Should paranoid schizophrenics be forcibly committed?

[astro]

I was watching this show on Court TV this evening, about how this woman with paranoid schizophrenia killed a harmless man because she believed he was a government assassin out to get her. In the course of her trial it became evident that she had been suffering with this mental disease since her twenties, and had always refused help because she thought that everyone else was either clueless about the conspiracies that surrounded her, or out to get her.

If you have someone who's seriously nuts like this, but has not yet committed any crime, is it moral and/or ethical to enforce therapeutic measures, even if it is against their will, for the safety of society?

[Qadgop the Mercotan]

Originally Posted by astro

If you have someone who's seriously nuts like this, but has not yet committed any crime, is it moral and/or ethical to enforce therapeutic measures, even if it is against their will, for the safety of society?

I don't believe so. IIRC, the actual percentage of schizophrenics who do significant harm to others is quite small. So one would be pre-emptively incarcerating hundreds, if not thousands of individuals in order to prevent each serious assault.

Frankly, I think the odds are better in terms of getting risky individuals out of the way if we pre-emptively jail everyone ever arrested more than once for drunk driving.

[GorillaMan]

Agreed. It's quite probable that the woman in question never showed any behaviour that would have indicated violent tendencies towards others. And schizophrenia only rarely causes such behaviour anyway.

[norinew]

Originally posted by astro
has not yet committed any crime

This is the key phrase. They haven't committed a crime, so they aren't a criminal, therefore we have no right to lock them up. One might argue about the potential for harm to others, but one would be full of it. Everyone who gets behind the wheel of a car (and I'm not talking drunk driving a la QtM, just every day driving) could potentially kill someone. But we don't lock up the people who drive because the potential for harm is very small. Same with the potential for harm with mentally ill people.

[EsotericEnigma]

People are incarcerated in mental hospitals all the time without committing any crimes, aren't they?

Paranoia/schizophrenia seems like reason enough to legally force psychological treatment on someone to me. In my currently right-thinking mind, I seriously hope that someone will commit me if I suffered from a mental disorder that I was unable to acknowledge as a side effect of the disorder itself.

Has nothing to do with protecting society, though. It has everything to do with helping the people with those disorders.

[The Flying Dutchman]

Originally Posted by EsotericEnigma

In my currently right-thinking mind, I seriously hope that someone will commit me if I suffered from a mental disorder that I was unable to acknowledge as a side effect of the disorder itself.

Exactly

I'll be damned I'd I allow the "demons" to take control of my life instead of the state. Certainly some institutions might show up on 60 Minutes, but the record of the "demons" is pretty dismal. I would say "If they kidnap me, please rescue me and put me in protective custody".

Its a damn shame to see the degree of homelessness out there, with a significant proportion caused by dumping the mentally ill out onto the street.

[GorillaMan]

Originally Posted by EsotericEnigma

People are incarcerated in mental hospitals all the time without committing any crimes, aren't they?

If they are judged to be an immediate danger to themselves, yes.

Paranoia/schizophrenia seems like reason enough to legally force psychological treatment on someone to me. In my currently right-thinking mind, I seriously hope that someone will commit me if I suffered from a mental disorder that I was unable to acknowledge as a side effect of the disorder itself.

Schizophrenia does not often render somebody incapable of understanding and consenting to treatment. Cases such as the OP are very very rare.

[Qadgop the Mercotan]

I'd be pretty damn hesitant to give over more power to the state to commit "those not in their right mind". You want to be forcibly held and medicated because you didn't vote the straight-party ticket? It's happened in the annals of modern psychiatry.

It's very difficult (but not impossible) to commit someone these days in the US. And that's the way it should be. Commit crimes, or be a clear and present danger to self and others, and then there are legitimate grounds for commitment. Fail to manage your life the way others think you should? Not a good reason for commitment to me.

And yes, there's lots of grey area in between. And yes, there's big problems with homeless mentally ill people. And more should be done. And perhaps those with mental illness who depend on public assistance should have their assistance tied in some way to compliance with a treatment plan. But lets not go nu..... Ahem. Let's not go overboard here and give the government more power to decide what methods of thinking need "intervention".

BTW, the institution where I work was originally named "Central Hospital For the Criminally Insane".

[YWalker]

This is just one of those situations where it's hard to come up with the best answer. I read what Qadgop just said, and I can't argue with any of it. But then I look back at the situation that my cousin was in. He was diagnosed as mentally ill. He heard demons, and they told him that he should kill himself because he was bringing only danger and shame to his family. The freckles on his arm were a sign of the mark of the beast.

He tried to kill himself with carbon monoxide, but failed when the vacuum hose he had rigged to bring the exhaust into the car melted. His father found him and tried to take him inside, but he fought off his father and ran away The family begged the sheriff's department to take him into custody for his own protection, but they weren't legally able to. But they were able to help find his body hanging from a tree on the family farm the next day.

