“Psychiatry Unlocked” Researchers Discuss Movements Against Involuntary Hospitalization

A Lancet editorial covers the growing movement aspiring to dismantle compulsory admission


A recent editorial in The Lancet critically examines the current and historical role of psychiatrists in involuntary hospitalization. The morality of compulsory admission, or involuntary hospitalization, is called into question alongside mention of the different committees and organizations opposing it.

“… it is also important to remember how serious—and open to abuse—the power to detain individuals in inpatient psychiatric care can be. Deprivation of liberty is never trivial.”

Photo Credit: Pixabay

The author opens by citing historian Ben Shephard’s commentary on the historical role of psychiatrists as “medical gaolers” in his book A War of Nerves: Soldiers and Psychiatrists, 1914-1994. Despite the various changes in the field that have since shifted from asylums toward alternative psychological and pharmacological therapies and community care, Shephard’s sentiment continues to be considered: “does the use of compulsory admission and treatment mean that psychiatrists are still, at heart, ‘medical gaolers?’”

Compulsory admission is deemed to be a measure judiciously taken to protect patients from making decisions resulting in damaging or persecutory consequences. This option is reasoned to prevent immediate danger, but also to protect the patient’s current self and future self from irreparable choices. This is, the author writes, the perspective portrayed by media outlets that report critical incidents and portray hospitalization as a primary responsibility held by psychiatrists. Yet, the history of human rights abuses committed at the hands of the mental health system cannot be disentangled from past and current policies that defer power over individual liberties to psychiatrists, even if such policies are purported to be protective.

“The mental health system does not sit outside of the society in which it exists. History has shown that society’s evils often become, sooner or later, psychiatry’s evils. Thus the gravity of a decision to use compulsory admission and treatment must constantly be recognised afresh.”

A growing movement argues that compulsory admission is a direct violation of the fundamental principles of human rights. The UN Convention on the Rights of Persons with Disabilities (CRPD) takes this stance and supports the notion that compulsory treatment should be abolished in the protection of human rights including “the enjoyment of the highest attainable standard of health, access to justice, the right to liberty, and even the right to life.”

The World Psychiatric Association (WPA) recently weighed in by crafting a Bill of Rights for Persons with Mental Illness, which, despite addressing rights of individuals experiencing mental health problems, the author notes, “skillfully bypasses ongoing debates about the validity of psychiatric diagnosis.” The issue of compulsory treatment and admission, they continue, goes unresolved.

Committees supporting the stance against involuntary hospitalization ambitiously strive toward a different form of medical practice, a decision that must be built upon a compromise between these two forms of protection, writes the author.

“But in the case of compulsory admission, when the psychiatrist must consider both the primacy of human rights and the possibility of serious harm to the patient, that compromise will always seem elusive and, when attained, tentative at best.”



The Lancet Psychiatry. “Psychiatry unlocked.” The Lancet. Psychiatry 4.4 (2017): 261. (Full Text)


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    • A previous post on the end of psychiatry
      ” And if we stop calling them patients, are we ready to treat them as full citizens, make them face the consequences of their behavior like everyone else, including being hauled before a court if they break the law?”

      You got it backwards. We first stop calling the psychiatric medicines , medicines. The chemicals psychiatry prescribes are just drugs, for there is no physical illness in the patient.

      Then with no “medicines” to issue to your patient, who are you doctor? Are you a doctor? How do you differentiate yourself from a religious leader who also uses words to treat his congregation?

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    • Nor was there any word, at least in the piece above, on community treatment orders. Community treatment orders where the “medical gaol” is actually extended into the community at large. I would say community treatment orders represent a threat to the freedoms we all cherish, and an understated one at that. You don’t even have to be “admitted” to the hospital/”gaol” anymore to have treatment forced down your gullet. Where’s the liberty in that!?

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      • I totally agree Frank community treatment orders are a blight on any society wishing to be modern and progressive… We can only hope that Finlands Open Dialogue approach expands into other countries including my own!

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        • So-called “community treatment orders” can only come from force, coercion, and a blatant dis-repect and disregard of personal rights. Despite being a (seemingly) legitimate`action, it’s actually showing how *SICK* the society and community truly *ARE*. Such force-imposed torture would not occur in healthy and sane communities. Why do we *BLAME* the *VICTIMS*, but not also blame the victimizers?….

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  1. His mother said the boy had merely thrown a tantrum. But a hospital owned by America’s largest psychiatric chain, UHS, held him…

    “It felt like my child had been kidnapped.”


