Involuntary Psychiatry Extends its Reach: Illinois

Great Debates
1

Compulsory mental health screening for children and pregnant women in Illinois.

So now a sizeable portion of Illinois’ citizenry has no choice but to be subjected to psychiatric evaluation and the very solid possibility of forced treatment if found to be, in the opinions of the screening shrinks, in need of treatment. Millions of people who would not have previously had the misfortune of running afoul of this batch of pillpushing finger-pointing pathology-insinuating arbiters of normality now get to queue up and see how many of them can make it through the checkpoint with their sanity unquestioned.

This is the best argument against reproduction since Zero Population Growth. If I were a pregnant woman in Illinois, I’d either move or have an abortion. Pity the established families with kids!

There’s scanty enough evidence that psychiatric services do a significantly greater good than harm even for people who come to them desperately seeking help. Their track record for identifying and helping allegedly “mentally ill” people who don’t consider themselves to be in need of psychiatric services is more akin to the body of success stories of the medieval inquisition in locating and successfully exorcising witches and restoring them to their happy lives.

In modern western civilization where even in the face of outbreaks of lethal and highly contagious diseases mandatory medical screening is fairly rare, Illinois is going to subject all of its children to a screening process that’s subjective *, not in any way based on labs*, for a noncontagious disease they don’t know how to cure and are as likely to do major harm as help when they try to treat, and which conveys upon the diagnosee a heavy and permanent stigma which can mark them for different treatment for the rest of their lives, and make it part of their permanent record.

• When you pay a body of people to identify occurrences of a problem, they have an interest in finding some of those problems. If they found very few, it would appear unnecessary to continue to have them engaged in this task, and their positions within the bureaucracy of state agencies would be found expendable.

• The perspectives of the psychiatric profession are at this point heavily informed by the pharmaceutical companies, which are heavily invested in and involved in shaping the curricula. Some may deny that this is the case, but as Loren Mosher, President of the American Psychiatric Profession put it in his resignation letter in 1988, After nearly three decades as a member it is with a mixture of pleasure and disappointment that I submit this letter of resignation from the American Psychiatric Association. The major reason for this action is my belief that I am actually resigning from the American Psychopharmacological Association. Luckily, the organization’s true identity requires no change in the acronym. It’s a profession where the alleged “diseases” and “disorders” are poorly defined, cause and etiology are unknown, cure rates as a consequence of treatment statistically nonexistent, and even ameliorative symptom reduction from treatment controversial and problematic, but the one thing a psychiatric doctor can do — and fewer creatures are more unhappy than doctors charged with treating a condition who have at their disposal nothing they know of to do — is prescribe a psychiatric drug. And if it isn’t working, prescribe a different one. There are a lot of them out there, new ones every year, and it can take a long long time to try them all, especially if you play mix-n-match with different combinations. And as far as the pharmaceutical companies are concerned, this is all, as Martha Stewart would say, a good thing. So, to get to the point, this initiative is all about “let’s find some people who ought to be on psych drugs and put them on them”.

• Nowhere in the initiative is focus given to forced treatment, but where psychiatric evaluation goes, forced treatment is allowed to follow whenever and wherever it is legal for psychiatrists to order treatment over the wishes of a patient. Or a parent.

The scary part is the suspicion that this is just a test bed, and that they’ll be rolling out something similar nationwide soon.

Fuck.

  • links to recent posts by me and KillerKatt in a current thread on being diagnosed bipolar. Expansions on the concepts, rather than supportive empirical data, but I’ll dig up references if anyone demands them.
2

I don’t know. I personally wish somebody had checked me out when I was a kid and identified my OCD earlier. I might have had a better time in school. Of course, might is the operative word here.

I don’t think it’s a bad idea. I do think * compulsory* treatment, without consent of a parent or the patient, would be a mistake, but identifying problems early is a good idea.

I’m just going to have to see how it breaks out.

3

I don’t see anything in the article about forced treatment or even what they plan to do with the results from all this screening. Where did you get the information that there is a “very solid possibility of forced treatment?”

4

AHunter3, your OP sounds very similar to the standard Scientology screed against psychiatry.

In the interest of full disclosure - are you a member or supporter of the Church of Scientology?

As to the content of the OP - I fully agree that a compulsory checkup cannot be followed by complusory treatment by the same organization. Just too much room here for all kinds of corruption. But you are doing a disservice to a valid point by taking it waaaaay too far, IMO. I see no problem with compulsory testing, as long, of course, as any and all results remain strictly confidential and the decision on whether to take treatment or not (if diagnosed) remains the diagnosee’s (or their legal guardian’s) alone.

