Forced psychiatric medication

Great Debates
61

Okay, TVAA. So you want to derail yet another thread about mental health issues. You’ve gone from claiming I said I don’t know anything about diagnosis and treatment to claiming I don’t know the ramifications or consequences of involuntary commitment. You must immediately quote where I said anything remotely suggesting the above. Particularly crucial is anything that suggests that I don’t know what my responsibilities as a practicing clinician are.

Ultimately, it would be particularly helpful if you could answer any of my questions, now asked of you specifically twice, and three times in general. An expert such as yourself should have no problem. However, first and foremost, QUOTE WHAT I SAID THAT JUSTIFIES YOUR CLAIMS!

62

Of course, they can usually spell ‘commitments’ better… aargh.

63

DSeid, part of the problem is that the law is partly contradictory, and the existing systems aren’t great. The fact is that we’re not good at predicting which people pose a significant threat of violence, either to themselves or others.

It’s not quite as bad as the days where all it took was a psychiatrist who thought commitment would be a good idea. There are slightly more checks and balances. But, I said, the system is far from perfect. The patient usually can’t appeal himself, and if he doesn’t have a concerned family with a lawyer or two… well.

A “normal person” probably couldn’t be incarcerated with the same amount of information as was against hlanelee. The standards are simply different, and the courts have a very strong bias towards “acting in the patient’s best interest” (read: commitment).

The laws aren’t great, their spirit isn’t often followed, and they’re sometimes broken.

64

I want to clear up one misunderstanding about my own experience. The psychiatrist responsible for giving me the shock treatments was the one who was helpful to me – even though I had no input. The psychiatrist who misdiagnosed me, lied to me and gave me the wrong medication did quite a bit of damage.

Back to the OP: Dateline tonight had the story of a college student who had intentionally driven his car into a crowd of other students, killing four of them. He was convicted of murder and then determined by the jury to have been insane. (Very strange case.) At any rate, he had stopped taking his medications and his parents were aware that he had stopped. Because they did allegedly did nothing about it and did not notify school officials of his illnesses and his refusal to continue with medication, they have had several wrongful death lawsuits brought against them. I think they are settling out of court.

If they are still held responsible for their son’s actions after he is a legal adult, think of the repercussions if he were a minor and they did not see to it that he took his medications.

65

TVAA “concerned family with a lawyer” didn’t help much either. My wife’s cousin is the Solicitor, then and now, my lawyer is in his brother’s firm, it didn’t make a difference. Also I went to high school with the high sheriff at that time. He told me that when the order of detention came across his desk he was doubtful but like everyone else, once the order was signed by a judge (that they all had to work with on a daily basis) nothing could be done until the “doctor of the day” evaluated me, treated me, and a group of doctors(?) released me to my wife’s custody. It actually was a case of backwoods, Southern justice in action.

DSeid one does not necessarily get drunk by choice. Many times I went out to have a “beer or two” and woke up 100 miles from where I started. Also, I can feel mania coming on, pressured speech, fast thinking, etc. If I think I’m going to do something scary or it is inconvenient, I’ll call my Doc. But mania can be a highly pleasurable experience, sometimes I like to “feel like God” and that’s what it is but sometimes it’s scary. Being drunk is the same.

Speaking from personal experience rather than academically, I would rather wake up in a communal drunk tank than naked in a pink room isolated after being shot in the ass with thorazine. Let me repeat what I said, how you live with your past is a measure of who you are and is vital to growth and development.

Some people think that it would be nice for “crazy” people to be made to take their meds so that they may think like “normal” people. I like thinking like “normal” people, but it occurs to me, and I’m more an engineer than a doctor, that ideas like the Nash Equilibrium, for instance, did not come from “normal” people.

