  Many years and lives are lost before help, if it is given at all, is given.

People who fall through the cracks of this system are the lucky ones.  Psychiatric 'help' is not helpful - and when imposed involuntarily is oppression disguised as benefaction.

Consider this example -- and for the experts in the field, they will confirm this is a story which is often times too true: a 14-year-old boy who started experimenting with drugs to ease his severe depression.  That happens.  This former honor student became a drug addict.  He dropped out of school, was incarcerated six times in 16 years.  Only two years ago, when he was 30 years old, did the doctors finally diagnose his condition as bipolar disorder, and he began a successful program, a successful long-term treatment program.

A 'diagnosis' of so-called bipolar disorder, also known as manic-depressive illness, like most in psychiatry, is largely arbitrary.  In this case, it means someone's excitement or enthusiasm and, at other times, sorrow exceed the range of emotions that is acceptable to other people.  As with all other psychiatric diagnoses, no biological basis for so-called bipolar disorder has been found, and there is no biological test for bipolar disorder or any other so-called mental illness.
      The most frequent treatment for this supposed disorder is lithium.  Lithium is a toxic chemical that slows all aspects of thinking.  It was discovered by accident in 1949 by psychiatrist John Cade who found it made guinea pigs tame and docile and lethargic.  He experimentally found it has the same effect on people.  Dr. Cade didn't know why lithium works, and today we still don't know.  Taking lithium may impair a person's thinking enough to prevent him from doing things he shouldn't, but this benefit comes at the expense of the cognitive slowing and physical lethargy that is the primary effect of the drug.  It can be compared with keeping a person chronically intoxicated.  In psychiatry, keeping a person who tends to behave in socially unacceptable ways on such a drug is called 'a successful long-term treatment program.'

And to make sure that the cracks are closed, I am honored to announce what we call the new Freedom Commission on Mental Health.  It is charged to study the problems and gaps in our current system of treatment, and to make concrete recommendations for immediate improvements that will be implemented -- (applause) -- and these will be improvements that can be implemented, and must be implemented, by the federal government, the state government, local agencies, as well as public and private health care providers.  To chair the commission, I've selected Michael Hogan.  Dr. Hogan, I appreciate your coming, Michael.  (Applause.)  Dr. Hogan has served as the Director of the Ohio Department of Mental Health for more than ten years, and is recognized as a leader in this profession.  He has been focused, as a state official, on how our mental health system works, and how it doesn't work.  I look forward to the Commission's findings.  I look forward to their proposals.  I look forward to making progress and fixing the system, so that Americans do not fall through the cracks.  (Applause.)

Calling this committee the Freedom Commission on Mental Health is reminiscent of George Orwell's concept of newspeak in his novel 1984 in which words invert the truth.  The job of this Commission will be to study how to get more Americans into mental health care.  Current mental health care in America is a system in which those who don't submit willingly are forced into 'therapy,' including involuntary 'hospitalization,' forced drugging of hospitalized patients (and of others through outpatient commitment laws) and involuntarily administered electroconvulsive 'therapy.'  Why call this committee the Freedom Commission on Mental Health?  It is unlikely this Commission will be studying ways to give people the freedom to refuse so-called mental health care.  The opposite is more likely to be the case.  This Commission, or committee, will no doubt be composed of mental health professionals who will recommend measures that will benefit them rather than people who become psychiatric patients.  It's like appointing group of health care quacks to study and report on health care quackery, or appointing a group of businessmen to study how to get more people to patronize their businesses - or, in this case, how to not only persuade but when necessary force people to be customers whether they want to be or not.

The third major obstacle to effective mental health care is the often unfair treatment limitations placed on mental health in insurance coverage.  (Applause.)  Many private health insurance plans have developed effective programs to identify patients with mental illnesses, and they help them get the treatment they need to regain their health.  But insurance plans too often place greater restrictions on the treatment of mental illness than on the treatment of other medical illnesses.  As a result, some Americans are unable to get effective medical treatments that would allow them to function well in their daily lives.  Our health insurance system must treat serious mental illness like any other disease.  (Applause.)  And that was Senator Domenici's message to me at the Oval Office.  (Laughter.)  And it was Nancy's message when we had them up for dinner.  (Laughter.)  And I want to appreciate the fact that they have worked tirelessly on this problem.  (Applause.)
      I have a record on this issue.  As the Governor of Texas, I signed a bill to ensure that patients who critically need mental health are treated fairly.  Senator Domenici and I share this commitment: health plans should not be allowed to apply unfair treatment limitations or financial requirements on mental health benefits.  (Applause.)
      It is critical that we provide full -- as we provide full mental health parity, that we do not significantly run up the cost of health care.  I'll work with the Senator.  I will work with the Speaker.  I will work with their House and Senate colleagues to reach an agreement on mental health parity -- this year. (Applause.)