I don't claim to know the answer to this difficult question. But I don't think the system we have is working.

[DSeid]

While I am sure that AHunter will be here shortly* allow me just to chime in -

The burden of proof is that the individual is an imminent risk of danger to him or herself or to others. Without such proof involuntary treatment should not be imposed.

Now having admitted to voices that tell him to kill himself or having made an attempt to do so meets that burden. Just having a different perception of reality than you or I do does not.

*AHunter, for those who have not yet met him online here, is our resident untreated schizophrenic who is quite articulate (and convincing) in his defense of his rights to be as he pleases and to make the decision to avoid treatment that he feels has very significant side effects.

[hlanelee]

Being mentally ill myself and pretty much indigent, also, I can tell you that the government is lax on providing mental health treatment to people that want it and cannot afford it, now. I've known people that reach a point that they can no longer stand the voices and their only option is to go to an emergency room and rant in a corner till someone comes out and gives them a shot of thorazine and locks them in a pink room. I don't know that the government is prepared to provide treatment to people against their will even though they may need it.

[hlanelee]

Just so you know right now a month's supply of Resperidal, a good antipsychotic, costs about $300 to $400. Do I need to remind anyone on the government's stance on prescription drugs?

[Zagadka]

Screw medication and treatment, lock us in a deep hole and throw away the key!

[AHunter3]

Hi, I'm a citizen, diagnosed paranoid schizophrenic, I'm "at large" and untreated, and I view the possibility of involuntary psychiatric incarceration and/or treatment as a grave violation of my civil rights. And yours.

a) Define "paranoid schizophrenic". You'd better be prepared to do so if you're going to support locking people up for "being" it. You could, of course, defer to the medical definition thereof, but there's something you need to know: the working definition of "paranoid schizophrenic" is "person who has been diagnosed paranoid schizophrenic". There is no "rule-out mechanism", nothing that anyone can test for to determine that a prior diagnosis was made in error. And the initial diagnosis is made on the basis of reported and observed behavior and self-reported feelings. Do you really want to advocate locking up anyone who, on the basis of opinion derived from interpretations of behavior alone and unsupported by any labs or other rigorously empirical evidence, has been labeled as such?

b) Why lock us up? The conventional standard for locking someone up in our society is "for doing something illegal and being convicted of it". There are people in America who openly belong to organizations such as the KKK and ascribe to sentiments about the permissibility and appropriateness of violence, and yet we don't lock them up until they actually do something. Some of us may be really hard to understand (and find other people hard to understand, for that matter); you may be afraid of them and they may be afraid of you. And yet that only occasionally makes some of us violent some of the time (and we're more likely to be on the receiving end of the violence, picked on for being "nuts"). The psychiatric standard in most of the country is "mentallly ill and dangerous to self and/or others", not "mentally ill" by itself, and yet the ability of people to predict dangerousness is pretty limited and their accuracy rate is lousy (I'll dig up a cite on this if requested). So why not just treat us like everyone else and arrest us and charge us if we actually do something?

c) On the other hand, why stop there? I mean, already you're talking about having us locked up without due process (how could due process exist if we're being locked up for something we are rather than something we did? how does one defend against that? we can't even deny being "paranoid schizophrenics", see (a) above), and unless you had a finite sentence in mind (you'd release us after, say, a year? but we're still "paranoid schizophrenics" the day we get out, wouldn't you have us locked up again on the same basis as we were locked up the first time?), that means indefinitely. Having permitted this kind of an approach to public safety and security, why not just have us gassed? I mean, is there a human rights or civil liberties concern that gets invoked at this point, but not prior to this point, that would cause you to have problems with that? Or maybe burning us at the stake would be more the thing, depending I suppose on one's historical precedence preferences.

[laigle]

I dunno. I'm definitely for forced treatment. I might even be for forced hospitilization on a case by case basis, to get the people who are absolutely out of synch with reality some help. It's a rather touchy subject, because I am vehemently against locking people up when they only have the potential for harm, but you have to take into consideration that in these cases people may have no real control over that potential.

[BrainGlutton]

Yes, you should be.

[koeeoaddi]

I usually don't post in Great Debates, but this issue is of great interest to me. My grandfather, a First World War veteran, spent the last 30 years of his life committed to a V.A. Hospital Psych Ward. He was diagnosed with PTSD ("Shell Shock"), which changed over the years to Paranoid Schizophrenia.

It wasn't easy to have him committed, even back in the 1930s. It took a temporary commitment with psychological testing, a hearing in front a judge with the testimony of three doctors, his family and several witnesses on both sides. Still, once they had him, AHunter3 is right, they had him till his very last day on earth.

Though I understand why my family had him committed, a look into his medical records reveals just a glimpse of one of the saddest, most depressing existences imaginable. An utterly wasted life.

I don't know what the answer to this is, beyond the hope for more effective, accessible drugs.

