NAMI HelpLine

Posted on April 24, 2002

On Sunday, April 21, 2002, CBS News' 60 Minutes broadcast a segment, "Dr. Torrey's War," spotlighting sweeping criticism of the National Institute of Mental Health's (NIMH's) scientific research priorities offered by Dr. E. Fuller E. Torrey, a leading expert on schizophrenia.

The lack of perspective, context, and depth in CBS's reporting in this complex area of science - including failure to note significant advances made through the very kinds of research that the segment criticized - has come to characterize current public debate on serious mental illness. At a time when America faces an ongoing crisis in the treatment of mental illness and President George W. Bush is preparing to announce a commission on reform of our nation's fragmented mental health system, CBS News and the rest of the journalism profession owe us a much higher standard of inquiry and reflection. The segment did not meet that standard. Without careful, rational public discourse in the months and years ahead, we risk squandering a moment of historic opportunity.

Correspondent Morley Safer was correct to note that Dr. Torrey "uses mockery to make his point, scanning NIMH grants for goofy titles," including ones about "bird brains." What he failed to report, however, is that research into such esoteric things as the brains of snails, newts and birds contributed to American scientists winning the Nobel Prize in 2001 and has helped to increase our understanding of the workings of the human mind. Dr. Torrey also belittled NIMH grants to study adolescent romantic relationships and peer rejection among teenage girls. Unfortunately, CBS failed to report - if only for minimal context-that suicide, almost always caused by major depression, is the third - leading cause of death among teenagers today.

Basic research is essential to a balanced, productive approach to generate new information about the human brain and how it works. The results of basic research lead to hypotheses, which can be tested and explored further. Because of the terrible toll that mental illness can impose upon individuals and families, there is always a temptation to jump-start science, and find shortcuts. But using public money, NIMH has a broader responsibility. A research portfolio must be evaluated in its totality, not its elements, and as a total package. While we are on record with our concerns about insufficient research in many areas of importance including bipolar disorder, mental illness among the elderly and among children, and mental illness within distinct cultural communities, we recognize that building a quality portfolio and a cadre of skilled researchers is a slow process. NAMI believes that NIMH has begun that process and is moving in the right direction.

Unfortunately, the 60 Minutes segment only exacerbates the trend toward "sound bite advocacy" that is increasingly evident in mental health. Assuming that the public has little understanding or interest in the complex, mundane issues of mental health system reform, the news media offers opportunities for sensational reviews that titillate but fail to educate. Advocates are encouraged to offer their most outrageous quotes as fodder for sensational broadcast or publication. Sniping, rather than honest dialogue among advocates, is encouraged and rewarded. As a result, the public is exposed only to extreme views on issues where the middle ground is nearly always more fertile and productive, and correct. This trend ultimately leads to a feeling among the public that the mental health community is self-serving, polarized and does not deserve public trust. In turn, this perception leads to a downward spiral of investment and a greatly diminished future for people with mental illness. Ultimately, all Americans are placed at risk, because the long arm of mental illness will embrace the majority of American families at some time in their lives.

An example of the downward spiral of "sound bite advocacy" stems from Dr. Torrey's April 2002 article published in The Washington Monthly. To summarize the article, it's fair to say that Dr. Torrey doesn't like the Center for Mental Health Services (CMHS) anymore than he does NIMH. But in protesting Dr. Torrey's broad-brush condemnation of a complex federal agency, some advocates have called for a rally outside a NAMI affiliate dinner where he will speak next week. A flyer now circulating around the country declares: "Dr. Torrey recently called for shutting down the federal Center for Mental Health Services because it supports consumer-operated services that promote recovery."

In truth, Dr. Torrey attacked the overall effectiveness of the agency in its critical charge to leading the national system that delivers mental health services. NAMI believes that a review of CMHS's effectiveness in carrying out its congressionally mandated mission is a valid and important area of inquiry. We do not agree that this purpose is well served by a cursory, broad-brushed review by any single author, no matter how prominent and outspoken. But to accuse Dr. Torrey of standing against programs that contribute to true recovery from mental illness is as misleading as it is absurd. For advocates to respond in-kind with narrow and misleading representations of Dr. Torrey's position only fuels a death spiral of intelligent discourse.

One small, praiseworthy alternative approach that is a step in the right direction stands out this week in sharp contrast: an On-Line Forum organized by PBS in conjunction with the premiere of the documentary A Brilliant Madness: The Story of John Nash on April 28, 2002. (See www.pbs.org/amex/nash) The forum includes Dr. Torrey and Robert Whitaker, author of Mad In America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill, along with several other experts on schizophrenia, including one of NIMH's leading research managers. Torrey and Whitaker are polar opposites. Perhaps the only view they share is disdain for the psychiatric establishment, but for different reasons. The PBS Forum offers an opportunity for the kind of careful, nuanced discussion our movement sorely needs.

Because of the complexity of issues America faces in reforming mental health services, NAMI recently formed a Policy Research Institute (NPRI). It is our intention to work with sincere advocates of all stripes to find common ground and solutions to problems where there may not seem to be any ready agreement. We call on the community of mental health advocates to join with us, to identify areas of broad agreement, as well as areas in need of further dialogue, and to stop exploiting the media's craving for polarity and division. The time is coming-now, this year and next and the decade ahead-to begin moving together to confront the dramatic failures of the status quo. It is past time to build the infrastructure we need to provide support for the mental health needs of Americans today and tomorrow. There is a great deal more upon which we can agree than there is that divides us, and probably much more than any of us imagine.

Let's work together to change the Mind of America, using science and supports on behalf of individual dignity. And for all our sake, let's hope 60 Minutes does a better job the next time they decide to dabble in science.

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