Today, July 1, 2016, the Alaska Supreme Court issued its Opinion in In the Matter of the Hospitalization of Mark V. This was an appeal brought by the Alaska Public Defender Agency in which they argued the trial court should not have granted the commitment because Mark could have functioned in the community with the help of his willing parents. The statute allows a person to be committed even if they are not a harm to self or others as “gravely disabled” if their previous ability to function independently in the community would deteriorate substantially without hospitalization. See the definition of “gravely disabled” in AS 47.30.915. In Wetherhorn v. Alaska Psychiatric Institute, which was a PsychRights case, in which the Alaska Supreme Court held that this could be constitutional only “if construed to require a level of incapacity so substantial that the respondent is incapable of surviving safely in freedom.” The Alaska Supreme Court in Wetherhorn also phrased the requirement as the “distress” suffered by the person must be such that it “prevents the person in question from being able to live safely outside of a controlled environment.” It cited this latter phrasing in today’s decision.
What strikes me the most about the case is that Mark’s expressing the view that a psychiatric drug he was being required to take is poison, that it had side effects related to his sexual performance, and that it was killing him were all cited as proving Mark was delusional. As readers of this site know, these drugs can quite reasonably be characterized as poison, they do cause sexual dysfunction, and they are quite lethal to many many people, shortening lives on average by 25 years for those in the public mental health system, such as Mark.
Interestingly, just a month before this decision came out, Dr. Peter Gøtzsche gave a talk in Anchorage describing how ineffective and lethal neuroleptics are, titled Forced Admission and Treatment in Psychiatry are Violations of Basic Human Rights and Must be Abolished (YouTube video), to which I invited all of the Alaska Supreme Court justices. I didn’t really expect them to attend, and none did, but today’s case illustrates the problem of the acceptance by the courts of the misinformation perpetrated by the psychiatric industry.
Mark V. does have some good rulings. The Alaska Supreme Court held, “Finding that no less restrictive alternative exists is a constitutional prerequisite to involuntary hospitalization,” and
We reiterate that a person’s inability to function outside of an institutional setting even with the support of family and friends is indeed a constitutionally-required part of the test for whether the person may be involuntarily committed.
This is based on United States Supreme Court precedent, so it is not new. The court also rejected the hospital’s position that it was the burden of the person facing involuntary commitment to prove there is a less restrictive alternative, holding instead that the state must prove it by clear and convincing evidence. This is mostly a theoretical victory because the hospital is not interested in putting on evidence for less restrictive alternatives, especially once it has decided it would like the person committed. Therefore, as a practical matter, people faced with involuntary commitment are going to have to at least identify less restrictive alternatives.
One thing that I am sure the Alaska Supreme Court was not aware of is that the psychiatrist’s testimony essentially admitted that the so-called “emergency” drugging of Mark V while in the hospital was not legal. The Alaska Supreme Court stated, “API staff had several times been required to administer emergency injections to calm him down when he became aggressive and threatening.” However, AS 47.30.878 provides that “emergency” medication can be administered only if:
[T]here is a crisis situation, or an impending crisis situation, that requires immediate use of the medication to preserve the life of, or prevent significant physical harm to, the patient or another person, as determined by a licensed physician or a registered nurse;
The psychiatrist is quoted as saying she did not believe Mark was truly a physical threat to others or in danger of harming himself. Clearly, the emergency drugging was not authorized by law.
This is just an example of people’s rights being ignored as a matter of course. I wrote a law review article with that theme, Involuntary Commitment and Forced Psychiatric Drugging in the Trial Courts: Rights Violations as a Matter of Course.
To me, the Mark V decision illustrates the need to
- Educate the public, including the judiciary, that psychiatric imprisonment, euphemistically called involuntary commitment, and forced drugging is not helpful to people;
- Have alternatives, and
- Enforce people’s rights.
I wrote about this in my first Mad in America blog, A Three Pronged Approach to Mental Health System Change, and there is an hour-long YouTube where I talk about it, Role of Litigation in a Strategic Approach to Mental Health System Change.
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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.