E. Fuller Torrey
Encyclopedia
Edwin Fuller Torrey, M.D. (b.September 6, 1937, Utica
, New York
), is an American
psychiatrist
and schizophrenia
researcher. He is Executive Director of the Stanley Medical Research Institute (SMRI) and founder of the Treatment Advocacy Center
(TAC), a nonprofit organization with the goals of eliminating legal and clinical obstacles to the treatment of severe mental illness.
Dr. Torrey has conducted numerous research studies, particularly on possible infectious causes of schizophrenia. He has become well known as an advocate of the idea that severe mental illness is due to biological factors and not social factors. He has appeared on national radio and television outlets and written for many newspapers. He has received two Commendation Medals by the U.S. Public Health Service and numerous other awards and tributes. He has been criticized by a range of people, including federal researchers and others for some of his attacks on de-institutionalization and his support for forced medication as a method of treatment. He has also been described as having a black-and-white view of mental illness and as being iconoclastic, dogmatic, single-minded and a renegade
.
Torrey is on the board of the Treatment Advocacy Center (TAC), which describes itself as being "a national nonprofit advocacy
organization. http://www.psychlaws.org TAC supports involuntary treatment
when deemed appropriate by a judge (at the urging of the person's psychiatrist and family members). Torrey has written several best-selling books on mental illness
, including Surviving Schizophrenia.
, and his medical doctor's degree from the McGill University
School of Medicine. Torrey also earned a master's degree in anthropology
from Stanford University
, and was trained in psychiatry at Stanford University School of Medicine. At McGill and later at Stanford, he was exposed to a biological approach and recalls that one of his first-year instructors at McGill was Hans Lehman, the first clinician in North America to use the first antipsychotic, chlorpromazine
. The medical school was housed next door to the Montreal Neurological Institute
, a premier neuroscience center.
Torrey then practiced general medicine in Ethiopia
for two years as a Peace Corps
physician and in the South Bronx. From 1970 to 1975, he was a special administrative assistant to the NIMH director. He then worked for year in Alaska
in the Indian Health Service. He then became a ward physician at St. Elizabeth’s Hospital for the mentally ill in Washington, D.C.
for nine years, where he reportedly worked with the most challenging patients and aimed to avoid the use of seclusion or restraints on the acute admission units. He also volunteered at Washington homeless clinics.
in the US. SMRI also maintains a collection of postmortem brain
tissue from individuals with schizophrenia, bipolar disorder, and major depression
and from unaffected controls, which are made available to researchers without charge.
After reading Torrey's book "Surviving Schizophrenia", Theodore Stanley, a businessman who had made a fortune in direct-mail marketing and whose son had been diagnosed in the late 1980s with bipolar disorder, contacted Torrey and he and his wife provided the funds for the new institute.http://pressherald.mainetoday.com/specialrpts/braindonors/041017torrey.shtml
As of 2004 the Stanley Institute had 30 employees and funded half of all U.S. research on bipolar disorder and about a quarter of all schizophrenia research. In 2003 the institute's rapidly growing research budget exceeded $40 million, 74 percent of which was given out to other researchers through grants.http://pressherald.mainetoday.com/specialrpts/braindonors/041017torrey.shtml It reports that 75% of its expenditure goes towards the development of new treatments.http://www.stanleyresearch.org/dnn/Home/tabid/36/Default.aspx
The Stanley Medical Institute in Bethesda Maryland has collected in excess of 600 brains PDF In ARCH GEN PSYCHIATRY/VOL 61, NOV 2004, in a report called, "Brain Anatomy in Adults With Velocardiofacial Syndrome With and Without Schizophrenia", SMRI published results of a Structural Magnetic Resonance Imaging Study showing difference in brain structure of people with and without schizophrenia.
The SMRI has been sued for allegedly taking brains for use in research without proper consent. One lawsuit was settled out of court.http://www.washingtonpost.com/wp-dyn/content/article/2005/06/29/AR2005062902923_pf.htmlhttp://www.lawyersandsettlements.com/case/organ_donation.html
As of 2008 SMRI was also supporting the Stanley Center for Psychiatric Research at the Broad Institute, which plans to scan the entire genome for variants that predispose to schizophrenia and bipolar disorder, and screen hundreds of thousands of compounds against new molecular targets prior to clinical testing.http://www.stanleyresearch.org/dnn/CenterforPsychiatricResearch/Overview/tabid/162/Default.aspx
SMRI reports that it has a close relationship with and is the supporting organization for the Treatment Advocacy Center
(TAC).http://www.stanleyresearch.org/dnn/Home/tabid/36/Default.aspx
for certain people with mental illness who, in his view of their treatment history and present circumstances, are judged unlikely to survive safely in the community without supervision. TAC has been credited by New York State Attorney General Eliot Spitzer
and others with helping pass Kendra's Law
in the state. Kendra's Law allows court-ordered involuntary treatment of people diagnosed with schizophrenia or other severe mental illness who have a history of noncompliance with psychiatric advice, i.e., individuals who are, "as a result of his or her mental illness, unlikely to voluntarily participate in the recommended treatment pursuant to the treatment plan."http://www.omh.state.ny.us/omhweb/Kendra_web/Ksummary.htm Previously, only inpatient programs were available to submit a person to involuntary treatment. TAC's efforts to pass Kendra's Law led to similar successful passage of Laura's Law
in California
, and similar laws in Florida
and elsewhere. Torrey has testified numerous times in front of Congress.
(NAMI). Parents felt that he spoke up for them when much of the medical establishment had previously held that parenting was responsible for schizophrenia. Torrey helped build NAMI into a powerful political force through campaigning and donating the hardcover royalties from the sale of his book "Surviving Schizophrenia".
Although Torrey, TAC, and NAMI remain aligned, NAMI may have tried to distance itself from TAC in 1998. One source The Psychiatric Times, reported that TAC was designed from the start to be "a separate support organization with its own source of funding."http://www.psychiatrictimes.com/p980739.html According to MindFreedom International
, an association of survivors of psychiatric treatment opposed to involuntary treatment, NAMI severed its relationship with TAC because of pressure from groups opposed to Torrey both from within NAMI and outside NAMI. Torrey is, according to MindFreedom, one of 'the most feverishly pro-force psychiatrists in the world'. MindFreedom suggests that the 'links between NAMI and TAC are simply going from overt to covert.'