[GorillaMan]

Originally Posted by laigle

I dunno. I'm definitely for forced treatment.

Why, in cases where people are no immediate danger (assuming that by hospitalisation when 'out of synch with reality' means when shizophrenia does theaten people's safety)? Or are you in favour of forced treatment on a wider scale, such as blood transfusions for Jehovah's Witnesses, or animal-derived pharmaceuticals for strict vegans?

[Zagadka]

Originally Posted by AHunter3

Hi, I'm a citizen, diagnosed paranoid schizophrenic, I'm "at large" and untreated, and I view the possibility of involuntary psychiatric incarceration and/or treatment as a grave violation of my civil rights. And yours.

Interesting, I am as well. What you said speaks volumes, but I'd like to add some to it.

b) Why lock us up?

The kind of thinking, "lock them all up" is falling back centuries in history. We've come to a point where we have medications and therapy that are effective. "Locking them up" is a solution that led to centuries of people with mental disorders having their lives RUINED. You may as well just execute us - it would be better than spending life in an institution rotting away. I've spent enough time there, thanks.

I don't have a problem with "forced treatment" - the problem is, how do you fund the treatment? I'd be happy if you want to foot the bill for me. I can't work, so have no insurance, and holding people in hospitals for long periods of time is very expensive... not to mention the thousands of dollars of meds every month.

c) On the other hand, why stop there?

On that note, romances cause way more murders than schizophrenics or schizo-effectives. I can think of a hundred things that you could prevent from happening to sanitize society before locking us all up and throwing away the key.

[laigle]

Originally Posted by GorillaMan

Why, in cases where people are no immediate danger (assuming that by hospitalisation when 'out of synch with reality' means when shizophrenia does theaten people's safety)? Or are you in favour of forced treatment on a wider scale, such as blood transfusions for Jehovah's Witnesses, or animal-derived pharmaceuticals for strict vegans?

There is no case where a threat is not posed to the public by a paranoid schizophrenic. In mild cases of the disease the symptoms can be recognized and controlled, but in an advanced state the person is unaware of actual events around them and convinced that those around them are trying to do them imminent harm. They are in a state in which they are presented with a situation that would cause a reasonable person to commit acts of violence against others. That situation just isn't real. It's unfortunate, even tragic, but their rights do not negate or supersede the rights of those around them.

We regularly commit the insane. We also quarantine those carrying dangerous, communicable disease. When people have conditions that make them a threat to others, they are isolated if necessary and treated where possible.

What does your utter piffle about Jehovah's Witnesses have to do with mental illness? Or are you just going to plug up your ears and pretend that schizophrenia is merely a difference of opinion?

[GorillaMan]

Originally Posted by laigle

There is no case where a threat is not posed to the public by a paranoid schizophrenic.

That is simply not true. Learn the facts before making sweeping statements.

What does your utter piffle about Jehovah's Witnesses have to do with mental illness?

I was asking how far you extend your policy of forced medication and treatment for people who do not pose a threat.

Or are you just going to plug up your ears and pretend that schizophrenia is merely a difference of opinion?

Did I say that? No.

[AHunter3]

laigle, I may or may not be unaware of actual events around me, I may or may not be a danger to people, and on these matters you don't have any easy way of discerning. All you know is that a psychiatrist once diagnosed me as paranoid schizophrenic.

Do you propose that I should be locked up against my will indefinitely?

[EsotericEnigma]

Originally Posted by AHunter3

Hi, I'm a citizen, diagnosed paranoid schizophrenic, I'm "at large" and untreated, and I view the possibility of involuntary psychiatric incarceration and/or treatment as a grave violation of my civil rights. And yours.

a) Define "paranoid schizophrenic". You'd better be prepared to do so if you're going to support locking people up for "being" it. You could, of course, defer to the medical definition thereof, but there's something you need to know: the working definition of "paranoid schizophrenic" is "person who has been diagnosed paranoid schizophrenic". There is no "rule-out mechanism", nothing that anyone can test for to determine that a prior diagnosis was made in error. And the initial diagnosis is made on the basis of reported and observed behavior and self-reported feelings. Do you really want to advocate locking up anyone who, on the basis of opinion derived from interpretations of behavior alone and unsupported by any labs or other rigorously empirical evidence, has been labeled as such?

b) Why lock us up? The conventional standard for locking someone up in our society is "for doing something illegal and being convicted of it". There are people in America who openly belong to organizations such as the KKK and ascribe to sentiments about the permissibility and appropriateness of violence, and yet we don't lock them up until they actually do something. Some of us may be really hard to understand (and find other people hard to understand, for that matter); you may be afraid of them and they may be afraid of you. And yet that only occasionally makes some of us violent some of the time (and we're more likely to be on the receiving end of the violence, picked on for being "nuts"). The psychiatric standard in most of the country is "mentallly ill and dangerous to self and/or others", not "mentally ill" by itself, and yet the ability of people to predict dangerousness is pretty limited and their accuracy rate is lousy (I'll dig up a cite on this if requested). So why not just treat us like everyone else and arrest us and charge us if we actually do something?

