One in 6 American Adults Say They Have Taken Psychiatric Drugs, Report Says

About one in six American adults reported taking at least one psychiatric drug, usually an antidepressant or an anti-anxiety medication, and most had been doing so for a year or more, according to a new analysis. The report is based on 2013 government survey data on some 37,421 adults and provides the finest-grained snapshot of prescription drug use for psychological and sleep problems to date.

“I follow this area, so I knew the numbers would be high,” said Thomas J. Moore, a researcher at the Institute for Safe Medication Practices, a nonprofit in Alexandria, Va., and the lead author of the analysis, which was published Monday in JAMA Internal Medicine. “But in some populations, the rates are extraordinary.”

Mr. Moore and his co-author, Donald R. Mattison of Risk Sciences International in Ottawa, combed household survey and insurance data compiled by the federal Agency for Healthcare Research and Quality. They found that one in five women had reported filling at least one prescription that year — about two times the number of men who had — and that whites were about twice as likely to have done so than blacks or Hispanics.

Nearly 85 percent of those who had gotten at least one drug had filled multiple prescriptions for that drug over the course of the year studied, which the authors considered long-term use. “To discover that eight in 10 adults who have taken psychiatric drugs are using them long term raises safety concerns, given that there’s reason to believe some of this continued use is due to dependence and withdrawal symptoms,” Mr. Moore said.

Dr. Mark Olfson, a professor of psychiatry at Columbia University, who was not involved in the study, said the new analysis provided a clear, detailed picture of current usage: “It reflects a growing acceptance of and reliance on prescription medications” to manage common emotional problems, he said.

The most commonly used type of drug was an antidepressant like Zoloft and Celexa, followed by an anti-anxiety or sleeping pill like Xanax and Ambien. All of these drugs can have withdrawal effects, including panic attacks and sleep problems, for many people on them long term. The prescribing of most anti-anxiety pills is strongly regulated in this and other countries because the drugs can be habit forming.

Usage rates were also higher with increased age, with one in four people of retirement age reporting at least one prescription. This is a growing concern among some doctors, as the incidence of diagnosable mental problems, with the exception of insomnia, tends to be much lower in elderly people than in young adults.

The increased rates in this group are most likely due in part to the fact that most elderly people get psychiatric drugs from their primary care doctor, who often prescribe for episodic conditions like mild depression and insomnia. “Particularly for this group, we need to be mindful of the trade-offs in prescribing,” Dr. Olfson said. “These are not benign drugs.”

The Mental Health Crisis in Trump’s America

A few days after Donald J. Trump was elected president, I started getting anxious phone calls from some of my patients. They were not just worried about the direction President-elect Trump might take the nation, but about how they were going to fare, given their longstanding and serious mental illnesses.

“Will I still have insurance and have my medications covered?” one depressed patient asked me.

As a psychiatrist, I wish that I could be more reassuring to my patients during a highly stressful political transition, but in truth, they have reason to worry.

Mr. Trump campaigned on a promise to “repeal and replace” the Affordable Care Act, and his pick for secretary of health and human services, Tom Price, is a staunch opponent of Obamacare. The 2010 law provides medical coverage to an estimated 20 million Americans and specifically included mental health and substance abuse treatment as one of 10 “essential benefits” that all private insurers and Medicaid have to cover.

For the 43.6 million American adults living with a psychiatric illness and the 16.3 million who have an alcohol use disorder, it is hard to exaggerate the importance of this. Until this law was passed, people with mental illness and substance abuse problems were subject to capricious annual or lifetime limits on coverage, higher deductibles or no coverage at all.

Obamacare changed all that and mandated that psychiatric disorders be treated on a par with non-psychiatric medical illnesses like cancer and heart disease.

It also prohibited the exclusion of people with pre-existing illness from medical coverage, which was an enormous boon for the mentally ill. Three-quarters of all serious mental disorders in adults — like major depression, schizophrenia and anxiety disorders — are present by age 25. So mental disorders are largely chronic illnesses that, while very treatable, are still characterized by relapses and recurrences.

