A Prescription For Murder?

I’ve just returned from holiday today and I found an e mail informing me that a star of this blog, Dr David Healy, appeared on a ‘Panorama’ programme, ‘A Prescription For Murder’, a few days ago. Naturally I watched the programme on catch-up.

Healy was doing pretty much what I thought that he would be doing – he was appearing in the guise of an ‘expert’, proffering his opinion that the consumption of a prescribed SSRI had caused someone to commit mass murder. The case featured in the programme was that of James Holmes, the PhD student from the University of Colorado who gunned down a load of people in a cinema a few years ago during a screening of a ‘Batman’ film. Healy went over to meet Holmes in prison after the murders and was happy to inform ‘Panorama’ that he definitely attributed Holmes’s killing spree to his use of the SSRI sertraline. Healy was not called to give evidence at Holmes’s trial – it was not explained why not – and Holmes’s plea of insanity was rejected by the jury. Holmes is now serving a sentence of thousands of years, one of those sentences that are sometimes handed down by American courts although everybody is well aware that no-one would ever live long enough to serve the sentence. A number of other ‘experts’ were featured on the programme as well. One was a psychiatrist who maintained that Holmes committed the murders because he was mentally ill and that his crimes were completely unrelated to sertraline, another pursued an argument that Holmes’s use of sertraline had disinhibited him sufficiently to commit the crimes and a Prof Peter Tyrer took the same line as Healy, ie. that sertraline was definitely responsible for causing Holmes to commit the murders. Holmes himself stated that he believed that sertraline caused him to commit the crimes.

Much of the programme was spent discussing Holmes’s alleged mental state, both before he got anywhere near murdering anyone and then in the weeks and days leading up to the murders. We heard much about his ‘social anxiety’ (presumably this meant that he was shy) his failure to embark upon a relationship with a woman until a relatively late age (he wasn’t 80 though, he must have been in his early or mid 20s) and his pursuit of a PhD in neuroscience because he knew that he was a bit messed up. Upon taking sertraline, he dyed his hair red, took some selfies whilst wearing coloured contact lenses and then began keeping notes which allegedly detailed his disintegrating psyche until the day that he gunned a load of people down. None of this was really very convincing. Scores of young men are shy and many people do not enter into sexual relationships until their twenties. Dying one’s hair really is not a sign of being unhinged (I had pink hair for a few years and I was always interested to note how many people told me that it was because I was bipolar – no, it was because I really liked having pink hair) and neither is wearing coloured contact lenses or taking selfies whilst gurning. As for doing a PhD in neuroscience – yes, it is very obvious that a lot of people who enter what Nikolas Rose calls the psy disciplines seem to do so in the hope of tackling their own problems (one look around the School of Psychology at Bangor University or indeed the Hergest Unit where Healy himself works will confirm that), but doing a PhD in neuroscience will have meant that James Holmes almost certainly had been exposed to the work of Healy and co who maintain that SSRIs can precipitate aggressive outbursts. So James Holmes might have been a young man with problems who then lost it completely after taking sertraline – or he might possibly have been someone who for reasons best known to himself was planning a massacre and thought that if he kept detailed notes documenting his own deteriorating mental state for a few weeks, notes that were consistent with the ideas of people who believe that SSRIs can cause violent outbursts, he might escape jail on a plea of insanity, especially if he could wheel out someone like David Healy as an expert witness. Healy’s views on SSRIs are well-known and he has held them for a very long time – a neuroscience PhD student would have to be a pretty poor student not to know about them.

The evidence presented on ‘Panorama’ was in no way sufficient to convince a viewer of anything really – Holmes might have been mentally ill or he might not; he might have reacted badly to sertraline or the changes in his mental state – if indeed there were any changes – might have been precipitated by something else. He might have suddenly developed a desire to make copious notes charting his mental state or this might have been a calculated action designed to enable him to produce those notes as ‘proof’ in the aftermath of a crime that he was planning. I am not aware that anyone has yet shown a statistical relationship between dying one’s hair, wearing contact lenses, taking selfies and murder.

