Beginning in August 2019, every month, PsychWatch Australia will be announcing a 'Disease-Monger of the Month' Award. If the last decade of rampant, psychiatric, disease-mongering in Australia and internationally is any indication, competition will be fierce. The award is open to anybody, including mental health practitioners, researchers, politicians, and the media. Nominations, detailing the alleged disease-mongering are now open and can be emailed to psychwatchaustralia@gmail.com
What is disease-mongering?
Australian health researcher/writer, Dr Ray Moynihan, defined disease-mongering as “the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments”. According to Moynihan, examples include “pharmaceutical industry–funded disease-awareness campaigns—more often designed to sell drugs than to illuminate or to inform or educate about the prevention of illness or the maintenance of health”.[1]
The term “disease-monger” was first used in 1992 by health writer Lynn Payer, the author of Disease-Mongers: How Doctors, Drug Companies, and insurers Are making You Feel Sick.[2]
Inspired by the work of Payer and Moynihan, for the purposes of this award, PsychWatch Australia defines psychiatric disease-mongering a
Identifying what was previously considered within the range of normal human experiences as abnormal, and in need of treatment.
Defining a psychiatric disorder broadly so that the number of people who qualify for a diagnosis is maximised.
Claiming that a psychiatric disorder is caused by a biological factor (e.g. genetic biochemical factor) when there is no means of confirming that.
Conducting a psychiatric disorder ‘awareness campaign’ for conditions with uncertain causes, loosely defined symptoms, no biological markers and/or an uncertain prognosis.
Using statistics that exaggerate the impact of a disorder and/or overstate the benefits, or understate the risks, of treatment.
Attributing improvements in symptoms to treatment when it is likely patients would have got better as quickly (or quicker) if no treatment was given.
Retrospectively diagnosing disorders (and attributing suffering or dysfunction) to previously undiagnosed disorders in dysfunctional populations. (e.g. attributing criminality to undiagnosed ADHD in prison populations)
How is the Disease-Monger of the Month award judged? Examples of disease-mongering, as defined in 1 to 7 above, will be assessed for their impact and originality.
Impact - What is the likely effect of the disease-mongering? A statement by a Government Minister or a prominent psychiatrist, that validates some spurious claim, is more likely to have an impact than a similar statement by a backbencher, or an obscure clinician. In a similar vein, disease-mongering by a major national media player is much more likely to have an impact than a page 7 item in the East Woop-Woop Community Newsletter. (Weighting 80%)
Originality - Is the disease-mongering the disease-monger's own work? Most disease-mongering involves the unquestioning repetition of previous disease-mongering that often has its origins in the DSM. Sometimes disease-mongering is original work, where innovators have found new ways to define previously sane individuals as mentally ill, or new ways of putting a positive spin on treatments. (Weighting 20%)
Why is disease-mongering more common in mental health than physical health? Disease-mongering occurs for both physical and mental health. However, the boundaries between mental illness and normality are vague, with less hard science involved in the diagnosis of mental illness than physical illness. Despite these differences, it is often asserted that psychiatric disorders, like depression, are illnesses just like any other such as heart disease, diabetes, asthma and cancer. Depression is even sometimes described as a disease.
These descriptions are dangerously misleading. There are fundamental differences in our understandings of physical illness and mental illness. Cancer is diagnosed by observing physical abnormalities of body organs and/or at a cellular level. Diabetes results in observable abnormal fluctuations in blood sugar levels. Despite repeated (broken) promises of imminent scientific breakthroughs, none of the 300+ psychiatric disorders outlined in DSM-5 are diagnosed by observing physical abnormalities.
These are just some of the reasons people are particularly vulnerable to the dangers of psychiatric disease-mongering. PsychWatch Australia looks forward to, on a monthly basis, giving Australia's and the world’s leading psychiatric disease-mongers the recognition they so richly de$erve.
References
[1] Moynihan R, Henry D (2006) The Fight against Disease Mongering: Generating Knowledge for Action. PLoS Med 3(4): e191. Available at https://doi.org/10.1371/journal.pmed.0030191 https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0030191 (accessed 9 May 2019)
[2] Payer, Lynn (1992). Disease-Mongers: How Doctors, Drug Companies, and Insurers Are Making You Feel Sick. New York: J. Wiley. ISBN 978-0471543855.
This blog was published on 17 June 2019
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