    I was a victim of UHS, its embarrassing but I needed alcohol detox and 100% voluntarily went to the ER instead of buying more alcohol and got transported to a UHS hellhole where after the nightmare was over I got my medical records and I saw they lied and wrote that I was suicidal. The idea of what happens when you die has always scared the crap out of me, I don’t do ‘suicidal’ I never have.

    Now I have that slander on a medical record along with ‘bipolar’ another lie. Self medicating anxiety with alcohol, ( the thing that was making anxiety worse) and alcohol dependency would have been accurate but not profitable enough for UHS so my medical record said suicidal bipolar. UHS is scum.

    Alcohol detox would have only taken a few days but as the links to other stories in the article I posted point out UHS fraudulently holds people for as long as insurance will pay. This happened to me years ago but UHS is still doing it.

    The same people who want to keep the beds full for profit decide who is ‘sick’ and who is well, that is about as a bad as a conflict of interest can get.

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    • You’re right, The_cat, forced psychiatry is about the money, not about medical care. They hold you until the insurance company says, “no more money.” And great point, “The same people who want to keep the beds full for profit decide who is ‘sick’ and who is well, that is about as a bad as a conflict of interest can get.”

      This is the, now FBI convicted, doctor who held me against my will and had me massively poisoned, likely because I was an organ donor, or he wanted to cover up prior iatrogenesis, or he wanted to cover up medical evidence of child abuse for the owners of his hospital, or he wanted to perform an unneeded tracheotomy to “cure” a non-existent “chronic airway obstruction” for which he’d claimed I needed to be admitted.


      Forced psychiatric treatment needs to be made illegal. It’s being abused for illegal reasons.

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    • Yes, I too still suffer the repercussions of being kidnapped, locked up and drugged by psychiatry. It plunged me into my first ever and only “psychosis” at age 50. Now over 60 I still find it almost impossible to trust my fellow human beings and am terrified of the power doctors have to detain and drug.

      In my journals at the time I referred to them as my “gaolers” and “torturers”, and it took me quite a while to get off their drugs…Olanzapine and Mertazapine and then Prozac. What hell they caused me.

      Community treatment orders, especially with depot injections are another horrific means of torturing innocent people who have done nothing that could warrant their sentence under regular mechanisms.

      Psychiatry is there purely to control and torture innocent people, to act as judge, jury and gaoler and to step in where, because of human rights and the letter of the law, the general judicial systems dare not go.

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      • When they told me inpatient take these drugs or we will have you injected I reminded them that some day in the future it is very possible I will see one of them outside that ‘hospital’ alone and I could stick them with a needle.

        Is that a threat, do we need to call the police ? Ya go a ahead and call the police all I did was make the exact same threat you just did and you made your threat first. Go ahead and call, they did not.

        Before I paint a picture of me being an aggressor, I was scared. No place to run, backed into a corner, threats coming at me and no way was I swallowing that handful of pills, I knew it was too much and dangerous turn my mind to mush and make my muscles spasm and twitch. Haldol shuffle and drool. Its my body, I kind of need it to exist and them sons of bitches think they can force pills or just stick a needle in me, invade the inside of me, violate my body like rapists endangering my health and life. Psychiatric drugs have no medical value what so ever all they can do is damage your health.

        They never touched me but I had made up my mind if they did I was going to assault who ever did the needle stick in me outside the ‘hospital’ and so what I get what 6 months in jail, no one gets away with assaulting and raping me. Run up or sneak up and break a leg with a baseball bat then run away.

        WTF did I do to be treated like the way I was in that place? I got kidnapped for $20,000 in insurance money.

        I swore when that nightmare was over I was going to speak out and here I am.

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          • The Ethics of Revenge by The Last Viking http://www.ekran.no/revenge/Scripts/Ethics.html

            They would have called me a criminal if I counter assaulted anyone who assaulted me in retaliation as I would have known what I did was “wrong”.

            I am talking all tough guy now but the truth is I was scared and making threats at them was all I had left at my disposal to fight with in the interest of self preservation. I know how I react to drugs and they were attempting to coerce me to take an overdose. I took that needle threat seriously, I saw staff assaulting people several times a day.

            Nightmare, I don’t feel like writing about it anymore today.

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        • Your experience reminded me of the first night I spent at the state “hospital”. When introduced to the unit where I would stay the nurses were going through their check lists of things I needed to do. One of the things was the shot for the TB skin test. I can’t take that test because the last time I took it I reacted so strongly that my arm swelled up. Doctors told me to NEVER, EVER take the skin test again.

