# Why do we protect the "right" of people to avoid medication and remain mentally ill? **URL:** \ **Category:** Great Debates\ **Created:** [August 20, 2004, 2:07am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639 "2004-08-20T02:07:54Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![ultrafilter](https://avatars.discourse-cdn.com/v4/letter/u/3d9bf3/32.png) [@ultrafilter](https://boards.straightdope.com/u/ultrafilter)\ **Post date:** [August 21, 2004, 2:12am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/21 "2004-08-21T02:12:37Z")
> [@doreen](#): > > I myself, don’t have a problem with this. Until the other side comes in. The side that says " It’s not my fault I (committed that crime, violated my probation, whatever). It’s all because I have (fill in the diagnosis of the week) Allow me to go to a mental health program instead of jail, and I will comply with the treatment. Just don’t send me to jail". I don’t believe you have or would do this, but I see it every day in my work. The problem you face is not only the people who define your state of mind as a disease, but also the ones who attempt to use their similar states of mind as a “get out of jail free” card I don’t like it either. I’m in favor of two official designations for mental health: legally competent, and legally incompetent. ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [August 21, 2004, 2:40am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/22 "2004-08-21T02:40:02Z")
> [@laigle](#): > > We draw the line at the point where they represent a danger to themselves or others. Seems perfectly reasonable to me. So where do the megalomaniac neocons fit into that scheme? They’ve gotten a lot of people killed with their crazy schemes for world domination. The line you draw at being a danger to self or others isn’t as clear as you would like us to believe. > [@](#): > > We finance the judiciary branch for this exact reason, to make situational judgements about the application of broad legal standards. Lawyers and judges are _not_ commonly mental health experts. What makes them competent to make these decisions for us? ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [August 21, 2004, 4:02am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/23 "2004-08-21T04:02:13Z")
Court ordered Ritalin; [A Parent’s Nightmare: Losing a Child to Drug-Induced Psychosis](http://www.eagleforum.org/educate/2002/june02/drug-induced.shtml) [Everyday Horrors of the Mental Health System](http://psychrights.org/horrors.htm) ---
**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\ **Post date:** [August 21, 2004, 4:59am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/24 "2004-08-21T04:59:27Z")
> [@ultrafilter](#): > > I don’t like it either. I’m in favor of two official designations for mental health: legally competent, and legally incompetent. Right, as though one person cannot move from one category to another based on how well they are they are responding to the treatment plan of the day that their psychiatrist gives them. If they show any overt signs of their illness, they should be locked up in a state psychiatric warehouse (remember this is going to be millions of people) until their lawyers (or lack thereof) and the judical system see fit to let them out. If they screw up again, then it is right back in the hole. That’ll teach em! Maybe, your two official designations should be “bat-shit crazy” and “good, normal people”. :rolleyes: :wally ---
**Author:** ![AHunter3](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ahunter3/32/368_2.png) [@AHunter3](https://boards.straightdope.com/u/AHunter3)\ **Post date:** [August 21, 2004, 5:33am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/25 "2004-08-21T05:33:05Z")
I, too, think there should essentially just be two standards: competent and incompetent. If you’re incompetent, you don’t vote; you can’t sign contracts; you don’t get to manage your own financial affairs; you don’t get to make your own medical decisions, psychiatric or otherwise; and you aren’t held accountable for your actions, but you can be prevented from having much of a window of opportunity to misbehave for that very reason. The standards of proof for finding you incompetent should be very exacting — we dont want greedy nephew Freddie putting rich Uncle Pennybags in a Home for the Incompetent in hopes of getting his claws into the family estate holdings, after all! It should be proof, based on concrete evidence, not opinion, sufficient to convince beyond a reasonable doubt (not merely the preponderance of the evidence). And such a finding should be reverisible because some conditions are temporary. If you’re not incompetent, you get to make your own decisions, act like an adult, and yes you can and should be held accountable for your actions because actions have consequences. I’m no fan of the criminal justice system’s modalities, but I do not expect and would not appreciate different treatment on the grounds that I’m a schizophrenic. Thomas Szasz, mentioned earlier in this thread, said much the same thing. ---
