Mad in Australia


Our report ‘Mad in Australia’ uses the history of medical abuse documented in ‘Mad in America’, adapting it to create an Australian activist publication proposing solutions.

It reviews official reports of abuse in Australia and presents people currently forcibly medicated in the health and prisons systems. It analyzes international human rights agreements and Australian mental health law.

The report presents patient proposals for safe solutions dealing with the underlying personal and social problems. We launched it at a meeting of the National Mental Health Commission considering forensic mental health this past month. It caused protest by others in authority, who have been invited to respond to the living draft.

Brett Collins has represented detainees, and specifically the interests of prisoners and mental health patients, in Australia and internationally for over thirty years.  He is coordinator for Justice Action and a spokesperson for the Prisoners’ Action Group, as well as founder and managing director of Breakout Media Communications.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. I mean this, when I say I think you are a great Australian. I’m aware of the boundless compassion you have shown to the most unpopular form of criminals in all of society, I refer here to your work with sex offenders and the assistance and brave stands you’ve taken to stand up for the right for them to pay their debt to society and then regain their full equality once freed from prison. Your work in this regard is second to none in all of Australia that I know of and shows you to be a truly compassionate human being. I have immense respect for your work. Immense. And I’m happy to see you here at this site.

    I’ve read the report, a good report, and you’ve put a lot of hard work into it I can see this.

    However this position taken below stops me supporting this report:

    “In our view, the only valid justification is the first; that involuntary treatment is only ever justified in
    preventing immediate and tangible harm to others or the self. As such, when a patient is a clear danger to themselves, or other individuals, the use of medical practitioner discretion to use involuntary
    medication to calm and treat the patient is supported.”

    I urge you to reconsider. We are talking about individuals already locked within a psychiatric facility here, not people armed with weapons, and I can only urge you consider that self defense, and immobilization of emergently, acutely, violent unarmed persons, has been carried out for millennia without resorting to entering their brains and performing invasive forced drugging.

    Your report appears to accept there exists “people with a mental illness”, a popular phrase with Australian governments, where I see people labeled ‘mentally ill’, declared so by state psychiatric fiat, ‘ill’, unquestioningly declared as having bona fide ‘medical’ problems, when no physician in the situation can demonstrate anything is occurring other than a unilateral declaration of irrationality and problematic thoughts, feelings or behaviors, couched in medicalized language, of course.

    Your report appears to accept the notion that the drugging of never-proven-diseased living conscious human being’s brains constitutes a bona fide ‘medical’ “treatment”. I don’t accept this assertion. Drugging of course, with tranquilizer drugs that act biologically on no known or proven diseased biology.

    Your report appears to accept the notion that any individual in a given jurisdiction can legitimately come to be known by the descriptor “patient”, when an agent of the state declares that relationship, by fiat, by force, to be a so called ‘doctor/patient’ relationship. I don’t accept this.

    Your report seems to be detecting, rightly so, that in Australia countless individuals in recent decades have been forcibly drugged for expediency, ‘sedation’, tranquilization and as a “chemical restraint”. I put it to you that the use of invasive forced drugging, forced government initiated brain function alteration, regularly amounting to forced total unconsciousness, is exponentially more invasive than any other form of restraint short of a fatal police bullet or the death penalty, and should in no circumstances be supported or viewed as somehow ‘more’ humane than physical or mechanical restraint. I further take issue with the word “calming”, or a rationale for forced drugging said to be “to calm” the targeted individual.

    An unconscious body appears ‘calm’, a tranquilized zoo animal appears ‘calm’, but to objectively say that what one sees in the aftermath of a forced injection is a ‘calm’ human being is to not see the reality. A forced injection creates a physiologically impaired human being incapable of higher order consciousness or even consciousness itself, ‘calm’ might be the light and fluffy interpretation/spin that the perpetrators of this moral atrocity like to put on it, but make no mistake, in choosing to solve a combative situation# by *entering* the inside of the person’s body, rather than immobilizing or touching the outside, the most extraordinarily and profoundly invasive and dehumanizing option has been chosen.

    #It is a fact that most combative situations inside psychiatric facilities occur when individuals learn that they are being detained, learn that they are being denied legal due process, and learn that they must now submit their bodies and brains for forced drugging. Also when people are denied the substances they have been using on the outside.

    Your report leaves open, the Australian ‘open slather’ situation where problem detainees with problem behavior can just be immediately declared ‘dangers to self or others’, and swarmed by syringe wielding human rights abusers. Something happened in the last 60 years, restraining someone’s arms and legs, came to be seen as a vile, disgusting, dehumanizing thing to do. Restraining their neurotransmission, crossing their blood brain barrier by force, showing contempt for their human right to bodily integrity, their consciousness and its right to exist, came to be seen as a bona fide ‘medical treatment’. This interpretation is false, misguided, egregiously mistaken, and contemptible because it fundamentally fails to address the extraordinary profundity of the invasiveness we are talking about here.

