This is a reply to the letter of the 25 September 2024 sent by the President of the Royal College of Psychiatrists:
To: Dr Lade Smith, CBE, President of the Royal College of Psychiatrists
From: Dr Peter Scott-Gordon
Subject: Thank you for your reply
26 September 2024
Dear Dr Smith,
Thank you for your reply to our letter on patient safety in relation to antidepressant prescribing.
We understand how busy you will be as President of a Royal College. However, despite polite reminders to you as President of the Royal College of Psychiatrists, you only finally replied after we copied-in a number of individuals who have a role in protecting patient safety [included in this e-mail].
We made clear in our letter to you that we “understand a wish to avoid people with severe depression being fearful of treatments: however we know they are far outnumbered by patients without severe depression”.
In relation to harms emerging beyond short-term EBM studies on antidepressants, it is less than the whole truth for you to state that “the College has taken a lead role in raising awareness about [these issues] over recent years”. It might be closer to the truth to say that the College, to protect its credibility, has continued to ignore/dismiss/disbelieve such lived experience for at least 3 decades. There can of course be arguments about numbers involved. But to ‘ignore’ lived experience is surely stigma.
In your reply, which one would naturally assume had input from the RCPsych Communications team and Head of Policy and Campaigns, there is careful, perhaps deliberate avoidance to acknowledge, let alone explain, why you chose [as President] to promote on social media a most misleading opinion piece in the Guardian by a career-long paid opinion leader. The overall tone of the Guardian piece suggested there is “little to be concerned of here . . . it is time to move on”. In your reply to us you have continued to develop this suggestion.
1 in 4 of our population are now taking an antidepressant. This is mass prescribing. A significant percentage of this 1 in 4 have been taking an antidepressant beyond an evidenced-based period. Your reply avoided commenting on whether this very large group requires an antidepressant for recurrent major depressive disorder. Your reply avoided giving balanced recognition of those who find that they cannot stop antidepressants even when they have NO craving for them. Instead, you ended your letter with:
“Finally, I am sure that we all agree that the incidence and prevalence of depression across the world, and the inadequate provision of the range of treatment options that we know are effective, is an area we should be focusing on. I hope that you support this view.”
My determined wish is to reduce suffering. This is the focus of all those who signed this letter. Our primary focus.
Kind wishes
Dr Peter Scott-Gordon