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Thursday, 23 February 2012

Dr Steve Wiseman on CASPER - child/adolescent suicide are highly influenced by the challenges faced by the aboriginal population - FIDDAMAN

Thank-you for your email and for drawing this to my attention. Clearly, this process follows Scientology's/CCHR's typical modus operandi of creating a legitimate-sounding front group, enlisting the help of bereaved or distressed members of the public (and probably putting them in a propaganda video at some point), and cherry-picking / misinterpreting a piece or two of real research to provide a patina of "science" to the whole enterprise.,5453.0/prev_next,prev.html#new

The subject of suicide, suicide risks and rates, and suicide prevention is incredibly complex; pulling one or two papers and interpreting them to suit your own needs is not demonstrating any type of understanding of this area. Also, the 2004 study quoted, as it mentions in its own abstract, cannot be used to make conclusions about causation...only correlation, which may be on account of many different factors. CCHR/Scientology makes this mistake over and over again, probably in a very cynical fashion, when it presents stories of people committing suicide or homicide while receiving psychiatric treatment and then concluding the treatment CAUSED the action. And then they call psychiatry a "pseudoscience"?

Suicide rates vary across the lifespan, and in general, older folks (particularly men) end their lives far more frequently than others. So, in an aging population, you will see rates increase even if measures are put in place to reduce them. As there is no control group in this type of study, one simply doesn't know what would happen if the intervention programs DIDN'T exist. Changing rates and trends re: substance abuse are also key factors and need to be considered.

New Zealand figures for child/adolescent suicide are highly influenced by the challenges faced by the aboriginal population, and here one must agree with CASPER in that solutions must be found not only from the perspective of mental health programs, but from larger social and societal changes as well. One cannot separate illness from social conditions/circumstances in this struggling population; to twist this fact into a club by which to strike psychiatry, as CCHR is doing, is as usual both perverse and odious.

The best part of all of this remains the charge that psychiatry is a pseudoscience, when it is an article, or articles, published by mental health professionals in psychiatric journals, that is identifying the issue jumped upon by the CCHR. One of the hallmarks of true science is that a scientist looks long and hard in the mirror, and asks herself the difficult questions, and does not hold on to beliefs in the face of evidence to the contrary. The fact that psychiatry is looking at, and publishing on the surface negative results about, suicide prevention programs is not an example of psychiatry's failure, but of its honesty, courage, and success as a science.

Can you imagine Scientology supporting research and then publishing results identifying situations and circumstances in which auditing has been shown to be entirely unsuccessful? Or journals of homeopathy publishing results suggesting that their methods do not beat a credible placebo in virtually any circumstance? Or an astrology publication letting us know just how many predictions they are failing to make when they look up at the planets?

Finally, CASPER asserts that current methods of reducing suicide rates "cannot work". How do they reach this conclusion? Again typically, what they seem good at is attacking and trying to tear down psychiatric practice...but what do they offer in the alternative? What, specifically, are they suggesting WILL work?

Psychiatry, as a science dedicated to helping people, would love to see CASPER be able to come up with an idea, direction, or program ultimately able to meaningfully reduce suicide rates in children and adolescents. This would be something to be celebrated, applied universally, and "owned" by none. What, specifically, do they propose? And, importantly, how do they propose to measure the results and compare them to the status quo so that we all can know indeed if the new ways are truly effective? This is the standard by which every aspect of psychiatric practice is measured. Of course, it is not perfect, and the desire over time is always to improve.

So, CASPER, the ball is in your court. How do you propose to proceed?

Kind regards,

Steve Wiseman

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