The point is not that mental heal professionals are evil, scheming manipulators who go around committing perfectly healthy people.
The point is that the system has certain weaknesses that make it vulnerable to well-meaning professionals who want to help people but become overzealous in doing so.
This statement is well below you, Vorlon, and I am surprised. As you are aware, I did not say I was unfamiliar with them, and you have avoided the point that you are employing a typology while criticizing another typology.
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I get the impression that you can’t handle the truth.
The alleged “mental illness” or lack thereof should not even come up as relevant subject matter in a competency hearing. It has no bearing on the subject.
Danger to self or others, except insofar as it demonstratably stems from an inability of the person in question to plan, make observations, and comprehend likely outcomes, is also not relevant, even where it can be supported by explicit evidence of actual behavior rather than prediction. You have the right to make incredibly stupid decisions (and the obligation to be held responsible for having made them) as long as you are competent.
Hearings into competency should not be segregated in such a way that there would exist courts into which only the allegedly “mentally ill” are brought. They need to have their hearings in the same venue as any other competency hearing. The tendency I’ve observed is for the standard competency hearing to operate from an assumption of competency, which must be challenged by the parties alleging a lack thereof; whereas psychiatric commitment hearings tend to operate from an assumption that “you wouldn’t be here if you didn’t need it”, leaving the burden of demonstrating otherwise to the person in question.
I’d like to know where Hamlet lives, as his descriptions make it sound like a much more reasonable place to live than any place I’ve been.
**
Then you know that those are not separate typologies.
The DSM criteria are presented by definitive – they are completely accurate not because they match an unknown phenomenon, but because their criteria define the category of, say, “depression”.
At the same time, these definitive criteria are acknowledged to be secondary to clinical judgment and opinion.
Don’t you see a problem with this?
As far as legal representation goes, she could not afford an attorney so she had one oppointed to her. At least according to her the attorney didn’t do a damn thing, and was more of a spectator. She fought the whole process bitterly, and believes that how pissed off she was at the thought of involuntary incarceration worked against her, making her look less competent and reasonable. Then again, how many of us would look reasonable when someone is telling us it is reasonable that we are going to get locked up without having done anything.
If I recall correctly she was held for three days. She never got back to her apartment after having been takin to the hospital, so apparently the hearing came real quick. She was released only when someone would legally sign her out, thereby taking responsibility for her. As she was new in town and it was spring break she only had one friend in town and that person (also a psych student) refused to do it because she thought that if anything happened to my friend then her insurance rates as a psychologist would go up. That is really a Pit topic though. Eventually a friend from out of town drove in to get her out of the hospital. If he had not been there there was not a preset limit on how long she would be in the hospital (this is how I understand it, but we are no longer dating and I am not about to ask about clarrification about this).
Iowa and Illinois. I’ve done these kinds of cases in both.
Lemmie get this straight, without the DSM to define it, there would be no such thing as depression?
does schizophrenia work the same way? cause I could just rip those pages out of my DSM right now and save some of my clients a whole lot of trouble…
TVAA is right. In the absence of a laboratory test – you know, a test for ‘n-schizophrenase’ or something – the definition of the malady is the list of symptoms, perhaps with a qualifier like “displaying 4 or more of these 6 symptoms”.
And then if you play fast and loose with that definition, as the field of psychiatry does in fact do, you end up with “well, I know it when I see it”. Or, as I put it previously, the mental illnesses are in practice defined as the possession of a psychiatric diagnosis of same.
By the way:
http://members.bellatlantic.net/~adhdah/psych_inmates_libfront/vol_4/drey.html
I have more.
No one has ever managed to show that people with specific emotional states are actually sick in some physically definable way.
It’s entirely possible that many people who are depressed truly have something wrong with their brains. It’s unlikely that the majority of them do.
Basically, greck, the category of depression requires the DSM to define it.
I wish it were possible to make people feel better by destroying the DSM… but we could eliminate the diagnostic category by doing so.