In response to a Morley Safer
60 Minutes
piece in 2002, NAMI provided Torrey with a partial defense of comments made by Torrey on 60 Minutes defending NIMH programs Torrey attacked, such as a study on adolescent romantic relationships and studies on the brains of snails, newts and birds but NAMI stated also Torrey was for 'true recovery'. http://www.nami.org/Content/ContentGroups/E-News/20023/April_20022/NAMI_Condemns_CBS_s_60_Minutes__For__Sound_Bite_Journalism_.htm.
Torrey was also the keynote speaker at the 23rd annual NAMI convention in 2002. http://www.psychlaws.org/PressRoom/documents/VitaeEFTNov2005.pdf.
In 2005, NAMI gave Dr. Torrey a tribute on its 25th Anniversary Celebratory Donor Wall, for those who have donated over $25,000. It called him a groundbreaking researcher, a ferociously resolute advocate, a prominent and admired author of dozens of books and a dedicated practicing clinician, and said that he had "touched the lives of countless NAMI members throughout this nation."https://www.nami.org/customsource/donation/TorreyTribute.cfm
NAMI has some continuing links to TAC via their board of directors. One individual, Frederick Frese, is presently on both the NAMI and TAC boards. TAC has two other former NAMI board members on their board and Laurie Flynn, the former NAMI executive director, is part of the TAC Honorary Advisory Committee.
In 2008, Torrey disagreed with a NAMI view on second-generation antipsychotics and accused the medical director and executive director of failing to disclose conflicts of interest, because they are employees of an organization that receives more than half its budget from pharmaceutical companies. He argued they were not representing the views of many members of NAMI including himself.
Torrey has been a fierce opponent of the influence of Freud and psychoanalysis
. He has also argued that psychiatry
should focus only on severe mental illness, conceived as neurological disorders, rather than other mental issues that he viewed as non-medical.
Torrey was principal investigator of a NIMH
Schizophrenia/Bipolar Disorder Twin Study conducted at the Neuroscience center of St Elizabeth's Hospital in the late 1980s/early 1990s, and copublished more than a dozen studies on structural brain differences between affected and unaffected siblings. He differed from his collaborators in arguing that the genetic heritability
of schizophrenia was lower than typically estimated. A review of Torrey's data analysis, however, suggested he had erroneously compared different sorts of concordance statistics.
In the early 1970s, Torrey became interested in viral infections as possible causes of schizophrenia or bipolar disorder, particularly a parasite Toxoplasma gondii
whose definitive host is the cat
, but whose intermediate host
can be any mammal, including humans. Up to one third of the world's human population is estimated to carry a Toxoplasma infection. Since then he has published, often with Robert Yolken, more than 30 articles on seasonal variation and possible infectious causes of schizophrenia, focusing especially on Toxoplasma gondii. He is involved in five or six ongoing studies using anti-Toxoplasmosa gondii agents (e.g. antibiotics such as minocycline
and azithromycin
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8142504&dopt=Abstracthttp://aac.asm.org/cgi/content/abstract/41/10/2137) as an add-on treatment for schizophrenia. He believes that infectious causes will eventually explain the "vast majority" of schizophrenia cases. Some of his collaborators have disagreed with the emphasis he has placed on infection as a direct causal factor. Many of the research studies on links between schizophrenia and Toxoplasma gondii, by different authors in different countries, are funded and supported by the Stanley Medical Research Institute. The hypothesis is not prominent in current mainstream scientific views on the causes of schizophrenia
, although infections may be seen as one possible risk factor that could lead to vulnerabilities in early neurodevelopment in some cases.
Torrey has generally been in favor of antipsychotic
drugs. He has claimed that taking antipsychotics reduces the risk of violence, homelessness and prison. He has argued that "noncompliance" in about half of cases of schizophrenia and bipolar disorder is due to lack of "insight" into the illness because the part of the brain for self-awareness has been affected; and that in some who are aware it is due to adverse effects ranging from tremors or sedation to sexual dysfunction to substantial weight gain. He has also reported that at least some antipsychotics cause medical conditions in some people that can be fatal, especially African Americans.http://ajp.psychiatryonline.org/cgi/content/full/160/12/2241 He has also argued that pharmaceutical companies have too much influence over psychiatric organizations and psychiatrists, effectively buying them off.
Torrey has advocated in favor of a flexible well-funded range of community mental health services, including Assertive Community Treatment
, clubhouses
(staffed by professionals with consumers as members), supported housing and supported employment
, emphasizing illness and medication compliance throughout.
. In 1999, he received a research award from the International Congress of Schizophrenia. In 2005, a tribute to Torrey was included in NAMI's 25th Anniversary Celebratory Donor Wall.
with not concentrating its resources sufficiently on severe mental illness and directly applicable research; NIMH has disputed his statistics and viewpoint.http://pn.psychiatryonline.org/cgi/content/full/39/5/8-a
Torrey has been charged with acting to limit the voice of those consumers, survivors and ex-patients
that he disagrees with, opposing their civil rights and censoring and ridiculing their ideas and those of their supporters. Torrey has been a long-time critic of the Center for Mental Health Services
that provides support and advocacy, on the grounds that they support antipsychiatry groups and those opposed to outpatient commitment
, claiming they neglect the seriously mentally ill due to a hippie 60s attitude, distributing funds on the basis of other factors such as "community cohesion" and ethnic minority involvement, and being more dysfunctional than the individuals it is supposed to help.http://www.accessmylibrary.com/coms2/summary_0286-25288801_ITM He has specifically opposed public funding for the National Empowerment Center
, for rejecting the medical model
and arguing for a recovery model
without necessarily needing medication; it has since lost its funding from the CMHS.http://www.necwest.org/ Torrey has in general been instrumental in lobbying against, and undermining, community-based consumer projects because they promoted social and experiential recovery and questioned the standard medical model. Consumer organizations have protested that they are already economically disadvantaged and vulnerable to political whim while Torrey and his organizations have rich and powerful backers. It has been argued that Torrey and other psychiatric and family member advocates do not necessarily have the same interests as consumers/survivors themselves. Differences in ideology sharpened after the development of NAMI. In criticizing the New freedom commission on mental health
for not recommending forced outpatient medicating, Torrey claimed that stigma against people with mental disorders was largely due to them committing violent acts due to not taking medication, and called the recovery model
harmful for sending a cruel message of hope, or implicit blame, to those he believes cannot engage in a recovery process, despite being a laudable long-term vision for the Commission. Torrey hopes to live long enough to see vaccines to prevent many or most cases of schizophrenia.
