Why “Chronic mercury poisoning is highly unlikely to present in a psychiatric setting.”?

Mr Clarke made this Freedom of Information request to Birmingham and Solihull Mental Health NHS Foundation Trust

Response to this request is long overdue. By law, under all circumstances, Birmingham and Solihull Mental Health NHS Foundation Trust should have responded by now (details). You can complain by requesting an internal review.

From: Mr Clarke

6 September 2011

Dear Birmingham and Solihull Mental Health NHS Foundation Trust,

1. Given that it has been well-known for years, decades, and even
centuries, that among the most characteristic symptoms of chronic
mercury poisoning are nervousness, shyness, depression, agitation,
fatigue, impaired memory, lack of concentration, and indecision (as
per abundant documentation indicated below)….
Why did the BSMHFT (Birmingham and Solihull Mental Health
Foundation Trust) state this year in a FOI reply
that “Chronic mercury poisoning is highly unlikely to present in a
psychiatric setting.”?

2. What scientific or evidential basis existed to justify such a
statement?

3. Who in the BSMHFT gave that answer, and from where did they
derive that conclusion? Where did the notion originate?

Yours faithfully,
Mr Clarke

DOCUMENTATION:

Numerous studies and reports exist, for example:
- Alfred Stock 1926:
”Mental weariness and exhaustion, lack of inclination and ability
to perform any, particularly mental, work, and increased need for
sleep.…. nearly complete memory loss…..Obstacles, which formerly I
would have overlooked smilingly, seemed insurmountable….merely
writing a simple letter caused unending effort….”
- BMJ 287:1961 (1983) Did the Mad Hatter have mercury poisoning? HA
Waldron:
“The principal features of erethism were excessive timidity,
diffidence, increasing shyness, loss of self confidence, anxiety,
and a desire to remain unobserved and unobtrusive. The victim also
had a pathological fear of ridicule and often reacted with an
explosive loss of temper when criticised.”
1899 Tuthill: “makes a mental wreck of its victim”.
1974 J Am Dent Soc 98(4),904: “symptoms include ….
self-consciousness, embarrassment without justification,
disproportionate anxiety, indecision, poor concentration,
depression, irrational resentment of criticism, and irritability.”

TOXICOLOGICAL PROFILE FOR MERCURY
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Agency for Toxic Substances and Disease Registry March 1999
Page 276:
Neurological Effects. The nervous system is the primary target
organ for elemental and methylmercury-induced toxicity.
Neurological and behavioral disorders in humans have been observed
following inhalation of metallic mercury vapor and organic mercury
compounds, ingestion or dermal application of inorganic
mercury-containing medicinal products (e.g., teething powders,
ointments, and laxatives), and ingestion or dermal exposure to
organic mercury-containing pesticides or ingestion of contaminated
seafood. A broad range of symptoms has been reported, and these
symptoms are qualitatively similar, irrespective of the mercury
compound to which one is exposed. Specific neurotoxic symptoms
include
tremors (initially affecting the hands and sometimes spreading to
other parts of the body), emotional lability (characterized by
irritability, excessive shyness, confidence loss, and nervousness),
insomnia, memory loss, neuromuscular changes (weakness, muscle
atrophy, and muscle twitching), headaches, polyneuropathy
(paresthesias, stocking-glove sensory loss, hyperactive tendon
reflexes, slowed sensory and motor nerve conduction velocities),
and performance deficits in tests of cognitive and motor function
(Adams et al. 1983; Albers et al. 1982, 1988; Aronow et al. 1990;
Bakir et al. 1973; Barber 1978; Bidstrup et al. 1951; Bluhm et al.
1992a; Bourgeois et al. 1986; Chaffin et al. 1973; Chapman et al.
1990; Choi et al. 1978; Cinca et al. 1979; Davis et al. 1974;
DeBont et al. 1986; Discalzi et al. 1993; Dyall-Smith and Scurry
1990; Ehrenberg et al. 1991; Fagala and Wigg 1992; Fawer et al.
1983; Foulds et al. 1987; Friberg et al. 1953; Hallee 1969; Harada
1978; Hook et al. 1954; Hunter et al. 1940; Iyer et al. 1976; Jaffe
et al. 1983; Jalili and Abbasi 1961; Kang-Yum and Oransky 1992;
Karpathios et al. 1991; Kutsuna 1968; Langauer-Lewowicka and
Kazibutowska 1989; Kutsuna 1968; Langolf et al. 1978; Langworth et
al. 1992a; Levine et al. 1982; Lilis et al. 1985; Lundgren and
Swensson 1949; Matsumoto et al. 1965; McFarland and Reigel 1978;
Melkonian and Baker 1988; Miyakawa et al. 1976; Ngim et al. 1992;
Piikivi and Hanninen 1989; Piikivi and Tolonen 1989; Piikivi et al.
1984; Roels et al. 1982; Sexton et al. 1976; Shapiro et al. 1982;
Snodgrass et al. 1981; Smith et al. 1970; Tamashiro et al. 1984;
Taueg et al. 1992; Tsubaki and Takahashi 1986; Verberk et al. 1986;
Vroom and Greer 1972; Warkany and Hubbard 1953; Williamson et al.
1982). Some individuals have also noted hearing loss, visual
disturbances (visual field defects), and/or hallucinations (Bluhm
et al. 1992a; Cinca et al. 1979; Fagala and Wigg 1992; Jalili and
Abbasi 1961; Locket and Nazroo 1952; McFarland and Reigel 1978;
Taueg et al. 1992). Although improvement has often been observed
upon removal of persons from the source of exposure, it is possible
that some changes may be irreversible. Autopsy findings of
degenerative changes in the brains of poisoned patients exposed to
mercury support the functional changes observed (Al-Saleem and the
Clinical Committee on Mercury Poisoning 1976; Cinca et al. 1979;
Davis et al. 1974; Miyakawa et al. 1976).