    Altering somebody’s outside environment is a drastic step to take, yes. The world closing in, becoming a locked psychiatric facility, is a huge step, overwhelming a combative detainee physically, a huger step still. It’s not a human rights abuse in my opinion. Altering somebody’s consciousness by force, with forced drugging or forced electroshock, altering their INNER world, wow, this is so egregious a human rights abuse that it is nothing short of molecular violence, one of the most dehumanizing things a human being or group of human beings can do to another. And it must be abolished, without exception. As I said, law enforcement, tribal societies, whatever, dating back through recorded history, have found ways to restrain people without raping their brains/consciousness. If the combative person is unarmed, and is outnumbered, (as is the case in the situations in question), there is always a less invasive way to defuse a situation. I cannot support the position your organization has taken in its report.

    -Forced drugging is always an escalation of violence.

    -Forced drugging is the most invasive thing government does to its citizens bodies short of fatal police bullets or the death penalty.

    -Forced drugging sometimes kills.

    -Forced drugging is applied to potentially any citizen in society, it traumatizes and decimates the lives of a large enough cohort of those subjected to it to render any cohort of the ‘thankful coerced’ simply a group of people who had quality of life transferred to them at the ghoulish cost of other people having their lives destroyed, hence inevitably, for this practice to continue to exist, deaths from it, traumatized, destroyed people will be created, and will be the collateral damage, in order to create the cohort of ‘thankful coerced’.

    -Forced drugging is cruel, inhuman and degrading treatment as per the UN Special Rapporteur on torture. (He hasn’t said that the combative, resisting, arrests and handcuffings that police forces carry out tens of thousands of times daily the world over are human rights abuses).

    -Physical restraint and detention in suicide resistant cells change the external environment of the person, forced drugging bulldozes its way into the consciousness and brain function of detainees (whom no physician can demonstrate bona fide brain disease in).

    -The Israeli blockade of Gaza, is a serious, serious military action and restraint on the people and government of Gaza. Kinetic warfare within Gaza, air strikes for instance, is orders of magnitude more serious and escalatory/violent.

    -The blockade of a living, conscious human being’s neurotransmission, the action of forced drugging, is I believe rightly considered to be orders of magnitude more violent/escalatory/invasive than mere physical restraint, or the removal of being at liberty to have freedom of movement in the community.

    I don’t support discriminatory forced psychiatry laws that take people off the streets on a psychiatrist’s say so, I know this profession to have no particular primacy when it comes to predicting the future/risk than a clairvoyant. If we are going to live in a society where some forms of ‘self harm’ are prohibited, then that is a democratic conversation a society can have, and all measures to restrain the individual’s activity, should fall short of remodeling their brain function, and no physician in the world can prove there is something wrong with the brain function of people targeted for forced psychiatry. It is a belief held on faith, and a belief held by powerful agents of the state that upon which is premised their reserve powers to enter the bodies of anybody they choose to target, in effect, this is violent fanaticism, the use of force to impose one’s belief on others against their will. This is what makes forced psychiatry so terrifying. Jihadist terrorists will put nails from a nailbomb into your body because of their interpretation of a book. Psychiatrists use their holy book, the DSM, to justify putting drugs into the bodies of strangers by force. There are terrifying parallels here.

    The violent remodeling of a citizen’s brain function, should be seen for the act of immense, and profound violence and violation that it is. Every month in the press I read of a troublesome passenger aboard an airliner, and even in such a precarious environment as 30,000 feet in the air, these individuals are overwhelmed, outnumbered, restrained, and controlled without resorting to such invasive tactics. I can think of no situation where an unarmed detainee of a psychiatric facility, psychiatric facilities being of their very nature controlled environments where overwhelming outnumbering and force has always been available, that ‘chemical restraint’ is the only option. The fact that self defense has become ‘medicalized’ should terrify every citizen in society and poses enormous risks for the right to bodily integrity to be respected as a norm across all spheres of government.

    In fact, every single time a forced needle, a syringe with sharpened steel is stabbed into naked skin of a detainee, by definition, that person has already been held down, outnumbered, and immobilized, why not stop there? Why drill down, why extend, why escalate, this control, to the molecular level? It is a moral obscenity, in the extreme, and a gross human rights abuse and should not be tolerated in any free society.

    In the West, we handcuff thieves. In Saudi Arabia, they use sharpened steel, cut off their hands, and their blood flows.