So what we have to rely on here is the expertise and integrity of the experts – Healy and Tyrer. Can Healy and Tyrer’s expertise and integrity be relied upon?

My post ‘The Biggest Expert Of The Lot’ (as well as other associated posts) gives an account of some of the rampant research fraud and bad practice that I witnessed at the Hergest Unit in the early and mid-1990s when Healy et al claimed to be participating in cutting edge research. Healy’s blog makes reference to Nobel prize winners no less visiting the Hergest Unit. Er no, I never saw a Nobel prize winner there. I saw a bunch of utterly unscrupulous psychiatrists and their colleagues who were neglecting and abusing patients and some of those people were colluding with and even facilitating a paedophile ring that was known to be operating through the social services dept that employed some of that lot attending the ‘research seminars’. There was one high profile cutting edge researcher who did visit the Hergest Unit and that was Marius Romme, the psychiatrist who pioneered work on hearing voices. Marius Romme was working with Dr Phil Thomas who left the Hergest Unit a few years later.

Phil Thomas is the only member of staff who worked at the Hergest Unit at that time whose name does not appear on the documents now in my possession demonstrating that staff at the Hergest Unit were going to great lengths to have me prosecuted for crimes that they knew that I had not committed or declared dangerous and banged up without trial. The names of everybody else appears on those documents at some point – including Healy. Healy’s contribution was to order the staff to call the police and have me arrested if I approached the Hergest Unit for assistance. Healy was not my consultant and I did not know about the existence of this document until my lawyers retrieved it a few years later. Last year I e mailed dear old Healy via his blog to ask him to explain his actions, but I did not receive a reply. I know of another Hergest patient who was arrested on the orders of David Healy after this patient rang the Unit and told a nurse that he was so suicidal that he felt like chopping a gas pipe. He was taken to Walton Prison where he spent some weeks although he was never found guilty of any offence. David the radical!

During the ‘Panorama’ programme, Healy admitted that he sometimes prescribes SSRIs. However he stressed that if one sees unfortunate side-effects developing, one should stop increasing the dose immediately. The Hergest patient whom Healy had arrested for feeling like chopping a gas pipe was some years ago on SSRIs. Now this man believes, like Healy, that SSRIs CAN precipitate violence and aggression. He believes this because whilst he was in the Hergest Unit, after being prescribed SSRIs, he felt a level of aggression that he had never previously experienced and he threw a wardrobe across the room. He told his consultant psychiatrist – one of Healy’s colleagues – who told him not to be so ridiculous, of course it was nothing to do with the SSRIs. That particular consultant had attended all those research seminars with the putative Nobel prize winners. The same patient was prescribed SSRIs again a few years later. The prescribing psychiatrist continually increased the dose until the patient became so worried that he sought out information about the therapeutic levels of the SSRI concerned. He had been prescribed three times the maximum therapeutic dose. The prescribing psychiatrist was Richard Tranter, Healy’s friend and protégé, who like Healy is an ‘expert’ in psychopharmacology. But then Tranter prescribed me a combination of drugs some six years ago that was neurotoxic. I didn’t take them which made Tranter very cross but it probably kept me alive. A prescription for murder anyone?

Of course, Healy cannot be held responsible for the actions of his colleagues – although some of those actions of some of those colleagues have involved such serious negligence, malpractice and criminality that if Healy was anything like the public image that he trades on he’d have shopped them to the GMC or even the police by now. However, although Healy cheerily jets off around the world to dispense his words of wisdom to patients having problems with SSRIs when they have been prescribed by people unconnected with his colleagues, I’m wondering if he takes a rather different view if the problems erupt closer to home.