**Author:** ![cichlidiot](https://avatars.discourse-cdn.com/v4/letter/c/5f9b8f/32.png) [@cichlidiot](https://boards.straightdope.com/u/cichlidiot)\ **Post date:** [August 21, 2004, 5:44am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/26 "2004-08-21T05:44:12Z")
> [@Ranchoth](#): > > It’s probably not popular with the public because of the old ghost all the willy-nilly lobotomies that went on for so many years. I mean, the lobotomizers were _trying_ to help people, and they thought what they had going _was_ the best way to treat a lot of mental illnesses…but nowadays, they just end up looking like a bunch of, well, “inept bunglers.” And so today there’s that lingering fear and distrust over the field of mental illness treatment, coupled with the fear that our modern best efforts in psychiatric medicine might just be more “bungling.” I disagree. I think if you talk with some people who have dealt with the mental health system, you will find people who have legitimate concerns, rather than fear of lobotomies. To speak to my experience and say it is a result of lingering fear and distrust, it’s plain not true. As to modern best efforts, when the left hand doesn’t know what the right is doing; i.e., not knowing their own patient was released, unaware that a patient under their care has been diagnosed with a co-occurring disorder by one of their own, or even unaware that a patient has been a recent past client, the best efforts start looking something less than that. However, you don’t have to take my word for it, [these comments](http://www.akmhcweb.org/docs/NewFreedomcomments_011003.htm) are worth a look. > [@](#): > > So, I guess it’s probably best for our collective consciences just to leave alone all the badly mentally ill street people. They probably know what they’re doing, anyway. Yeah, because if those homeless people are picked up and forcibly medicated, their problems are over. ---
**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\ **Post date:** [August 21, 2004, 5:55am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/27 "2004-08-21T05:55:26Z")
Maybe, I am reading it wrong but it seems like this competent/incompetent thing has some serious social implications if it is taken seriously. First, you would have to sweep the streets of the vast numbers of homeless people with a serious mental illness. Can the police just do it on a whim? They would be likely found incompetent and if they are incompetent then it is implied that they are immune to the usual penalties under the justice system. You can’t just have people walking around free like that can you? Even for someone who is not homeless, it would mean that they would have to be committed involutarily even if they are not a risk to self or others. Most mentally ill people are not violent but some can be prone to other types of crime such as tresspassing or buglary. Where are you going to get the facilities to treat all of these people? There is a waiting list at all of the psych hospitals that I know off unless the person is an immenent danger to self or others. Homeless people obviously aren’t going to have insurance. We would have to build massive psychiatric hospitals to house all of those people for an indeterminate amount of time and experience has shown us that they will not get the, um, best care available. Anyway, don’t we already have the “competent to stand trial” hearing before the trial if the person has a serious mental illness? Think about the implications of a binary system like that. ---
**Author:** ![chorpler](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chorpler/32/2888_2.png) [@chorpler](https://boards.straightdope.com/u/chorpler)\ **Post date:** [August 21, 2004, 6:17am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/28 "2004-08-21T06:17:14Z")
> [@alaricthegoth](#): > > The drill seems to be cocktailing an ssri (to ease the anxiety from throwing stuff out) with methedrine (to prevent the wave of good feeling from the ssri from overcoming and demotivating the sufferer) plus a “coach”, with ruthless disposal dogma Another question: why would methedrine _prevent_ waves of good feelings? People take it recreationally (methedrine, methamphetamine, whatever you call it) specifically for its good feelings and energy boosting effects, don’t they? ---
**Author:** ![ambushed](https://avatars.discourse-cdn.com/v4/letter/a/3bc359/32.png) [@ambushed](https://boards.straightdope.com/u/ambushed)\ **Post date:** [August 21, 2004, 6:22am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/29 "2004-08-21T06:22:45Z")
It would seem that few if any of you have had a situation like (or worse than) mine. A good friend’s brother was released into his mother’s care from a mental health institution with his assurance that he would continue to take his much-needed medication. Of course, very shortly after his release, he stopped taking them anyway. As a result, he changed from a reasonable, rational, and loving person to a very frightening, threatening presence in the home. The mother tried calling the institution, the doctors, the city’s, county’s, and