On his visit to Canada last week Pope Francis apologised to the First Nation people for their treatment at the hands of the Catholic church which, in the name of being ‘for their own good’ forcibly pursued policies which proved disastrous for their culture and way of life.

In Ireland, we have had our own experience of institutional abuse in the Magdalen laundries, the mother and baby homes, the forced and secretive adoptions and the industrial schools where it was also stated that the practices pursued were for the good of the victims. Better late than never the abuse, the injustice, the cruel and harsh treatment was finally recognised for what it was, irrespective of the context of the times and long overdue apologies were issued by two Taoisigh (Irish Prime Ministers) in the Dail (Irish Parliament) on behalf of the Irish people.

Yet today there remains one last institutional establishment where an apology for the terrible practices carried out in its name has never been delivered either by itself or any taoiseach speaking in the Dail.

This institution is the psychiatric establishment.

In Ireland, its professional body is The College of Psychiatrists of Ireland.

In the world, it’s The World Psychiatric Association.

Leaving aside the barbaric and primitive treatments employed by psychiatrists in the 19th century, there are many practices from just the 20th century which have been visited upon vulnerable people as being for their own good.

One of the worst of these was the practice of prefrontal lobotomy which reached its apogee in the United States in the 40s and 50s as epitomised by the record of Dr. Walter Freeman. A prefrontal lobotomy involved surgically cutting the lobes of the brain on both sides. Freeman later developed the technique of inserting a surgical icepick through the eye socket of the patient and ‘more effectively’ as he termed it, achieving the desired ‘therapeutic’ outcome. Literally, thousands of such lobotomies were carried out in Europe and the US. The result was to leave the patient in a passive, childlike state. Rose Kennedy, the sister of JFK, was subjected to a lobotomy which left her confined to a mental institution for the rest of her life.

Another example of ‘cure’ by brain damage’ is the practice of electroshock. First developed by Italian psychiatrist Ugo Cerletti in the 1930s, it involves deliberately inducing a series of grand mal seizures. Carried initially out like lobotomy without anaesthetic, the practice was graphically depicted in the film One Flew Over the Cuckoo’s Nest. Electroshock is still administered in Irish hospitals today but because it is now done under anaesthetic higher voltages of electricity are necessary, causing even more brain damage. And like lobotomy, twice as many women as men experience it and many are elderly.

Equally controversial and unscientific was insulin shock treatment, which was widely used in the mid-20th century. People were repeatedly given large doses of insulin to produce daily comas over several weeks. An American recipient Leonard Frank described it as “the most devastating, painful and humiliating experience of my life”. In an untypical move of fallibility, psychiatry eventually ceased to utilise the practice but without apologising.

And have you heard of the T4 Program? This was the mass killing of what were termed ‘the mentally ill and unfit’ by the Nazis with the cooperation of many prominent German psychiatrists who, like their counterparts elsewhere, were enthusiastic proponents of the eugenic theories of the time.

And then there are the countless humiliations, the most primitive backwards, the imprisonment of vulnerable people who had committed no crime, the locked doors, the stripping of dignity, the relegation to third class status, the silencing of voices, the Machiavellian manipulation – all of which constituted psychiatric practice in Ireland in the 20th century and just a few steps removed from the T4 Program.

I have never heard The College of Psychiatrists of Ireland apologise for any of this. In fairness, the German Psychiatric Association did belatedly apologise for the T4 Program in 2010, some 70 years later, a rare event only serving to underline psychiatry’s general reluctance to admit its failings.

Also last week another psychiatric theory was exposed as a sham by outspoken psychiatrist Dr. Joanna Moncrieff. For over 30 years psychiatry has peddled the notion of a chemical imbalance in the brain to explain the reason for conditions it refers to as ‘manic depression’ or ‘bipolar disorder’ . This chemical imbalance requires balancing with SSRI drugs just as a diabetic person requires insulin, it said. Now psychiatry is saying that this was just a simple metaphor to encourage patients to accept their drug treatment. People fully believed what they were told. They were misled. As Dr. Moncreiff said, “Imagine being told you had a major problem in your heart that required medication to fix – only to find out that that problem was not truly there”. Rightly people are angry but there has been no apology from psychiatry.

The chemical imbalance theory highlights the essentially pseudoscientific nature of psychiatry. Psychiatry’s bible – The Diagnostic and Scientific Manual – reflects this. Since its first publication in 1952, the DSM contains a growing list of psychiatric conditions, many of them reflecting the natural emotional problems of everyday life. These conditions are arrived at by a vote taken at formulation meetings of the American Psychiatric Association. Again underlining its pseudoscientific nature is that homosexuality was once listed as a psychiatric condition before being removed by vote in 1973.

The ever-present influence and power of Big Pharma also play a part. With an increasing number of DSM conditions, the market for increasing drug treatment continues to grow and it is a proven fact that there are strong financial links with psychiatry in the form of sponsorships, bursaries, marketing and promotions.

And what of the drugs themselves? Even though they may be of benefit in the short term, the reality is that once started, they are constantly prescribed long term with all the adverse effects that follow. These range from weight gain to loss of libido to tremors and to a general emotional numbing, in effect a chemical lobotomy. And if a person doesn’t want to be drugged, the Mental Health Act legally allows for them to be administered forcibly by way of injection while the person is physically restrained. For their own good of course.

Today, apart from Cognitive Behavioural Therapy, Dialectical Behavioural Therapy, Shock Therapy and some Mindfulness, psychiatry has little more to its treatment armoury other than drugs. Do they work? What does the revolving door syndrome of continuous admissions and readmissions say? Does psychiatry encourage people to taper off their drugs? Not if you believe the advice of a prominent psychiatrist who only last week in response to Dr. Moncrieff advised people to “keep taking their tablets”.

People find themselves in a bind. Many would like to but find it difficult. Withdrawal syndrome, particularly when attempted too quickly, carries its own dangers. An Oireachtas health sub-committee Report on the Adverse Effects of Pharmaceuticals published in 2007 still lies gathering dust. Nothing is done. Few alternative treatments are encouraged or promoted. It’s drugs, drugs and more drugs.

In August 2012 my wife Mary and I met with a representative of the Irish College of Psychiatry. We outlined our concerns and our personal experience of the current psychiatric system. We never heard from the College again.

In October 2017, we were invited in a cynical PR exercise to show their listening credentials to make a presentation at the meeting of the World Psychiatric Association in Berlin. Approximately 10,000 psychiatrists were present from all over the world. Fewer than 20 turned up to hear the story of how my wife had successfully weaned herself off her 20-year cocktail of drugs in 2000 and 22 years later is totally drug-free.

In Ireland, the Mental Health Commission oversees the practice and implementation of psychiatry. Its annual report is full of statistics. It comments on the physical shortcomings and the need for the upgrading of facilities but it never questions the medical model in universal use, other than mild reservations about the over-reliance on drugs.

Neither does the Mental Health Tribunals established under the Mental Health Act. Instead, they bow to the professional expertise of the psychiatrists involved as do the legal representatives appointed to represent the ‘patient’.

Established psychiatry rules the roost. The media too facilitates its rule. Programmes and articles are one-sided. I don’t expect this article to be given mainstream exposure.

And as for an apology from such a tone-deaf and arrogant establishment for its shameful past?

Dream on.

Jim Maddock