Some weeks ago, in Antidepressants and Premature Death RxISK featured an article by Narinder Balsal and colleagues from Bristol in the British Journal of Psychiatry, which caused quite a fuss. See below.
Today we are posting about another article by her in PLoS Medicine. This comes with an Animated Trailer – the first RxISK post to feature one.
The article – Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography – is the first meta-ethnography RxISK has featured.
It takes several days to read it fully and even longer to digest it. The Animated version comes in very handy as a guide to what is going on. Several distinguished folk have commented that it is one of the most important articles ever, especially on the topic of race. Important because it gives all the research done on this issue and important because of the position it takes.
Race is where Harry and Meghan come in – link included in case you’ve never heard of them. When they ran into difficulties, Harry apparently faced his father and brother telling him that all the women who came into the family had difficulties, so just suck it up.
To which Harry replied that this was different because of the Race Factor. Was it? Is it? Entering any new family can be difficult and there can be a temptation to re-read these difficulties in terms of race, or something else, rather than confront a difficulty common to all of us across cultures.
Race is Different
Race impacts on both health and mental health. The vaccine posts are full of Race. The Ventavia operation, that Brook Jackson reported on, along with other trial centres competed to be involved in the Pfizer vaccine trial on the basis of an ability to recruit people from diverse backgrounds – non-whites.
Buenos Aires was a godsend to any trial attempting to meet diversity quotas – offering as it did so many Latinos and non-whites.
There is nothing enlightened about this. It is a naked attempt to get more medicines into more people.
Some of the black heads of black universities and medical schools came under pressure to get their alumni to follow their example and get vaccinated. There was a great response to this and government efforts in general from Tuskegee – you want us to Trust You, show us you are Trustworthy.
The Table below shows that Whites overwhelmingly are the takers of psychotropic drugs in America. The same is true for other drugs.
As Joseph Davis outlines in Chemically Imbalanced, Black, Asian and Hispanic communities are still more likely to try to support troubled teens or the rest of us from within their own communities rather than have them turn to pills.
As the debate usually goes, Black communities in particular are being deprived of healthcare and lacking health insurance they certainly are.
The other angle is they still stigmatize mental illness and new Black, Brown and Asian doctors are persuaded to help lift the stigma of mental illness in their communities and get folk taking meds.
This is the bad side to things but there is a good side.
It means Black, Hispanic and Asian communities are probably enjoying growing life expectancies compared to Whites whose life expectancies and replacement rates are falling. Those who figure there is a Great Replacement going on perhaps have something to learn from Black, Asian and Hispanic communities.
Having made this point, if you look more closely at the image above, you will see that while Black communities take less meds than White, there is greater use of antipsychotics than found among Whites.
This is particularly true when it comes to depot antipsychotics. Some of this will be linked to the use of drugs in foster care but it seems highly likely that, in many cases and overall, this is simply linked to being black and male. See Being Black.
Taking a depot antipsychotic in low dose voluntarily can be helpful but involuntarily and in even slightly higher doses, the experience is more likely to be torture – bad enough to lead to suicide. Antipsychotic drugs are among the drug most likely to cause suicide if not used with care – see Drugs Causing Suicide.
Black communities have had strikingly low suicide rates compared to Whites in the US – until recently. There is a growing rate of suicides among Black children and teenagers and young men that has been causing concern – Ring the Alarm – what is going on?
Is Race Different?
Nobody from another group, women, LGBTQ or whatever, is likely to have to experience anything quite like what happened the man in Being Black – at least not on a routine basis.
The solution offered in Being Black doesn’t work for Black folk either – perhaps because it was too individual. If 50 people – a community – organised to do something like this would it be different?
The image here is of Afghan women. It brings out a community dimension – but one that at least at the moment hasn’t worked. If you are up against power, its going to be a fight.
The image also brings out a hypocrisy. A Western Taliban are forcing people out of jobs, and splitting families with vaccine mandates and a resolute unwillingness to face up to the harms their drugs are causing, yet at the same time they sanctimoniously give out about abuses of power elsewhere. Lots of unvaccinated folk (men at least) would still be in jobs now if working in Afghanistan rather than North America.
Young Black Men on Depot Antipsychotics are the ECT of our day – a visible symbol of a police power that we can see is wrong.
But White Women on Antidepressants is the greater reality at least in terms of an exercise of soft power that is leading to far more deaths and injuries and a comparable inability to get redress or be listened to.
Common to both is the ability of power to silence us – wherever there is Silence, there is oppression. This will not be solved by victims – it needs communities.
One of the best examples of a community forming in response to being silenced lies with the efforts of REACT19.org, Bri Dressen, Suzanna Newell with Team Humanity, and Jennifer Sharp (image below) with her movie Anecdotals.
The message of Shipwreck is that beyond race, sex, and gender, the people who are most comprehensively silenced are those who are injured by therapies. They are silenced even more than those who are victims of child abuse.
Narinder in response would likely point out that Race is the one place where there are laws and obligations that we can turn to in our efforts to make a difference. The problem here though is those with the deepest pockets can make the law work for them – unless we understand what we are up against and can handle Forked Tongues.
The opening paragraph mentioned controversay about Narinder’s earlier article about antidepressants
The pharmaceutical industry may even have intervened. The best reason to think they didn’t was because they rarely do – they get medical proxies to fight their wars for them.
An article appeared by Chittaranjan Andrade on all the flaws in Narinder’s study. It was published in an online section of the J of Clinical Psychiatry – a journal that publishes a lot of ghostwritten industry studies that lack access to the study data. We would post Dr Andrade’s article here except blazoned all over it is a message that it is illegal to post this copyrighted article and curiously it seems impossible even to copy chunks of text.
This appears to be a Link to the Andrade article. It talks about depression rather than antidepressants causing cardiac problems.
A blackly amusing example of this tactic was Lilly claiming Schizophrenia and not Zyprexa causes Diabetes. This was a wonderful test of whether most doctors, women and men, white and black, gay and straight, would go along with something so utterly farfetched. Lilly knew what they were doing and its what we are up against.
For a link to data on this issue – see Khan et al.
RxISK acknowledges that the experiences of those who have been harmed by medical treatments are the cornerstone on which it is built, and believes this should be the case for all of medicine.
See Black Robe, White Coat for more detail on this people acknowledgement