The Noonday Demon (96 page)

376
The McCarran-Ferguson Act was passed in 1945. Dr. Scott Harrington, in his “The History of Federal Involvement in Insurance Regulation,” quotes the act as stating “that no act of Congress ‘shall be construed to invalidate, impair, or supersede’ any state law enacted for the purpose of regulating or taxing insurance.” This paper is in
Optional Federal Chartering of Insurance,
edited by Peter Wallison.

376
The statistics on Clinton’s proposed budget for FY 2000 may be found on-line at the NIMH’s Web site at
www.nimh.nih.gov/about/2000budget.cfm
. According to the NIMH, the final budget for FY 2000 will not be settled until early 2001.

376
That the Community Health Services Block Grant was increased by 24 percent is in
NAMI E-News
99–74, February 2, 1999.

378
National-level suggestions for mandatory tuberculosis treatment are issued by the Center for Disease Control’s Division of Tuberculosis Elimination’s Directly Observed Treatment (DOT) program. This program proposes weekly meetings with health care workers who deliver treatment and verify compliance with treatment protocols. For more on the Center for Disease Control’s recommendations, see:
www.cdc.gov/nchstp/tb/faqs/qa.htm
. While all fifty states recognize the DOT program, it is implemented at state and city levels according to local needs. In New York State, for example, mandatory tuberculosis treatment regulations are issued and enforced through the New York State Department of Health in conjunction with city and local governments. The New York State Department of Health stipulates a DOT program that provides for “directly observed administration of antituberculosis medications for people who are unwilling or unable to comply with prescribed drug plans.” For more, see
www.health.state.ny.us/nysdoh/search/index.htm
. In New York State, more than 80 percent of people with tuberculosis are put into a DOT program. In New York City, the Commissioner’s Orders for Adherence to Anti-TB Treatment states, “the Department of Health works with health care providers to facilitate patients’ adherence to anti-tuberculosis treatment and to protect the public health. Most individuals adhere to treatment when they are educated about tuberculosis and receive incentives or enablers, assistance with housing problems, enhanced social services, and home or field programs of directly observed therapy (DOT). However, if these measures seem likely to fail or have already failed, the Commissioner of Health is empowered by Section 11.47(d) of the New York City Health Code to issue any order deemed necessary to protect the public health.” See the New York City Department of Health’s website at
www.ci.nyc.ny.us/html/doh/html/tb/tb5a.html
for more information. For a statistical analysis of mandatory tuberculosis treatment in New York City, see Rose Gasner et al., “The Use of Legal Action in New York City to Ensure Treatment of Tuberculosis,”
New England Journal of Medicine
340, no. 5, 1999.

379
The ACLU position on involuntary treatment of those with mental disabilities may be found in Robert M. Levy and Leonard S. Rubinstein’s
The Rights of People with Mental Disabilities,
page 25.

380
For more on Willowbook, see David and Sheila Rothman’s
The Willowbrook Wars.

381
The budget breakdown for mental health spending in the Veterans Administration
is in the testimony of the American Psychiatric Association to the Department of Veterans Affairs, April 13, 2000, and can be found on the APA’s Web page at
www.psych.org
by clicking on “Public Policy and Advocacy,” and then “APA Testimony.”

381
I have taken from Representative Marcy Kaptur the anecdotal evidence that psychiatric disturbances may be the most frequent among veterans.

381
This statistic that 25 percent of veterans at VA hospitals suffer from mental illnesses is taken from the testimony of the American Psychiatric Association to the Department of Veterans Affairs, April 13, 2000, and can be found on the APA’s Web site at
www.psych.org
by clicking on “Public Policy and Advocacy,” and then “APA Testimony.”

381
That more than half of all practicing physicians have had part of their education within the VA health-care system comes from the Veterans Administration Web site. They report: “The Veterans Administration currently is affiliated with 105 medical schools, 54 dental schools, and more than 1,140 other schools across the country. More than half of all practicing physicians in the United States have had part of their professional education in the VA health-care system. Each year, approximately 100,000 health professionals receive training in VA medical centers.” From
www.va.gov/About_VA/Orgs/vha/index.htm
.

386
Kevin Heldman’s piece is “7½2 Days,” published in
City Limits,
June/July 1998.

387
Estimates of the percentage of patients with depressive disorders within state and county mental health facilities are taken from Joanne Atay et al., “Additions and Resident Patients at End of Year, State and County Mental Hospitals, by Age and Diagnosis, by State, United States, 1998,” published by the U.S. Department of Health and Human Services in May 2000. They report that affective disorders are the second most prevalent disorder among residents at 12.7 percent, page 53. For nonresidents this number increases to 22.7 percent, page 3.

391
The figures for the mental health budget for Pennsylvania were supplied by the Mental Health Association of Southeastern Pennsylvania. I thank Susan Rogers of the Mental Health Association of Southeastern Pennsylvania for her tremendous effort in tracking down this and several other statistics.

391
Regarding the effectiveness of community-based programs, one report declares that community services “are virtually always more effective than institutional services in terms of outcome” is reported in the
Amici Curiae Brief for the October 1998 Supreme Court Case of Tommy Olmstead, Commissioner of the Department of Human Resources of the State of Georgia, et al., vs. L.C. and E.W., Each by Jonathan Zimring, as Guardian ad Litem and Next Friend,
prepared by the National Mental Health Consumers’ Self-Help Clearinghouse et al., in support of respondents, page 24. This report cites numerous studies supporting their findings, two of which are especially pertinent: A. Kiesler, “Mental Hospitals and Alternative Care: Noninstitutionalization as Potential Public Policy for Mental Patients,”
American Psychologist
349 (1982), and Paul Carling, “Major Mental Illness, Housing, and Supports,”
American Psychologist,
August 1990.