Obamacare isn’t perfect. No legislative action can erase the stigma surrounding mental illness, which is a major barrier to getting good treatment. Nor can it solve the serious shortage of mental health specialists or the limited access to psychiatric treatment, especially in rural areas.

Still, if President-elect Trump makes good on his promise to repeal the law, he will effectively strip millions of Americans with mental illness overnight of the most medically rational and humane benefits they have ever had — without giving them any indication of what, if anything, will replace them.

The consequences would be quick and devastating. Psychiatrically ill Americans who lost their coverage would be forced to seek treatment in emergency rooms, causing a meteoric rise in health care costs. And untreated mental disorders like depression, bipolar illness and schizophrenia would almost certainly lead to higher suicide rates.

The current annual cost to society of treating depression alone is $210 billion — 60 percent of which represents reduced efficiency at work and costs related to suicide. With a reduction in mental health care, this bill will balloon. In other words, untreated mental illness is not just a source of individual morbidity, mortality and immense suffering; it is also a largely preventable drain on our economy.

There is at least one more reason to worry about mental health in the age of Trump. Mr. Trump has said that Congress should give each state a lump sum of federal money for Medicaid, the health insurance program for lower-income people. This would effectively roll back the expansion of Medicaid under Obamacare, which provided coverage to an additional 12 million people in 31 states. Since people with mental illness are far more likely to receive public insurance like Medicaid than private insurance, this will hurt them disproportionately.

America can’t be great if millions of our citizens with medical and psychiatric illnesses lose their insurance coverage. An anxious nation is rooting for Mr. Trump not to let that happen.

Mental health group plans fundraising campaign

Copy of article from Juneau Empire

October 27th, 2016

The Mental Health Consumer Action Network, a new nonprofit devoted to lobbying on behalf of the mentally ill, will begin a door-to-door drive Friday.

Executive director Gregory Evan Fitch said he plans to “try to knock on every door in Juneau” in order to gain 2,000 members who support the organization. Dues are $24 a year or $2 per month. Donations also will be accepted.

The campaign comes as the Alaska Mental Health Trust undergoes significant changes. The Trust’s executive director for the past 21 years abruptly resigned Wednesday following conflicts with the Trust’s board of directors.

Consumers’ mental health nonprofit begins membership drive in Juneau

Copy of Article from KTOO Public Media

October 29th, 2016

By Jeremy Hsieh, KTOO

A fledgling Juneau nonprofit formed to advocate for mental health consumers began a membership drive and door-knocking campaign this weekend.

Mental Health Consumer Action Network founder Greg Fitch said this follows the organization’s first official board meeting earlier this month, and getting MCAN’s charitable tax status and other organizational business in order.

MCAN’s new board president Wade Rathke has decades of experience with the once-infamous organization ACORN International, which he founded in 1970. The progressive group has had its scandals, some real, some bogus, but that’s old news now. Rathke still works with many nonprofits and lives in New Orleans — he’d worked with Fitch at ACORN there in the ‘90s — but was recently in Juneau for the first board meeting and discussed his role and aspirations for the new organization.

Rathke said he hasn’t had mental health issues himself, but, “I think it’s important that people build an organization to give them voice and to allow them to empower themselves around their own grievances and issues to be able (to) act. Mental health consumers over the last, you know, 50 years … are people who’ve been marginalized without a voice in many cases.”

He said organizing the marginalized is exactly what he’s spent his life doing.

“Part of what’s so true about mental health issues, people see it as personal, their own private concern,” he said. “And don’t realize there are other people who are struggling in some cases with the same thing who they could unite with and not only find support but collective cause.”

For a long time, he said society has treated people with mental health issues like a “crazy aunt in the closet.”

“And that’s not appropriate,” he said. “And to have people increasingly willing to talk about issues they’ve faced, how they’ve met those challenges, and how they could have met those challenges in a better way both for themselves and our whole society is a radical new thing, and that’s why I think it’s so exciting to see what MCAN is going to be.”

Rathke said he expects challenges recruiting potential members, who may perceive risk in outing themselves as mental health consumers. But, he’s optimistic.