Although Torrey described family members as "surviving schizophrenia" in his book of that title, in 1997 he said the term "psychiatric survivor" used by ex-patients to describe themselves was just political correctness and he blamed them, along with civil rights lawyers, for the deaths of half a million people due to suicides and deaths on the street. His comments elicited a record number of letters in response, some in favour of Torrey but most against. The accusations have been described as inflammatory and completely unsubstantiated, and issues of self-determination and self-identity said to be more complex than Torrey realizes. In the same journal in 1999, Torrey and Miller of the Stanley Foundation Research Progam argued for an incentivised schizophrenia treatment system backed by a credible threat of force, modelled on that used for the fatal infectious disease Tuberculosis
; replies criticized the logic of the analogy and resort to forced drugging rather than developing alliances and understanding, to which Torrey accused the director and members of MindFreedom International
of living off federal funds while denying illness and not caring about the mentally ill on the streets and in prisons.
Torrey has been a vocal critic of the failures of deinstitutionalization and inadequate community mental health services. He has generally linked this to issues of violence, homelessness and medication noncompliance, as well as lack of proper focus by the relevant governmental organizations. He has been accused of gaining influence by sensationalizing and exaggerating the incidence of violence and its link to medication noncompliance, including disseminating unsubstantiated and unreliable statistics. When a California NAMI journal editor included a questioning of Torrey's statistics, the local board glued together the pages http://www.namiscc.org/newsletters/March01/Sacramento-web.htm and effectively shut down the journal. Others, while agreeing that public mental health care in the U.S. falls far short of what people with serious psychiatric disorders need and deserve, have argued that Torrey's solutions are outdated and that his book The Insanity Offense is based on unsubtantiated portrayals of certainty on the statistics on violence, outpatient commitment and medication, stigmatizing tens of thousands of people, deeply offending and insulting those who hold views differing from his own, and promulgating one-dimensional solutions. TAC's attempts to associate violent incidents in the news with lack of medication have been described as wild hyperbole
, and the use of the term "assisted treatment" has been described as a euphemism
for forced drugging.
Philip Dawdy has challenged it.
He wrote
"You might even ask him why his group cites violence done by people not taking medications, but ignores violent acts committed by people who were on medications and why so many of the studies the group cites are decades old"
and California Network of Mental Health Clients (CNMHC) has challenged it.
"Contrary to Treatment Advocacy Center's explicit claims, the study makes no mention of "untreated" mental illness, schizophrenia, manic-depression, or any other diagnosis. Equally, there is no basis for extrapolating the 4.3% of the national population. TAC arbitrarily raised DOJ's homicide estimate from 4.3% to 5%. Then they arbitrarily attributed these homicides to less than 1% of the U.S. population, the number TAC says have "untreated schizophrenia and manic-depression."
In another error: 4.3% of 16,914 (the total homicides in 1998) is 727, not 1,000 as TAC claims. And DOJ's predictions for 1999 will lower the figure still further to 645."
Torrey has been criticized by, and has criticized, Thomas Szasz
, a libertarian
psychiatrist and author of The Myth of Mental Illness
who is opposed to involuntary treatment. Torrey has said he admires Szasz for his outspoken criticisms of many psychiatric practices, including "diagnostic creep" (disease mongering
) and the potential for the political abuse of psychiatric labels, but that when it comes to Szasz not seeing schizophrenia as a disease of the brain exactly like Parkinson's and Multiple Sclerosis then he is one of his most vocal critics.
Utica, New York
Utica is a city in and the county seat of Oneida County, New York, United States. The population was 62,235 at the 2010 census, an increase of 2.6% from the 2000 census....
, New York
New York
New York is a state in the Northeastern region of the United States. It is the nation's third most populous state. New York is bordered by New Jersey and Pennsylvania to the south, and by Connecticut, Massachusetts and Vermont to the east...
), is an American
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...
and schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
researcher. He is Executive Director of the Stanley Medical Research Institute (SMRI) and founder of the Treatment Advocacy Center
Treatment Advocacy Center
The Treatment Advocacy Center is national U.S. nonprofit organization dedicated to eliminating legal and other barriers to the timely and effective treatment of severe mental illness...
(TAC), a nonprofit organization with the goals of eliminating legal and clinical obstacles to the treatment of severe mental illness.
Dr. Torrey has conducted numerous research studies, particularly on possible infectious causes of schizophrenia. He has become well known as an advocate of the idea that severe mental illness is due to biological factors and not social factors. He has appeared on national radio and television outlets and written for many newspapers. He has received two Commendation Medals by the U.S. Public Health Service and numerous other awards and tributes. He has been criticized by a range of people, including federal researchers and others for some of his attacks on de-institutionalization and his support for forced medication as a method of treatment. He has also been described as having a black-and-white view of mental illness and as being iconoclastic, dogmatic, single-minded and a renegade
Turncoat
A turncoat is a person who shifts allegiance from one loyalty or ideal to another, betraying or deserting an original cause by switching to the opposing side or party...
.
Torrey is on the board of the Treatment Advocacy Center (TAC), which describes itself as being "a national nonprofit advocacy
Advocacy
Advocacy is a political process by an individual or a large group which normally aims to influence public-policy and resource allocation decisions within political, economic, and social systems and institutions; it may be motivated from moral, ethical or faith principles or simply to protect an...
organization. http://www.psychlaws.org TAC supports involuntary treatment
Involuntary treatment
Involuntary treatment refers to medical treatment undertaken without a person's consent. In almost all circumstances, involuntary treatment refers to psychiatric treatment administered despite an individual's objections...
when deemed appropriate by a judge (at the urging of the person's psychiatrist and family members). Torrey has written several best-selling books on mental illness
Mental illness
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...