First of all, it is incorrect to refer to 'mental illness and other medical illnesses.'  By 'medical illness' what you really mean is 'physical illness' or 'biologically caused illness.'  There is no convincing evidence any so-called mental illness is a 'medical' or 'physical' or 'biological' illness, so it is misleading for the President of the United States to announce publicly that it is.  See Does Mental Illness Exist? for evidence supporting this argument.  Second, there is no such thing as people being 'unable to get effective medical treatments [for mental illness] that would allow them to function well in their daily lives.'  The reason is all of psychiatry's 'medical' treatments disrupt normal brain function rather than promoting or improving it.  Psychiatric 'treatment' is harmful except for common-sense counselling (pretentiously called 'psychotherapy') that can be done as well by sympathetic, nonprofessional, untrained people as by professional 'psychotherapists' such as psychiatrists and psychologists.
      Laws forcing insurance companies and health maintenance organizations (HMOs) to pay for so-called mental health care are wrong for several reasons.  First, such laws make more money available for forced 'therapy' and therefore promote the violation of human rights in America.  I recall more than 30 years ago when a fellow involuntary patient who seemed entirely normal to me told me he was convinced the reason he was being kept in the psychiatric ward of the hospital against his will was his being there enabled his doctor to get a check from his health insurance company every week.  Like many of us, he was probably subjected to involuntary commitment until his mental health insurance benefits ran out and there was no longer a financial incentive for the 'professionals' to keep him in the hospital.  Equal benefits for mental health care will promote and prolong such abuses of human rights.  This should not be permitted in a nation like the United States of America where freedom is touted as the reason for American patriotism.  Second, health care insurance companies and HMOs should not be forced to pay for health care quackery, or harmful treatment.  They should not be forced to pay for anything that is not bona-fide health care.  Psychiatry is not health care; rather, it is social control disguised as medical treatment.  Psychiatry - particularly biological psychiatry - is health care quackery, and it hurts rather than helps people.  Counselling ('psychotherapy') about how to live one's life may be helpful but is not health care.  The third reason is freedom of contract: Some people - myself included - would like to be able to have health care insurance that does not include psychiatry or any kind of 'mental health' coverage.  We should not be forced to choose between buying health care insurance that includes psychiatric coverage we do not want or forgoing health care insurance altogether.  A fourth reason the proposed legislation is wrong is it is federal legislation.  The U.S. Constitution does not give the federal government authority in this area.  The Tenth Amendment reserves those powers not granted to the federal government to the states or to the people as individuals.

We must work for a welcoming and compassionate society, a society where no American is dismissed, and no American is forgotten.  This is the great and hopeful story of our country, and we can write another chapter.  We must give all Americans who suffer from mental illness the treatment, and the respect, they deserve.  (Applause.)

For once, I agree.  However, being a welcoming and compassionate society where no American is dismissed or forgotten and in which so-called mentally ill people are given the treatment and respect they deserve means something different to me than it does to you, Mr. President.  To you these words mean subjecting every troubled or troublesome American to psychiatric 'therapy.'  To me those words mean respecting the right of all Americans, that is, all law-abiding Americans, to freedom and autonomy, including those we (erroneously) think of as mentally ill.  Yes, we do need to write another chapter in American history, a new and very different one.  The violation of human rights in America goes all the way back to colonial times, for example, the Salem witch trials in 1692, and the hanging of Mary Dyer in Boston Common in 1660 because 'She was caught preaching Quakerism in Massachusetts' where that religion had been banned (according to the State Library of Massachusetts web site) ; she is now considered a martyr for religious freedom, and a statute of her sits in front of the Massachusetts State House (the state capitol building) a short distance from where she was executed.  The violation of human rights in America continued with the kidnapping of black people in Africa who were brought to America as slaves.  It continued during World War II when Japanese Americans were forced into concentration camps in the U.S.A.  It continues today with the imprisonment (forced 'hospitalization') and forced drugging and involuntary administration of electric shock treatment to law-abiding but so-called mentally ill people, and the use of torture such as four and five point physical retraints, which have not just tortured but killed hundreds if not thousands of psychiatric patients in America's mental hospitals and psychiatric wards.  Yes, we need a new chapter in American history in which we give real meaning to our political rhetoric about America being a land of freedom.  We need a new chapter in American history in which we start living up to our image of ourselves - our image of America - as a shining example of human rights to the rest of the world.