66

Wait a second,

One certainly does necessarily get drunk by choice. Purchase alcohol, consume alcohol, repeat. Step one in the process may be circumvented at times if the beer is free. I suppose one could be forced to drink at gunpoint or whatever, but If were talking about intent to “have a beer or two” we’re not talking about coersion or torture.
This reads like an argument that you shouldn’t be allowed to drink even if you want to.

No way can you compare getting drunk to a manic phase in terms of how the two come about, although the feeling may be similar.

Are you suggesting that John Nash was able to experience enhanced understanding and creativity specifically because he had schizophrenia?

Most of the people with mental illness I’ve known have been of about average intelligence, and have had diminished ability to apply their respective strengths because of their illnesses.

67

People drink alcohol to lower their inhibitions. This impairs judgement, “why not have another drink?” and so on. Is drunkeness always really a choice? People should not drink alcohol. This is my opinion but I would not force it on anyone.

If a woman is bipolar and wants to have a baby would you MAKE her take Valproate or Eskalith, knowing they may cause birth defects? That brings up another nasty issue. My grandfather was diagnosed schizoprenic, two of his sons are bipolar, my mother appears bipolar at times, and no one doubts my mental condition, should my family not be allowed to procreate?

I have in the past been encouraged to take an antipsychotic to help my condition. I’ve taken several different ones. I will not take one again, no one will make me. I do not like sleeping ten hours or more a day and as long as I am able, I will enjoy an occasional hard-on.

68

DSeid:

Sure

More on request.

69

The first drink is a sober choice, clear and simple.
the second drink is affected by the first, but still a choice.
the third is still a choice, as is every one after that. They’re choices affected by increasing drunkenness, but still choices. This is the act of surrendering one’s capacity to make clear choices, a knowing purposeful act.

At some point the bartender has to cut them off. You wouldn’t?

Now, if you want to argue that someone who is alcohol dependent doesn’t have a choice, that’s another story, but then, should someone force that person into rehab or let them die?

I wouldn’t advocate for anyone’s reproductive rights to be rescinded. I would advocate improved services for those who are in need.

So, there’s no situation wherein you’d have your loved ones commit you and have you medicated?

70

Greck NOW I agree, in extreme circumstances someone’s loved-ones should be able to have them committed and force treatment, someone that sincerely cares. I have helped do it. I would want it done to me. Speaking as someone who is mentally-ill and a recovering alcoholic I know that sometimes there is no other way. My interpretation of the OP was: “Forced psychiatric medication”…by some minion of the government. This scares the shit out of me.

I would like to offer my sincerest apologies to all participants in this thread for my misunderstanding. I am after all brain-damaged, but that is another thread.

71

Itis our “loved ones” who have often been the most egregious offenders. Best intentions and roads thusly paved, with friends like these, serpent’s tongues, and all that. Dieties of record, protect us from NAMI!

New York (my locale, and the site of the events referenced in my cite above) has a law somewhat better than that of many US states, in that it specifically says you have the legal right to refuse psychiatric meds even if said to be mentally ill, even if found mentally ill and dangerous to self or others and therefore appropriate for involuntary commitment, and that therefore they have to hold a hearing to determine whether the patient is competent.

And, as my link should illustrate, the situation still sucks.

The law should more explicitly spell out what constitutes adequate decision-making capacity, and should also specify that the hearing must take place in a venue not separated from the venue where people other than the “mentally ill” are evaluated for competency, and not in a segregated block of hearings.

Actually, they should not be able to involuntarily incarcerate someone in the first place as “mentally ill and in need of treatment”. Involuntary incarceration should depend on being found incompetent. The competency hearing should not be a place where it is even legal to mention the phrase “mentally ill”, and it should be necessary to convince a judge predisposed to assume all individuals competent unless their incapacity to make rational decisions can be demonstrated right there in the courtroom that the person in question should not be making his/her own decisions about his/her own medical treatments or anything else and therefore needs a court-appointed guardian.

Then, if a guardian is so appointed, the guardian would have the authority to consent to psychiatric incarceration and to psychiatric treatments proposed by the doctors.