393
Thomas Szasz’s views are expressed in his numerous writings. His books
Cruel Compassion
and
Primary Values and Major Contentions
are a good place to start.

393
The story of the lawsuit against Thomas Szasz is told by Kay Jamison in
Night Falls Fast,
page 254.

393
The op-ed on denying care to the mildly mentally ill is Sally L. Satel, “Mentally Ill or Just Feeling Sad?”
New York Times,
December 15, 1999.

394
The education programs of the pharmaceutical industry run quite a range. At the annual meeting of the American Psychiatric Association (APA), industry-sponsored forums include presentations by some of the most prominent psychiatrists in the United States, many of whom have received independent research grants from pharmaceutical companies. Salesmen in the pharmaceutical industry often end up giving doctors the better part of their continuing education; their work keeps doctors up-to-date on available treatment, but their educative activities are, of course, biased.

394
On the strategies of research and “intellectual property” see Jonathan Rees, “Patents and intellectual property: A salvation for patient-oriented research?”
Lancet
356 (2000).

397
The quotations from David Healey are from
The Antidepressant Era,
page 169.

397
The suggestion that mood disorders affect a quarter of the world’s population is from Myrna Weissman et al., “Cross-National Epidemiology of Major Depression and Bipolar Disorder,”
Journal of the American Medical Association
276, no. 4 (1996).

398
These quotations from David Healy are from
The Antidepressant Era,
page 163.

398
The idea of taking antidepressants off prescription is in
Ibid.,
256–65.

398
That the SSRIs are not particularly fatal or dangerous even in overdose is indicated in J. T. Barbey and S. P. Roose, “SSRI safety in overdose,”
Journal of Clinical Psychiatry
59, suppl. 15 (1998), in which they write, “Moderate overdoses—thirty times the common daily dose—are associated with minor or no symptoms.” Only at “very high doses—seventy-five times the common daily dose”—do more serious events occur, “including seizures, ECG changes, and decreased consciousness.”

401
The quotations from Michael McGuire and Alfonso Troisi are from their book
Darwinian Psychiatry,
pages 150 and 157.

403
The quotation from C. S. Sherrington I take from
The Integrative Action of the Nervous System,
page 22.

403
C. U. M. Smith’s explanation of emotion and mood is in his article “Evolutionary Biology and Psychiatry,”
British Journal of Psychiatry
162 (1993): 150.

404
Jack Kahn’s astute observation is quoted from John Price, “Job’s Battle with God,”
ASCAP
10, no. 12 (1997). For more information, see Jack Kahn’s
Job’s Illness: Loss, Grief and Integration: A Psychological Interpretation.

404
Anthony Stevens and John Price express their views in their book
Evolutionary Psychiatry.

404
On the orangutan as a loner, see Nancy Collinge’s
Introduction to Primate Behavior,
pages 102–4.

404
On the basic principle of the alpha male, see
Ibid.,
143–57.

404
A large amount of literature exists on the general matter of depression and rank societies. Leon Sloman et al., “Adaptive Function of Depression: Psychotherapeutic Implications,”
American Journal of Psychotherapy
48, no. 3 (1994), is perhaps one of the first solid formulations of a coherent theory.

405
John Birtchnell’s views are in his book
How Humans Relate.

405
Russell Gardner’s thoughts on altered dominance mechanisms in higher mammals are described in a variety of his publications. For the most comprehensive description of his ideas on depression and social interaction, see John Price et al.,
“The Social Competition Hypothesis of Depression,”
British Journal of Psychiatry
164 (1994). For more focused discussions, see Russell Gardner, “Psychiatric Syndromes as Infrastructure for Intra-Specific Communication,” in
Social Fabrics of the Mind,
edited by M. R. A. Chance, and “Mechanisms in Manic-Depressive Disorder,”
Archives of General Psychiatry
39 (1982).

406
Tom Wehr on depression and sleep and energy-conservation strategy is in his “Reply to Healy, D., Waterhouse, J. M.: The circadian system and affective disorders: Clocks or rhythms,”
Chronobiology International
7 (1990).

406
Michael McGuire and Alfonso Troisi on the genome lag may be found in
Darwinian Psychiatry,
page 41.

407
J. H. van den Berg’s book was originally published as
Metabletica,
a title I prefer. The ideas expressed here are developed throughout his text.

408
On the difficulties of freedom, see Erich Fromm’s classic
Escape from Freedom.
Ernst Becker also has a pertinent discussion of freedom and its relationship to depression in
The Denial of Death,
beginning on page 213.

408
The description of the boy whose family had moved and who hanged himself is in George Colt’s
The Enigma of Suicide,
page 50.

408
The statistics on the number of goods in the produce section of the supermarket is taken from Regina Schrambling, “Attention Supermarket Shoppers!”
Food and Wine,
October 1995, page 93.

409
The work of Paul J. Watson and Paul Andrews I have taken primarily from their unpublished manuscript “An Evolutionary Theory of Unipolar Depression as an Adaptation for Overcoming Constraints of the Social Niche.” A shortened version of this paper was published in
ASCAP
11, no. 5 (1998), under the title “Niche Change Model of Depression.”