Forced Psychiatric Interventions Need More Insight…
Dale, E. (2010). Is supervised community treatment ethically justifiable? Journal of Medical Ethics, 36 (5), 271-274 DOI: 10.1136/jme.2009.033720
The most controversial aspect of psychiatry has always been its reliance, I would argue, its obsessive over-reliance, on coercive practices. Historically, that makes sense. When, in the early 19th century, overcrowded cities in Europe and elsewhere were stretched about what to do with all manner of distressed or unpleasant people hogging the streets, the emerging profession of psychiatry stepped in to offer the perfect solution: incarceration and treatment in purpose-built asylums. Thus, was established the classic model of mental health service delivery that has persisted to the present, a model based on the triple evils of coercion, punishment and control. ‘Freedom’ becomes the conditional carrot waved in front of anyone so designated by medical orthodoxy to be ‘mentally ill’. To be free means accepting that you are indeed as mad as a cut snake and that you are willing to ingest, without question or hesitation, whatever psychoactive substance is forced down your throat.
Dale (2010), almost from the outset of this brief article, stumbles into the confounding territory that is populated by insight, capacity, and psychiatric treatment (p.271). Contrary to what he claims, a lack of understanding or refusal to accept a particular diagnosis does not necessarily indicate anything, let alone that someone is in desperate need of forced interventions (2010, p.271). However, I find Dale’s (2010) logic useful, because it so deftly explains how something so insidiously fucked as psychiatry can persist as pseudo-science for two centuries, with nothing more to bolster its existence than, as I have referred to elsewhere, ‘the promise’ (pp.273-274). That is, the promise one day to produce the evidence that to date has eluded this rambunctious profession. In the meantime, smokescreens and dodgy ruses play poor substitute for the facts. We can like utter dolts nod knowingly when psychiatry tells us that there is a biological basis for, just say, a lack of insight (2010, p.272) or we can look just a little further and discover that what we have on offer is nothing more than a pile of shite…
Stop Censorship
I really do agree that in many cases the issue of mental illness and it’s forced interventions can be not only the action of the psychiatric community but also a tool used to silence political dissent, an aid in divorce cases, child custody cases, inheritance issues and even business dealings all have potential leverage which can be provided by the psychiatric community in many cases unwittingly. The main reason for this is that it can circumvent the legal system and avoid in many cases due justice.
Ciao Kristoff Morgan
Those uncommon circumstances where a citizen might need to be forcibly restrained for his or her own safety (and/or the safety of others) does not require a separate mental health legal regime. And yes, that separate process does deny anyone caught within its net, access to due process (etc.).
I also wonder how much this practice discourages people from getting needed help. I know that coming from a suffocating fundamentalist religious background the idea of a society nodding along because everything’s fine, everything’s great, you’re being crushed into nothing, but neverfear, it’s all for the best! is very familiar to me.
I need help getting over that anxiety and possibly even some form of PTSD but… the group of people I need to get help FROM have been documented to be engaging in pretty much the exact same activities I’m trying to get away from– social authority marginalizing other voices and stuffing them away “for their own good.”
How could I really trust them?
Colleagues of mine who work in public mental health have had to advocate for years to get things like dialectical behaviour therapy (DBT) groups included as part of the treatment program. Innovative and effective as such groups often are, they are still seen by the powers that be as a bit of lark.