Dani

5

Well, if you want to get technical, most venues in America psychiatrists already have the right to impose treatment on you over your objections. There are some criteria that they are supposed to feel are applicable to your situation (“dangerous to self or others” in some places; “gravely disabled and in need of treatment” suffices in a few), but they don’t have to demonstrate that these conditions exist to the satisfaction of a 3rd party, they just have to cite it as being the case in their professional opinion.

But that’s not really my primary concern here. I don’t anticipate a huge wave of psychiatrists directly invoking their state-sanctioned police powers to detain and force treatment upon the kids and mommies of Illinois as a consequence of this law.

But this initiative is different from a psychiatrist making an individual assessment of someone – it’s a screening. When Suzy Fourthgrader goes to have a chat with the shrink as a standalone event, it’s unlikely that she would be affected by any school or community policy referencing the findings thereof, even if the shink in question thinks she has some serious problems. (We’ll assume in this case that the shrink does not impose involuntary treatment as described in the above paragraph). When Suzy Fourthgrader is assessed as part of a mass screening and is one of a group of kids her age who have been marked down as being in need of psychiatric treatment, how likely do you think it is that there could be a policy put in place about what has to happen next in order for Suzy to continue to attend school and/or Suzy’s parents to not be in a pile of administrative and legal trouble?

And for Sharon Momtobe, who along with many other pregnant women is found to be in need of psychiatric services in the opinion of the screening doc – a requirement attached to such things as AFDC, new additions to the postpartum discharge procedures at the hospital, maybe even an automatic referral to the social workers at Child Protective referencing any moms who have not complied with recommended psychiatric followup? Ya think?

Now do you see how coercion gets to be part of the package?

6

Forced Treatment:

Most states have adopted a very vague rule about treating those with psychiatric diagnosis. If the person is shown to be a harm to his or herself or a harm to others, then that person can be held, for an indefinite period of time, without trial, bail, or arrest (if your not arrested, you do not have the right to an attorney). Unfortunately, since most judges and law enforcement officials are ignorant about psychiatry, being a harm to oneself can and sometimes does include not taking medication.

Basically, anything a person does has the potential to harm that person or someone else. Once you get over that thought, it’s pretty easy to be confined to a mental hospital “for you own safety.”

I have been “involuntarily confined” at least 10 times. One time was court ordered and lasted 4 months. Granted, most of those were for being suicidal. However, one of those was because I was pulled over for speeding, and the officer just happened to remember me from a previous suicide attempt, so by a leap of logic on his part, I spent the better part of a week in a hospital because he decided I was trying to kill myself by driving too fast.

I will never advocate to have all psychiatry banned; I have seen too many people properly diagnosed and their lives greatly improved. I have also seen many people, including myself, lose far more that I ever gained.

BTW, if interested, this is what is used to “diagnose” people: DSM-IV-TR

The DSM-IV covers everything from ADD to Voyerism, and several things you might not think would be psychological disorders. The whole book is made to work with the OPINION of the psychiatrist. Do you really want your children forced to take medication, that could cause brain damage, based on the opinion of someone who might have graduated in the bottom 1% of their class?

Psyachiatric brain damage:
http://www.sntp.net/drugs/damage.htm
http://www.zmag.org/ZMag/articles/march02levine.htm
http://www.breggin.com/

Question about suicide. Before this all started about 4 years ago, I was making about 60K a year, had a house, nice car, lots of stuff and a steady relationship. Now I’m a janitor, I own almost nothing, and my car is falling apart. Obviously the system didn’t work for me, so why do people still freak out if I think about killing myself? And who do I sue for ruining my life?

7

I must be missing something or am I the only one absolutely stunned by this. COMPULSORY MENTAL HEALTH SCREENING of private citizens?!! If anything AHhunter3 needs to take the decibel level up a few notches.

The mental health professions in the US have an extremely checkered history of a significant number of mental health service providers credulously buying into the mental dysfunction paradigm and therapy of the moment, and constructing dangerous and useless treatments based on these later discredited hypotheses.

Compelling mental health screening of an entire class of citizens is a slippery slope of the slipperiest type and is a very bad idea, especially by a profession that is barely qualified to be considered a “science.”

8

Noone Special:

Fuck no. Those assholes show up at some of our demonstrations or rallies sometimes, and the Dianetics/Hubbardism bullshit they push is…well, if not quite as lethal as psychiatric practice, at least no more scientifically founded. They give me the creeps. And they like to coopt events. They’re as bad as the Socialist Workers Party for showing up at events they did nothing to help organize and did nothing to publicize in advance, but for which they’d like to step forward with their own glossy materials and try to create the impression that the entire event is all about their stuff.