c) On the other hand, why stop there? I mean, already you're talking about having us locked up without due process (how could due process exist if we're being locked up for something we are rather than something we did? how does one defend against that? we can't even deny being "paranoid schizophrenics", see (a) above), and unless you had a finite sentence in mind (you'd release us after, say, a year? but we're still "paranoid schizophrenics" the day we get out, wouldn't you have us locked up again on the same basis as we were locked up the first time?), that means indefinitely. Having permitted this kind of an approach to public safety and security, why not just have us gassed? I mean, is there a human rights or civil liberties concern that gets invoked at this point, but not prior to this point, that would cause you to have problems with that? Or maybe burning us at the stake would be more the thing, depending I suppose on one's historical precedence preferences.

Your mental disorders are a medical condition. I don't advocate "locking you up" or indeed doing anything at all regarding the criminal justice system. This is not a criminal case.

Similarly, I would be in favor of forced medical treatment for someone who has shattered their elbow playing tennis, or who contracts teburculosis, and insists on ignoring treatment.

Why exactly have you decided not to seek treatment, by the way? It sounds like you recognize the disorder in yourself, and are intentionally avoiding treating it, which makes as much sense to me as getting stabbed in the leg and trying to walk it off while it bleeds.

Treatment for paranoia/schizophrenia is almost never a "lock them up" case. I seriously doubt that anyone who has not committed a crime has been involuntarily incarcerated for this disorder, and certainly not without either harming or attempting to harm themselves or other people. I personally know a severe paranoid schizaphrenic, who has made death threats and done violent damage to property due to his condition, and endangered his child's life during one particular episode while he was driving (an episode that ended with him in the hospital and his car completely totalled), before he was treated for the condition. His treatment involves psychology and medical prescriptions.

[GorillaMan]

Originally Posted by EsotericEnigma

Similarly, I would be in favor of forced medical treatment for someone who has shattered their elbow playing tennis, or who contracts teburculosis, and insists on ignoring treatment.

OK, so TB is a public health issue - but why on earth do you want to impose treatment on somebody with a broken elbow?

[yosemite]

Originally Posted by GorillaMan

OK, so TB is a public health issue - but why on earth do you want to impose treatment on somebody with a broken elbow?

Yeah, I wanna know too. Was that a typo?

[Zoe]

According to an article that was in the British Journal of Psychiatry in 2002, only .03% of schizophrenics are convicted of a violent crime each year. We can't look people up because they might become violent. They are human beings! You might have a brother or child who is schizophrenic. Can you imagine having that person removed from your family?

And think of how many groups might end up on that list as "potentially violent."

Zagadka: I can't work, so have no insurance...

Have you applied for Social Security? That won't help with medicine much, but Medicare does make a big difference in what you are charged to see a physician. And maybe there will be relief soon for expensive medications. It is a hassle to apply, but there are people who can help. I have a permanent disability because of chronic depression. (My illness responds well to medicine, but the medicine has side effects which also cause problems in functioning normally.)

[vanilla]

Originally Posted by laigle

We also quarantine those carrying dangerous, communicable disease. When people have conditions that make them a threat to others, they are isolated if necessary and treated where possible.

Who'se we?
You've described people with AIDS, and they are certainly not quarantined.

[Squink]

Originally Posted by laigle

When people have conditions that make them a threat to others, they are isolated if necessary and treated where possible.

If that's the case, why do I see so many people driving down crowded city streets at 40mph with all their attention riveted to their cell-phone. I had to swerve to avoid one of these self-obsessed assholes today. Clearly he was a threat to me and himself.

[AHunter3]

EsotericEnigma:

Your mental disorders are a medical condition. I don't advocate "locking you up" or indeed doing anything at all regarding the criminal justice system. This is not a criminal case.

Similarly, I would be in favor of forced medical treatment for someone who has shattered their elbow playing tennis, or who contracts teburculosis, and insists on ignoring treatment.

Why exactly have you decided not to seek treatment, by the way? It sounds like you recognize the disorder in yourself, and are intentionally avoiding treating it, which makes as much sense to me as getting stabbed in the leg and trying to walk it off while it bleeds.

1. Because I like me the way I am and I do not wish to be normal.

Allegory time: Not too terribly long ago, gay folks were regarded as being not merely different but sick. (In fact, it would not have been unusual for someone to receive a diagnosis of schizophrenic as a consequence of being homosexual). And "normal" (i.e., hetero) people of that time had no comprehension of how or why anyone would or could embrace such a difference. But nowadays most of us have a better grasp of gay pride. We understand that, occasional exceptions aside, most gay folks do not wish they had been straight instead; they would not embrace a therapeutic "conversion" to heterosexual if one were available and would wage a political fight against one if it were proposed that a conversion be forced upon them. Because they like the way they are. So do I. Think of it as "schizzy pride".