Some years ago I lived on a hill farm in Snowdonia with a farming family who had let out a caravan to a rather quiet man who told us all that he was involved in psychological research, although he didn’t seem to be attached to any university. The grandson of the farming family had a pet sheepdog, Rex. One day with no warning at all, the man in the caravan walked over to Rex with a carving knife and stabbed him to death. The farmer’s wife was the only person at home and was terrified, locked herself in the house, rang her husband and then me. By the time that we had all got back to the farm the man who killed Rex had been arrested by the police and was in custody. Later that night the police sent a message to the farmers saying that the Arfon Community Mental Health Team – the team attached to the Hergest Unit where Healy works – had ‘assessed’ the killer of Rex and had deemed him not to be mentally ill. So he had appeared in court and had been bailed – but he had fled the area because some animal rights activists were after his blood. Over the following few days we found out that he was actually a psychiatric nurse himself who had left his post after becoming ill and had been prescribed SSRIs by a GP in Caernarfon. A few weeks later he pleaded guilty to killing Rex and received a suspended sentence – he had left the area completely by then.

Some two years later I read an article in I think the ‘Guardian’ – it was by him. He explained in the article that he believed that it was the SSRIs that had caused him to kill Rex and he had set up a website discussing the danger that he believed SSRIs posed. I visited the website and I noticed that the man concerned had consulted ‘a world expert’ on SSRIs, one David Healy. But Healy had told him that he really couldn’t be certain whether it was the SSRIs that had caused him to kill Rex. The other thing that was mentioned on the website was that the Arfon Community Mental Health Team had broken the law when conducting their ‘assessment’. (This will surprise no-one with knowledge of the Arfon Community Mental Health Team.) This man knew this because he was a mental health nurse himself and he knew the appropriate procedures for assessing someone in those circumstances. Judging from that website, I don’t think that the man who killed Rex realised that his world famous expert was a colleague of the Arfon Team. But I bet Healy noticed that they’d broken the law when he reviewed the case. (Healy certainly knew all about the misconduct of the Arfon Team – they were of course some of the people attending the research seminars where Nobel prize winners did not make an appearance.)

So when Healy was confronted with the wrongdoing of his colleagues, as ever he remained silent – and he also concluded that the prescription of SSRIs had not caused the tragedy. If Rex and his killer had been living in America would Healy’s conclusions have been different perhaps?

During the ‘Panorama’ programme, they gave a plug for a previous ‘Panorama’ investigation into SSRIs – which again relied upon the expert opinion of David Healy. That was in 2002. Rex was killed in 2002. David Healy ordered staff to have me arrested rather than agree to treat me in 2002. In 2002 so many people were committing suicide in north west Wales that it showed up as a statistical outlier in UK figures. In 2002, despite Healy’s best intentions, I was eventually admitted to the Hergest Unit with depression. Whilst I was there I was assaulted by the staff and told by Healy’s colleague Dr Tony Roberts that I didn’t have a mood disorder, I had a ‘personality disorder’. I was discharged and refused further treatment – and was arrested for ‘threatening to kill’ a manager, when what I had actually done was tell his secretary, on the phone, that he was a fat idiot. The case circulated around the Courts for two years whilst numerous staff at the Hergest Unit perjured themselves (see post ‘Interesting Happenings In The Legal System’). I was eventually convicted of calling the manager a fat idiot. There was never an investigation into my assault at the hands of Hergest staff or the perjury. Last year I found out that after the case a certificate of indictment had been forged stating that I’d been convicted of ‘violent disorder’ (see post ‘An Update On Those Legal Conundrums’). I am still waiting for the legal dept of the North Wales Police to sort it out. In the wake of the abuse and neglect that I was subjected to at the hands of the Hergest Unit, I complained to the GMC about Dr Tony Roberts. Last year I discovered that the GMC were in possession of a forged document which they had used to ‘investigate’ my complaint against Roberts and subsequently clear him (see post ‘The General Medical Council And Yet Another Forged Document’). I complained about another Hergest psychiatrist at the same time, a man who was my former neighbour so should never have been involved in my case and whom I knew to be suffering from a mental illness himself and to be violently assaulting his wife. I was branded as making ‘outrageous allegations’ and no action was taken against this doctor. He was later removed from the Medical Register after beating up his wife so badly that she was sectioned as a result of her own distress and his children were taken into care as a result of severe neglect.

