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Toronto Background

At the end of November 2000, the Department of Psychiatry in Toronto had a 75th anniversary meeting on the theme of Looking Back: Looking Ahead.  I was asked to speak.  I had been appointed to the University of Toronto as a Professor of Psychiatry in the Mood and Anxiety Disorders Programme at the Clarke Institute a year before and was waiting for a visa to come through before moving.  The week after, I was due to give an annual guest lecture plus seminars on the history of psychiatry in Cornell University Medical School, New York.   I arranged to give the same talk in both places.  In between the two talks I was scheduled to visit Pfizer’s Zoloft archive in New York.  Before the second lecture, senior figures in Cornell were contacted telling them that Healy was manic-depressive, violent and that the lecture should be cancelled.

The talk I gave in both university settings was one that had first been worked up for a major meeting for Astra-Zeneca and it had led to invitations to give it again.  In an expanded form, the talk gave a synopsis of a then forthcoming Harvard University Press book, The Creation of Psychopharmacology [i] .

This talk, reviewing developments over 50 years of psychopharmacology, looked at the drugs, the development of clinical trials and subsequently the development of concerns about conflicts of interest.  It touched peripherally on the central claims of this book -- that SSRIs can make people suicidal and that since the problem arose there had been no research undertaken to map out its dimensions and how best to minimize the risks these drugs can pose [ii] .  This lecture was well received in New York, with Jack Barchas, then the editor of the Archives of General Psychiatry, saying this work would be remembered 100 years from now. 

The day before the meeting in Toronto, I had been interviewing a psychologist for a position on the program I would be running, considering décor for my office, and discussing the practicalities of moving from Britain to Canada with David Goldbloom, the then physician in chief at the Centre for Addiction and Mental Health,  out of whose budget part of my salary would come.   I had discussed the SSRI medico-legal cases I was involved in with him and he seemed to have no problem with this.  The day of the meeting some members of the Toronto psychiatric department were in Indianapolis discussing ‘work product’ with Lilly, who had funded research in the department.  In the previous year, the mood disorders program had received over 50% of its research funding from pharmaceutical companies.

The Toronto meeting looked interesting from the moment I heard about it - Charles Nemeroff, with whom I had had a previous encounter was also speaking on the program.  Nemeroff didn’t stay for the celebration meal after the day’s lectures; he had a meeting in New York the following day, where it seems he had ventilated at length before a group of psychiatrists at a council meeting of the American Foundation for Suicide Prevention in New York, on Healy and his views. 

After the lecture in Cornell, Bob Michels, the Dean, asked me what had happened in Toronto.  Surprised by the question, I outlined the fact that I had delivered in Toronto the same talk that he had just heard.  When the post-meeting feedback forms came through from Toronto some weeks later, they showed that my talk had rated the highest and that Nemeroff’s the lowest.  But that only became clear later.  I outlined to Michels and the others at the meal an encounter earlier in the year with Nemeroff.  The day of the talk in Toronto, according to his lawyer, Nina Gussack, it seems that Nemeroff had talked to some people in the University about Healy and had been under the impression that decisions had been taken [iii] .  Michels made it clear I had been sacked from Toronto.

When I got home from New York the following day it was to find an email from David Goldbloom:

“Essentially, we believe that it is not a good fit between you and the role as leader of an academic program in mood and anxiety disorders at the Centre. While you are held in high regard as a scholar of the history of modern psychiatry, we do not feel your approach is compatible with the goals for development of the academic and clinical resource that we have. This view was solidified by your recent appearance at the Centre in the context of an academic lecture.”

What could explain what had happened?  The University of Toronto was still embroiled in the Nancy Olivieri affair, where a clinical researcher was dismissed for publishing data on adverse events from a clinical trial [iv] .  The international outcry led to her reinstatement, and a new Dean had pledged to uphold the core values of a university [v] .  Another Olivieri case would be a disaster for the University.  It might be an even bigger disaster for Lilly, Pfizer and SmithKline, because it was the kind of story a jury could understand only too well.

Having thought through the issues, I wrote to the University, indicating that the picture might be a more complex one than they might have initially appreciated. Against the background of Lilly having withdrawn their funding from the Hastings Center after an article I had written covering much the same ground, it was easy to see that the likely press interpretation would be that CAMH had been worried about the threat to the funding to the psychiatric department [vi] .  But had CAMH unwittingly maneuvered the University of Toronto into the extraordinary position of compromising a witness in a legal case? 

[i] Healy D.  The Creation of Psychopharmacology.  Harvard University Press, Cambridge Mass, 2002.

[ii] It was not a talk about SSRIs and suicide

[iii] Healy D (2002).  Conflicting interests in Toronto: The Anatomy of a Controversy at the Interface of Academia & Industry.  Perspectives in Biology & Medicine.

[iv] Barer ML, McGrail KM, Cardiff K, Wood L, Green CJ (eds) (2000).  Tales from the Other Drug Wars.  The Center for Health Services and Policy Research, Vancouver.

[v] Thompson J, Baird P, Downie J (2001).  The Olivieri Report.  James Lorimer & Co., Toronto.

[vi] McIlroy A (2001)..  Globe and Mail.