, including Surviving Schizophrenia.
Education and early career
Torrey earned his bachelor's degree, magna cum laude, from Princeton UniversityPrinceton University
Princeton University is a private research university located in Princeton, New Jersey, United States. The school is one of the eight universities of the Ivy League, and is one of the nine Colonial Colleges founded before the American Revolution....
, and his medical doctor's degree from the McGill University
McGill University
Mohammed Fathy is a public research university located in Montreal, Quebec, Canada. The university bears the name of James McGill, a prominent Montreal merchant from Glasgow, Scotland, whose bequest formed the beginning of the university...
School of Medicine. Torrey also earned a master's degree in anthropology
Anthropology
Anthropology is the study of humanity. It has origins in the humanities, the natural sciences, and the social sciences. The term "anthropology" is from the Greek anthrōpos , "man", understood to mean mankind or humanity, and -logia , "discourse" or "study", and was first used in 1501 by German...
from Stanford University
Stanford University
The Leland Stanford Junior University, commonly referred to as Stanford University or Stanford, is a private research university on an campus located near Palo Alto, California. It is situated in the northwestern Santa Clara Valley on the San Francisco Peninsula, approximately northwest of San...
, and was trained in psychiatry at Stanford University School of Medicine. At McGill and later at Stanford, he was exposed to a biological approach and recalls that one of his first-year instructors at McGill was Hans Lehman, the first clinician in North America to use the first antipsychotic, chlorpromazine
Chlorpromazine
Chlorpromazine is a typical antipsychotic...
. The medical school was housed next door to the Montreal Neurological Institute
Montreal Neurological Institute
The Montreal Neurological Institute and Hospital is an academic medical centre dedicated to neuroscience research, training and clinical care. The Institute is part of McGill University and the Hospital is one of the five teaching hospitals of the McGill University Health Centre, in Montreal,...
, a premier neuroscience center.
Torrey then practiced general medicine in Ethiopia
Ethiopia
Ethiopia , officially known as the Federal Democratic Republic of Ethiopia, is a country located in the Horn of Africa. It is the second-most populous nation in Africa, with over 82 million inhabitants, and the tenth-largest by area, occupying 1,100,000 km2...
for two years as a Peace Corps
Peace Corps
The Peace Corps is an American volunteer program run by the United States Government, as well as a government agency of the same name. The mission of the Peace Corps includes three goals: providing technical assistance, helping people outside the United States to understand US culture, and helping...
physician and in the South Bronx. From 1970 to 1975, he was a special administrative assistant to the NIMH director. He then worked for year in Alaska
Alaska
Alaska is the largest state in the United States by area. It is situated in the northwest extremity of the North American continent, with Canada to the east, the Arctic Ocean to the north, and the Pacific Ocean to the west and south, with Russia further west across the Bering Strait...
in the Indian Health Service. He then became a ward physician at St. Elizabeth’s Hospital for the mentally ill in Washington, D.C.
Washington, D.C.
Washington, D.C., formally the District of Columbia and commonly referred to as Washington, "the District", or simply D.C., is the capital of the United States. On July 16, 1790, the United States Congress approved the creation of a permanent national capital as permitted by the U.S. Constitution....
for nine years, where he reportedly worked with the most challenging patients and aimed to avoid the use of seclusion or restraints on the acute admission units. He also volunteered at Washington homeless clinics.
Stanley Medical Research Institute
Torrey is the founder and Executive Director of the Stanley Medical Research Institute (SMRI), a large, private provider of research on schizophrenia and bipolar disorderBipolar disorder
Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
in the US. SMRI also maintains a collection of postmortem brain
Brain
The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...
tissue from individuals with schizophrenia, bipolar disorder, and major depression
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
and from unaffected controls, which are made available to researchers without charge.
After reading Torrey's book "Surviving Schizophrenia", Theodore Stanley, a businessman who had made a fortune in direct-mail marketing and whose son had been diagnosed in the late 1980s with bipolar disorder, contacted Torrey and he and his wife provided the funds for the new institute.http://pressherald.mainetoday.com/specialrpts/braindonors/041017torrey.shtml
As of 2004 the Stanley Institute had 30 employees and funded half of all U.S. research on bipolar disorder and about a quarter of all schizophrenia research. In 2003 the institute's rapidly growing research budget exceeded $40 million, 74 percent of which was given out to other researchers through grants.http://pressherald.mainetoday.com/specialrpts/braindonors/041017torrey.shtml It reports that 75% of its expenditure goes towards the development of new treatments.http://www.stanleyresearch.org/dnn/Home/tabid/36/Default.aspx
The Stanley Medical Institute in Bethesda Maryland has collected in excess of 600 brains PDF In ARCH GEN PSYCHIATRY/VOL 61, NOV 2004, in a report called, "Brain Anatomy in Adults With Velocardiofacial Syndrome With and Without Schizophrenia", SMRI published results of a Structural Magnetic Resonance Imaging Study showing difference in brain structure of people with and without schizophrenia.
The SMRI has been sued for allegedly taking brains for use in research without proper consent. One lawsuit was settled out of court.http://www.washingtonpost.com/wp-dyn/content/article/2005/06/29/AR2005062902923_pf.htmlhttp://www.lawyersandsettlements.com/case/organ_donation.html
As of 2008 SMRI was also supporting the Stanley Center for Psychiatric Research at the Broad Institute, which plans to scan the entire genome for variants that predispose to schizophrenia and bipolar disorder, and screen hundreds of thousands of compounds against new molecular targets prior to clinical testing.http://www.stanleyresearch.org/dnn/CenterforPsychiatricResearch/Overview/tabid/162/Default.aspx
SMRI reports that it has a close relationship with and is the supporting organization for the Treatment Advocacy Center
Treatment Advocacy Center
The Treatment Advocacy Center is national U.S. nonprofit organization dedicated to eliminating legal and other barriers to the timely and effective treatment of severe mental illness...
