Mental Health Groups Say No To Drug Funding

"Reducing depression within the U.S. population must be an essential priority," according to Mental Health America's recent study ranking the states by depression and suicide rates. The 50-page review, heralded by psychiatrists, was a panoramic snapshot of the state of mental illness in the United States. It ranked South Dakota as the happiest state with the lowest per capita number of suicides and ready access to mental health assistance. Utah was rated the most depressed.

But in all the hoo-ha about the "Ranking America's Mental Health" report, there was one detail that most experts and journalists neglected to mention: Funding for the report came from Wyeth Pharmaceuticals, a Pennsylvania drug company that employs about 50,000 people and in 2006 earned more than $20 billion in revenue. Wyeth is the producer of several popular antidepressants.

But some Vermont mental health organizations and psychiatrists are shying away from industry money to avoid the appearance of a conflict of interest and the chance that corporate money could influence prescribing patterns or advocacy work. Pharmaceutical money has a subtle, but very real, influence on the mental health field, according to Rep. Anne Donahue, R-Northfield, who is an advocate for mental health issues at the Statehouse. She says there is cause for concern given that funding is scarce for nonprofit mental health organizations and that pharmaceutical money has been linked to doctors' prescription patterns in studies. "They certainly aren't just giving away the money," she said.

Ken Libertoff stopped using pharmaceutical money last spring. Libertoff, the executive director of the Vermont Association for Mental Health, told his group's parent organization &endash; Mental Health America &endash; that he would no longer accept funding from drug corporations, even though much of it was flowing from the national office. CEO and president of Mental Health America, Only about 2 percent of VAMH's annual budget came from industry grants and donations, Libertoff said. But Mental Health America relies heavily on pharmaceutical companies for financial support. "Out of their $8 million budget, $5 million comes from the pharmaceutical companies," Libertoff said.

Libertoff has been ruffling some feathers in the mental health field in the last year as he encourages other organizations and workers to shed their dependency on money from drug companies. He is concerned that pharmaceutical money is changing the advocacy work of organizations and affecting the prescribing pattern of doctors. Libertoff said much of the research in the field is paid for by the industry. "There is a growing consumer movement now that recognizes that the inappropriate influence the drug companies have on the field," Libertoff said. "The environment is shifting right now and it may be that Vermont will become the state that helps change attitudes on this major issue."

Libertoff said he sees troubling signs in his field that he links to that influence, such as the focus on new medications as treatment for mental illnesses. He points to testimony last year at the Statehouse indicating that 46 percent of Vermont's prisoners receive some form of psychotropic medications and the troubling trend of prescribing adult medication to children, sometimes with disastrous and deadly results. "The mantra in Vermont and the United States that this is unrestricted money is a myth," he said. "It really has distorted treatment and advocacy in the field."

Before becoming commissioner of the Vermont Department of Health, Michael Hartman worked for Washington County Mental Health. There he saw the gifts that the pharmaceutical industry would lavish on the nonprofit organization: Pens, notepads and offers of free training and educational opportunities. Some of the novelty gifts that industry representatives would try to drop off at the office were even tasteless at times. "One company that marketed an anti-psychotic medicine was giving away small foam brains," Hartman remembered.

Before Hartman joined the department, the state had one brush-up with pharmaceutical money. A public health event supported with state money also included some dollars from a drug company that was funneled through a local nonprofit group involved in the project. The Mental Health Department last year established guidelines for events, strongly suggesting that organizations disclose whether a speaker or program is supported with corporate money. The guidelines may become official department policy, Hartman said.

Hartman understands why pharmaceutical money looks attractive: It's often hard for nonprofit groups to stay afloat financially, and free pens and paper cut down on office costs. But he said it would be wise practice for groups to wean themselves off such donations. "I would prefer that they find alternative funding methods," he said. "Some of them may not realize that receiving this money is an implicit endorsement."

Washington County Mental Health has a similar policy in place. Director Paul Dupre said the organization began restricting pharmaceutical access in 2003 and a year later stopped accepting grants to support its budget. Dupre said studies have shown that there are links between drug company influence and a doctor's prescribing patterns. But the issue is clouded when it comes to advocacy organizations accepting funding because they are supposed to represent the consumers, not the companies. "If a group is getting a lot of pharmaceutical money, if they are dependent on these companies for their budget, that puts them in a very awkward position," he said.

One won't find any pens or paper with pharmaceutical logos at Jonathan Weker's office. The Montpelier psychiatrist refuses to accept money or gifts from the industry and a few months ago even stopped meeting with pharmaceutical representatives all together. Weker is also a member of No Free Lunch, a New York-based coalition of health care providers who, according to the group's Web site, "believe that pharmaceutical promotion should not guide clinical practice." Instead, Weker said he gets his information on new treatments or drugs from scientific studies, not from the industry. "I've never had the benefit of being sent to the Caribbean for a seminar," he joked.

from the article Free From The Influence Of Pharmaceutical Money Vt. Mental Health Groups Shunning Drug Funding by Daniel Barlow (Vermont Press Bureau) 1/08

 

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