state’s mental health services, and the police informing them of this change in her son’s condition, that he’d stopped medicating himself, and that the was fearful of her safety. They all said, just as many of you seem to so thoughtlessly and irresponsibly want, that the law gave them no right or power to do anything about it. Soon thereafter, she was viciously murdered by her son with an axe. Apparently, that’s what many of you want to protect at all costs: the rights of the insane who refuse to take their medications to endanger and even murder others rather than taking proactive legal steps to prevent it. You refuse to endorse the rights of people to be protected from mentally ill people who refuse to take their medications, and will only support imprisoning them _ **after** _ they’ve killed. My heart goes out to the mentally ill, it truly does. And I certainly don’t want to grant excessive power to the government or the legal or medical systems to impose draconian solutions on _anyone_, either the mentally ill or the people they might reasonably endanger. Great care must be taken to avoid injustice, as in all legal matters, especially those that involve personal liberties. But a just and responsible society would mandate that those who suffer to a substantial degree from a class of mental illness that is historically prone to violence if it goes unmedicated must either agree to be compulsorily medicated or remain in a locked medical facility. ---
**Author:** ![chorpler](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chorpler/32/2888_2.png) [@chorpler](https://boards.straightdope.com/u/chorpler)\ **Post date:** [August 21, 2004, 6:54am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/30 "2004-08-21T06:54:05Z")
> [@ambushed](#): > > But a just and responsible society would mandate that those who suffer to a substantial degree from a class of mental illness that is historically prone to violence if it goes unmedicated must either agree to be compulsorily medicated or remain in a locked medical facility. How do you determine what classes of mental illness are “historically prone to violence” unless medicated? ---
**Author:** ![Milford\_Cubicle](https://avatars.discourse-cdn.com/v4/letter/m/3be4f8/32.png) [@Milford\_Cubicle](https://boards.straightdope.com/u/Milford_Cubicle)\ **Post date:** [August 21, 2004, 7:02am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/31 "2004-08-21T07:02:21Z")
> [@Squink](#): > > **Lawyers and judges are _not_ commonly mental health experts. What makes them competent to make these decisions for us?** They aren’t… this is why they’re advised by experts. Do you honestly expect lawyers to be knowledgeable in every field they might come into contact with? ---
**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\ **Post date:** [August 21, 2004, 7:04am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/32 "2004-08-21T07:04:26Z")
> [@ambushed](#): > > It would seem that few if any of you have had a situation like (or worse than) mine. A good friend’s brother was released into his mother’s care from a mental health institution with his assurance that he would continue to take his much-needed medication. Of course, very shortly after his release, he stopped taking them anyway. As a result, he changed from a reasonable, rational, and loving person to a very frightening, threatening presence in the home. > > The mother tried calling the institution, the doctors, the city’s, county’s, and state’s mental health services, and the police informing them of this change in her son’s condition, that he’d stopped medicating himself, and that the was fearful of her safety. They all said, just as many of you seem to so thoughtlessly and irresponsibly want, that the law gave them no right or power to do anything about it. > Soon thereafter, she was viciously murdered by her son with an axe. > > Apparently, that’s what many of you want to protect at all costs: the rights of the insane who refuse to take their medications to endanger and even murder others rather than taking proactive legal steps to prevent it. You refuse to endorse the rights of people to be protected from mentally ill people who refuse to take their medications, and will only support imprisoning them _ **after** _ they’ve killed. > > My heart goes out to the mentally ill, it truly does. And I certainly don’t want to grant excessive power to the government or the legal or medical systems to impose draconian solutions on _anyone_, either the mentally ill or the people they might reasonably endanger. Great care must be taken to avoid injustice, as in all legal matters, especially those that involve personal liberties. > > But a just and responsible society would mandate that those who suffer to a substantial degree from a class of mental illness that is historically prone to violence if it goes unmedicated must either agree to be compulsorily medicated or remain in a locked medical facility. So what would you recommend **ambushed?