Edwin Fuller Torrey

 

 

Edwin Fuller Torrey, M.D. (born 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.[4

Torrey is on the board of the Treatment Advocacy Center (TAC), which describes itself as being "a national nonprofit advocacy organization.  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

 

Education and early career

Torrey earned his bachelor's degree, magna cum laude, from Princeton University, 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 Heinz Lehmann, 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.[3] 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 disorder 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.

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.  It reports that 75% of its expenditure goes towards the development of new treatments.

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.

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.

SMRI reports that it has a close relationship with and is the supporting organization for the Treatment Advocacy Center (TAC).

 Treatment Advocacy Center

Torrey is a founder of the Treatment Advocacy Center, a national organization that supports outpatient commitment 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."  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.

National Alliance on Mental Illness

Torrey was for many years an active advisor for the National Alliance on Mental Illness (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." 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 2002, NAMI's Executive Director issued a statement highly critical of 60 Minutes for producing a piece entitled "Dr. Torrey's War." In the statement, NAMI alternately criticized and backed various positions espoused by Torrey while aiming its criticism at 60 Minutes for what NAMI called "sound bite journalism." .

Torrey was also the keynote speaker at the 23rd annual NAMI convention in 2002.

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."

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. 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.[12] 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[14][15]) 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.  He has also argued that pharmaceutical companies have too much influence over psychiatric organizations and psychiatrists, effectively buying them off.[1

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.

 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 NARSAD (now known as the Brain & Behavior Research Foundation). 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.