          Well, here came this snotty acting little nurse with the needle. When I asked her what she planned to do with it she smugly stated that I’d better put out my arm so she could give me the skin test. I explained that I could no longer take that test and she came at me with the needle anyway.

          I backed up and stated that I would not take the test since it would result in harm to me. By golly, she came at me again. So I backed up again and balled my fist up at my side. I told myself that if she didn’t stop I was going to punch her in her smug and snotty face. At about that time the charge nurse stepped in and told her to leave me alone and we’d get it straightened out in the morning. The snotty nurse stated that she was going to give me the skin test no matter what because it was the rules. The charge nurse told her to stand down and leave the area since she was being insubordinate. It was unbelievable.

          The next morning it was confirmed by my medical records that I should never be given the skin test!

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          • I know, so far this article has 850 views, but how do you explain to readers what its like to be kidnapped by these people and be put in an environment without any of the usual checks and balances that make a civilized society? They think they own you inside an out, violate your body like rapists at will.

            I don’t have the writing skills to describe it. The skin test is an example of how patient prisoners have no credibility or right to what happends to there own bodies in those hellholes just like I knew damn well that pile of pills they expected me to ingest was too much.

            It was awful just standing by and watching other people get assaulted by staff and not be able to do anything, I could have but taking a beating is one thing that Haldol poisoning is quite another. Call me selfish but I was not exposing myself to that.

            Amazing how they still have the pubic thinking these hellholes are “help”.

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  2. There is also no distinction made between detention and “treatment.” If it is deemed that someone be held against their will for threatening others or for otherwise being dangerous, why does that automatically confer the right to “treat” the detainee with some enforced drugging regimen that can do irreparable harm and end one’s life years early? Why not be honest and admit we’re simply arresting and detaining a person to avoid speculative and ostensible harm, and stop pretending we’re “treating” or “helping” the person, thereby justifying all manner of paternalistic abuse in the name of “help?”

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  3. On 08Aug2013, Dr Hamalion of Denver health, my lead doctor, told me in the presence of Dr Gardener (who had coerced me into talking to the doctors off the record by threatening me with 90 days of involuntary hospitalization unless I would talk to them without preserving the conversations with the recorder my family brought me, which was quickly taken from me by the doctors so that I would be unable to preserve an accurate record of my treatment) that she did not believe I was a danger to myself, a danger to others, or gravely disabled. In Colorado, those are the only legal reasons a doctor may hospitalize a patient against his will. I was not released until 13Aug2013. I reported my kidnapping, a class 2 felony, to the Denver DA’s office and the Denver police. No action was taken. Then I got a $30,000 medical bill. I have worked hard and saved money, so I could have paid the bill in full, but I refused to pay the hospital when the doctor, by her own admission in front of two witnesses, violated the law by keeping me there against my will when I did not meet the legal threshold for involuntary hospitalization. When I tried to rent an apartment later, I was told that despite offering to pay the full term of the rental up front, plus a security deposit, my credit score was too low to rent to me. I have lived with my parents or in my car ever since. I don’t work because my problem isn’t lack of money, it’s that I am not able to spend my money on rent. Having a job would get me more money, but wouldn’t improve my credit score, which is what is keeping me from living a normal life. I never signed any agreement to pay. I have disputed the debt with Experian 4 times, each time they have found the hospital debt to be valid despite the absolute absence of a signed contract. Here in America, we have a word for when the economic output of person A belongs to person B without the consent of person A. That word is slavery, and the US constitution, the highest law of the land, says it is illegal. I don’t want to live in my car anymore, but I am unable to move on from the stagnant hell my life has become my money doesn’t spend on rent. What am I supposed to do?

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    • ESSEX, Vt. — A mother who has been hospitalized against her will for five weeks following a murder-suicide involving her teenage son and her estranged husband says she and her insurance company are being billed for her unwanted treatment.

      “I am not ill; I am simply a mother who is grieving the tragic loss of her young son,” Christina Schumacher told the Burlington Free Press this week. “No mother should ever have to experience this loss.”

      Schumacher’s situation is an example of a broader concern, said state Rep. Anne Donahue, a longtime advocate for improving treatment in Vermont for the mentally ill.

      “People are billed as if they are there voluntarily,” Donahue said in a phone interview Tuesday. “It’s a bill you didn’t ask for and you didn’t want.”

      Read more https://www.usatoday.com/story/news/nation/2014/01/22/grieving-mom-involuntary-hospitalization-medical-bill/4778897/

      Its just legalized kidnapping followed by extortion.

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