(TAC).http://www.stanleyresearch.org/dnn/Home/tabid/36/Default.aspx
Treatment Advocacy Center
Torrey is a founder of the Treatment Advocacy Center, a national organization that supports outpatient commitmentOutpatient commitment
Outpatient commitment refers to mental health law that allows the compulsory, community-based treatment of individuals with mental illness.In the United States the term "assisted outpatient treatment" or "AOT" is often used and refers to a process whereby a judge orders a qualifying person with...
for certain people with mental illness who, in his view of their treatment history and present circumstances, are judged unlikely to survive safely in the community without supervision. TAC has been credited by New York State Attorney General Eliot Spitzer
Eliot Spitzer
Eliot Laurence Spitzer is an American lawyer, former Democratic Party politician, and political commentator. He was the co-host of In the Arena, a talk-show and punditry forum broadcast on CNN until CNN cancelled his show in July of 2011...
and others with helping pass Kendra's Law
Kendra's Law
Kendra's Law, effective since November 1999, is a New York State law concerning involuntary outpatient commitment. It grants judges the authority to issue orders that require people who meet certain criteria to regularly undergo psychiatric treatment. Failure to comply could result in commitment...
in the state. Kendra's Law allows court-ordered involuntary treatment of people diagnosed with schizophrenia or other severe mental illness who have a history of noncompliance with psychiatric advice, i.e., individuals who are, "as a result of his or her mental illness, unlikely to voluntarily participate in the recommended treatment pursuant to the treatment plan."http://www.omh.state.ny.us/omhweb/Kendra_web/Ksummary.htm Previously, only inpatient programs were available to submit a person to involuntary treatment. TAC's efforts to pass Kendra's Law led to similar successful passage of Laura's Law
Laura's Law
Laura's Law is a California state law that allows for court-ordered assisted outpatient treatment. To qualify for the program, the person must have a serious mental illness plus a recent history of psychiatric hospitalizations, jailings or acts, threats or attempts of serious violent behavior...
in California
California
California is a state located on the West Coast of the United States. It is by far the most populous U.S. state, and the third-largest by land area...
, and similar laws in Florida
Florida
Florida is a state in the southeastern United States, located on the nation's Atlantic and Gulf coasts. It is bordered to the west by the Gulf of Mexico, to the north by Alabama and Georgia and to the east by the Atlantic Ocean. With a population of 18,801,310 as measured by the 2010 census, it...
and elsewhere. Torrey has testified numerous times in front of Congress.
National Alliance on Mental Illness
Torrey was for many years an active advisor for the National Alliance on Mental IllnessNational Alliance on Mental Illness
The National Alliance on Mental Illness was founded in 1979 as the National Alliance for the Mentally Ill. NAMI is a nation-wide American advocacy group, representing families and people affected by mental illness as a non-profit grass roots organization and has affiliates in every American state...
(NAMI). Parents felt that he spoke up for them when much of the medical establishment had previously held that parenting was responsible for schizophrenia. Torrey helped build NAMI into a powerful political force through campaigning and donating the hardcover royalties from the sale of his book "Surviving Schizophrenia".
Although Torrey, TAC, and NAMI remain aligned, NAMI may have tried to distance itself from TAC in 1998. One source The Psychiatric Times, reported that TAC was designed from the start to be "a separate support organization with its own source of funding."http://www.psychiatrictimes.com/p980739.html According to MindFreedom International
MindFreedom International
MindFreedom International is an international coalition of over one hundred grassroots groups and thousands of individual members from fourteen nations. It was founded in 1990 to advocate against forced medication, medical restraints, and involuntary electroconvulsive therapy. Its stated mission is...
, an association of survivors of psychiatric treatment opposed to involuntary treatment, NAMI severed its relationship with TAC because of pressure from groups opposed to Torrey both from within NAMI and outside NAMI. Torrey is, according to MindFreedom, one of 'the most feverishly pro-force psychiatrists in the world'. MindFreedom suggests that the 'links between NAMI and TAC are simply going from overt to covert.'
In response to a Morley Safer
Morley Safer
Morley Safer is a Canadian reporter and correspondent for CBS News. He is best known for his long tenure on the newsmagazine 60 Minutes, which began in December 1970.-Life and career:...
60 Minutes
60 Minutes
60 Minutes is an American television news magazine, which has run on CBS since 1968. The program was created by producer Don Hewitt who set it apart by using a unique style of reporter-centered investigation....
piece in 2002, NAMI provided Torrey with a partial defense of comments made by Torrey on 60 Minutes defending NIMH programs Torrey attacked, such as a study on adolescent romantic relationships and studies on the brains of snails, newts and birds but NAMI stated also Torrey was for 'true recovery'. http://www.nami.org/Content/ContentGroups/E-News/20023/April_20022/NAMI_Condemns_CBS_s_60_Minutes__For__Sound_Bite_Journalism_.htm.
Torrey was also the keynote speaker at the 23rd annual NAMI convention in 2002. http://www.psychlaws.org/PressRoom/documents/VitaeEFTNov2005.pdf.
In 2005, NAMI gave Dr. Torrey a tribute on its 25th Anniversary Celebratory Donor Wall, for those who have donated over $25,000. It called him a groundbreaking researcher, a ferociously resolute advocate, a prominent and admired author of dozens of books and a dedicated practicing clinician, and said that he had "touched the lives of countless NAMI members throughout this nation."https://www.nami.org/customsource/donation/TorreyTribute.cfm
NAMI has some continuing links to TAC via their board of directors. One individual, Frederick Frese, is presently on both the NAMI and TAC boards. TAC has two other former NAMI board members on their board and Laurie Flynn, the former NAMI executive director, is part of the TAC Honorary Advisory Committee.
In 2008, Torrey disagreed with a NAMI view on second-generation antipsychotics and accused the medical director and executive director of failing to disclose conflicts of interest, because they are employees of an organization that receives more than half its budget from pharmaceutical companies. He argued they were not representing the views of many members of NAMI including himself.