I’d rather not hijack this thread into any kind of Scientology discussion though, if you don’t mind.

9

To be fair, Larry Trainor, the guy quoted in the Leader article, claims to be affiliated with the Citizens Commission on Human Rights, which is well-known to be a Scientology front group. It’s quite likely that some of the rhetoric being used by the campaign against such intrusive and illfounded measures as these is being provided by those with close connections to the rather infamous Church of Scientology.

Of course, the fact that Scientology is opposed to this idea doesn’t automatically make it a good idea. Once in a while, even the Hubbardians get something right.

10

I think that the state is going to find out the hard way that this may be a big mistake-- not because of over-diagnosis, but because real problems might be missed, leading to lawsuits.

My aunt killed herself in January one month after giving birth. It’s highly likely that post-partum depression was a major contributing factor. Her family, those closest to her, didn’t see the signs. My aunt hid her pain very well. The OB’s office which was taking care of her is known for its kindness and concern for patients, which, sadly, is remarkable these days. I know that if they’d had any inkling of what was going on, they would have taken all possible steps to prevent her death.

My aunt was a clever lady. She was careful not to give any clues. I’m sure she could have passed a cursory examination by a harried state mental health official.

So, wouldn’t my family have grounds for a big, fat lawsuit at that point? Couldn’t we say, “Hey, you sent her home to us, certified as being sane, and look what happened”?

While I know they’re doing this with the best of intentions, unfortunately, a beuracracy, by nature, has many flaws. They’re not going to catch every illness, and they are going to make mistaken diagnoses, both of which can lead to harm.

11

No way in hell should the state just pull someone in and start mucking around in their mind. Involuntary mental examinations of citizens seems to be quite a violation of a person’s right to privacy regarding their medical affairs, and a threat to their liberty in general.

Who are these people who think it’s a good idea for the state to force someone to have psychiatric exams? Not only is there a lot of room for abuse in a system like this, a system like this is abuse.

12

Would anyone care to find out what we’re all talking about?

Last year the Illinois Legislature passed the Illinois Children’s Mental Health Act of 2003. www.legis.state.il.us/legislation/public acts/full text.asp?name=093-0495. It did basically three things: 1) require screening prior to medicaid-funded admission to inpatient psychatric hospitals, including “a determination of the appropriateness and availability of out-patient support services,” 2) Ask school districts to incorporate social/emotional learning into their educational mission, and 3) establish a panel, composed of about half the population of the state, called the Childrens’ Mental Health Partnership, whose mission was to develop a preliminary plan and submit it the the governor on 30 September 2004, with a final plan due on 30 June 2005. Their preliminary plan was finished earlier this month, it’s available at www.ivpa.org, and four rounds of public forums were completed earlier this week. It’s long, but worth reading. It’s provisions include adding social/emotional development diagnostics to the already-mandatory medical exams before Kindergarten, fourth and ninth grades, and mental health screening for children who go through state agencies like DCFS and the juvenile justice system.

I decline to enter the debates over whether psychiatrists are evil and mental illness is a myth. It may calm some of you to know that there is very little psychiatry, forced or not, involved here. It seems to be mostly about identifying children who need care and seeing that it’s made available to them, with strong emphases on 1) confidentiality, 2) ensuring that children who get treatment stay with their families and in school as much as possible, and 3) making sure that pharmacological responses to illness are used no more than necessary. It’s a public health-care program, and one of its goals is to remove the unreasoning prejudices about mental illness that largely, in my opinion, contribute to our continuing inability to diagnose and treat it in the U.S.

13

Well, this is one time when I’d be happy to find out that I’ve played the part of Chicken Little.

I’ll poke around some more and post a retraction after verifying.

:o

14

One man’s “care” is another man’s “fuck with my kid’s head.”

15

Exactly, the same way a dentist fucks with your kid’s teeth, vaccines fuck with you kid’s immune system, school nutritionists fuck with your kid’s stomach, and cardiologists (you won’t believe this) actually fuck with your kid’s heart! Evil bastards.

16

Thanks for the direct text links. It’s exactly what AHunter3 indicated. You are going to have a large class of people subjected to a screening process on a cumpulsory basis. The goal and the critera of this screening will not be to see if they have measels or allergies etc., it will be to determine if they are mentally "well’ or “need care”. Now, if I was confident that the people being entrusted with this huge power would be intelligent, judicious and sensitive enough to wield this power effectively, and parse out real mental problems from the huge range of lesser emotional issues that afflict mankind, then I would be less concerned, but the history of handing that kind of power to people in the US (or elsewhere) is not particularly comforting.