    In the West, we see the physical restraint of the detainees of psychiatric facilities to be inhumane. In the West, we see the stabbing of sharpened steel, the addition to their blood flow of brain disabling tranquilizer drugs as, for some reason, humane. It’s not humane. It’s not justified. It’s an ugly, disgusting, government overreach, overwhelmingly obscene and violent, and cannot be tolerated in a free society.

    Your organization’s report giving so called ’emergency forced drugging’ a pass, is not something I can support or accept. I am heartened that someone from Australia is putting together such detailed reports, that reflect an understanding of all the laws international and domestic. I am glad to see your report, and I wish you all the best of luck with your engagement with the Australian Mental Health Commission etc… but forced drugging is not acceptable. Ever.

    Nowhere inside any darkened corner of any psychiatric facility, anywhere in the free world, should people who are already body slammed to the floor, outnumbered, outgunned, who are screaming out ‘NO!’, pleading with their attackers, ‘NO! don’t inject me!’, ‘NO! I do not consent’, nowhere… Nowhere, not ever, should that situation be escalated by the government employees into the invasive violence and violation of forced drugging. No means no, and I guarantee you, any forced psychiatry practitioner who read your report, would see the quoted passage as a carte blanche invitation to continue the practice of ‘chemical restraint’. It’s a sick world that came to believe restraining the cells inside a person’s body is just interchangeable and on par with physical restraint. Like almost all beliefs in psychiatry, it’s a false belief, unjustified by logic, and a product of psychiatry having 200 years of unhindered power to dominate its captives. A product of people who aren’t survivors of forced drugging being socialized for generations into considering it NORMAL that while the inside of their body is sacrosanct, the inside of anybody labeled a ‘mental patient’ is a piece of government property. My brain is not a piece of government property. Where any ‘discretionary’ power exists to allow agents of the state to enter and violate my body for expedient social control, I don’t have equality. Why is it that I can look upon cops who handcuff and arrest people and see them as law enforcers invested with power and responsibility that is a necessary control arm of the state? but I look upon those who wield syringes in mental hospitals as beneath contempt? as human rights criminals who deserve prison time? As people who have caused profound human distress and trauma in the lives of innocent strangers? This equation all comes down to invasiveness.

    Those who wish to dedicate efforts to bringing about equality and making people with psychiatric labels and mental and emotional problems in life feel safe, and who seek to bring about a world where these people have their basic humanity respected, can’t leave the door open, ajar even just a little bit, to forced drugging. Forced drugging laws, these powers, being ‘on the books’, is a threat to our human rights, leaving this extremely invasive use of government force in the ‘discretion’ of modern day madhouse keepers, for them to exercise behind closed doors, where as others have said, “syringes sit prepped”, cannot be accepted. The threat of forced injection is the trump card, the nuclear weapon of social control that runs through the institutional fabric of all psychiatric facilities. It is an evil so profound, a destroyer of trust, beneficence, a profound warping, deforming of the therapeutic project, such a profound abuse of psychiatric power, that it has no right to exist.

    Syringes exist inside psychiatric facilities for one thing and one thing only. To deliver liquid chemicals into the bodies of the non-consenting. They are tools of terror, tools of torture in this context, the tools of a violent, and medical-in-name-only, form of social control, diabolically invasive in nature, anathema to everything medicine should stand for.

    The forced drugging of teenage Canadian Ashley Smith: (trigger warning)

    compare to a resisting arrest video from the tv show ‘Cops’:

    The police arrest of the unarmed, resisting suspect, didn’t involve the government entering and altering the person’s biology.

    Forced psychiatric drugging is not humane, cannot be made humane, and must be abolished. Forced psychiatric drugging existing, implies some people’s thoughts and consciousness have no right to exist, for it is with forced drugging that this consciousness is bulldozed, deleted, and obliterated. Rather, I say it is forced drugging that has no right to exist.

    Thank you for your sincere efforts you’ve made with your organization’s report. I only hope that one day we can live in peace. There will be no peace in ‘mental health’ until psychiatry stops initiating the most degrading and profound violence upon those it labels ‘patients’. It’s just such a human tragedy that this profoundly misguided profession has thrown enough propaganda up against the wall, about our brains, even though it can’t prove jack, and society betrayed us, by handing our brains over to these quacks to tinker with. It really is a terrifying fact about modern history, that all it took was a bunch of well-meaning, yet quick to dehumanize, quacks, to plaster the world with phony ‘brain disease’ mantras, and even our own supposedly democratic governments gave them the reserve power to enter the living brain of any citizen in society by force, should psychiatry ‘detect brain disease’ in that person, without ever even once examining their brain. Someone, or some thing, or some ideology, has told forced psychiatry workers that when the ‘brain diseases they treat’, squirm under hand, cry out, and plead with their attackers not to inject them, that this isn’t a human being speaking. And that’s a tragedy. Cardiac surgeons peel back layers of the heart to access the interior of the heart during medical procedures. Forced psychiatry workers violently pull down the jeans of 19 year old teenage females to get access to the naked skin where a forced injection is going to be ‘administered’. There’s only a select few groups of people who drift off to sleep at night, their day being filled with recent memories of participating in ripping the clothes off strangers and hearing them scream out in terror telling them to stop. Forced psychiatric drugging is not a medical procedure. It’s violence. It cannot be reformed, it must be abolished.