2. Because the institutions that have the forced treatments don't have a cure anyhow.

What they have is an arsenal of pharmaceuticals. Those pharmaceuticals have varying effects on our neurological functions, most of them muffling the tendency of nerve cells to do what nerve cells do: synapse. This is especially true of the class of chemicals that are prescribed for schizophrenics. No matter what you may have heard, these meds are not to schizophrenia what insulin is to diabetes. They are more akin to what demerol is to someone with a killer migraine. Taking demerol will enable some migraine sufferers to think coherent thoughts instead of being incapacitated by the pain, but for others the medication just muffles everything and puts them in a drugged-up haze. So it is for psych meds. They help some of us with symptoms that we find unpleasant. For others, they are worse than the symptoms they purport to treat. Oh, and they are risky, and tend to cause permanent brain damage if you use them for a prolonged stretch. Me, I'll pass.

3. You would really advocate forcing elbow reconstruction surgery on an adult who did not consent to it? Astonishing. Would you force open-heart surgery on an adult with a cardiac condition who preferred to just see if diet and good luck would get them through? If the enthusiastic neurologist who lives down the street from me decides you have Tourette's, is it OK if he has you strapped to the operating table while he does a little experimental surgery on your hippocampus?


I am not a disease. I appear to have a difference which I share with other people. I am an activist in a pluralistic society saying that I like who and how I am. I break no laws and I want no cure.

[AHunter3]

Oh, btw:

Treatment for paranoia/schizophrenia is almost never a "lock them up" case. I seriously doubt that anyone who has not committed a crime has been involuntarily incarcerated for this disorder, and certainly not without either harming or attempting to harm themselves or other people.

You are wrong.

I wish you were right, but you're not.

[Qadgop the Mercotan]

Originally Posted by EsotericEnigma

Treatment for paranoia/schizophrenia is almost never a "lock them up" case. I seriously doubt that anyone who has not committed a crime has been involuntarily incarcerated for this disorder, and certainly not without either harming or attempting to harm themselves or other people.

Snort

I trained in the "D building" of the old Baltimore City Hospital.

Pull the other one, it's got bells on it.

QtM, MD

[Guinastasia]

AHunter3, FWIW, you certainly don't sound like someone with paranoid schizophrenia, who happens to be untreated.

Is there research to find a better way to treat this disorder, so people WON'T have to go around in a drugged up haze? So it could be something like anti-depressants, that are used to restore a chemical imbalance?

[alaricthegoth]

might one not legitimately distinguish

danger to others

from

danger to self?

I'm far less uncomfortable with a preemptive involuntary intervention where homicidal ideation is demonstrable; suicidal ideation, on the other hand, is really no body's business.

[EsotericEnigma]

Originally Posted by AHunter3

EsotericEnigma:

1. Because I like me the way I am and I do not wish to be normal.

Allegory time: Not too terribly long ago, gay folks were regarded as being not merely different but sick. (In fact, it would not have been unusual for someone to receive a diagnosis of schizophrenic as a consequence of being homosexual). And "normal" (i.e., hetero) people of that time had no comprehension of how or why anyone would or could embrace such a difference. But nowadays most of us have a better grasp of gay pride. We understand that, occasional exceptions aside, most gay folks do not wish they had been straight instead; they would not embrace a therapeutic "conversion" to heterosexual if one were available and would wage a political fight against one if it were proposed that a conversion be forced upon them. Because they like the way they are. So do I. Think of it as "schizzy pride".

2. Because the institutions that have the forced treatments don't have a cure anyhow.

What they have is an arsenal of pharmaceuticals. Those pharmaceuticals have varying effects on our neurological functions, most of them muffling the tendency of nerve cells to do what nerve cells do: synapse. This is especially true of the class of chemicals that are prescribed for schizophrenics. No matter what you may have heard, these meds are not to schizophrenia what insulin is to diabetes. They are more akin to what demerol is to someone with a killer migraine. Taking demerol will enable some migraine sufferers to think coherent thoughts instead of being incapacitated by the pain, but for others the medication just muffles everything and puts them in a drugged-up haze. So it is for psych meds. They help some of us with symptoms that we find unpleasant. For others, they are worse than the symptoms they purport to treat. Oh, and they are risky, and tend to cause permanent brain damage if you use them for a prolonged stretch. Me, I'll pass.

3. You would really advocate forcing elbow reconstruction surgery on an adult who did not consent to it? Astonishing. Would you force open-heart surgery on an adult with a cardiac condition who preferred to just see if diet and good luck would get them through? If the enthusiastic neurologist who lives down the street from me decides you have Tourette's, is it OK if he has you strapped to the operating table while he does a little experimental surgery on your hippocampus?