Scientific research and views
In the 1950s, it was commonly thought that schizophrenia was caused by 'bad parenting'. Torrey has argued that this theory had a toxic effect on parents. His sister had severe schizophrenia and spent most of five decades in hospitals and nursing homes until her death.Torrey has been a fierce opponent of the influence of Freud and psychoanalysis
Psychoanalysis
Psychoanalysis is a psychological theory developed in the late 19th and early 20th centuries by Austrian neurologist Sigmund Freud. Psychoanalysis has expanded, been criticized and developed in different directions, mostly by some of Freud's former students, such as Alfred Adler and Carl Gustav...
. He has also argued that psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
should focus only on severe mental illness, conceived as neurological disorders, rather than other mental issues that he viewed as non-medical.
Torrey was principal investigator of a NIMH
National Institute of Mental Health
The National Institute of Mental Health is one of 27 institutes and centers that make up the National Institutes of Health...
Schizophrenia/Bipolar Disorder Twin Study conducted at the Neuroscience center of St Elizabeth's Hospital in the late 1980s/early 1990s, and copublished more than a dozen studies on structural brain differences between affected and unaffected siblings. He differed from his collaborators in arguing that the genetic heritability
Heritability
The Heritability of a population is the proportion of observable differences between individuals that is due to genetic differences. Factors including genetics, environment and random chance can all contribute to the variation between individuals in their observable characteristics...
of schizophrenia was lower than typically estimated. A review of Torrey's data analysis, however, suggested he had erroneously compared different sorts of concordance statistics.
In the early 1970s, Torrey became interested in viral infections as possible causes of schizophrenia or bipolar disorder, particularly a parasite Toxoplasma gondii
Toxoplasma gondii
Toxoplasma gondii is a species of parasitic protozoa in the genus Toxoplasma. The definitive host of T. gondii is the cat, but the parasite can be carried by many warm-blooded animals . Toxoplasmosis, the disease of which T...
whose definitive host is the cat
Cat
The cat , also known as the domestic cat or housecat to distinguish it from other felids and felines, is a small, usually furry, domesticated, carnivorous mammal that is valued by humans for its companionship and for its ability to hunt vermin and household pests...
, but whose intermediate host
Intermediate host
A secondary host or intermediate host is a host that harbors the parasite only for a short transition period, during which some developmental stage is completed. For trypanosomes, the cause of sleeping sickness, humans are the primary host, while the tsetse fly is the secondary host...
can be any mammal, including humans. Up to one third of the world's human population is estimated to carry a Toxoplasma infection. Since then he has published, often with Robert Yolken, more than 30 articles on seasonal variation and possible infectious causes of schizophrenia, focusing especially on Toxoplasma gondii. He is involved in five or six ongoing studies using anti-Toxoplasmosa gondii agents (e.g. antibiotics such as minocycline
Minocycline
Minocycline is a broad-spectrum tetracycline antibiotic, and has a broader spectrum than the other members of the group. It is a bacteriostatic antibiotic, classified as a long-acting type...
and azithromycin
Azithromycin
Azithromycin is an azalide, a subclass of macrolide antibiotics. Azithromycin is one of the world's best-selling antibiotics...
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8142504&dopt=Abstracthttp://aac.asm.org/cgi/content/abstract/41/10/2137) as an add-on treatment for schizophrenia. He believes that infectious causes will eventually explain the "vast majority" of schizophrenia cases. Some of his collaborators have disagreed with the emphasis he has placed on infection as a direct causal factor. Many of the research studies on links between schizophrenia and Toxoplasma gondii, by different authors in different countries, are funded and supported by the Stanley Medical Research Institute. The hypothesis is not prominent in current mainstream scientific views on the causes of schizophrenia
Causes of schizophrenia
The causes of schizophrenia have been the subject of much debate, with various factors proposed and discounted or modified. The language of schizophrenia research under the medical model is scientific...
, although infections may be seen as one possible risk factor that could lead to vulnerabilities in early neurodevelopment in some cases.
Torrey has generally been in favor of antipsychotic
Antipsychotic
An antipsychotic is a tranquilizing psychiatric medication primarily used to manage psychosis , particularly in schizophrenia and bipolar disorder. A first generation of antipsychotics, known as typical antipsychotics, was discovered in the 1950s...
drugs. He has claimed that taking antipsychotics reduces the risk of violence, homelessness and prison. He has argued that "noncompliance" in about half of cases of schizophrenia and bipolar disorder is due to lack of "insight" into the illness because the part of the brain for self-awareness has been affected; and that in some who are aware it is due to adverse effects ranging from tremors or sedation to sexual dysfunction to substantial weight gain. He has also reported that at least some antipsychotics cause medical conditions in some people that can be fatal, especially African Americans.http://ajp.psychiatryonline.org/cgi/content/full/160/12/2241 He has also argued that pharmaceutical companies have too much influence over psychiatric organizations and psychiatrists, effectively buying them off.
Torrey has advocated in favor of a flexible well-funded range of community mental health services, including Assertive Community Treatment
Assertive Community Treatment
Assertive community treatment, or ACT, is an intensive and highly integrated approach for community mental health service delivery. ACT programs serve people whose symptoms of mental illness result in severe functional difficulties that interfere with their ability to achieve personally meaningful...
, clubhouses
Clubhouse Model of Psychosocial Rehabilitation
The of Psychosocial Rehabilitation is a comprehensive and dynamic program of support and opportunities for people with severe and persistent mental illnesses...
(staffed by professionals with consumers as members), supported housing and supported employment
Supported Employment
Supported employment is a term used to describe a system of support for people with disabilities in regards to ongoing employment in integrated settings. Supported employment provides assistance such as job coaches, job development, job retention, transportation, assistive technology, specialized...
, emphasizing illness and medication compliance throughout.
Recognition
Dr. Torrey has appeared on national radio and television (outlets like NPR, Oprah, 20/20, 60 Minutes, and Dateline) and has written for many newspapers. He has received a 1984 Special Families Award from NAMI, two Commendation Medals from the U.S. Public Health Service, a 1991 National Caring Award, and a humanitarian award from NARSADNARSAD
NARSAD, or National Alliance for Research on Schizophrenia and Depression, is a private, not-for-profit public charity. It is the largest donor-supported organization that supports research on brain and behavior disorders...
