Dr David Bell, a retired psychiatrist, has written an engrossing account of events during the half century that he spent in the psychiatric services of New South Wales. A highly informative and moving account of some scandals in the mental health services and some of the efforts to improve them, written by a caring doctor committed to the welfare of patients in care.
The story began at Callan Park Hospital in the 1950s (now Rozelle Hospital) and Dr Bell’s first encounter with the charismatic and ultimately criminal Harry Bailey who achieved notoriety with the deaths of several patients in his Chelmsford Deep Sleep clinic.
Before he left the Department of Health to go into private practice he designed a comprehensive drug treatment system including provisions for diversion from the criminal justice system into treatment, an innovation that was introduced three decades later after the NSW Drug Summit in 2003.
Much of Dr Bell’s career was spent in court providing professional evidence on compensation cases, an experience which did not improve his opinion of the court system, the legal profession and the medical profession.
He also became involved in the RSI epidemic and helped to end the scam.
CHAPTER 1: THE ASYLUM
CALLAN PARK, THE BAILEY YEARS, ROYAL COMMISSION
CHAPTER 2: LIBERATING THE INSANE
THE SPLIT MIND, THE MAN IN THE GREEN HAT, TOXINS, SERUMS AND BAD MOTHERS
SHOCK AND COMA THERAPY
CHAPTER 3: BETWEEN BODY AND MIND
LONDON, PURGATORY, GROUP THERAPY, A REMARKABLE BOND
CHAPTER 4: ADDICTION
ADDICTION VS DEPENDENCE, THE SPREAD OF ADDICTION, MANAGING ADDICTION
CHAPTER 5: STIRRING LAW
THE DEMEANOUR DELUSION, DEEP SLEEP THERAPY ON TRIAL, THE DISADVANTAGE OF INNOCENCE, FORENSIC MALPRACTICE
CHAPTER 6: NEUROPSYCHIATRY IN COURT
A CASE OF REAL BRAIN DAMAGE, NEUROLEPTIC TOXICITY, A CASE OF MEDICAL POISONING
CHAPTER 7: MALINGERING
SIMULATED ILLNESS, HYSTERIA, MALINGERING, TRIAL BY VIDEO, MUNCHAUSEN’S SYNDROME
CHAPTER 8: EPIDEMIC PSEUDO-ILLNESS
REPETITIVE STRAIN INJURY, THE MAKING OF A PSEUDO-ILLNESS, PAIN
CHAPTER 9: THE STRESS MESS
CYCLE OF BELIEF, THE MENTAL RESPONSE TO CATASTROPHE, THE MAGIC OF NAMES, UNRELIABLE MEMORY
CHAPTER 10: CONSEQUENCES
HOW TO CREATE AN EPIDEMIC, A MULTI-MILLION DOLLAR SERIES, TREATMENT AS ENTERPRISE
CHAPTER 11: THE BREATH OF LIFE
CASE HISTORY: CONSTABLE JONES, THE HYPERVENTILATION DISORDER, A BRIEF HISTORY OF PANIC, SOLDIER’S HEART
CHAPTER 12: DEPRESSION
HEALTH OR ILLNESS? A CASE OF DEPRESSIVE PSYCHOSIS, MANIC-DEPRESSIVE PSYCHOSIS, SEARCHING FOR THE SILVER BULLET, ANTIDEPRESSANTS
CHAPTER 13: BIG PHARMA
MILTOWN, BENZOS AND MANY OTHERS, ANTICONVULSANTS, PHARMACOGENETIC VULNERABILITY, THE MEDICALISATION OF ADVERSITY, SUPERSENSITIVITY PSYCHOSIS
CHAPTER 14: MASTERY
THE LEGAL ARENA FROM FRYE TO DAUBERT, FALSIFIABILITY, SOLUTIONS, EPILOGUE, MEME TYRANNY, NATURE’S SOLUTION
DAVID BELL explores failures of Medicine and the Law to expose false, but treasured,beliefs. He describes the mythology that developed around epidemics of witchcraft and pseudo-illness, through the mass hysteria of repetitive strain injury (RSI), to the still popular post-traumatic stress disorder (PTSD). The complaints promoted by a health and legal disaster-based industry contrast with the sad products of genuine disasters. The promotion of pseudo-illness by psychiatrists, the courts, media and the public seems unstoppable until the epidemic becomes as ludicrous as it is intolerable.
Psychiatry, despite its occasional success, comes off badly in this analysis. The failure to employ logic either in its diagnostics (DSMs) or its therapies (counselling, electrotherapy, sleep therapy, psychoactive drugs and psychosurgery) are well covered. The problems, and sometimes the solutions, are illustrated by the many detailed and fascinating case histories. The Law does a little better even though no less illogically. Too often prejudice determines the outcome of innocence or guilt.