A Search for Justice – Death in Bray
I have already expressed my opinion on the Shane Clancy murder/suicide and those views can be found here. No doubt much opinion and debate will follow after this documentary airs on TV3 tonight. In the meantime, some readers might be interested in this article by Maria Bradshaw, mother of Toran Henry. Like Shane, Toran also died by SSRI induced suicide. Maria is a fantastic patient advocate, she is extremely well informed, and she expresses her views on the subject of SSRI’s and the related issues very well.
Check out this recent post from Maria, from the Mad in America Blog:
I think Professor Patricia Casey has behaved unethically and brought the profession of psychiatry into disrepute in a statement she made in the media today diagnosing a man who died nearly five years ago as mentally ill.
This is my opinion. It is based on never having met Prof Casey, never having met anyone who knows her well, never having seen her contract with Lundbeck Pharmaceuticals or attended any of the paid services she has delivered for them. It is based on my not having expert knowledge of the Code of Ethics of the Irish College of psychiatry or seen any of Prof Casey’s notes in relation to diagnosing the dead. It could therefore be seen as an uninformed opinion by someone who thinks they have the right to comment because they have an MBA, have dealt with issues of conflicts of interest and business ethics in their work and has been influenced by those who consider they have been harmed by the Professor.
Professor Patricia Casey would no doubt be outraged by my assuming to voice an opinion about what motivates her actions and making an assessment of her behaviour. She would quite reasonably argue I have insufficient evidence on which to base my views and that as such they have little or no validity or value. I imagine she would argue that publishing my opinion is disrespectful and contributes nothing worthwhile to any discussion of the ethical practice of psychiatry.
Where her credibility has been challenged in the past, Prof Casey has generally issued a solicitors letter requiring any published criticism be removed and the writer desist from publishing further criticism of her. I assume that should I question her motives and suggest they are influenced by her financial relationship with Lundbeck Pharmaceuticals, she would consider issuing me with the same.
On Monday night, Irish television is screening a documentary on the events leading to the deaths of Shane Clancy and Sebastian Creane. I have previously written a blog about Shane who, under the influence of Citalopram killed Sebastian and then himself. In today’s Sunday Times, Professor Patricia Casey is quoted as saying that she does not believe the drug played any role in Shane’s actions and that in her opinion he suffered from a psychiatric illness.
On what does Prof Casey base this opinion? Shane is dead and she did not ever meet him when he was alive. She has never spoken to his family, does not have access to his medical records and has not spoken to his doctor. By any analysis she has none of the requisite information on which to make a diagnosis. Not one shred. She has spoken to his ex-girlfriend and the family of the person he killed but despite the DSM-V lowering the diagnostic threshold for psychiatric disorders, even it does not allow for a diagnosis to be made solely on interviews with ex partners and the family of those the patient has harmed.
A recent study on the validity of psychological autopsy studies –post mortem psychiatric assessments – concluded that “as a diagnostic tool psychological autopsies should now be abandoned.” Conducting a mental state assessment on a dead person is problematic for a variety of reasons including whether it is really possible to assign psychiatric diagnoses to someone who is dead by interviewing someone else given that the majority of questions on which a diagnosis is based cannot be reliably answered by anyone other than the deceased, and cannot therefore lead to valid conclusions. I have written about this study here.
Shane’s medical file records his experiencing adverse effects from the drug Citalopram. It does not record any diagnosis of a mental disorder. His file records the information gathered by a doctor who actually sat in the same room as Shane.
Professor Casey’s offer to provide expert evidence at Shane’s inquest was declined by the Coroner. Professor David Healy who did provide expert testimony had access to Shane’s family and his medical records. He is both a psychiatrist and a psychopharmacologist. He is an acknowledged expert in the area of psychiatric drug induced suicide and homicide having conducted research on these issues and provided expert testimony in numerous homicide trials. He is the founder and CEO of a global pharmacovigilance organisation specializing in assessing causal relationships between drugs and adverse reactions. For these reasons, he was selected over Patricia Casey to provide evidence at the inquest examining the circumstances leading to Shane and Sebastian’s deaths. The Coroner’s decision in this respect should not be difficult to understand.
Despite having far more information than Professor Casey, Professor Healy did not presume to conduct a psychological autopsy on Shane. Rather he provided an expert opinion, using good science, on the causal link between Citalopram and Shane’s killing of someone else and himself. He is an expert in making such assessments. Professor Casey is not. Prof Healy provides evidence to support his assessment of the causal relationship between the drug and Shane’s actions. Professor Casey does not provide evidence to support her diagnosing of Shane as psychiatrically ill almost five years after his death.
Psychiatry is the one field of ‘medicine’ that has spawned a huge international survivors movement peopled by those who have suffered psychiatric abuse. The practice of conducting psychological autopsies is in my view another form of psychiatric abuse. Those of us whose children have died as a result of an acknowledged adverse reaction to psychiatric drugs are standing up for our rights – and theirs – not to be stigmatized with psychiatric labels following their deaths. We believe that psychological autopsies are unscientific and unethical. We know they are disrespectful and cause pain to families.
We demand that psychiatrists like Professor Casey cease and desist from this practice forthwith and we ask that the psychiatric survivors movement support the right of those who did not survive to cease being hounded and abused by psychiatry as they lie in their graves