The characteristic symptoms of chronic mercury vapour are also
documented in innumerable other studies and sources and case
histories:
a) “References documenting symptoms to mercury exposure” published
by the International Academy of Oral Medicine and Toxicology,
www.iaomt.org ; the first seven in their list are all very familiar
as major symptoms of this inquirer, namely irritability,
anxiety/nervousness, loss of memory, inability to concentrate,
lethargy/drowsiness, insomnia, mental depression/
despondency/withdrawal; plus also very familiar, 9: muscle
weakness, 11: tremors of hands, legs, eyelids, 12: decline of
intellect, 13: loss of self-confidence, 16: bleeding gums, 18:
loosening of teeth, etc.
b) Mats Hanson “Effects of Amalgam Removal on Health; 25 studies
comprising 5821 patients” lists the main removal findings as
“fatigue, anxiety/depression, muscle pains, headache, concentration
problems, joint problems, metal taste, mouth symptoms,
vertigo/dizziness, gastrointestinal problems, memory disturbances,
problems with sight, irritability, sleep disturbances, heart
problems, skin problems, allergies, problems with hearing,
numbness, infection-prone (bold added here to indicate this
Claimant’s most notable symptoms in that list).
c) Extensive further documentation of causation of these same
symptoms can be seen in excerpts here appended from
www.flcv.com/depress.html and www.flcv.com/amalg6.html.

Excerpt from http://www.flcv.com/amalg6.html
Bernard Windham compilation of references re amalgam removal cases
[….]
VI. Results of Removal of Amalgam Fillings
[…] There are extensive documented cases (many thousands) where
removal of amalgam fillings led to cure or significant improvement
of serious health problems such as:
[excerpts here:]
epilepsy (5,35,309,229,386e,557),
dizzyness/vertigo
(8,40,95,212,222,229,233bcdgh,271,322,376,453,525c,551,552),
523,525c,538,551, 552,556,557,583),
insomnia (35,62,94,212,222,233ag,271,317,322,376,525c,583),
MS
62,94,95,102,163,170,212,222,229,271,291,302,322,369,469,485,34,35c,229,523,532),
ALS (97,246,423,405,469,470,485,535,35),
Alzheimer’s (62,204,251c,386e,535,35),
Parkinson’s/ muscle tremor (222,248,228a,229,233f, 271,322,
469,557,212,62,94,98,35),
Chronic Fatigue Syndrome
(8,35,47f,60,62,88,185,212,293,229,222,232,233abcdfgh,271, 313,
317, 322,323,342, 346, 369,376,386de, 440, 469,
470,523,532,537,538, 551,552,556,557,595),
nausea (525c),
neuropathy/paresthesia (8,35,62,94,163,212,222,322,556,557),
memory disorders (8,35,94,212,222,322,437,440,453,552,557,595),
depression
(62,94,107,163,185,212,222,229,233bcfh,271,294,285e,317,322,376,386de,437,453,
465,485,523, 525c,532,538,551,556,557,583,595,35,40),
anxiety & mental confusion
(62,94,212,222,229,233abcfgh,271,317,322,440,453,525c, 532,551,
557,583,35,57),
neuropathy/paresthesia (8,35,62,94,163,212,222,322,556,557),