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  2. Brett, I commend your work in our prisons, especially drawing attention to the mental health issues. And I commend you taking this advocacy to our forensic psychiatric facilities.

    But like ‘anonymous’, I cannot support your ‘Mad in Australia’ report that endorses involuntary psychiatric treatment “when a patient is a clear danger to themselves, or other individuals”.

    First of all, despite your careful analysis of human rights principles elsewhere, you offer no analysis to justify your support for the violation of this human right. Indeed you seem to fall into the status quo assumption that forced drugging is OK, indeed necessary at times, to “calm” and subdue people who are deemed “dangerous”. Furthermore, you seem happy to leave this judgement to “medical practitioner discretion”, which is hardly in line with human rights principles.

    Second, you regard the other two criteria for involuntary treatment under our mental health laws – i.e. (a) incompetence due to “mental illness” that (b) requires medical treatment – as invalid and not justifiable. I agree, but then following your logic, I presume you must therefore also support forced drugging to calm and subdue all dangerous people, which is currently NOT permitted in our criminal justice system (with the exception perhaps of capsicum spray).

    Another fundamental human rights principle is that a human right should never be “limited” (i.e. ignored, neglected or denied) unless it can be demonstrably shown to be reasonable, necessary, justified and proportionate. I don’t know of anywhere in the world where such a justification has been made for forced psychiatric drugging. Instead, all we have are the same old status quo assumptions which, in my view, don’t stand up to scrutiny.

    I was deeply saddened to see these same old assumptions in your otherwise excellent and important report. Please re-think your position on this extremely important issue.

    Cheers – David

    PS I have quite a lot of material on this – my focus is on suicide prevention and how psych force contributes to, rather than reduces, the suicide toll. But the argument’s the same, I reckon. Happy to share what I have if you’re interested. Can’t find your email address yet, but you can email me either through the MIA contacts page here, or through my website at

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  3. I too greatly admire Brett Collins’ work. I also am against forced treatment. However, I wonder whether “Anonymous” and David have been in the situation where a person is throwing him/herself against walls, bashing his forehead over and over again or is out of her mind with methamphetamines.

    I have recently worked in an acute psychiatric unit. Having been away from acute work for 30 years. Short of putting someone in a straitjacket, I could see no other way for the staff to help the person than to medicate. Often midazelam is sufficient and avoids the use of antipsychotics, but there is no doubt that the latter is necessary in cases where drugs like Kronic and amphetamines are concerned.

    Sedation is also necessary when someone has to be airlifted to a hospital, as is frequent in Australia.

    The major danger is that people then get a label and be forced to take antipsychotic medication long term. That becomes a human rights issue, one that is rarely addressed by current psychiatric practice. Thomas Szasz was a voice in the wilderness for most of his career, but his books should be read by anyone who cares about the rights of the “mad” and the “bad”. Winnick’s book “The Right To Refuse Mental Health Treatment” is also useful.

    In prisons, the distress or aggression may be due to the treatment within the prison itself . It is rare for prisons to change their regimes to accommodate prisoners. It is also rare for prisons to allow minor tranquilisers to be used. Antipsychotics have many side-effects and should be used briefly and in the lowest dose possible.

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    • You raise a very interesting point, which I think the most contentious and difficult to get to the root of.

      But I would first like to ask the question and direct my curiosity to how a person who is self-harming or harming others subsequent to significant substance use is in an acute mental health unit? Why? Notoriously, from my experience working in said units and in E.D., we avoid admitting people who are acutely intoxicated for the very ethical dilemma that ensues. Leave that to the police and doctors in E.D.

      For whoever has the unfortunate outcome to end up in an acute adult MH unit however, we should perhaps then ask the question, why? why is this person here? what is stopping us from unrestricting our practice? is the person really a risk of harm (to themselves or others)? what does it mean to harm? are we harming them? is that better than them harming themselves or others? why? could we do something different? have we tried?

      Ultimately, I’ve asked myself these questions, and I believe there’s always a better way. But due to how systems and the MHA2016 (and related other state Acts) operate, we’re pidgeon-holed into being custodians. Which I thought, was the very thing we were trying to get away from.

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