In a year’s time, Rathke said he’d like to see MCAN with a stable membership in Juneau and possibly start expanding to Fairbanks and Anchorage.

How the former head of ACORN became president of a Juneau mental health organization

Copy of article from Juneau Empire

August 4th, 2016

At age 20, Wade Rathke was a community organizer fighting for the welfare rights of single mothers in Massachusetts. The following year, in 1970, he founded the Association of Community Organizations for Reform Now, better known as ACORN.

ACORN went on to become one of the biggest community-organizing groups in the U.S. that advocated for low- to moderate-income families on issues like voter registration, health care and affordable housing.

Now, at age 67, Rathke has taken on the task of leading the Juneau-based Mental Health Consumer Action Network, or MCAN, in its infancy and helping it get off the ground.

People experiencing mental health issues are “exactly the kind of group that needs to come together to look at how it interacts with programs designed for them,” Rathke said in a recent phone interview. “This is not a group that often has a voice, and it’s a voice that needs to be heard.”

So, how exactly did Rathke — a well-known figure on the national stage — get connected with a hyperlocal Juneau organization? Through Juneau resident Greg Fitch, founder and executive director of MCAN.

In the early 1990s, Fitch worked as a community organizer for ACORN in New Orleans. Rathke’s partner, Beth Butler, who also worked at ACORN, was Fitch’s mentor and the office Fitch worked in was next door to Rathke’s. The two became friends.

Fitch is also a mental health consumer. In the mid 2000s, he was diagnosed with bipolar disorder and PTSD. He wants MCAN to be the voice of people experiencing mental health issues and to have a say when mental health policy is made.

“When I came up with MCAN, the idea of MCAN was organizing the mental health consumer for social justice and change. So I basically took the ACORN concept and turned it into MCAN,” he said.

Fitch reached out to Rathke a few months ago, 25 years after the two worked together, and they started emailing and talking on the phone about MCAN.

“This is getting to the point where we can make a difference in people’s lives and I said, ‘Why don’t you just take over the board and become president?’ and he agreed,” Fitch said.

Rathke said Fitch was a good community organizer in New Orleans and he believes in his current efforts.

“He obviously knows what he’s doing, but I think what he’s trying to do is very rare. I only know of only two or three other efforts in the whole United States where people have tried to organize something similar. I think it’s a project with real promise and desperately meets a need,” Rathke said.

He added that it’s important for mental health consumers to speak for themselves and “be able to participate fully as citizens with a vested interest in their own lives and well-being. How can that not be anything other than good? Yet we don’t necessarily have people standing up and applauding this kind of effort.”

Rathke will initially serve as MCAN board president from afar. Once the group gets more established with resources, he plans to attend board meetings in person. He said the first orders of business will include forming bylaws and formally incorporating as a 501(c)3.

It’s not like Rathke isn’t already busy. After a series of controversies, Rathke left ACORN in 2008, a couple years before the organization ended in 2010, but he’s still the chief organizer of ACORN International and travels to countries like Honduras, Kenya and Peru. Based in New Orleans, Rathke also manages a couple of noncommercial radio stations and a local union; is putting the finishing touches on his third book, which has been in the works for 12 years; and runs a fair trade coffee shop. Not to mention all the other nonprofits and projects he has his hands in.

“I try to help out and keep as many balls in the air as I can before they drop and smash,” he said.

With Rathke as president, Fitch is in the process of filling in the other board positions, which will include a mental health consumer. MCAN is also working on funding. Beyond that, “our first goal is awareness,” Fitch said. “We cannot change things unless we educate people about what we go through. Awareness is our huge first key.”

Fitch wants MCAN to be a statewide organization and eventually go national. Until then, Fitch and others involved in MCAN have already been meeting with state lawmakers. The group hopes to get a state-sanctioned mental health awareness week in Alaska.