. In 1999, he received a research award from the International Congress of Schizophrenia. In 2005, a tribute to Torrey was included in NAMI's 25th Anniversary Celebratory Donor Wall.
Criticism
Torrey has criticized many organizations. He has charged the National Institute of Mental HealthNational Institute of Mental Health
The National Institute of Mental Health is one of 27 institutes and centers that make up the National Institutes of Health...
with not concentrating its resources sufficiently on severe mental illness and directly applicable research; NIMH has disputed his statistics and viewpoint.http://pn.psychiatryonline.org/cgi/content/full/39/5/8-a
Torrey has been charged with acting to limit the voice of those consumers, survivors and ex-patients
Psychiatric survivors movement
The psychiatric survivors movement is a diverse association of individuals who are either currently clients of mental health services , or who consider themselves survivors of interventions by psychiatry, or who identify themselves as ex-patients of mental health services...
that he disagrees with, opposing their civil rights and censoring and ridiculing their ideas and those of their supporters. Torrey has been a long-time critic of the Center for Mental Health Services
Center for Mental Health Services
The Center for Mental Health Services is a unit of the Substance Abuse and Mental Health Services Administration witin the U.S. Department of Health and Human Services. This U.S. government agency describes its role as:...
that provides support and advocacy, on the grounds that they support antipsychiatry groups and those opposed to outpatient commitment
Outpatient commitment
Outpatient commitment refers to mental health law that allows the compulsory, community-based treatment of individuals with mental illness.In the United States the term "assisted outpatient treatment" or "AOT" is often used and refers to a process whereby a judge orders a qualifying person with...
, claiming they neglect the seriously mentally ill due to a hippie 60s attitude, distributing funds on the basis of other factors such as "community cohesion" and ethnic minority involvement, and being more dysfunctional than the individuals it is supposed to help.http://www.accessmylibrary.com/coms2/summary_0286-25288801_ITM He has specifically opposed public funding for the National Empowerment Center
National Empowerment Center
The National Empowerment Center is an advocacy and peer-support organization in the United States that promotes an empowerment-based recovery model of mental disorder. It is run by consumers/survivors/ex-patients in recovery....
, for rejecting the medical model
Medical model
Medical model is the term cited by psychiatrist Ronald D. Laing in his The Politics of the Family and Other Essays , for the "set of procedures in which all doctors are trained." This set includes complaint, history, physical examination, ancillary tests if needed, diagnosis, treatment, and...
and arguing for a recovery model
Recovery model
The Recovery Model as it applies to mental health is an approach to mental disorder or substance dependence that emphasizes and supports each individual's potential for recovery...
without necessarily needing medication; it has since lost its funding from the CMHS.http://www.necwest.org/ Torrey has in general been instrumental in lobbying against, and undermining, community-based consumer projects because they promoted social and experiential recovery and questioned the standard medical model. Consumer organizations have protested that they are already economically disadvantaged and vulnerable to political whim while Torrey and his organizations have rich and powerful backers. It has been argued that Torrey and other psychiatric and family member advocates do not necessarily have the same interests as consumers/survivors themselves. Differences in ideology sharpened after the development of NAMI. In criticizing the New freedom commission on mental health
New Freedom Commission on Mental Health
The controversial New Freedom Commission on Mental Health was established by U.S. President George W. Bush in April 2002 to conduct a comprehensive study of the U.S. mental health service delivery system and make recommendations based on its findings...
for not recommending forced outpatient medicating, Torrey claimed that stigma against people with mental disorders was largely due to them committing violent acts due to not taking medication, and called the recovery model
Recovery model
The Recovery Model as it applies to mental health is an approach to mental disorder or substance dependence that emphasizes and supports each individual's potential for recovery...
harmful for sending a cruel message of hope, or implicit blame, to those he believes cannot engage in a recovery process, despite being a laudable long-term vision for the Commission. Torrey hopes to live long enough to see vaccines to prevent many or most cases of schizophrenia.
Although Torrey described family members as "surviving schizophrenia" in his book of that title, in 1997 he said the term "psychiatric survivor" used by ex-patients to describe themselves was just political correctness and he blamed them, along with civil rights lawyers, for the deaths of half a million people due to suicides and deaths on the street. His comments elicited a record number of letters in response, some in favour of Torrey but most against. The accusations have been described as inflammatory and completely unsubstantiated, and issues of self-determination and self-identity said to be more complex than Torrey realizes. In the same journal in 1999, Torrey and Miller of the Stanley Foundation Research Progam argued for an incentivised schizophrenia treatment system backed by a credible threat of force, modelled on that used for the fatal infectious disease Tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
; replies criticized the logic of the analogy and resort to forced drugging rather than developing alliances and understanding, to which Torrey accused the director and members of MindFreedom International
MindFreedom International
MindFreedom International is an international coalition of over one hundred grassroots groups and thousands of individual members from fourteen nations. It was founded in 1990 to advocate against forced medication, medical restraints, and involuntary electroconvulsive therapy. Its stated mission is...
of living off federal funds while denying illness and not caring about the mentally ill on the streets and in prisons.
Torrey has been a vocal critic of the failures of deinstitutionalization and inadequate community mental health services. He has generally linked this to issues of violence, homelessness and medication noncompliance, as well as lack of proper focus by the relevant governmental organizations. He has been accused of gaining influence by sensationalizing and exaggerating the incidence of violence and its link to medication noncompliance, including disseminating unsubstantiated and unreliable statistics. When a California NAMI journal editor included a questioning of Torrey's statistics, the local board glued together the pages http://www.namiscc.org/newsletters/March01/Sacramento-web.htm and effectively shut down the journal. Others, while agreeing that public mental health care in the U.S. falls far short of what people with serious psychiatric disorders need and deserve, have argued that Torrey's solutions are outdated and that his book The Insanity Offense is based on unsubtantiated portrayals of certainty on the statistics on violence, outpatient commitment and medication, stigmatizing tens of thousands of people, deeply offending and insulting those who hold views differing from his own, and promulgating one-dimensional solutions. TAC's attempts to associate violent incidents in the news with lack of medication have been described as wild hyperbole
Hyperbole
Hyperbole is the use of exaggeration as a rhetorical device or figure of speech. It may be used to evoke strong feelings or to create a strong impression, but is not meant to be taken literally....