Any other way yo do it, you effectively create a legal end run around the individual freedom protections set up under law.

I know there are those who say “But psychiatric commitment and forced psychiatric medication and electroshock and whatnot are almost always only applied to people who really are incoherent and messed up in the head / I work with them, believe me if you saw them you’d agree that they have no business making their own decisions”, etc. But one could make a similar argument for police officers, i.e., “they arrest you because you broke the law, it’s their job to make that evaluation, people who are not doing wrong hardly ever get hauled off to jail, and no matter how the Perry Mason show depicts things the arrested and accused are pretty much universally guilty of what they were charged with” – but we recognize the need for protecting the rights of the accused; we put the concern for the few who are wrongly accused on a higher pedestal than we put the desire to punish the guilty and let none of them get away with what they did. We set up a system where the accused must be prosecuted and the guilt w/regards to the alleged crime proven beyond a reasonable doubt in the face of the assumption of innocence.

So why in the world should it be tolerable to have a system whereby the statement of a specialized medical doctor, whose opinion is derived from observation and interpretation of behavior and not backed by empirical objective laboratory data, to the effect that a given person’s mind is not working right, is sufficient in a non-adversarial pseudo-courtroom to have that person involuntarily incarcerated? Psychiatric commitment hearings are not due process. There is an assumption of “you would not be here if you did not need to be here”, combined with “it’s a medical issue, not a legal issue, and the psychiatrist does of course know best” in an environment where no assumption to the contrary is mandated.

And, as many of us who have been involuntarily psychiatrized will tell you from our own personal experiences, it can happen to anyone and it can be and has been used as an alternative to administrative or police intervention when someone finds you inconvenient or inappropriate and wishes to have your activity stopped.

72

AHunter3 Where were you when I first started posting? I was committed by an employer that didn’t want to be sued. I agree it’s easier and cheaper to put away a spouse than get a divorce. When I was committed it was determined by an intern that my doc with 15+ years experience was giving me the wrong treatment. The system has gaping holes. The powers that be really don’t care. You are not a clinician, are you? It’s interesting a number of posts in this thread are one person trying to get another one to apologize to him. These are probably clinicians, that would be par.

I have been a victim of the system and it does indeed suck. The problem is that too many innocents; children, spouses, people in the street; end up dead because someone impared by mental illness or alcohol (I don’t specify) killed them. The powers that be need to look useful.

73

hlanelee, what is the best way, in your opinion, to prevent someone with a mental illness from killing innocent people? (I acknowledge that not everyone with a mental ilness or alcohol impairment is violent.)

Should threats be considered? Past behavior? Carrying a weapon? What clues should we follow to prevent tragedy?

74

Zoe, what is the best way, in your opinion, to prevent a person who doesn’t have mental illness from killing innocent people, and why would it differ if the person happens to have a psychiatric diagnosis?

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I don’t know, AHunter3. I just know that I think that more needs to be done about people who threaten and/or stalk – whether they have a diagnosis or not.

You post about competency left me wondering if you think that all people who are incompetent should be dealt with the same way.

hlanelee, don’t worry about the misunderstanding. It happens to all of us sooner or later. I just appreciate your talking to us about your own experience. That must have been really frightening and frustrating.