• Contact reporter Lisa Phu at 523-2246 or

New nonprofit seeks awareness and housing for mentally ill

Copy of article from KTOO Public Media

August 7th, 2016

By Quinton Chandler, KTOO

No one knows the challenges of living with a mental disorder better than someone who has been diagnosed with one. That’s the argument the founder of a new nonprofit made to explain why his organization will be effective helping improve life for the mentally ill, starting with housing in Juneau.

“I suffer from a mental illness and have for about 25 years,” said Gregory Fitch, the founder of the Mental Health Consumer Action Network, or MCAN. He has schizoaffective disorder, “Which is minor schizophrenia, I also have bipolar and I have what’s called borderline personality disorder.”

“I got together and started to realize that maybe we need to come together as a people to have our voices heard. That’s what MCAN is about. MCAN is about reaching the top level of policymaking, have our voices and concerns heard, so we can get better benefits from policies that affect us,” Fitch said.

He calls people who, like himself, suffer from mental illness “consumers.” He said the word is already widely used in mental health care and it reduces the stigma attached to the words “mentally ill.”

He first thought of starting MCAN eight years ago while working for another community organizer. He said his battle with mental illness slowed the process for getting MCAN off the ground, but recently he found himself in the right place and decided it was time.

“I got better on the right medications. It’s working and I said, ‘You know what? It’s time to do this.’ So we did it. We incorporated in April.” Fitch said. “Since then we have built a massive organization. We have a major president onboard who (was) the president of ACORN International, his name is Wade Rathke. He supports us. We have a local board of representatives here in Juneau.”

ACORN International is the organization Fitch worked for when he first imagined MCAN. A funding shortage and public embarrassment from an embezzlement scandal forced ACORN to disband in 2010 after 40 years of activism.

Gregory Fitch, founder of MCAN on Friday, August 5, 2016. (Photo by Quinton Chandler/KTOO)

MCAN founder Gregory Fitch on Friday at KTOO. (Photo by Quinton Chandler/KTOO)

Fitch is not a registered lobbyist yet. Under State law, he doesn’t have to register until he gets paid. His first goals on MCAN’s list are to educate people on the issues the mentally ill face and to offer a solution to one of their biggest problems – housing.

Dominic Smith is helping Fitch launch MCAN. He’s also a consumer. He said he has a slew of diagnoses starting with clinical depression and attention deficit disorder.

“I have generalized anxiety disorder. I have panic attacks, sometimes they can be minor and it’s just, you’re irritated, agitated and people think you’re just a jerk. They think you’re angry and violent, but I’m not a violent person,” Smith said.

Also on his list are post-traumatic stress disorder, seasonal affective disorder and insomnia.

“The big thing is when I have anxiety or a panic attack, I cannot function. Sometimes I cannot even breathe,” he said, his voice starting to shake. “Sorry if I get emotional but it’s even been so bad that I have flashbacks to my childhood.”

Smith said he came from Wisconsin after years of saving and planning his move to Juneau. He said he came to town with a place to live, but he was accused of stealing a laptop and had to leave.

“And it turns out that next evening they found their computer,” Smith said.

He lived in hotels for a while, then he started camping in the woods and he said he’s not the only one.

“I have many friends that live in boats, people that live in cars and people that just live in the woods like I do,” Smith said.

Recently he found a place to live but he was camping out long enough to get acquainted with the challenges of homelessness. He said multiple items were stolen from him and he was barred from entering businesses because he looked homeless.

Fitch believes MCAN will be able to help other consumers like Smith so, even if they hit a rough patch, they won’t have to sleep in the woods.

“Possibly a shelter situation for the consumer, by the consumer. We’d like to see the mental health community involved in this definitely. This is a long-term goal of ours,” Fitch said. “We’d like to possibly break ground on this within a year.”

Fitch said MCAN will find a headquarters in a few more weeks and then they’ll start making headway. He said they’re serious, that in four months they went from an idea to a social welfare nonprofit, securing support from community members, state legislators and Gov. Bill Walker.

Long-term, Fitch hopes to take MCAN national.

Juneau man wants to start a mental health revolution through new nonprofit

Copy of Article from Juneau Empire

May 21st, 2016


Greg Fitch is starting a nonprofit that strives to give people experiencing mental illness “a voice in change.”

