Tuesday, May 17, 2022

Floundering Failure of Those Urging Neural Solutions to Mental Illness

About a week ago the Los Angeles Times had an interview with mental health expert Andrew Scull, one in which Scull calls attention to the huge failure of those trying to treat mental illness mainly through neural solutions such as alterations of brain chemistry.  Scull claims that the director of the National Institute of Mental Health from 2002 to 2015 produced "uniformly dismal results." He cites a Wired interview in which that person (Tom Insel) made this confession: "I spent 13 years at NIMH really pushing on the neuroscience and genetics of mental disorders, and when I look back on that I realize that while I think I succeeded at getting lots of really cool papers published by cool scientists at fairly large costs---I think $20 billion---I don’t think we moved the needle in reducing suicide, reducing hospitalizations, improving recovery for the tens of millions of people who have mental illness.” 

In that interview we read about how Insel is interested in monitoring people's online speech, to try to pick up signs of mental illness. We read this:

"One of the first tests of the concept will be a study of how 600 people use their mobile phones, attempting to correlate keyboard use patterns with outcomes like depression, psychosis, or mania. 'The complication is developing the behavioral features that are actionable and informative,' Insel says. 'Looking at speed, looking at latency or keystrokes, looking at error---all of those kinds of things could prove to be interesting.' "

So will Big Brother soon be monitoring your online speech, ready to report you to some mental-health monitoring authority if you are writing something that violates fluctuating norms of correct speech? That sounds very Orwellian. 

In the LA Times interview, Scull blasts the mental health approach based on genetics and neural chemistry. Scull states the following: 

"People with serious mental illness live, on average, 15 to 25 years less than the rest of us, and that gap seems to be widening, not narrowing. While genetics and neuroscience have flourished within the confines of universities, their therapeutic payoff has been minimal or nonexistent.  I’m a sociologist, so you may think I’m biased. Perhaps I am, but in my judgment, Insel’s fixation on biology and biology alone has been a profound error. It threatens to undermine the prospects for progress in the mental health arena.  Unfortunately, it is the same approach that seems to dominate the thinking and priorities of his successor at NIMH [the National Institute of Mental Health], Joshua Gordon. Gordon is a neuroscientist whose own work, focused on neural activity in mice, and his appointment indicates that the federal research enterprise will double down on neuroscience and genetics."

Scull describes some of the mistreatment of the mentally ill that occurred in the twentieth century by people convinced that mental illnesses were almost entirely matters of genetics and the brain:

"Compulsory sterilization; removal of teeth, tonsils and internal organs to eliminate the infections that were allegedly poisoning their brains; inducing life-threatening comas with injections of insulin; subjecting them to multiple episodes of electroshock treatments day after day till they were dazed, incontinent, and unable to walk or feed themselves; damaging the frontal lobes of the brain, either with an instrument resembling a butter-knife or by using a hammer to insert an icepick through the eye socket and sever brain tissue: these were unambiguously, horrendous interventions."

Great progress may be made in treating the mentally ill when we stop thinking of human beings as brains and bags of genes, and start thinking of human beings as souls and products of society, who can be helped mainly with social, educational, psychological, charitable and spiritual aid. 

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