So that’s what was happening on David’s doorstep in 2002 as he appeared on ‘Panorama’ as their expert. In 2002 people in north west Wales were openly talking about the chaos and neglect at the Hergest Unit and the hatred between the consultants there. GPs had started doing just about anything to avoid referring patients to the Unit and were privately conceding that the Unit was unsafe. One long-serving consultant, Dr Tony Francis (‘Dr X’) had recently taken early retirement after open warfare with his colleagues. The documents now in my possession show that this man was concealing the paedophile ring that had been in operation in the region. Francis killed himself some three years ago, as Operation Pallial re-opened the investigation into the north Wales paedophile ring. I was told just before I went on holiday that Tony Francis had actually been under suspicion of having been involved in the child abuse ring himself.

Healy’s CV describes him as having been the leading consultant in the north west Wales mental health service for many years and having been responsible for the ‘development’ and ‘training’ in that service. So the carnage on the ground is presumably down to Healy and his ‘leadership’. Healy believes in the concept of a ‘fall guy’. In the case of the Hergest Unit it should most definitely be him.

It’s not much to boast about really is it David. Many years ago David Healy won a notorious case against a drug company after they withdrew a job offer. Healy was alleged to have won a substantial settlement. I cannot help but think that if the drug company concerned had known what Healy and his colleagues were doing at the time, they would ask for their money back.

What of the other ‘expert’ featured on ‘Panorama’, Prof Peter Tyrer? Tyrer agreed with Healy – sertraline caused James Holmes to commit mass murder. Most of Tyrer’s work seems to be concerned with improving the classification of personality disorders (I think the biggest improvement would be to stop using such an asinine term) and to bring about a halt to stigmatising patients with such diagnoses and to achieve better therapeutic outcomes for them. Which is the polar opposite of what has gone on at the Hergest Unit for years – that Unit has become notorious for declaring patients to have ‘borderline personality disorders’ after they have dared make a complaint about the abuse that pervades the place and then refusing to treat them. A number of patients have been literally left to commit suicide under these circumstances.

So who is Tyrer? He is the Professor of Community Psychiatry at the Centre for Mental Health at Imperial College. For info about malpractice, research fraud and general skulduggery at Imperial, see post ‘A Cause Close To Our Hearts’. Tyrer was appointed to that post in 1991, but I cannot find any references to his biography before that, so whether he has passed through those hallowed portals of corruption St Georges Hospital Medical School and the Maudsley I do not know. Imperial’s website also tells us that the Centre for Mental Health is associated with the Central and North West London NHS Foundation Trust. The Chief Exec of that Trust is one Claire Murdoch – who is also NHS England’s ‘Mental Health Chief’ and Director of the Imperial College Academic Health Science Partnership, which currently has a ‘partnership’ with the drug company GSK (see post ‘News Update And A Few More Accessories’). That’s the GSK that manufactures the SSRI paroxetine that was the target of the 2002 ‘Panorama’ programme with David Healy. This week’s ‘Panorama’ programme stressed that Pfizer had omitted certain crucial case histories from the information that they released about sertraline. Well ‘Panorama’ seems to have omitted quite a lot of crucial info pertaining to Healy and his colleagues as well as to Tyrer’s links. ‘Panorama’ can’t plead ignorance re north Wales psychiatry either – I offered them a story and documentary evidence about the wrongdoing of the mental health services in north Wales about six years ago. I wondered if their failure to take up what would have been a far more devastating expose than even Winterbourne View was related to the media silence that surrounds anything to do with the North Wales Child Abuse Scandal (see post ‘Did Glenda Occupy A Key Role In Keeping It All Out Of The Media?’), but I wonder if it was because they’d given Healy so much free publicity that they didn’t dare run a story on what was happening in his own Unit? The Betsi Cadwaladr Health Board, which runs the Hergest Unit and employs Healy, is currently in special measures and is the subject of two external investigations into the institutional abuse of mental health patients.

