International mental health watchdog is part of the outpouring of support for Britney Spears’ appeal to take back her life from a psychiatric mechanism that forces unwanted treatment—a practice that a United States-signed UN covenant condemns.

By CCHR International
The Mental Health Industry Watchdog
25 June 2021

Multi-award winning singer-songwriter Britney Spears is challenging a conservatorship over her affairs that she says has made her feel “demoralized and enslaved” for thirteen years.[1] Such controls are enabled through a psychiatric evaluation which Britney commented on, saying she has been subjected to numerous psychiatric evaluations and medications.[2] “I want to end the conservatorship without being evaluated,” she said.[3] The singer’s passionate plea comes at a time when several international organizations have condemned coercive practices in the mental health system and the need for democracy-based human-rights.

Although not domestic law, the United Nations (UN) Convention on the Rights of Persons with Disabilities that the U.S. has been a signatory to since 2009, recommends prohibiting forced treatment without informed consent.[4] On June 10, the World Health Organization issued a guideline for community mental health “Promoting person-centered and rights-based approaches,” that said coercive practices are still pervasive, “despite the lack of evidence that they offer any benefits, and the significant evidence that they lead to physical and psychological harm….”[5]

While not presuming that Britney has a “disability,” CCHR hopes the authorities reviewing her case will take into account direction from international agencies.

Former UN Special Rapporteur Dainius Pūras, M.D., in a recent interview with Psychiatric Times stresses: “human rights-based approaches are not taken seriously, and exceptions that override basic human rights principles, including that of informed consent, are allowed.” He is “convinced that democracy is a must for promotion of good mental health….”[6]

The outpouring of support for Britney’s inherent human rights has been encouraging and welcomed. An opinion by Tammy Bruce, talk radio show host and New York Times best-selling author, said that “far too many women are still dismissed as disturbed or ‘troubled’ because they do not conform…. We used to call women who misbehaved or threatened the established order ‘witches.’ In the modern age we usually use psychiatry to facilitate taking our freedom away with drugs, institutionalization, or ‘diagnoses’ requiring, yes, conservatorship.”[7]

Dr. Pūras points out that “the status quo in mental health policies and services is no longer acceptable, and it is high time to abandon discriminatory laws and practices. In other words, the time has come for another paradigm shift in this field.”[8]

The W.H.O. calls on countries to tackle the “unlawful or arbitrary institutionalization, overmedication and treatment practices [seen in the field of mental health] that fail to respect…autonomy, will and preferences.”[9] Britney’s case is a contemporary example of this.

W.H.O. recommends people sign an advanced mental health directive to protect the autonomy it sees as important. CCHR has long advocated a “Psychiatric Living Will“ as it enables a person to make decisions about potential mental health care in the future, including treatments they refuse, and designating a guardian to act in accordance with these wishes should the person be deemed incompetent.[10] In 1969, CCHR also wrote a Mental Health Declaration of Human Rights that spells out vital protections that are needed worldwide.

Lithium Causes Toxicity & Birth Defects

Britney is rightly concerned about lithium being prescribed her against her will and it appears she has not been allowed to make decisions regarding her own healthcare wants. The W.H.O. report says: “People wishing to come off psychotropic drugs should also be actively supported to do so” and stresses using resources to “support people to achieve this.”[11]

Such support, under medical supervision, is vital. No psychiatric drug should be stopped abruptly. In CCHR’s experience, psychiatrists have deliberately allowed a patient to do this, knowing the adverse reactions that can occur. Rather than acknowledge these as drug-induced, they claim the person’s “mental illness” has returned with a vengeance. However, numerous studies reveal these are drug-induced withdrawal phenomena. The withdrawal symptoms can extend long after the drugs leave the body.[12] See CCHR’s report, Psychiatric Drugs Create Violence and Suicide.

Withdrawal symptoms for lithium can include heightened anxiety, sleep disturbances and irritability.[13] Generally, the longer the period of time someone was on this “mood stabilizer,” the longer the tapering off process needed—under medical supervision.[14]

The Food and Drug administration (FDA) has issued a black box warning about the risk of lithium poisoning, which can happen at close to normal dosages. Lithium poisoning can cause psychosis, kidney failure and coma.[15] Diarrhea, vomiting, drowsiness, muscular weakness, loss of appetite, and coordination difficulties may be an early sign of lithium toxicity.[16] Confusion, poor memory, or lack of awareness are adverse effects from taking lithium, while the drug has been linked to certain birth defects, when the mother has taken it during pregnancy.[17] See CCHR’s Psychiatric Drugs Side Effects Database for more information.

Psychiatric Evaluations Unreliable

CCHR says concerns about psychiatric evaluations have merit because of their unreliability.

• A former director of the National Institute of Mental Health says the psychiatric diagnostic system “lacks validity.”[18] Former heads of Task Forces developing The Diagnostic and Statistical Manual for Mental Disorders (DSM) admit that the desired reliability among the practicing clinicians using it has not been obtained.[19]

• The Psychiatric Times reported, “Despite the ongoing revision of diagnostic criteria with each subsequent iteration of DSM, clinicians report concerns that diagnostic reliability generally remains poor.”[20]

• Phillip Hickey, Ph.D. retired clinical psychologist, says the American Psychiatric Association “continues to push the notion that the manual is based on solid science. In fact, it isn’t, and never has been. Its purpose is to create the appearance of science, and to provide an umbrella under which psychiatrists can do pretty much whatever they like.”[21]

• In a report published in the International Journal of Clinical and Health Psychology, it noted that current psychiatric diagnostic systems do not share the same scientific security, of belonging to a technological model developed by research grounded in the natural sciences, as the rest of medicine.[22]

• Lawrence Kelmenson, who has practiced psychiatry for 32 years, reinforced his profession’s lack of science and how it undermines people’s innate resilience to overcome problems without a pill, writing that “biological psychiatry’s kookiest claim is its denial of our capacity to understand, flexibly adapt to, and solve our own problems….”[23]

Such unreliability and lack of science should never be used as the basis for depriving someone of their right to liberty and freedom of choice, especially as there is no guarantee that forced treatment “works” and doesn’t harm.