, and the use of the term "assisted treatment" has been described as a euphemism
Euphemism
A euphemism is the substitution of a mild, inoffensive, relatively uncontroversial phrase for another more frank expression that might offend or otherwise suggest something unpleasant to the audience...
for forced drugging.
Philip Dawdy has challenged it.
He wrote
"You might even ask him why his group cites violence done by people not taking medications, but ignores violent acts committed by people who were on medications and why so many of the studies the group cites are decades old"
and California Network of Mental Health Clients (CNMHC) has challenged it.
"Contrary to Treatment Advocacy Center's explicit claims, the study makes no mention of "untreated" mental illness, schizophrenia, manic-depression, or any other diagnosis. Equally, there is no basis for extrapolating the 4.3% of the national population. TAC arbitrarily raised DOJ's homicide estimate from 4.3% to 5%. Then they arbitrarily attributed these homicides to less than 1% of the U.S. population, the number TAC says have "untreated schizophrenia and manic-depression."
In another error: 4.3% of 16,914 (the total homicides in 1998) is 727, not 1,000 as TAC claims. And DOJ's predictions for 1999 will lower the figure still further to 645."
Torrey has been criticized by, and has criticized, Thomas Szasz
Thomas Szasz
Thomas Stephen Szasz is a psychiatrist and academic. Since 1990 he has been Professor Emeritus of Psychiatry at the State University of New York Health Science Center in Syracuse, New York. He is a well-known social critic of the moral and scientific foundations of psychiatry, and of the social...
, a libertarian
Libertarianism
Libertarianism, in the strictest sense, is the political philosophy that holds individual liberty as the basic moral principle of society. In the broadest sense, it is any political philosophy which approximates this view...
psychiatrist and author of The Myth of Mental Illness
The Myth of Mental Illness
The Myth Of Mental Illness: Foundations of a Theory of Personal Conduct is a controversial book by Thomas Szasz and published in 1961. It is highly influential in the anti-psychiatry movement...
who is opposed to involuntary treatment. Torrey has said he admires Szasz for his outspoken criticisms of many psychiatric practices, including "diagnostic creep" (disease mongering
Disease mongering
]Disease mongering is a pejorative term for the practice of widening the diagnostic boundaries of illnesses, and promoting public awareness of such, in order to expand the markets for those who sell and deliver treatments, which may include pharmaceutical companies, physicians, and other...
) and the potential for the political abuse of psychiatric labels, but that when it comes to Szasz not seeing schizophrenia as a disease of the brain exactly like Parkinson's and Multiple Sclerosis then he is one of his most vocal critics.
External links
- DBSAlliance.org - 'Responding to Charges Made on CBSCBSCBS Broadcasting Inc. is a major US commercial broadcasting television network, which started as a radio network. The name is derived from the initials of the network's former name, Columbia Broadcasting System. The network is sometimes referred to as the "Eye Network" in reference to the shape of...
’ 60 Minutes60 Minutes60 Minutes is an American television news magazine, which has run on CBS since 1968. The program was created by producer Don Hewitt who set it apart by using a unique style of reporter-centered investigation....
, Leading Mental Health Groups Support National Institute of Mental HealthNational Institute of Mental HealthThe National Institute of Mental Health is one of 27 institutes and centers that make up the National Institutes of Health...
', Depression and Bipolar Support AllianceDepression and Bipolar Support AllianceThe Depression and Bipolar Support Alliance is a non-profit organization providing support groups for people with depression or bipolar disorder as well as their friends and family. DBSA's scope, also includes outreach, education and advocacy regarding depression and bipolar disorder...
(April 23, 2002) - mindfreedom.org - 'Mind control implants are now a science fact, not science fiction: University of PennsylvaniaUniversity of PennsylvaniaThe University of Pennsylvania is a private, Ivy League university located in Philadelphia, Pennsylvania, United States. Penn is the fourth-oldest institution of higher education in the United States,Penn is the fourth-oldest using the founding dates claimed by each institution...
developing implantable discs that slowly release neuroleptics up to a year', MindFreedom InternationalMindFreedom InternationalMindFreedom International is an international coalition of over one hundred grassroots groups and thousands of individual members from fourteen nations. It was founded in 1990 to advocate against forced medication, medical restraints, and involuntary electroconvulsive therapy. Its stated mission is...
(June 1, 2002) - TreatmentAdvocacyCenter.org - 'E. Fuller Torrey' (Biography), Treatment Advocacy CenterTreatment Advocacy CenterThe Treatment Advocacy Center is national U.S. nonprofit organization dedicated to eliminating legal and other barriers to the timely and effective treatment of severe mental illness...
- TreatmentAdvocacyCenter.org - 'Washington's Best and Brightest: Roots of Mental Illness - E. Fuller Torrey, Psychiatrist', John PekkanenJohn PekkanenJohn Pekkanen is an author, and two-time National Magazine Award-winning American journalist and the winner of ten other national journalism awards including the National Headliner Award, the Penney-Missouri Award for medical journalism, and the Award of Excellence from the American College of...
, The WashingtonianWashingtonian (magazine)Washingtonian is a monthly magazine distributed in the Washington, DC area since 1965. The magazine describes itself as "the magazine Washington lives by." The magazine's core focuses are local feature journalism, guide book-style articles, and real estate advice.-Editorial Content:Washingtonian...
(December 2001) - Schizophrenia.com - 'Schizophrenia's Most Zealous Foe - Dr. E. Fuller Torrey' (excerpt), Michael Winerip, New York Times (February 22, 1998)
- NYDailyNews.com - 'Does this explain that crazy lady in Apt. 5B?' Jordan Lite, New York Daily NewsNew York Daily NewsThe Daily News of New York City is the fourth most widely circulated daily newspaper in the United States with a daily circulation of 605,677, as of November 1, 2011....
(November 9, 2005) - WashingtonMonthly.com - 'Bird Brains: While 2.3 million Americans suffer from bipolar disorder, the National Institute of Mental Health is studying how pigeons think', E. Fuller Torrey, M.D., Washington Monthly (May, 2001)