1. 2011 NZPsS Conference Can Poverty Drive You Mad? 'Schizophrenia', Socio-Economic Status and the Case for Primary Prevention New Zealand Journal of Psychology (2010) 39, 7-19 The Hunter Award Address Professor John Read University of Auckland

2. Introduction: Poverty and Mental Health Problems with Construing Madness as an Illness Dominance of the ‘Medical Model’ The Pharmaceutical Industry The Bio-Psycho-Social Model The ‘Schizophrenia’ Construct Summary of the Research Explanations Can madness cause poverty? Poor people can’t deal with stress Biased diagnoses Public Opinion Treatment Bias Therapeutic and Policy Implications

3. George Albee1922-2006Past President American Psychological Association

4. Relative povertyWilkinson & Pickett ‘The Spirit Level’ (2009)

5. Drug company influence Research Funding Educational/training institutes Training for doctors Drug licensing bodies Lobbying governments (especially bad in USA) More recently, the internet…..

6. Drug Companies and the Internet Significant Biological-Bias in Drug Company (D-C) funded websites (% D-C Funded)Causes Treatments Total Schizophrenia (58%) X X X (Read 2007) Depression (42%) X X (de Wattignar & Read, 2008) PTSD (42%) X X (Mansell & Read, 2008) ADHD (37%)X X (Mitchell & Read 2011) Erectile X X X Disorder (44%) (Mati & Read, in preparation)

7. Dr Steven Sharfstein – President, American Psychiatric Association (2005)If we are seen as mere pill pushers and employees of the pharmaceutical industry, our credibility as a profession is compromised.As we address these Big Pharma issues, we must examine the fact that as a profession, we have allowed the bio-psycho-social model to become the bio-bio-bio model.”

8. Professor Mike Shooter, President of the Royal College of Psychiatrists (2005): “I cannot be the only person to be sickened by the sight of parties of psychiatrists standing at the airport desk with so many perks about them that they might as well have the name of the company tattooed across their foreheads. It simply will not do.”

9. Epidemiologia e Psichiatria Sociale, 18, 4, 2009 “Time to abandon the bio-bio-bio model of psychosis: Exploring the epigenetic and psychological mechanisms by which adverse life events lead to psychotic symptoms” JOHN READ, RICHARD P. BENTALL, ROAR FOSSE

10. Introduction: Poverty and Mental Health Problems with Construing Madness as an Illness Dominance of the ‘Medical Model’ The Pharmaceutical Industry The Bio-Psycho-Social Model The ‘Schizophrenia’ Construct **Summary of the Research** Explanations Can madness cause poverty? Poor people can’t deal with stress Biased diagnoses Public Opinion Treatment Bias Therapeutic and Policy Implications

11. No single cause.As for other mental health problems - causes, usually in combination, include: Genetic predisposition ?? Brain differences – structural and functional (can be caused by environment) Maternal prenatal health and stress Birth complications Rape and physical assault War combat Child abuse Child neglect Parental loss Bullying Urban living Ethnicity (poverty, isolation and racism) Heavy early cannabis use Poverty- ‘the cause of the causes’

12. CHICAGOFaris& Dunham, 1939

13. Pilgrim State Hospital had 14,000 patients, a bakery, a laundry, fire and police departments, a power plant, a church with a cemetery, a post office, a farm, and its own station on the Long Island Railroad.

14. Introduction: Poverty and Mental Health Problems with Construing Madness as an Illness Dominance of the ‘Medical Model’ The Pharmaceutical Industry The Bio-Psycho-Social Model The ‘Schizophrenia’ Construct Summary of the Research ** Explanations ** Can madness cause poverty? Poor people can’t deal with stress Biased diagnoses Public Opinion Treatment Bias Therapeutic and Policy Implications

24. www.isps.orgispsnz@gmail.com

25. ISPS International Psychosis Conference - Dubrovnik 2011

31. Introduction: Poverty and Mental Health Problems with Construing Madness as an Illness Dominance of the ‘Medical Model’ The Pharmaceutical Industry The Bio-Psycho-Social Model The ‘Schizophrenia’ Construct Summary of the Research Explanations Can madness cause poverty? Poor people can’t deal with stress Biased diagnoses ** Public Opinion ** Treatment Therapeutic and Policy Implications

32. Public believe mental health problems, including schizophrenia, caused primarily by adverse life events(Read et al. 2006) South Africa China Egypt Turkey Fiji Japan Malaysia Switzerland Ethiopia Greece Bali Brazil England Ireland Germany India Australia Italy Mongolia Russia and … New Zealand

33. Introduction: Poverty and Mental Health Problems with Construing Madness as an Illness Dominance of the ‘Medical Model’ The Pharmaceutical Industry The Bio-Psycho-Social Model The ‘Schizophrenia’ Construct Summary of the Research Explanations Can madness cause poverty? Poor people can’t deal with stress Biased diagnoses Public opinion Treatment ** Therapeutic and Policy Implications **

35. Similarities found in brains of severely abused children and adult ‘schizophrenics’: Overactivity of hypothalamic-pituitary-adrenal (HPA) axis Abnormalities in neurotransmitter systems (especially dopamine) Hippocampal damage Cerebral atrophy Reversed Cerebral Asymmetry Read et al (2001)

36. Brain differences between two groups do NOT prove the ‘brain disease’ hypothesis. The brain is designed to respond to the environment