Never mind ‘Panorama’ – all the info is going up on this blog, free to good homes. Including that drug company that Healy sued all those years ago…

 

 

More Experts and Their Expertise

My blog post ‘Experts In Suicide Prevention??’ describes a conundrum that exists in north Wales – a history of people based in the mental health services up here who claim expertise in ‘suicide prevention’ yet who have worked for many years in a region with an astronomical suicide rate (and in a very dysfunctional mental health service). Yet the expertise claimed in suicide prevention is not the only glaring inconsistency evident in the mental health services in north Wales.

My attention was first drawn to some possible very questionable claims of ‘expertise’ and associated ‘research’ many years ago in the Hergest Unit. (Please see blog post ‘The Hergest Unit’ for an account of the many problems at the Hergest Unit.) Back in the early/mid 1990s, every week in the ‘seminar room’ at the Hergest Unit an interesting performance took place. The psychiatrists and some of the associated staff would congregate for ‘seminars’ and ‘journal club’, at which they claimed to be sharing their research expertise with each other. Now unlike most people who were patients in the north Wales mental health system at that time, I had previously been involved in biomedical research, so I knew what researchers and research seminars looked like. And they didn’t look like this. Yes, the ‘seminars’ and ‘journal club’ held at the Hergest Unit were sponsored by pharmaceutical companies, so everyone had a free nosh, but there weren’t many serious researchers in evidence. But there was a motley crew of neglectful and abusive practitioners – even Dr Dafydd Alun Jones occasionally turned up for a free lunch (literally). As far as I could see, there were only two members of staff from the Hergest Unit who were regulars at those seminars who were genuinely involved in research and that was Dr David Healy and another psychiatrist who left the Hergest Unit soon after this, Dr Phil Thomas. Yet the Hergest Unit at that time used to enthusiastically claim that it was a buzzing hive of research activity – into eg. mindfulness, SAD (seasonal affective disorder), drug interactions and various psychological therapies.

I remember the Hergest Unit’s foray into Seasonal Affective Disorder. There was interest in whether exposure to a certain type of artificial light provided to the patient by them sitting in front of a ‘lightbox’ for a certain period of time daily would lift some types of depression. I understand that someone had theorised that there were certain villages in north Wales that were built in the shadow of mountains and received relatively small quantities of daylight and that this was a possible explanation for rates of depression in those villages. A lightbox appeared in a side room in the Hergest Unit and very soon scores of patients – including me – were asked if we’d like to try out the lightbox. So we did. But no-one told us how long we should expose ourselves to the lightbox for or how regularly we should do it. (I also suspect that for the lightbox to have had any effect if the theory was correct, that patients would have had to sit in a particular orientation to the lightbox to ensure that they were properly exposed to the light.) We just used to wander into the room and sit in front of the lightbox for a bit. And then our friends would come and join us as well, because they wanted to talk to us. So a common scene was an assortment of people, all with different diagnoses, sitting around the lightbox having a chat and indeed a fag. Maybe there were randomised clinical trials done with the lightbox – but I never encountered them and I didn’t know any patients who were ever party to any results/advice gained from such trials. Yet an article appeared in a local paper reporting on the pioneering work being done at the Hergest Unit with the lightbox – it named a certain junior doctor as leading the research. The next week in the newspaper an apology appeared with a correction – explaining that the junior doctor named wasn’t actually leading the research. So presumably someone more senior had had a hissy fit and sat on him. After a few months the lightbox was removed and never reappeared and we heard no more about the research.

However farcical the lightbox was, it was at least harmless and was useful in that it provided a focal point enabling the patients to gather and socialise. As the Hergest Unit later descended into utter madness, I started hearing tales of another form of expertise there that seemed to be doing some people quite a lot of damage. By the late 1990s, it was clear that the Hergest Unit was unravelling – staff were in conflict with each other, good staff were leaving, facilities and services were being successively withdrawn, complaints were soaring and patients were dying. At about this time it became noticeable that an awful lot of patients were being diagnosed with ‘borderline personality disorder’, although they had often received different diagnoses previously (and usually received yet different diagnoses again if they subsequently sought help outside of north Wales). I was having less contact with the mental health services by then, but I still stayed in regular contact with many patients and continued to hear some very worrying anecdotes.