** This a serious question. The police and the hospital were grossly incompetent because that is someone that needs to be involuntarily committted. That is already in place but a lot of people screwed it up. What more can be done on a practical level? Do you want to keep all seriously mentally ill patients committed for life even if thay are responding to treatment? We would all prefer that cases like that never happen and my sympathies are with you and the family. However, you can’t just look at a case like that and extrapolate to all cases. Like I said, there is a procedure to deal with that It is used in situations like that where the patient poses a “threat to themselves or others”. You can’t just take a case like that and insist on sweeping changes if you don’t suggest what those might be and how they may be implemented realistically. How would you do it if you were the American King? I really am interested. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [August 21, 2004, 7:21am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/33 "2004-08-21T07:21:39Z")
> [@ambushed](#): > > It would seem that few if any of you have had a situation like (or worse than) mine. A good friend’s brother was released into his mother’s care from a mental health institution with his assurance that he would continue to take his much-needed medication. Of course, very shortly after his release, he stopped taking them anyway. As a result, he changed from a reasonable, rational, and loving person to a very frightening, threatening presence in the home. > > The mother tried calling the institution, the doctors, the city’s, county’s, and state’s mental health services, and the police informing them of this change in her son’s condition, that he’d stopped medicating himself, and that the was fearful of her safety. They all said, just as many of you seem to so thoughtlessly and irresponsibly want, that the law gave them no right or power to do anything about it. > Soon thereafter, she was viciously murdered by her son with an axe. Um, wait-I seem to recall this exact same thing on an episode of _Law & Order_. ---
**Author:** ![Leaper](https://avatars.discourse-cdn.com/v4/letter/l/4bbf92/32.png) [@Leaper](https://boards.straightdope.com/u/Leaper)\ **Post date:** [August 21, 2004, 7:27am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/34 "2004-08-21T07:27:26Z")
> [@Guinastasia](#): > > Um, wait-I seem to recall this exact same thing on an episode of _Law & Order_. Well, “ripped from the headlines” IS a mainstay of L&O writers… ---
**Author:** ![blowero](https://avatars.discourse-cdn.com/v4/letter/b/41988e/32.png) [@blowero](https://boards.straightdope.com/u/blowero)\ **Post date:** [August 21, 2004, 8:03am UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/35 "2004-08-21T08:03:11Z")
> [@Guinastasia](#): > > Um, wait-I seem to recall this exact same thing on an episode of _Law & Order_. But there’s other cases. For example, there was this man who was horribly abusive to his two friends. First, he would verbally abuse them, calling them “chowderhead”, etc. Then it escalated to horrible physical abuse. With the one friend, it started with poking in the eyes with his fingers and slapping him in the face. Then he began to attack him with fists, hammers, boards, pliers, etc. At one point, he put the claw end of a hammer in his friend’s nose and pulled upward. The slightest thing would set him off; sometimes he would be provoked simply by the words “nyuck, nyuck, nyuck.” With the other friend, besides slapping, punching, and kicking, he would grab fistfuls of his hair and yank it from his head. Despite years of victimizing his friends in this manner, he was never committed. ---
**Author:** ![hlanelee](https://avatars.discourse-cdn.com/v4/letter/h/3bc359/32.png) [@hlanelee](https://boards.straightdope.com/u/hlanelee)\ **Post date:** [August 21, 2004, 1:45pm UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/36 "2004-08-21T13:45:09Z")
Maybe one day they will have a handy little device that they can stick up your ass and say, “You’re crazy, take this haldol (or other antipsychotic).” Then the courts can force psychiatric treatmant. 😃😃😃 ---
**Author:** ![GorillaMan](https://avatars.discourse-cdn.com/v4/letter/g/50afbb/32.png) [@GorillaMan](https://boards.straightdope.com/u/GorillaMan)\ **Post date:** [August 21, 2004, 1:50pm UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/37 "2004-08-21T13:50:33Z")
> [@blowero](#): > > But there’s other cases. For example, there was this man who was horribly abusive to his two friends. First, he would verbally abuse them, calling them “chowderhead”, etc. Then it escalated to horrible physical abuse. With the one friend, it started with poking in the eyes with his fingers and slapping him in the face. Then he began to attack him with fists, hammers, boards, pliers, etc. At one point, he put the claw end of a hammer in his friend’s nose and pulled upward. The slightest thing would set him off; sometimes he would be provoked simply by the words “nyuck, nyuck, nyuck.” With the other friend, besides slapping, punching, and kicking, he would grab fistfuls of his hair and yank it from his head. Despite years of victimizing his friends in this manner, he was never committed. It’s impossible to comment on an individual example on a few recollected details. But it’s perfectly possible for somebody to be horrifically and unpredictably violent without it being caused by mental illness. ---
