‘CRAZY’: New Documentary about Forced Psychiatric Treatment

Bruce Levine, PhD
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The issue of control is front and center of “CRAZY,” Lise Zumwalt’s new documentary.

“I’ve always been interested in stories where there is a tension between social policy and law and individual rights—and mental illness is a great lens to look at that tension,” says Zumwalt, who has produced, written and edited films for National Geographic, PBS, BBC and several other major media outlets.

“CRAZY” follows Eric, a young adult diagnosed with serious mental illness, and his father, who together want to change Eric’s treatment. However, the county does not want to give them a say. In the reputed bastion of progressive thinking, Madison, Wisconsin, Eric, his father, and Eric’s attorney are all powerless in their attempt to create a more collaborative treatment plan.

Eric’s father, who is a physician, concludes, “The record is very clear. He was at his worst when he’s had the most medication he’s ever gotten in terms of antipsychotics.” After Eric sees his hands tremoring, he worries about tardive dyskinesia, an adverse effect of his antipsychotic medication. Eric and his father are not demanding Eric be taken off his medication, merely that his dosage be lowered.

This is a story about who is going to control Eric’s treatment. On one side are Eric, his father and his attorney, who argue for Eric’s right to have a say in his own treatment. On the other side, are the county’s evaluating psychologist and social worker, who explain why forced treatment is necessary. Further complicating the issue are disagreements between Eric’s parents, which cause tension for Eric.

In the film, a leading psychiatrist states that individuals diagnosed with severe mental illness lack insight into their problems, resulting in them rejecting the notion that they need help. However, “CRAZY” shows how the county not only deprives Eric of having any power over his own treatment, but also deprived of any say is Eric’s father, a physician and keen observer of his son.

Zumwalt has great access to the drama that unfolds. We see Eric making the decision to refuse medication and becoming an “outlaw,” hiding out in a hotel, and then being taken away to a psychiatric hospital which is not only unhelpful but traumatizing for him. For the most part, Eric’s altered states, when he does experience them, are not violent and do not cause problems for him. However, when Eric attempts to go off his antipsychotic medication cold turkey without tapering, he does have problematic consequences.

“CRAZY” is bittersweet. For Eric, there is a sane solution that enables him to graduate from college and gain the autonomy that he had been deprived of. But “CRAZY” may well be bitter for others who have been in Eric’s positon but lacked his “dream team” of a determined physician father and a tenacious ethical attorney, as well as the social pressure of a documentary filming. The overwhelming majority of people in Eric’s position lack any kind of backing.

One message of “CRAZY” is that fear makes all of us crazy. Families are understandably frightened when one of their members begin acting crazy, and families can get even more frightened by a serious mental illness diagnosis such as schizophrenia. Fear makes for a crazy political landscape, which pits medicating authorities against patients and patients’ rights advocates who are often labeled as naïve or irresponsible.

Why don’t we see more major films such as “CRAZY” that honestly explore this issue? It gets back to fear. Intimidated by the possibility of being labeled as irresponsible, filmmakers avoid this terrain or change facts so as to fit a politically correct narrative—as was done by Ron Howard in “A Beautiful Mind.” In Howard’s film version of the life of mathematician John Nash (played by Russell Crowe), a recovered Nash states, “I take the newer medications.” However, Sylvia Nasar’s book A Beautiful Mind states that Nash stopped taking medication in 1970 because of the way it blunted his intellect, and in an interview before his death in 2015, Nash confirmed that he had stopped taking medication.

Why did Howard change the facts? The Guardian in 2015 reported, “The change was apparently made because the screenwriter, Akiva Goldsman, whose mother was a prominent psychologist, was worried that the film might persuade people to stop taking their medication. There were also rumors that the National Alliance on Mental Illness put pressure on the filmmakers to include the line about medication.”

Zumwalt tells us that her original view of people diagnosed with schizophrenia was the view of many Americans—that if these patients just took their medication, they would be fine and so would society. However, she discovered that this is not always the case.

“The film is not anti-medication, it’s pro-choice,” Zumwalt makes clear. Her film is fair, balanced, and committed to the truth. She is honest about how frightening altered states can be in our society; and she is also honest about how society can do great damage by allowing fear to sanction forced treatments that are not only unhelpful, but which can worsen conditions and result in powerlessness and resentment.

Ultimately, “CRAZY” provides evidence that the tension between societal rights and individual rights of people diagnosed with serious mental illness can be resolved in a sane and humane way if only we can have respectful collaboration.

This article also appears on AlterNet

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3 COMMENTS

  1. Thank you for your article about this documentary, Dr. Levine. “CRAZY” is definitely a film that I’d be interested in watching, as I think that an awareness of how the coercive use of psychiatric medications can sometimes be more harmful than helpful for those who aren’t allowed to refuse such medications is something that’s definitely needed.

    • I find the trailer of this movie, and accompanying interview with the director, to be naive and very sad.

      It is obvious from Lise Zumwalt’s tone of voice as she describes her movie, that she’s oblivious to the true depth and dimensionality of the suffering of patients. She knows nothing about the scandalous, conspiratorial, and intended effect of stigma against patients, and the monolithic effect this has on their lives. And yet it is this same depth and dimensionality which is subliminally driving today’s manifest destiny of mental health care. Stigma is inherent to the medical model of mental illness.

      I’ve always been delighted by the exceedingly high rate of non-compliance with treatment by patients. (90% is it?) And like all other antipsychiatry activists, I know for a fact this has not one thing to do with a lack of insight into their, “sicknesses.” Rather, it is due to a universally-shared experience of patienthood, which says that being a mental patient means you will have no substantive life whatsoever beyond the point you foolishly enter the mental health system. It is a very sad state of affairs that patients have no other recourse to exact justice in their own behalves other than to eschew the drugs, sleep in the streets, and populate the jails. This is the bottom line which is driving behavioral system evolution.

      Yes, there are, “advocates,” and family members who will tell you that court-ordered outpatient treatment will solve the problem of willful non-compliance with treatment amongst patients. It won’t. The criterion for eligibility for outpatient forced treatment is so restrictive that only a miniscule segment of the overall patient population is subject to it. This then leaves the vast majority of patients with the continued prerogative of homelessness, jail, and obstruction.

      “Why not then broaden the criterion for eligibility for forced treatment,” some bright advocates say? Purportedly then all patients could be compelled to undergo treatment against their will.

      I don’t believe the U.S. Constitution will ever permit this.

      • Do you have a link to the interview with the director? I’ve seen the trailer that is on the Crazy website, but no interview. Sad, yes, but naive? Many people caught up in the mental health system have had their constitutional rights (until contested in court) taken away from them. This is what seems to apply in the case of Eric featured in the film.

        I would also say that given the treatment teams, conditional releases, and outpatient facilities that exist today, the criteria of eligibility for forced drugging is not so restrictive as you would suggest. There are people, who after an initial period of institutionalization, are not allowed a drug free option. Many lawyers, as well, are not sympathetic to their issues either. I consider myself lucky for having a family that was supportive, being locked before these all these security mechanisms came into existence, and, additionally, being relatively unscathed physically, unlike so many other people in long term “care”, by the treatments I received.

        Law permits forced treatment now. Mental health law still represents a loophole in constitutional law for locking up (and drugging) some people under medical pretenses despite constitutional protections that apply to the citizenry as a whole.