After nearly three decades as a member it is with a mixture of pleasure and disappointment that I submit this letter of resignation from the American Psychiatric Association. The major reason for this action is my belief that I am actually resigning from the American Psychopharmacological Association. Luckily, the organization’s true identity requires no change in the acronym [...].
At this point in history, psychiatry has been almost completely bought out by the drug companies. The APA could not continue without the pharmaceutical company support [...].
No longer do we seek to understand whole persons in their social contexts rather we are there to realign our patients’ neurotransmitters. The problem is that it is very difficult to have a relationship with a neurotransmitter whatever its configuration.
So, our organization provides a rationale, by its neurobiological tunnel vision, for keeping our distance from the molecule conglomerates we have come to define as patients [...]. It saddens me that after 35 years as a psychiatrist I look forward to being dissociated from such an organization. In no way does it represents my interests. It is not within my capacities to buy into the current biomedical-reductionistic model heralded by the psychiatric leadership as once again marrying us to somatic medicine. This is a matter of fashion, politics and, like the pharmaceutical house connection, money.
In addition, APA has entered into an unholy alliance with NAMI (I don’t remember the members being asked if they supported such an organization) [so] that the two organizations have adopted similar public belief systems about the nature of madness. While professing itself the champion of their clients the APA is supporting non-clients, the parents, in their wishes to be in control, via legally enforced dependency, of their mad/bad offspring. NAMI, with tacit APA approval, has set out a pro-neuroleptic drug and easy commitment-institutionalization agenda that violates the civil rights of their offspring. For the most part we stand by and allow this fascistic agenda to move forward [...].
The shortsightedness of this marriage of convenience between APA, NAMI and the drug companies (who gleefully support both groups because of their shared pro-drug stance) is an abomination. I want no part of a psychiatry of oppression and social control [...].
Finally, why must the APA pretend to know more than it does? DSM IV is a fabrication upon which psychiatry seeks acceptance by medicine in general. Insiders know it is more a political than a scientific document [...]. The issue is what do the categories tell us? Do they in fact accurately represent the person with a problem? They don’t, and can’t, because there are no external validating criteria for psychiatric diagnoses. There is neither a blood test nor specific anatomic lesions for any major psychiatric disorder. So where are we? APA as an organization has implicitly (sometimes explicitly as well) bought into a theoretical hoax [...].
We seem to have forgotten a basic principle: the need to be patient/consumer satisfaction oriented. I always remember Manfred Bleuler’s wisdom: “Loren, you must never forget that you are your patient’s employee”. In the end they will determine whether or not psychiatry survives in the service marketplace.
Mosher, Loren R.; and others (1972). "Schizophrenia and Crisis Theory". Presented at the Annual Meeting of the American Orthopsychiatry Association, Detroit, Michigan, April 7-10, 1972.Missing |last2= in Authors list (help) Conference proceeding and 1st report on Soteria House I think. There used to be full access to this pdf here: http://eric.ed.gov/PDFS/ED067600.pdf Not functioning at the moment. The article link in the citation provide an abstract however.
Mosher, Loren R.; Reifman, Ann; Menn, Alma (1973). "Characteristics of Nonprofessionals Serving as Primary Therapists for Acute Schizophrenics". Hosp Community Psychiatry24 (6): 391–6. PMID4706170. - Requires a subscription to Psychiatric Services. Abstract available here.
Mosher, L.R.; Menn, A. (1975). "Soteria: an alternative to hospitalization for schizophrenia". Current Psychiatric Therapies15: 287–96. PMID1181138. Requires a subscription.
Hirschfeld, Robert M. A.; Matthews, Susan M.; Mosher, Loren R.; Menn, Alma Z (1977). "Being With Madness: Personality Characteristics of Three Treatment Staffs". Hosp Community Psychiatry28 (4): 267–73. PMID844816. Requires a subscription. Abstract available here
Mosher, L.R.; Menn, A.Z. (1977). "Soteria House: One Year Outcome Data (Proceedings)". Psychopharmacology Bulletin13 (2): 46–8. PMID859995. Requires a subscription
Mosher, Loren R.; Menn, Alma Z. (1978). "Community Residential Treatment for Schizophrenia: Two-Year Follow-up". Hosp Community Psychiatry29 (11): 715–23. PMID700610. Requires subscription. Abstract available here
Mosher, Loren R.; Menn, Alma (1979). "Soteria: An alternative to hospitalization for schizophrenia". New Directions for Mental Health Services1979 (1): 73–84. doi:10.1002/yd.23319790108. Subscription required to Wiley. Abstract available here
Mosher, Loren R. (1980). "Community residential treatment for schizophrenia: two-year follow-up.". International Journal for Rehabilitation Research3 (3): 393–5. PMID6778831. Requires subscription. First page of brief report available here.
Ciompi, L.; Bernasconi, R. (1986). "'Soteria Bern.' Initial experiences with a new milieu therapy for acutely schizophrenic patients". Psychiatr Prax.13 (5): 172–6. PMID2878453. Article in German. Abstract available from pmid link.
Ciompi, L.; Kupper, Z.; Aebi, E.; Dauwalder, H.P.; Hubschmid T.; Trütsch K.; Rutishauser C. (1993). "The pilot project 'Soteria Bern' in treatment of acute schizophrenic patients. II. Results of a comparative prospective follow-up study over 2 years". Nervenarzt64 (7): 440–50. PMID8103570.Cite uses deprecated parameters (help) Article in German. Abstract available from pmid link.
Mosher, Loren R.; Vallone, Robert; Menn, Alma (1995). "The Treatment of Acute Psychosis Without Neuroleptics: Six-Week Psychopathology Outcome Data From the Soteria Project". International Journal of Social Psychiatry41 (3): 157–73. doi:10.1177/002076409504100301. PMID8847197. Subscription from Sage required. Abstract available here.
Herrell, James M.; Fenton, Wayne; Mosher, Loren R.; Hedlund, Sarah; Lee, Beth (1996). "Residential alternatives to hospitalization for patients with severe and persistent mental illness: Should patients with comorbid substance abuse be excluded?". The Journal of Behavioral Health Services and Research23 (3): 348–55. doi:10.1007/BF02522308.Cite uses deprecated parameters (help) Subscription to Springer required. Abstract available here
Mosher, Loren R.; Bola, John R. (2004). "Soteria-California and Its American Successors: Therapeutic Ingredients". Ethical Human Sciences and Services6 (1): 7–23. Requires subscription to Ingenta. Article abstract available here.