The 46-year-old Juneau resident wants to help mental health patients organize, let others know about their challenges and break the stigma surrounding them. Then, he wants to lobby, advocate for change and make accessing the mental health care system easier.

“How can the system know how to provide for us if they don’t know what we go through on a daily basis?” Fitch wondered.

Fitch knows firsthand about the challenges and stigma surrounding mental illness.

“My mental illness is bipolar. I’ve been diagnosed with some other things, like PTSD. I’m a recovering addict and alcoholic. Alcoholism and drug use is very prevalent within the mental health community. We self-medicate because sometimes we can’t get the proper medications,” he said in an interview earlier this month at his Juneau home.

Fitch always suspected he had mental health issues. He said his mother was schizophrenic and mental illness runs in his family.

He described being bipolar as having bouts of mania, or hyperactivity, followed quickly by extreme lows.

“Mania is like having a heightened sense of you can save the world. You’ll be running around trying to accomplish things, but you’re actually accomplishing nothing because you’re sick, and you don’t realize it,” Fitch said. “And you have mood swings, which is called cycling. I’m what you call a rapid cycler. I can cycle from a state of mania to a state of depression in minutes.”

Before he was diagnosed with bipolar and taking proper medications, Fitch had a nervous breakdown in 2004 and tried to kill himself.

“It’s a terrible experience. Mental illness is a very dilapidating disease and so many people go through it, but they’re afraid to come out and say so,” he said.

Since then, Fitch has found good medical care and is doing much better — enough to start an oraganization called Mental Health Consumer Action Network, or MCAN. He said the group is applying to become a 501(c)(3) nonprofit and is in the process of forming a board.

Juneau resident Levi LeCount has volunteered to be on that board. LeCount met Fitch at Polaris House, and he instantly related to the need to break down stigma.

“I’m disabled physically and mentally. I’m in a wheelchair. I have cerebral palsy, so I’ve dealt with stigma a lot of my life, as well,” LeCount said in a phone interview Friday.

He’s also bipolar and has other mental illness diagnosis. He wants MCAN to help get people with mental illnesses organized “so we’re a little more respected by the outside community.”

LeCount said organizations meant to help people experienceing mental illness “don’t always do the best job and it’s hard for a mental health consumer sometimes to articulate that for themselves.” That’s where he envisions MCAN helping out — to be that voice.

“It’s really hard to just get through your day when people don’t understand what’s going on in your head, when you can’t explain how you’re feeling or why you react to a certain situation the way you do,” LeCount said.

Fitch said the first goal of MCAN is to break the stigma surrounding people with mental illness. He was recently on a Capital Transit bus and saw a man having a really hard time.

“He was talking to himself. He was having a problem navigating the system and trying to get help,” Fitch said.

Instead of helping the man, Fitch saw people standing up and moving away from him.

“People didn’t want to be around him. People were scared of him. People need to be a little more understanding of what mental health is about. We’re not out to hurt you. We’re not out to do anything to you. Sometimes we have problems and we struggle with it, and people need to be understanding,” said Fitch, who talked to the man and calmed him down.

Fitch said MCAN plans to hold anti-stigma drives.

“We’re going to do T-shirts with some amazing slogans. Instead of ‘Got Milk?’ the shirt will say, ‘Got psychosis?’” he said.

Once MCAN has built a board and a robust membership, Fitch said he will identify what issues to start advocating for.

Some things he would like to see is better access to the healthcare system, more people on Medicaid and an expansion of services for people with mental illnesses. He thinks the hospital should have a unit devoted to crisis stabilization, a place where people can be watched for a few days.

Getting a nonprofit off the ground isn’t easy. Fitch said he’s been teaching himself tax law and nonprofit law.

“It’s a struggle on a daily basis, but it drives me harder to do something,” he said. “I have something to contribute.”

Fitch hopes he and MCAN can fire up the community of people experiencing mental illness and make a difference in their lives.

“We’re part of society, we’re intelligent people and we’re everywhere,” he said.

• Contact reporter Lisa Phu at 523-2246 or