Another Review Finds No Benefits to Forced Community Treatment

Rob Wipond
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Another review of the body of evidence has found that there are no benefits to compulsory community treatment of people diagnosed with severe mental illnesses.

Publishing in Schizophrenia Bulletin, Canadian and Australian researchers searched the Cochrane Schizophrenia Group’s Trials Register and Science Citation Index between 2003 and 2013, and examined all the randomized controlled clinical trials of compulsory community treatment compared with supervised care or various forms of voluntary care in the community.

“We found 3 trials with a total of 752 people,” they wrote. Compulsory community treatment “was no more likely to result in better service use, social functioning, mental state, or quality of life compared with either standard voluntary or supervised care.”

Kisely, Steve R., and Leslie A. Campbell. “Compulsory Community and Involuntary Outpatient Treatment for People With Severe Mental Disorders.” Schizophrenia Bulletin, March 12, 2015, sbv021. doi:10.1093/schbul/sbv021. (Abstract)

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Rob Wipond
Rob Wipond is a Victoria, British Columbia-based freelance journalist who has been writing on mental health issues for fifteen years. His research has particularly focused on the interfaces between psychiatry, the justice system, and civil rights. His articles have been nominated for three Canadian National Magazine Awards, six Western Magazine Awards, and four Jack Webster Awards for journalism. He can be contacted through his website.

9 COMMENTS

    • Ditto. Day treatment made me spiral down into further confusion and self-negativity. Holistic healing led to sense of self, integration, recovery, confidence, grounding, balance, healthy boundaries, and full health & well-being, for which I’m extremely grateful.

      Forcing anything on anyone would be harmful, specifically psychologically, that’s common sense.

  1. The real problem with allowing forced treatment with the neuroleptics / antipsychotics, which is the drug class I understand is most commonly “forced” upon patients, is that the antipsychotics actually cause the schizophrenia symptoms in a percentage of patients. Here is the medical proof from drugs.com:

    “neuroleptics … may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

    Doctors should not be allowed to force any patient to take drugs that are known to CAUSE the schizophrenia symptoms. And the higher the dose of antipsychotics, or the more types of antipsychotics the doctor prescribes, the higher the likelihood that a psychosis is actually the result of the central symptoms of neuroleptic induced anticholinergic intoxication syndrome, not “real” schizophrenia, if there is such a thing.

    Although, as a healthy grown adult, it only took a child’s dose of Risperdal (.5 mg) to make me psychotic, within two weeks of being put on this drug. So, obviously, this is not a safe dose of Risperdal for any child. The doctors can’t tell the difference between “real” schizophrenia or bipolar or depression, and psychosis caused by the central symptoms of neuroleptic induced anticholinergic intoxication syndrome. Forced treatment really needs to end, it’s morally repugnant.

    • Psycho active drugs are unpredictable. If a person comes out of anaesthesia and is jumping around the anaesthetist is likely to recognise Adverse Reaction and accommodate them – but in psychiatry akathesia will be ignored. It’s only because a few ethical specialists were prepared to risk their livelihoods that SSRI suicide and homicide became an issue. Most other prescribers would have hid behind the “illness”.

      • Fiachra,

        I agree, the psychiatric industry is quite deplorable in regards to claiming the ADRs to the psych drugs are a result of the supposed unprovable “illnesses.” But the entire White Wall of Silence of the mainstream medical community has seemingly bought into this game of blame the patient.

        I found it took quoting an oral surgeon, “concerns of child abuse are not cured with antipsychotics,” to finally embarrass a psychiatrist enough to wean me off drugs I’d been telling him for a year made me hear voices. And my medical records did state I was “hyper” to find the etiology of my illness, since I had no personal or family history of such.

        Thankfully, I did, the antipsychotics do in fact cause psychosis via the central symptoms of neuroleptic induce anticholinergic intoxication syndrome. And the only difference between the symptoms of schizophrenia and the central symptoms of neuroleptic induced anticholinergic intoxication syndrome are “inactivity” and “hyperactivity.” Being “hyper” about learning is good some times.

    • Thanks Someone!
      I would encourage NH to further evaluate the exploitation of this method of “Justice”, while incorporating much of information you too have shared. Interesting thing about “Involuntary Admission” here, within the criteria of the NH Law; if you do not take your drugs- your community release is revoked; one is committed and detained. I have witnessed this twice. Regardless of patient’s condition and beyond the administration of 2+X manufacturer’s dosage by prescribing CMH receiving facilities’ Dr. . One might think, “undue influence”; whereas by law: “a patient must be fully informed as to treatment administered”, the question becomes: How could they be, under such a mind altering state? Amazing.