Madam, - I was very surprised to read the letter in your newspaper from six professors of psychiatry calling for the resignation of Tim O'Malley, Minister of State in the Department of Health and Children, with special responsibility for mental health (Nov 16th).
On whose behalf do these psychiatrists speak? It is clear from the letters in your pages in recent days that there are psychiatrists in Ireland who do not share their view. Prior to their joint decision to raise the issue of the Minister's "position", did these six psychiatrists consult with the most important relevant group of all - the users of the mental health services, and service user groups? If not, why not? Are they not worth consulting? Are they not entitled to a voice?
Internationally, there is indeed a debate going on as to whether mental health problems should be seen as purely or indeed primarily medical conditions. Rather than castigate the Minister for mentioning this reality, perhaps these six psychiatrists might consider entering a public debate on the matter.
Medication certainly is an important part of the response to mental health problems. The fact remains that the presumed biological nature of mental health problems remains an unproven hypothesis.
I would hope that these six psychiatrists would be open to reasoned, rational debate on the matter.
Tim O'Malley has been an excellent Minister with responsibility for mental health.
I look forward to a public response from these psychiatrists regarding a public debate on mental illness as outlined above. - Yours, etc,
Dr TERRY LYNCH, Member, Expert Group on Mental Health Policy 2003-6, Member, Independent Monitoring Group for A Vision for Change 2006-8, Member, HSE Expert Advisory Group on Mental Health 2006, Ballykeeffe, Limerick.
Madam, - In recent days, concerns relating to statements made by the Minister of State for Mental Health, Tim O'Malley, have been expressed in your newspaper, including a call by eminent professionals for the Minister to consider his position. Throughout this, there has not been one squeak from any politician.
Is mental health really such a political backwater? - Yours, etc,
DAVID JOYCE, Seabury Parade, Malahide, Co Dublin.
Madam, - I agree with Breda O'Brien (Nov 11th) when she says that "a debate is needed on mental health". Hopefully, we will have an informed debate. Ms O'Brien would appear to have some way to go along that road.
Minister of State Tim O'Malley is to be praised rather than excoriated for his welcome comments. Rather than being "downright irresponsible", it is Ms O'Brien who appears to be downright dogmatic in her solid conviction of the efficacy of medication. Such dogmatism sits comfortably with Dr Patricia Casey and her five fellows (Nov 16th), a dangerous dogmatism that has resulted in the human rights abuses of forced injections, compulsory treatment orders and involuntary detention.
Is Ms O'Brien aware of what are euphemistically called the "side-effects" of medication? Has she heard of tardive dyskinesia or tardive akathesia? How does she think an already depressed young man feels when experiencing impotence as a "side-effect"? Is it just coincidence that the profits of the drug industry today are second only to the arms industry? If Dr Casey and her five fellows are concerned about "vested interests" they don't have to look too far themselves.
And rather than sarcastically dismissing Mr O'Malley as reckoning "that all that is required is a buddy", it would be welcome to see the professionals, as well as Ms O'Brien, appreciating the Minister's comments for what they are, namely that there is far more to dealing with emotional distress than just medication. An enlightened debate should not be beyond looking at realistic and viable alternatives, which, as we all agree, requires Mr O'Malley to put the Government's money where his mouth is. - Yours, etc,
JIM MADDOCK, MindFreedom Ireland, Manor Close, Rochestown, Cork.
Madam, - I read with great distress the letter of response from the team of six professors of psychiatry led by Prof Patricia Casey concerning the article "Minister's view on mental illness" by Breda O'Brien (Nov 11th).
Their letter highlights the attitude within psychiatry of "my way or no way". Those psychiatrists are definitely not open to debate.
How can patients be "restigmatised" by the Minister's comments, as they claim, when the stigma is within the labels of sickness that psychiatry chooses to pin on people who are in severe distress in their lives?
I would like this team of professors to show me the neuro-imaging of depression, to let me know the exact normal levels of serotonin in a human brain, and the exact gene involved in depression, please. - Yours, etc,
NURIA O'MAHONY, Holistic Action Group, Bandon, Co Cork.
Madam, - The knee-jerk response of six senior psychiatrists (Letters, Nov 16th) to Minister of State Tim O'Malley's questioning of the medicalisation of mental health problems is disappointing though not surprising. This group claims that the Minister has "restigmatised" thousands of Irish people with mental health problems but fails to justify how this is the case. Stating that depressed people may not be "ill" or "sick" but may simply be going through difficult times for which they have inadequate support seems, to me, an attempt to normalise, rather than stigmatise.
The placement of psychological distress in a biomedical framework within psychiatry is unsurprising considering the ways in which seniority is determined in the field. The decisions to appoint consultant posts, professorships and department heads depend hugely on the research success of the candidates - that is, their number of publications and the amount of research funding they have obtained. Drug companies are the largest funders of psychiatric research, with the result that there is a massively disproportionate focus on the medicalisation of psychological distress and on attempts to find biochemical, rather than psychosocial, interventions. Those who believe, with good reason, that psychosocial interventions would be better for their clients tend not to have the golden stamp "supported by an unrestricted educational grant from [insert drug company name here]" on their research papers.
The statement by the psychiatrists that the Minister should consider his position for shining a torch on a massive debate within the field of mental health is a scandalous attempt to silence debate. Their letter reflects authoritarian and dogmatic mindsets - appalling characteristics for psychiatrists. The claim that the Minister's words reveal "vested interests" is laughable. What are they suggesting, that he has shares in a psychotherapy firm? It is those who work with drug companies that must be questioned about vested interests. Nobody receives free trips to exotic destinations from social work companies. - Yours, etc,
PATRICK O'MAHONY , Camberwell, London.