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From: Mr Clarke

5 October 2011

Dear Birmingham and Solihull Mental Health NHS Foundation Trust,

I am concerned that you have not yet answered this important
question within the time required by law.

Yours faithfully,

Mr Clarke

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From: FOI Office

5 October 2011

Dear Mr Clarke,

We received your Freedom of Information- follow up request on 06.09.2011 regarding chronic mercury poisoning.

We will repond to your request as soon as possible.

Please accept our apologies for not contacting you sooner.

Kind Regards

FOI Officer

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From: Hobday Fiona

10 October 2011

Dear Mr Clarke,

REQUEST FOR INFORMATION - FREEDOM OF INFORMATION ACT (2000) – RFI.04.04.2011.Clarke-FOLLOW UP

Thank you for your request for information which following a previous request response, requested:

1. Given that it has been well-known for years, decades, and even centuries, that among the most characteristic symptoms of chronic mercury poisoning are nervousness, shyness, depression, agitation, fatigue, impaired memory, lack of concentration, and indecision (as per abundant documentation indicated below)…. Why did the BSMHFT (Birmingham and Solihull Mental Health Foundation Trust) state this year in a FOI reply that “Chronic mercury poisoning is highly unlikely to present in a psychiatric setting.”?

2. What scientific or evidential basis existed to justify such a statement?

3. Who in the BSMHFT gave that answer, and from where did they derive that conclusion? Where did the notion originate?

We have considered your request and can provide the following information:

Mercury poisoning is not recognised as the most likely cause of shyness, etc. Erythrism that is chronic low grade inhalation of mercury vapour can cause pathological shyness, irritability, memory impairment, impairment of attention span and intellect. The key here is that mercury poisoning is principally a neurological disorder or a neuropsychiatric disorder and the soft signs such as ‘pathological shyness’ occur in the context of neuropsychiatric symptoms such as memory disturbance, etc. It would be unusual to routinely investigate for mercury poisoning without adequate reasons.

The basis of the response to you is usual medical practice, based on all published evidence in textbooks, etc...

The information was provided by a Professor of Psychiatry.

If you are unhappy with the service you have received in relation to your request and wish to request a review of our decision, you should write to the Information Governance Lead, BSMHFT, 50 Summer Hill Road, Birmingham, B1 3RB, or e-mail [email address].

If you are not content with the outcome of your review, you may apply directly to the Information Commissioner for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by our trust. The Information Commissioner can be contacted at:

Information Commissioner's Office Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Telephone: 08456 30 60 60 or 01625 54 57 45 www.ico.gov.uk

We are always interested in improving our services. To give us feedback regarding your experience with the Freedom of information office, please visit: www.bsmhft.nhs.uk

Yours sincerely

Trust FOI Officer
e-mail: [email address]

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From: Mr Clarke

10 October 2011

Dear Hobday Fiona,

I would here thank you for answering my questions except that you
have emphatically not done so.

1- "Why did the BSMHFT (Birmingham and Solihull Mental Health
Foundation Trust) state this year in a FOI reply that “Chronic
mercury poisoning is highly unlikely to present in a psychiatric
setting.”?

You replied:
"Mercury poisoning is not recognised as the most likely cause of
shyness, etc. Erythrism that is chronic low grade inhalation of
mercury vapour can cause pathological shyness, irritability, memory
impairment, impairment of attention span and intellect. The key
here is that mercury poisoning is principally a neurological
disorder or a neuropsychiatric disorder and the soft signs such as
‘pathological shyness’ occur in the context of neuropsychiatric
symptoms such as memory disturbance, etc. It would be unusual to
routinely investigate for mercury poisoning without adequate
reasons."