I think a great deal of the problem here is the deep-set and irrational need that many mental health professionals have to be acknowledged as “correct” whether or not they are. Anyone who questions the correctness of the mental health practitioner is themselves mentally suspect. Since such suspicion comes from someone who is qualified to make such determinations, it is difficult to challenge. If the patient insists that the MHP is wrong, that is yet further proof that the patient is mentally unstable. The only way to avoid this trap is to concede that whatever the MHP says is true. By accepting that they are correct (or least pretending to) validates their own weak self-confidence and satisfies their need to exert power over other people, and allows the patient to escape their control. This sort of ridiculous conduct teaches patients to distrust MHPs and to lie to them in order to escape the MHP’s manipulative behaviors. Of course, doing so may later be used against the patient by another MHP.
Of course, MHPs deny doing this. The only thing that saves them from being proven mentally ill by this denial is that the accusation does not come from a MHP. Many MHPs set themselves up, at least in their own minds, as the final arbiter of the mental health of everyone around them, including themselves.
It is very rare for a mental health practitioner to acknowledge that he or she has a mental health condition. It is, however, not unusual for those outside the system to notice it. I know a number of doctors (not routinely working in mental health) whose impression is that the rate of mental illness amongst mental health professionals is substantially higher than the general population, and that there seem to be a great deal of people working in mental health with serious problems with the need to exert power over others.
Of course, this post will be disregarded by the MHPs in this forum because I am not a MHP and therefore totally incompetent to understand anything about mental health. As a non-MHP, it is my duty to accept whatever I am told by an MHP and acknowledge that it is factually true regardless of my misgivings on the subject. Failure to do so may result in my being labeled with a mental illness.
And then what?
KellyM, having dated a grad psych student I had the opportunity to meet most of the people in the department. Mental health issues seem to be a basic requirement of admission. The really frightening thing is that every one of them notices this trend but does not realize it applies to themself as well. Makes me happy to be an engineer, we may be socially inpet but at least we are sane.
KellyM, well I feel very special then, because I have moved through my training and practice as being the only one who states that I may be wrong. I am further special because I have done all this knowing other practitioners whom I respected and admired for their knowledge, compassion and ability to work from an empirically driven framework with the knowledge that they were not infallible.
As a point of logical debate, your post is really not helpful. I am not sure why you would throw “labeling” out there as one of the cruelties that MHP’s will inflict on you when you have labeled yourself with a mental illness earlier in this thread. You also turn this around as an attack on the mental health of MHP’s, which seems sadly hypocritical. If you are not satisfied with your mental health care, seek out a new provider. Perhaps this is better turned into a pit thread for prosumers of mental health services to try to deal with their frustrations. I for one find myself with conflicting feelings engaging in this debate.
Hentor the Barbarian, I am quite satisfied with both my psychologist and psychiatrist. However, I got to choose them, and choose to see them. A patient being subjected to involuntary committment does not have that right; the doctor has placed himself in the position of making those decisions for the patient. The comparison is therefore inapposite.
I am not saying that all psychologists are bad, just that there are more than a handful practictioners who are problems. The behaviors I describe are not universal to all MHPs, but they are at least somewhat common and they do represent a problem, whether or not you want to admit their existence or commonality.
Also, I do not consider my transsexualism to be a mental illness. It’s only categorized as such because the APA considers it one. I consider it to be a birth defect, and the only real reason I continue go to a psychologist is that the Standards of Care mandated for correcting that particular birth defect require that I be processed by one. While I still occasionally benefit from my visits with my psychologist, I could easily do without.
It is interesting, however, that you have chosen to bring back up the fact that I have been “labeled” as “mentally ill” (although if you asked my psychologist if I was mentally ill, he would probably say no); I would posit that that is a deliberate attempt on your part to diminish the significance of what I have to say. How typical.
Psychiatric institutional “help” is often akin to throwing a boat anchor at a desperately swimming person, pointing at the resultant agitation as proof that the swimmer is drowning and is in need of more boat anchors, then warning the crew that they must be on the alert for anyone trying to climb out of the water, because people in the water are swimmers and must receive boat anchors. Those of us safely in the boat are not swimmers. Swimming is bad: normal people walk on solid things like boat decks. Anchors cure swimming. Oh, and if anyone on deck looks kind of wet, be alert to the possibility that you may be seeing a swimmer. We need to do more outreach and make sure that everyone who needs to be thrown a boat anchor gets one thrown at them because the signs of swimming can be really subtle.
Leonard Roy Frank was committed when, after a lucrative Wall Street firm with which he was associated dried up, he took some time off to get in touch with his cultural roots: read up on orthodox Judaism, grew his beard out and grew long hair in the conventional orthodox style, became a vegetarian, studied the Talmud.
