Original SDMB thread: 'Mental illness' and compulsory treatment


I, along with many other people, have been diagnosed with a mental illness by a psychiatrist. (I have also been subjected to forced treatment, although not for any sustained duration, thank God).

The medical model of mental illness (the one you're probably familiar with) says that the manifestations in thought feeling and behavior that cause the diagnosis of mental illness to be applied are symptoms of an underlying biological condition of some sort. The proponents of this belief are either right or wrong, and we either do or don't have some underlying biological conditions setting us apart from other people. Just for the sake of argument, let's pretend that they are right (despite lack of convincing evidence).

Dear Psychiatric Establishment: You're calling my built-in difference a disease doesn't make it so Oh, are we "different"? Cool. We want affirmative action, babes. Protection against discrimination in employment and housing. Proportional representation everywhere. Bumper stickers: I'm schizophrenic and I vote. But on an individual-by-individual basis, if we don't seek treatment or otherwise indicate that we find our "differences" to be a problem for us, they don't constitute an illness. Just a difference. Like being gay or something. Now there's a movement to emulate.

But What Are You Gonna Do About [Insert Horrible Violent Crime by Crazy Person Here]? Well, either the behavior you wanna do something about is a crime, or it ain't. If it is, prosecute. If not...well, OK, let's move on to the next step, shall we? Either we go with a social system in which individuals are at liberty to behave except in ways explicitly proscribed by laws, and afforded the right to defend themselves if arrested and charged, and are liable only for things they actually did and not things that some charlatan thinks they mightdo, or we go with a social system in which we agree, openly, that yes we lock up people for being weird, for being unpredictable, for causing disturbances, etc., and that no we don't accord people the right to be accused of a specific crime and to defend themselves against it, we'll just trust the judgment of some experts. But if we're going to go with that one, let's leave "mental illness" out of it. It's a red herring. The presence or absence of this hypothetical built-in biological difference is not something that can be determined on the basis of behaviors that are as loosely defined as the behaviors for which people can be committed as "mentally ill and dangerous". (In most jurisdictions, it is defined no more precisely than = "in the opinion of a psychistrist licensed to practice in the state of XXXX", meaning any damn thing the expert finds to constitute "dangerous".)

But What Are You Going to Do About the Guy Standing in the Middle of the Fucking Freeway? Yeah, the one who thinks he's "blessing" the inhabitants of the automobiles as they whiz by. Or the guy talking to people who ain't there in the subway, dressed in old rags in minus 11 degree weather in January. Well, either these individuals would lose a competency hearing if one were to be held, in which case they would cease to be adults for most legal purposes, and someone else would make many of their decisions for them in loco parentis...or else they would NOT lose such a hearing, despite making a lot of judgment calls that you'd find weird and self-destructive. The competency hearing exists because the law recognizes the importance of giving an individual the opportunity to disprove allegations of senility or delirium -- otherwise the greedy kids could have rich old Grandpa put away and his millions placed in their administrative hands! So once again "mental illness" is a red herring. It doesn't matter WHY a person is or is not competent. I should have the right to make my own decisions as a legally competent schizophrenic.

But What If They Don't Realize That the Meds Would Help Them? Fine, I'm all in favor of informed consent. It isn't practiced much in the lunatic bins, that's for sure. The more complete the information placed at our disposal regarding the pills and procedures they recommend for us, the better. I'd love to see a mandatory double-blind test with a control population of nonschizzies and a 50/50 division of treated and untreated and a ten-year followup for every pharmaceutical and convulsion-induction and neurosurgical assault they have in their arsenal of psychiatric treatments, and the results required to be made available to every diagnosed person who is asked to consider submitting themselves to them! (Any of you "normal" people wanna volunteer to be part of the control population?). Meanwhile, though, a psychiatric treatment once refused should not be "offered" repeatedly, especially not in a confined setting, or the right to refuse is pretty meaningless. As in, "I said NO, now don't ask me again".


See my next post on this same thread


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