That's four sentences, none of which answer the question, whether
singly or in combination. The first and last sentences are of
negligible relevance. The second and third if anything confirm why
chronic merc poisoning WOULD present in a psychiatric setting
rather than be "highly unlikely" to. And the second sentence is
doubly incorrect - the term erethism (not spelt "erythrism") does
not mean "chronic low grade inhalation of mercury vapour" but
rather means that resulting collection of psychic symptoms mostly
listed there. How come your "experts" are so clueless about their
subject? Did they cheat in their exams too?

You then also fail to answer the second question:
2. "What scientific or evidential basis existed to justify such a
statement?"

You replied:
"The basis of the response to you is usual medical practice, based
on all published evidence in textbooks, etc..."

I quoted that huge load of scientific documents above here proving
that it would be highly likely to indeed present in a psychiatric
setting. Where's your list of so much as one or two scientific
references to prove the opposite? You fail to provide any. And
that's because there aren't any. Your statement is in reality an
indefensible falsehood, a charlatan quack pseudoscience nasty
"expert" deceit to callously cheat your innocent victims of their
proper treatment.

I invite your "professor of psychiatry" to have the decency to give
his/her name here and state some of the studies which justify
his/her assertion. But it isn't going to happen is it?
Pseudo-professor more like, earning money by false pretences while
hiding behind anonymity.

Sincerely,

Mr Clarke

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From: FOI Office

9 December 2011

Dear Mr Clarke,

REQUEST FOR INFORMATION - FREEDOM OF INFORMATION ACT (2000) – RFI.04.04.2011.Clarke-FOLLOW UP

In response to your email dated 10th October 2011 which expressed dissatisfaction at our response and raised further questions we have carried out a review of our response as per the act. Please see our response below:

It is the opinion on this Trust that your request is vexatious and as such we will not be issuing any further responses in relation to this request.

Section 14 of the Freedom of Information Act states:

(14) Vexatious or repeated requests
1) Section 1(1) does not oblige a public authority to comply with a request for information if the request is vexatious.
2) Where a public authority has previously complied with a request for information which was made by any person, it is not obliged to comply with a subsequent identical or substantially similar request from that person unless a reasonable interval has elapsed between compliance with the previous request and the making of the current request.

Guidance issued by the Information Commissioner includes criteria to help determine if a request is vexatious and it our belief that your request falls into some of these criteria.
1. Could the request fairly be seen as obsessive?
2. Is the request harassing the organisation or causing distress to staff?
3. Would complying with the request impose a significant burden in terms of expense and distraction?
4. Is the request designed to cause disruption or annoyance?
5. Does the request lack any serious purpose or value?

The Trust has previously provided you with 2 comprehensive responses on this matter which was provided by experts within the Trust. However, you appear to want to engage in an on-going debate with the Trust on this matter as to the validity of the response, which is not the purpose of the Freedom of Information Act. The act allows the public a right of access to recorded information and not a right to engage an organisation in on-going discussions/ debates about the information previously released and whether you do or do not accept it as correct/ accurate. Due to this the trust does not feel any progress can be made by continuing with this discussion and will not be issuing any further responses.

If you are unhappy with the service you have received in relation to your request and wish to request a review of our decision, you should write to the Information Governance Lead, BSMHFT, 50 Summer Hill Road, Birmingham, B1 3RB, or e-mail [email address]

If you are not content with the outcome of your review, you may apply directly to the Information Commissioner for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by our trust. The Information Commissioner can be contacted at:

Information Commissioner's Office Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Telephone: 08456 30 60 60 or 01625 54 57 45 www.ico.gov.uk

We are always interested in improving our services. To give us feedback regarding your experience with the Freedom of information office, please visit: www.bsmhft.nhs.uk

Yours sincerely

Trust FOI Officer
e-mail: [email address]

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From: Mr Clarke

9 December 2011

Dear FOI Office,

No it is not vexatious. I asked a perfectly reasonable simple
question, but the fact is that that claim about being "highly
unlikely" was a criminal lie to which you can provide no decent
scientific basis because there is none.

"The Trust has previously provided you with 2 comprehensive
responses on this matter"

That is a lie. You have not provided even a single scientific
reference in any of those supposedly "comprehensive" responses.
Which is because there is none you can.

You've now added the further lie that my request was vexatious. The
authors of these deceitful answers ought to be in prison for a very
long time for their outrageous crime against millions of tragic
innocent victims.

Yours sincerely,

Mr Clarke

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