76

I don’t know the answer. I used to work in quality control in manufacturing and when I worked on a problem, I liked to go closest to the people that actually did the work, the further away you moved from this, the more a problem became an “accounting” problem and became more academic than real. Any supervisor can tell you anything that is done on his line but it takes the actual workers to show what is really done. Most police officers can tell a person that is likely to be dangerous and can use good judgement if allowed (look like a duck, act like a duck). Some are fascists, true but that’s just life (I live near Goose Creek). I would rather trust a pig with the decision than a lawyer or doctor that is not on the scene but writing the orders and is probably more concerned with liability and appearances. In my case a judge signed the order based on evidence brought to him and it was final like the word of God. The police officers were told to pick me up, “Oh, by the way, he has a appointment to see his psychiatrist at 6:00, he’ll be there.”(look like a duck, act like a duck). I was in the custody of two different officers over 10 hours. They said that I did not seem dangerous but they were just doing their jobs. I think someone should actually be caught doing something threatening or there should be some damning evidence. I’m blue collar, though, and that’s just my opinion. (hijack) I think highly of my shrink, he’s better than average. A few weeks ago, I went to him to have him fill out some patient assistance forms from a pharmecuetical company. He did not know that I could not afford the medications he prescribed and he was impressed that I had researched as I had. When I told him that most people would just suffer, he said that they could go to the Mental Health Dept. He believes this. The fact is we cannot treat all the people that want and need treatment.

77

I won’t trot out the claim that we are no more violent than other people – it may be true, but I’m inclined to think that it should be a non-issue even if it were not true and we were statistically more violent than other people.

Profiling by race and ethnicity has been frowned upon and banned as a practice in many venues because it is widely felt that even if this or that ethnic group can be shown to be statistically more likely to commit a crime, the reasons for this would have more to do with an ongoing tendency to suspect, investigate, and arrest members of these groups (i.e., prior profiling), as well as economic and environmental situations that make members of these groups subject to more situational pressure and more opportunities to engage in these behaviors.

Same is true for us. If schizophrenics or bipolar people were to turn out to be statistically more violent than other people, I’d think it has a whole lot to do with the fact that our behavior is scrutinized more suspiciously with the worry and expectation of violence, and also a whole lot to do with the fact that we are selectively harassed, belittled, attacked, and otherwise subjected to aggressively conflictual behaviors and therefore respond in kind as people do, and even the violence of all of the involved people is tabulated we are going to come out as statistically more violent simply because we are a minority. Do the math. If 100 nonschizzies each pick one fight with one schizzy in a population containing 20 schizophrenics, and we count the number of times people have been in a fight, the schizophrenics come out looking pretty violence-prone.

And even when we think we know that a certain population is, as a population, more violent, inherently more violent, that it really is an inherent part of their nature to be more violent, we don’t modify the rule that says you are accountable for what you do and not for what someone thinks you might do if they didn’t lock you up beforehand to prevent it. If it makes sense to incarcerate the potentially violent, we’d round up the males. The stats are compelling. Even if you and I do not agree, there are many who believe that males are more violent not for any cultural or situational reason but simply as a consequence of being male in the first place.

And yet we say that we will only arrest men if they actually go out and do something. Despite the fact that this means the violent act was not prevented, that’s how we do it.

78

Just to clarify:

Is the problem with the structure of the system or the implementation of the system? That is, with the law itself or with how well or poorly judges and psychiatrists excercise their obligations as required by the law?

What changes to the structure would you propose?

79

Yes. (Well, you asked.)

80

Yeah, what TVAA said :slight_smile:

The law sucks (special laws that apply only to us, with insufficient guarantees of due process, insufficiently specific requirements and procedural directives pertaining to what must be established before our will can be legally overriden), and the implementation of existing law generally sucks as well (the protections that we do have are turned into a farce when the participating authorities are operating from a perspective where they believe the desired outcome is that the mental patients must be medicated). And the second is due in large part to the first (lack of specific protections combined with segregated hearings that only address the competency of mental patients rather than the competency of any adult whose competency is being challenged) results in an overall situaton that sucks.

DSeid, I thought I had proposed some structural changes-?? Rework all mental hygiene statutes that pertain to involuntary incarceration and treatment so that they simply say that they can’t take place unless a person is found incompetent according to mainstream (non-mental-illness specific) statutes. That gets the question of our decision-making capacity out of the “mental patient ghetto” and then they can force haldol on me only under the same circumstances that they could perform medical procedures on you against your will.