I am not a disease. I appear to have a difference which I share with other people. I am an activist in a pluralistic society saying that I like who and how I am. I break no laws and I want no cure.

Your points are not based on any logic that I can see. Paranoia and schizophrenia are medical conditions. Would you let a chipped tooth fester because you like the way you are, and don't want to be normal? That's just plain absurd. If treatment exists, there's no reason not seek it, especially in such a severe case like this.

I would not force elbow surgery on someone who has broken their elbow. I would force medical treatment for the broken bone if they insisted on leaving it broken. This point doesn't matter anyway, because I doubt anyone with judgement that is not impaired would intentionally avoid treatment for a broken bone. Surgery is not the only form of medical treatment. In fact, it's one of the least used forms.

Also, read above for my response to your hypothetical heart surgery patient. Seeking treatment for his ailment through proper diet and activity is still seeking treatment. Diseased hearts can and have become healthy through this method.

Honestly, I can't understand the stand you have taken here. You talk and debate like a person entirely in their right mind, but the end result of your arguments lead exactly where many other paranoid schizophrenics go, which is "I don't need treatment." The fact is, you DO, and the disease itself is what prevents you understanding this, the same as it prevents so many others with your same condition.

[yosemite]

Originally Posted by EsotericEnigma

I would force medical treatment for the broken bone if they insisted on leaving it broken.

That's creepy.

You just can't do that. People have their agency.

For example, most of the people in my family are "crackpots," in that we believe in herbal cures and therapies. Not all of them, but some of them, some of the time. I have "cured" minor toothaches with goldenseal tea and I have "cured" other ailments by using teas instead of over-the-counter medicines. Some of these "cures" are deemed to be worthless by mainstream society, but I feel they have worked for me. One of my sisters (who is otherwise the most sane and sensible of the bunch) believes in homeopathic medicine and has inflicted it on her family from time to time.

If we prefer our "crackpot" cures instead of mainstream, medically proven ones, would you force us to be cured in the way that you see fit? Why? And if not, how is that any different than forcing someone with a broken elbow to get it "treated"? Maybe they are getting it treated, but in a way that they prefer (juniper berries, or who knows?).

[Lamia]

Originally Posted by EsotericEnigma

Paranoia and schizophrenia are medical conditions.

Medical conditions that are not well understood even today. I don't believe "paranoia" is considered a disorder in and of itself anymore, but rather a symptom of "paranoid schizophrenia". It's not clear how the various types of schizophrenia are related or if they are related at all, and there is as of yet no actual cure for any of them.

Personally, I think it's stupid and irresponsible for a schizophrenic to refuse medication that would help them. The key phrase being "that would help them". If the medication does not in fact improve their quality of life, I cannot see much justification for forcing it upon them.

I would not force elbow surgery on someone who has broken their elbow. I would force medical treatment for the broken bone if they insisted on leaving it broken. This point doesn't matter anyway, because I doubt anyone with judgement that is not impaired would intentionally avoid treatment for a broken bone.

The father of a friend of mine broke his leg after slipping on an ice patch and chose not to go to the hospital for it. He "took it easy" for a month or so, and considered that sufficient. I think it was a pretty stupid decision, but the man is, to my knowledge, not a lunatic so much as a macho type who also hates visiting the doctor. Do you think government agents should have been able to kick in his door and drag him into an emergency room against his will?

[even sven]

Originally Posted by EsotericEnigma

Your points are not based on any logic that I can see. Paranoia and schizophrenia are medical conditions. Would you let a chipped tooth fester because you like the way you are, and don't want to be normal? That's just plain absurd. If treatment exists, there's no reason not seek it, especially in such a severe case like this.

Drugs are not perfect. Despite what you may think, modern medicine doesn't have perfect answers- especially when it comes to psychiatric medicine. What we do have is a lot of measures that help some people but most all of them have some major drawbacks. We don't even have a good idea how a lot of them actually work- we just noticed somewhere along the way that it seems to help.

For example, electro shock therapy is very effective, but it can also dramatically change a person's personality- to the point that they "miss" who they used to be- and we don't have any idea what it actually does to the brain. It works, yeah, but it's not a cleancut answer like setting a broken bone.

Sometimes our medicines are big fucking hammers. It's like fixing a broken bone by cutting the arm off. Or making your whole body numb so you can't feel the broken bone. It's "doing something" but it's not really a solution. We arn't talking about cures here. We don't have cures.

And then there is the problem of what a "cure" even constitutes when it comes to phsyciatric issues. It's traditionally defined as being able to hold a steady job, have regular relationships and generally to "function". There is no denying that this is deeply dependent on the society your living in. Mental disorders are not clear diagnoses. Curing them is not a 1+1=2 kind of thing. It's more of an interplay of personalities and society and chemistry. But somewhere in there is a human. And that human may not want their brain chemistry altered. And that is their right. It's their brain. You don't know what trade-offs they are willing to make, and you don't have a right to alter the very stuff of who they are.