**Author:** ![furlibusea](https://avatars.discourse-cdn.com/v4/letter/f/aca169/32.png) [@furlibusea](https://boards.straightdope.com/u/furlibusea)\ **Post date:** [August 21, 2004, 3:12pm UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/38 "2004-08-21T15:12:50Z")
I think sometimes that the current state of psyciatric drugs is alot like doing micro-surgery with a sledge hammer, and the state of diagnosis is worse. I will tell you the story of my sister. About 6 years ago she was commited after a suicide threat. She had been depressed for a long time and was anorexic. We were pretty sure that she was headed for trouble. While in the institution the psyciatrist diagnosed Bi-polar disorder. This despite the fact that none of us (including my sister) could ever remember a manic phase. Anyway she played the game and got out. Things went on but she really wasn’t getting better. She kept seeing the psyciatrist. Any time she said she didn’t think the diagnosis was right he would say she was in denial and up the dose. Eventualy she decided that he wasn’t listening to her and sought out a new psyciatrist. The new doc also questioned the diagnosis. The more she talked to my sister the more she began to believe my sister was certainly depressed, but it was mostly because of the situation she was living in. Something about living for 15 years with an emotionaly abusive alcoholic maybe does some damage. The new doc also ordered blood tests. I guess this is something you are supposed to do regularly for someone on Lithium which had never been done to my sister. The Lithium levels in her blood were at toxic level and had destroyed her thyroid. Not only that you can’t just stop taking the stuff or you die. You have to be weaned off of it. She is much better now. She left her marriage, and althought the early period of that was difficult she struggled through it. She is now up to a normal weight and has remarried. Here is the thing. There are no blood test to make sure that the diagnosis is right. The drugs don’t work for everyone, and almost all of them have nasty side affects. Until we can be sure that every diagnosis is right and that the drugs used won’t do more harm than good, I don’t think we can force people into treatment. ---
**Author:** ![furlibusea](https://avatars.discourse-cdn.com/v4/letter/f/aca169/32.png) [@furlibusea](https://boards.straightdope.com/u/furlibusea)\ **Post date:** [August 21, 2004, 3:15pm UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/39 "2004-08-21T15:15:13Z")
psst **gorillaman** I think you were wooshed. ---
**Author:** ![ultrafilter](https://avatars.discourse-cdn.com/v4/letter/u/3d9bf3/32.png) [@ultrafilter](https://boards.straightdope.com/u/ultrafilter)\ **Post date:** [August 21, 2004, 5:11pm UTC](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639/40 "2004-08-21T17:11:15Z")
> [@Shagnasty](#): > > Maybe, I am reading it wrong but it seems like this competent/incompetent thing has some serious social implications if it is taken seriously. First, you would have to sweep the streets of the vast numbers of homeless people with a serious mental illness. Can the police just do it on a whim? They would be likely found incompetent and if they are incompetent then it is implied that they are immune to the usual penalties under the justice system. You can’t just have people walking around free like that can you? Even for someone who is not homeless, it would mean that they would have to be committed involutarily even if they are not a risk to self or others. Most mentally ill people are not violent but some can be prone to other types of crime such as tresspassing or buglary. > > Where are you going to get the facilities to treat all of these people? There is a waiting list at all of the psych hospitals that I know off unless the person is an immenent danger to self or others. Homeless people obviously aren’t going to have insurance. We would have to build massive psychiatric hospitals to house all of those people for an indeterminate amount of time and experience has shown us that they will not get the, um, best care available. > > Anyway, don’t we already have the “competent to stand trial” hearing before the trial if the person has a serious mental illness? > > Think about the implications of a binary system like that. Nobody’s suggesting anything like that. The competent/incompetent distinction already exists in American law, and isn’t causing the sort of problems you seem to think it would. What **AHunter3** and I are really proposing is getting rid of insanity defenses. [Previous page](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639.md?page=1) [Next page](https://boards.straightdope.com/t/why-do-we-protect-the-right-of-people-to-avoid-medication-and-remain-mentally-ill/260639.md?page=3)