;j
His folks freaked that he wasn’t diligently seeking a new and equivalently lucrative position and was instead doing things that would probably minimize the likelihood of being hired in such a place, and arranged for a psychiatric consultation.
Psychiatric consultation resulted in Leonard Roy Frank’s involuntary incarceration which included an involuntary series of shock treatments and eventually the shaving of his beard while he was unconscious after one such treatment (an event that Frank refers to as “Beard Removal Therapy”)
:mad:
A million anecdotes about compassionate, brilliant, dedicated, and wise psychiatrists doesn’t alter the fact that they have way too much power, that there are insufficient checks against their abuse of it, and that this power is in fact horribly abused, and often.
You had a point until this. You provided two examples where abuse may have occurred, and conclude that horrible abuse happens often. In regards to the statutes involved, I think the most telling quote from your first example is
I agree wholeheartedly that if the safeguards in the statute are ignored and the rights of a person are not respected, then there is abuse. But it is abuse DESPITE the safeguards, not because of or due to. Although you give a much more sympathetic reading to the case (he had 6 prior hospitalizations, 2 of them involuntarily, and had been exhibiting symptoms including 3 verbal confrontations), I would agree he shouldn’t have been found to be a danger to himself or others. In your second example, it occurred in 1962, well before many of these safeguards were in effect. The state of mental illness law and patient rights was almost deplorable in 1962. Thank Og for the protections that are in place now. I think the fact you had to cite a 1962 event shows how successful these kinds of protective safeguards are at balancing the fine line in these cases.
You’ve pointed out two examples, one iffy and one old, that show how, if the protections are not in effect, how much worse it would be. You then take an astronomical leap of logic to assert that these two examples show how involutary commitment laws are “horribly abused,” and, even worse, that it is done "often. A quote from your own cite reads: “Most commitment proceedings involve serious acts of violence or severely distorted thinking; for instance trying to throw a child out a window in the belief that he is possessed by the Devil.” And your willingness to completely disregard “a million anecdotes” where these kinds of laws help people and potentially save lives, shows a bit of your bias.
If you would indulge me by answering a question: What would you have instead? No involuntary commitments? What other safeguards are missing? How would you solve these tough problems? I am interested.
a) may have?
b) how many you want? As I said before, I have more.
ABSOLUTELY. The legal structure that is in place for determining that a person is incompetent and lacks capacity to make medical decisions in general is all that is needed. And all that is appropriate.
I, personally, would like to see the safeguards followed. Unfortunately, I can’t trust MHPs to follow them. I’ve seen too many well-documented instances of them not being followed. And I’ve seen the atmosphere of mutual distrusts that MHPs involved involuntary commitment situations create that makes it difficult to believe them when they say that they are following them, even when they are. It’s too difficult to audit MHPs to verify indepedently that they really are following them, and MHPs cannot be trusted to audit themselves, as they have been proven untrustworthy too many times already.
You can’t just shrug away all the complaints of noncompliance by arguing (as many MHPs do) that the all people reporting abuses are “mentally ill” and “untrustworthy”. Certainly some of them are, but the “rank and file” position that I’m seeing from the MHPs here is that all or virtually all of the complainers are making it up and that what they’re saying happens really doesn’t. Hell, some MHPs even seem to believe that complaining about process abuse is outright evidence of mental illness (usually, of paranoia) in and of itself. It’s a self-fulfilling prophecy that acts to protect the mental health system from review and to destroy all hope for those caught in the maelstrom.
It should be the obligation of the mental health system to prove that it is conducting itself properly, not of their victims to prove that they are being harmed. We need to ditch the presumptive belief that MHPs are inherently supercredible.
The same problem, by the way, occurs in child protective services, and I think stems from judges that are too ready to accept whatever is said to them by MHPs or CPS caseworkers solely by virtue of their positions. Stricter public oversight of the process is probably the solution. Many of these hearings occur behind closed doors, ostensibly for “the privacy of the parties”.
As to safeguards: if the evidence shows that even the most stringent safeguards are inadequate to protect against abuses, then the power itself has to be taken away. Liberty is preferable to safety, and I shall not trade liberty for the spectre of safety, whether it be from terrorists, from people with mental illnesses, or from the people who purport to be able to cure them.