There is an embedded assumption in this process, and this bill, that the mental health needs of the population are being massively underserved, and that lots of mentally ill fish are escaping from the diagnostic net. This bill effectively pens the fish into a lagoon so they can be examined one by one. The combination of do-gooderism arrogance, and the complicity of the mental health professions in arranging this diagnostic cattle call is mainly frightening, when I consider the past history of what happens when you hand people of widely differing abilities and opinons a diagnostic branding iron and start running people through the chute.

I will guarantee you that once this process becomes bureaucratized that lots of people are going to get hit with that stigmatizing branding iron in one form or another, and that their lives will never be the same after that, and I don’t necessarily mean their lives will be better.

17

This is, of course, an oversimplification… but when psychiatric help, cardiologists, nutritionists, and dental care are made available for me, should I want or need them, they are “health care.”

When they become compulsory, whether I want them or need them or not, they are *“fuckin’ with me.” *

What next? Federal regulation of bedtime?

18

a) The actual bill (PDF)

I admit I don’t see anything in the text that indicates that all children in Illinois will be subjected to mandatory screening.

b) Might there indeed be a policy set into place as an outgrowth of all this that implements mandatory screening? It would seem to be in keeping with the general thrust of the legislation. From here:

And again from here(comment left by a reader)

c) But from this site:

Doesn’t look good for the home team. Better start warming up that crow.

d) On this site, the specifically voluntary nature of the mental health screening is cited:

e) Nevertheless, the state of Illinois and the imposition upon children of forced treatment in situations similar to what they’re screening for are not strangers to each other.

CONCLUSION: I have to admit it looks like parents can still say, on behalf of their kids, “no thanks you”, and not have their kid screened for mental health probs, and that, at least as of now, do so without any formidable repercussions.

Which means I was wrong, I am guilty of disseminating alarmist misinformation and ignorance, and for that I apologize.

I still don’t like this thing one bit. And I still think they’ve laid down the groundwork for imposing exactly what I was thinking they’d already done.

19

This is creeping 1984ism. If you don’t believe me just think back to the success the old USSR had using pyschiatric hospitals as reeducation and internment centers for dissidents. I have been seeing some disturbing studies published which I think must be Gov’t backed which if taken seriously would give more power to persecute citizens. One that springs to mind is a British study saying pot smokers are statistically more prone to schizophrenia, implying that the pot may cause it. People have smoked pot for thousands of years, if it caused schizophrenia in a statistically noticable percentage it would be part of the common knowledge of the drug by now. A questionable study wouldn’t be needed to make this evident.

But what this does enable the gov’t to do is imprison a person in a psych hospital as a ‘danger’ to the populous. A lot of people smoke pot and this study. I think it is just another lever to use for social manipulation.

The trouble with a ‘diagnosis’ was mentioned in the OP’s reference. It is subjective there is no CAT scan, exray or MRI that can diagnose alot of psychiatric ills. Some, but not most.

I can see the doctor now…

Your honor I’m afrraid ze patient has ze borrrderline perrzzzonality dizorder. He has ze 3 speeding-a tickets und ze massssterbation mit und porrrrnography. Michael Jackson has ze same dissseasse.
Zis man is to be dangerous sonner or lateren. I rrrecommend he be rre-educat um I mean incarcer, um I mean institutionalised until he has recovered.

Judge: Thank you Doctor Mengele, always nice to have you in my court. BAILIF!NEXT CASE!

20

AHunter3, don’t get me wrong. I have some problems with the proposal too, mostly because it seems to require specialized diagnostic skills in a whole lot of people who don’t have them now, and also because it is most coercive with respect to the least advantaged. Next year, we’ll get a final draft, which will be debated in public forums, and we’ll see.

Master Wang-Ka, there exists a program which is involuntary, institution-based, profoundly affects mental and psychosocial development, and applies to practically every child in the U.S. Worse, standards and practices and the quality of those who administer the program vary wildly. But I suspect you already knew that.

The state has a legitimate interest in compelling prevention and treatment of illness where public health is at risk. For those who disagree with this, see you after the polio, tuberculosis and influenza epidemics, maybe. For those who believe mental health is not a public policy issue, tell it to the Columbine school board.

This thread really needs a poster who can speak knowledgably about public mental health outreach, or for that matter, mental health care period. I’m not that guy, but I doubt that widespread lobotomies, involuntary commitment and psychotropic drug regimens are what is contemplated by the state of Illinois. Again, most of the proposal seemed to me to be geared quite the opposite way.