Mental disorders are a big tragedy. It sucks that people have them, and it sucks more that we don't have any real easy solutions. But it's insulting and outright wrong to liken them to broken arms.

[Zagadka]

Originally Posted by even sven

Sometimes our medicines are big fucking hammers. It's like fixing a broken bone by cutting the arm off. Or making your whole body numb so you can't feel the broken bone. It's "doing something" but it's not really a solution. We arn't talking about cures here. We don't have cures.

No shit. My 1.5 mg of Xanax just about knocks me out. It isn't so much blocking it out as numbing everything. BUT - it and my other meds lets me function around other people. A cure? No, but it makes life possible.

As a side note, schizophrenia is not incurable. I've known many cases of people who, after years of work, have overcome it.

Mental disorders are a big tragedy. It sucks that people have them, and it sucks more that we don't have any real easy solutions. But it's insulting and outright wrong to liken them to broken arms.

No, it is more like paralysis. It is something you can be born with, or can get through tragedy (PTSD, etc). It affects your ability to be around people, to get around, to live life, to work. It puts a burden on your loved ones as they help carry your weight (and put up with you on your worse days).

I have two friends I met before my schizophrenia really kicked in, one who has been paralyzed from the neck down for life, and one who is blind. The three of us couldn't work very well alone, but together, we had a great time (the blind chick is also the best pipe packer I've ever met). It is a pain in the ass going out, but we manage to do it, and do it almost normally. Boy, did we ever get on the Disabled Students Program's shitlist. But I learned a lot from them - I learned that anyone can live a normal life. The only time I actually feel psychologically safe is around them, not at the hospitals or anything.

[laigle]

Originally Posted by AHunter3

laigle, I may or may not be unaware of actual events around me, I may or may not be a danger to people, and on these matters you don't have any easy way of discerning. All you know is that a psychiatrist once diagnosed me as paranoid schizophrenic.

Do you propose that I should be locked up against my will indefinitely?

If you refuse treatment? Absolutely. Note the "I may or may nnot be aware of actual events around me" bit. Do you not understand that this makes you dangerous, especially when your condition makes you susceptible to believing you are under imminent threat from people around you? Or do you just not care?

[laigle]

Originally Posted by vanilla

Who'se we?
You've described people with AIDS, and they are certainly not quarantined.

Actually, if they go around spreading the disease,
we do.

[laigle]

Originally Posted by Squink

If that's the case, why do I see so many people driving down crowded city streets at 40mph with all their attention riveted to their cell-phone. I had to swerve to avoid one of these self-obsessed assholes today. Clearly he was a threat to me and himself.

A. Poor driving is hardly a condition, now is it?

B. Actually, reckless driving is a criminal offense for which said driver was liable for government sanction, now isn't it?


So you're actually going to suggest we don't lock people up for criminal acts. You do realize that's a non-starter, no? Let alone that it has no bearing on the debate of whether society should take measures to protect itself from people based on an innate condition.

[Lamia]

Originally Posted by laigle

If you refuse treatment? Absolutely. Note the "I may or may nnot be aware of actual events around me" bit. Do you not understand that this makes you dangerous, especially when your condition makes you susceptible to believing you are under imminent threat from people around you? Or do you just not care?

I don't think the fact that you don't know if he's aware of actual events around him or not makes him dangerous, and that's all the man was saying. That you don't know anything about his abilties or whether he's a danger to himself or others, just that he was once diagnosed as a schizophrenic, and you're prepared to treat him like a criminal for no other reason than that.

[Canadjun]

Originally Posted by laigle

If you refuse treatment? Absolutely. Note the "I may or may nnot be aware of actual events around me" bit. Do you not understand that this makes you dangerous, especially when your condition makes you susceptible to believing you are under imminent threat from people around you? Or do you just not care?

Many KKK and Aryan Nations folk believe they are under imminent threat from non-whites. I guess that's justification for locking them all up (probably wouldn't be a bad idea, but that's a different issue ).

The fact that someone may or may not be aware of actual events does not imply that they believe they are under imminent threat. You hear about the few paranoid schizophrenics that do believe that and act aggressively upon it; you don't hear about the many that do not.

[AHunter3]

Guinastasia thinks I don't sound sufficiently schizzy



...and EsotericEnigma thinks I'm so sick I don't understand how sick I am:

Honestly, I can't understand the stand you have taken here. You talk and debate like a person entirely in their right mind, but the end result of your arguments lead exactly where many other paranoid schizophrenics go, which is "I don't need treatment." The fact is, you DO, and the disease itself is what prevents you understanding this, the same as it prevents so many others with your same condition.

From this, can we conclude that Guinastasia is sick and in need of treatment, since she's sufficiently sick that she doesn't see how sick I am?