Dr. Pūras said: “Let us assume that each case of using nonconsensual measures is a sign of systemic failure, and that our common goal is to liberate global mental healthcare from coercive practices. We should search, with concerted efforts, for creative ways to replace substitute decision making with support according to an individual’s will and preferences.”[24]

CCHR’s co-founder, the late Thomas Szasz, professor of psychiatry and renowned author exposing the dangers of psychiatric practices argued that “For centuries, involuntary psychiatric interventions were regarded as things done for the so-called patient rather than as things done to him…increasing numbers of persons, both in the mental-health professions and in public life, have come to acknowledge that involuntary psychiatric intervention are methods of social control. On both moral and practical grounds, I advocate the abolition of all involuntary psychiatry.”

References:

[1] “Tammy Bruce: Britney Spears deserves to prevail in fight for her freedom. Here’s why her saga matters,” Fox News, 25 June 2021, https://www.foxnews.com/opinion/britney-spears-fight-freedom-tammy-bruce

[2] “Britney Spears to court: I feel ganged up on, bullied, left out and alone: The singer said she has been traumatized by the conservatorship and has refrained from speaking publicly because she felt no one would believe her,” NBC News, 23 June 2021, https://www.nbcnews.com/pop-culture/pop-culture-news/britney-spears-give-rare-public-testimony-conservatorship-battle-n1271943

[3] Ibid.

[4] World Health Organization’s “Guidance on Community Mental Health Services: Promoting Person-Centered and Rights-Based Approaches,” p. 7; https://www.disabilityscoop.com/2009/07/31/un-convention-sign/4363/

[5] World Health Organization, “Guidance on Community Mental Health Services: Promoting Person-Centered and Rights-Based Approaches,” p. 8, https://www.who.int/publications/i/item/9789240025707

[6] Awais Aftab, MD, “Global Psychiatry’s Crisis of Values: Dainius Pūras, MD,” Psychiatric Times, 3 June 2021, https://www.psychiatrictimes.com/view/global-psychiatry-crisis-values

[7] Op. cit., Fox News, 25 June 2021

[8] Op. cit., Awais Aftab, MD, Psychiatric Times, 3 June 2021s

[9] Op. cit., World Health Organization, p. 5

[10] “CCHR Supports WHO Recommendations for Psychiatric Living Wills to Prevent Abuse,” https://www.cchrint.org/2021/06/06/cchr-supports-who-recommendations-for-psychiatric-living-wills-to-prevent-abuse/

[11] Op. cit., World Health Organization, p. 201

[12] “Psychiatric Drugs Create Violence and Suicide,” CCHR report, p. 37, https://www.cchrint.org/pdfs/violence-report.pdf

[13] https://pubmed.ncbi.nlm.nih.gov/2897893/

[14] https://mentalhealthdaily.com/2014/04/24/lithium-withdrawal-symptoms-list-of-possibilities/

[15] https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/017812s033,
018421s032,018558s027lbl.pdf; https://www.cchrint.org/psychdrugdangers/

[16] https://www.drugs.com/tips/lithium-patient-tips

[17] https://www.drugs.com/sfx/lithium-side-effects.html; https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-lithium

[18] https://www.cchrint.org/2021/03/08/resource-on-why-psychiatry-is-upset-about-its-failures-and-critics/

[19] Alex Spiegel, “The dictionary of disorder: How one-man revolutionized psychiatry,” The New Yorker, 2005:56–63, https://www.newyorker.com/magazine/2005/01/03/the-dictionary-of-disorder

[20] “Inter-Rater Reliability in Psychiatric Diagnosis,” Psychiatric Times, 5 Oct. 2012, https://www.psychiatrictimes.com/view/inter-rater-reliability-psychiatric-diagnosis

[21] Phillip Hickey, Ph.D., “DSM-5 Inter-Rater Reliability is Low,” 30 Mar. 2013, https://www.behaviorismandmentalhealth.com/2013/03/30/dsm-5-inter-rater-reliability-is-low/

[22] https://www.cchrint.org/2021/03/08/resource-on-why-psychiatry-is-upset-about-its-failures-and-critics/ citing:  Sami Timini, MD, “No more psychiatric labels: Why formal psychiatric diagnostic systems should be abolished,” International Journal of Clinical and Health Psychology, Vol. 14, Issue 3, Sept.–Dec. 2014, pp. 208-215, https://www.sciencedirect.com/science/article/pii/S169726001400009X

[23] https://www.cchrint.org/2021/03/08/resource-on-why-psychiatry-is-upset-about-its-failures-and-critics/, citing: Lawrence Kelmenson, MD, “You’ve Got to Be Crazy to Go to a Psychiatrist,” Mad in America, 1 Oct. 2020, https://www.madinamerica.com/2020/10/crazy-go-psychiatrist/

[24] Op. cit., Awais Aftab, MD, Psychiatric Times, 3 June 2021