Time and again, patients told me that they had been diagnosed with ‘borderline personality disorder’ and were having ‘DBT’. The DBT in question referred to Dialectical Behaviour Therapy, a type of therapy developed in America by Marsha Linehan, specifically for borderline personality disorder. DBT is a consistent, intense, highly structured therapy with very specific conditions and parameters, which also involves a degree of telephone support from the therapist. (As the popularity of, and interest in, DBT exploded, Linehan herself expressed concern regarding practitioners who claimed to be carrying out DBT when they were not and was frank that this would be ineffective or even harmful.) From what I was being told, it seemed that not only were the patients who claimed to receiving DBT not benefiting from it, but I doubted very much whether they were in fact getting DBT – the mental health services in Gwynedd by this time were such a shambles that they would have been incapable of providing the sort of support that DBT involves. Some patients moved out of the region to access mental health treatment – others continued to self-harm and even die. Things had very obviously become very grim in the mental health services. Then one day whilst I was doing my PhD, imagine my surprise when I was searching through some journal articles and I found an article written by a clinical psychologist (whom I knew) from Bangor who was involved in treating Hergest Unit patients – this article was reporting on a trial of ‘adapted DBT’ carried out with patients in Gwynedd. And according to this article, the trial was a roaring success. As with the lightbox, I was never able to locate anyone who had benefited from such a trial or from the dissemination of knowledge from such a trial – all I knew of by that time were many highly distressed patients, many of whom had complained, some who had died and a mental health service in meltdown.

I was able to gather more information regarding the ‘DBT’ being carried out around Bangor in the following years. I knew of one Hergest Unit patient who was told that they were going to be given DBT – so they ordered a book by Marsha Linehan on DBT because they hoped that it would help them engage with the therapy. I was later told that ‘I read the book and what they were doing was nothing like DBT’. Soon after this, I was told an even more worrying story from yet someone else who was told that they were going to be receiving DBT, this time from ‘therapist’ Maggie Fookes, a member of the notoriously dreadful Arfon Community Mental Health Team (please see my blog post ‘The Arfon Community Mental Health Team’), who were later alleged to have been removed from their posts after neglecting patients. The young woman who told me this story had a serious problem with Maggie Fookes, because she claimed that Fookes was obsessed with the notion that the young woman had been sexually abused, which the young woman absolutely maintained was not true (this was not the first time that I had heard about this problem from people on the receiving end of the mental health services in Gwynedd). It seems that the ‘therapy sessions’ involved Maggie Fookes repeatedly confronting her, stating that she had to ‘disclose’ ‘what had happened’. I was told that the grand finale culminated in a therapy session that involved Fookes locking the door of the therapy room and screaming at the young woman ‘I know that something happened, tell me what it was’. Whatever was going on, it certainly didn’t sound like DBT. (This young woman was one of many who eventually left north Wales in order to access competent mental health services.)

Interestingly enough, I know of a practitioner in north Wales who was interested in being trained in DBT. They went to the initial meeting for interested people – and found that Maggie Fookes was going to be the leading light in this group. They did not go to any more meetings because they told me that with Fookes involved, they felt that this was probably going to result in a horror.

The irony is that among all this grandiose huffing and puffing at the time about the ‘expertise’ present in the mental health services in Gwynedd, there was one person in the Hergest Unit who really did know her stuff, in this case in the field of CBT (this was before CBT was promoted as a cure-all by policymakers). That was the nurse who used to run the very popular day centre at the Hergest Unit. She had done her training at a hospital in England that had led the way in psychotherapy and she had received a first rate training in CBT and was enormously helpful to many patients. I never ever heard any of the self-appointed ‘experts’ in the Hergest Unit even mention her expertise in CBT, although one senior nurse (who was later part of the exodus from the Hergest Unit as it went downhill) one day said to me that ‘no-one realises how good she is’. The day centre that she ran was closed down….

There will be further blog posts soon with more information regarding the ‘research’ and ‘psychological therapies’ in the north Wales mental health services…