::scampers off giggling and capering::

[AHunter3]

Laigle, you may or may not be aware of things around you, too. Statement of incontrovertible fact.

[laigle]

Originally Posted by Lamia

I don't think the fact that you don't know if he's aware of actual events around him or not makes him dangerous, and that's all the man was saying. That you don't know anything about his abilties or whether he's a danger to himself or others, just that he was once diagnosed as a schizophrenic, and you're prepared to treat him like a criminal for no other reason than that.

Bzzt. Do try another strawman. I'd suggest saying I want to treat him like a heretic, but that's already been tried. I want to treat him like someone who is ill. Period. End of fucking story. Nice try on the childish, purile race/religion/politics bullshit all, but it's getting you nowhere.

Schizophrenia is a valid medical disorder. It causes the sufferer to be incapable of distinguishing reality from delusion. Delusions for paranoid schizophrenics generally revolve around the idea that they are under imminent threat from people around them for no particular reason. This is not a moral judgement. It's a symptom of a disease.

A disease which, I might add, is treatable in many if not most cases. However, the nature of the illness causes those suffering it often refuse treament. Look at the comments in this thread. "You can't make me take pills, I don't need pills, the pills infringe on my liberty, you're persecuting us all, you're just like the Klan!"

This is someone who needs medication to prevent them from being a threat to others, who refuses medication, and who must thus be put into a system of monitored treatment because they cannot provide care for themselves.

[don't ask]

In the 1970s I was a Psychiatric Nurse and it was a common event for the police to bring in some floridly psychotic individual that they had found on the streets. We would assess them , and if appropriate admit them under a schedule (a legal document that allowed us no more than 2 days before the patient was presented to a legal/medical panel to assess their competence). They would be medicated and often begin to function again, and would then be returned to their usual environment with the support of a community health team.

With the demise of the Psychiatric hospital system, as pre-empted by Ronald Reagan (RIP) in California these people are now consigned to lives of abject misery on the streets. I see them every day - 30 years ago they were being cared for in public institutions.

Largely these people were admitted because they were likely to cause harm to themselves, not others.

[Squink]

Originally Posted by laigle

A. Poor driving is hardly a condition, now is it?

A habit of choosing to drive recklessly, which is what cellphone addicts do whenever they pick up the phone under inappropriate conditions, borders on sociopathic behavior. Locking up cellphoners would reduce their threat to society, and might even help them learn to think before they do something stupid and dangerous.
If a person kills someone, it doesn’t matter to the victim what the killers state of mind was at the time of death. Flipped out paranoid, or thoughtless car-phoner, you still end up just as dead. So why discriminate on the basis of the killers state of mind? Should we allow our personal squeemishness towards those with classically defined mentall illnesses to blind us to the larger threat posed by inconsiderate jerks with cellphoners?
That said, I don’t much like the idea of stripping people of their freedom without damned good evidence that they pose a threat to society.

[astro]

Originally Posted by AHunter3

Guinastasia thinks I don't sound sufficiently schizzy

Well.. in all honesty AHunter3, you really don't, and please don't take this the wrong way as if I am imputing your credibility. I know nothing (really) of you and your mental health history, other than some of the threads I have seen where you discuss the ensnaring and stigmatizing nature of modern mental health treatment paradigms.

You have a very acute sense, and IMO, a largely accurate real world perspective on the current limits of medically diagnosing and treating serious mental health problems. I suppose the problem in seeing you - keyboard to keyboard - as a "paranoid schizophrenic" is that the condition in my layman's experience, based on the various paranoiacs I have met in my life (and I'm calling them that simply because IMO they behaved in an irrational and paranoid fashion), there is a seeming absolute inability to look outside the paranoia and understand that they are ill. Someone who can do this, consistently and successfully, is not a "paranoid schizophrenic". You apparently do this conversationally, and without medication.

In the show, the doctor they referenced as specialist on PS referred to it, as essentially having a "broken brain" and that there was no cure, period. The only real option was medication, and even that had its limits.

And yet here you are politely, rationally, cogently discussing the problem in all its details from a seemingly Olympian perspective. No one wants to dis your PS cred, but if what's supporting this definition (for you) is the egregious mis-diagnosis of whatever your problems were at the time, by some professionals in the past, the notion of your being really PS is a bit difficult to comprehend, (keyboard to keyboard at least).

[Squink]

Originally Posted by Astro

the condition in my layman's experience, based on the various paranoiacs I have met in my life (and I'm calling them that simply because IMO they behaved in an irrational and paranoid fashion), there is a seeming absolute inability to look outside the paranoia and understand that they are ill.

Have you been around a person with schizophrenia over a period of months or years? Often the condition cycles from better to worse, and back again. When times are good, it's not unusual for people with the disease to come across as cogently as does AHunter3. But you'd never know that if your only experience has been with strangers at a time of crisis.