Tina Minkowitz: The Abolition of Forced Psychiatric Interventions

Emily Cutler

This week on MIA Radio, we interview Tina Minkowitz. Tina is an attorney and survivor of psychiatry who represented the World Network for Users and Survivors of Psychiatry in the drafting and negotiation of the United Nations’ Convention on the Rights of Persons with Disabilities. Tina is a strong proponent for the abolition of all forced psychiatric interventions and played a major role in attaining a shift in international law in favor of such a ban.

In this interview, we talk about how the United Nations came to support the abolition of forced psychiatric treatment and why Tina believes that abolition of forced treatment, not reform, is necessary.

In this episode we discuss:

  • How Tina came to be interested in the intersection of international human rights law, disability rights law, and the issue of forced psychiatric treatment.
  • Why Tina believes in the abolition, not reform, of forced psychiatric treatment.
  • That the threat of forced treatment against some psychiatric survivors can be traumatic to the entire survivor community.
  • The barriers to the abolition of forced treatment, including public perceptions of people labeled mentally ill and lack of awareness of non-coercive alternatives.
  • That advocacy is needed to eliminate the 72-hour hold, not just ECT, forced drugging, or outpatient commitment.
  • Why forced treatment constitutes physical violence.
  • That we don’t need to put in place alternatives to the current mental health system in order to demand an immediate stop to forced treatment.
  • How mental health policy should center what we now consider alternative practices, such as peer-run services, hearing voices groups, and in-home supports.
  • How the issue of forced treatment fits within the disability rights framework.
  • Tina’s current activities with the Center for the Human Rights of Users and Survivors of Psychiatry.

Relevant Links:

The Center for the Human Rights of Users and Survivors of Psychiatry

Campaign to Support CRPD Absolute Prohibition of Commitment and Forced Treatment

CRPD Course

Committee on the Rights of Persons with Disabilities

Convention on the Rights of Persons with Disabilities

To get in touch with us email: [email protected]

© Mad in America 2018

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Emily Cutler
Emily Sheera Cutler is assistant editor and community moderator at Mad in America. Ever since her involuntary hospitalization at age 20, she has been passionate about fighting for the civil rights of people labeled mentally ill. Emily received her BA from the University of Pennsylvania, where she wrote an Honors Thesis on weight bias in the education system. She currently resides in Los Angeles, California.

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  1. This is good. But is anyone else out there skeptical of the term “users”? I really dislike that term. I also dislike the euphemism “interventions.” We need to call a spade a spade. Torture is torture. Abuse is abuse. Drugging is drugging. Involuntary incarceration is involuntary incarceration. Shock is shock. In any case, I’m glad that someone understands the need to abolish psychiatric force. Now, if we could only get people to understand the fact that psychiatry is synonymous with coercion and force, and thus, that psychiatry itself must be abolished.

    • As for the term “user”, you’ve also got “consumer” and “mental patient” which essentially mean the same thing. If you fight the idea of the last, in a “clinical” situation, force is still law, and the institution exists to get people to admit to “having” a “mental illness”, the basic justification for the psychiatric profession.

      “Intervention” gives me a problem, too, for the same reason that one country may have with another country interfering in it’s own internal affairs. MYOB doesn’t work where YOB is, as it is in psychiatry, another person’s B.

      You don’t have force without violence or the threat of violence. I’m glad that Tina pointed out the violence involved. The state has “danger to oneself or others” as an excuse to lock innocent people up. This makes the state guilty of an abuse of power where the state would use it’s authority to harm people who would harm nobody.

      One big difference I have with Tina’s view is that I think the “disability” excuse way over used. I also think the budding “disability” field of professional career “peer supporters” and “helpers” an example of corruption. My worry is what we are seeing. The numbers of adult babies existing in the world today has a heck of a lot to do with the numbers of adult baby sitters operating in the world today, and, by the way, vice versa.

      Forced treatment needs to be abolished. Reform is always about using more or less force. Abolish forced treatment, and you no longer have two reformist sides of the same debate debating whether more or less force should be applied. Instead, you don’t force unwanted maltreatment that claims to be “medical”, even when it is not “medicine”, on human beings.

    • The terminology gets developed for particular purposes – for me ‘forced interventions’ was a way of talking about the whole group of them, drugging, shock, restraint and solitary confinement, and the lockup itself, without using the term ‘treatment’ which of course is a lie that is offensive to the reality. We can use the word torture, but it was necessary to make an argument about what it is that we mean when we say psychiatric torture. See Manfred Nowak’s report as Special Rapporteur on Torture from 2008 (can search for UN Doc # A/63/175), and my work on torture, which you can find on the CHRUSP website Resources page or on the CRPD Course website under Segment 2.

      On the terminology and concept of disability- I think that disability captures the element of discrimination, the ‘on account of factor’. Why are these forms of mistreatment targeted at certain people and not others? Psychiatric labeling ties into an ideology of fitness and unfitness, that treats any impairment or infirmity as meaning the person is an inferior human being whose rights do not have to be respected, who can be treated as expendable.

      For some of us, the subjective anguish we go through in our lives or divergent habits or beliefs really mean we are different in ways that society treats as an impairment even though we don’t necessarily experience it that way. (Some people who are born with physical characteristics different than the norm also do not see themselves as impaired.) For this reason, and also because many of us reject the concept outright but nevertheless were treated as inferior human beings based on psychiatric labeling, we use the terminology of ‘actual or perceived impairment/disability’.

      Also some of us are highly affected in terms of what we can do in our lives or how we live, because of the anguish or divergent habits or beliefs, and may need accommodation or supports from others. It does not have to be a shame or secret to have these needs. Ideally we would live in ways that it was naturally accepted people are all different and have whatever needs we have, but so long as we live in a society that has concepts of ‘normality’ and acceptability that some of us remain outside of, there’s a need to name that as discrimination to be remedied.

      Be that as it may, even if you still disagree with the term disability – if you can find other ways of framing legal theories to abolish forced psychiatry that will have any traction, that will gain adherence and understanding in the legal community, I’d certainly support that as complementary. In my experience in this movement, everything we tried earlier, simply talking about forced drugging as an abomination that should not be done to anyone, failed because society shrugged its collective shoulder and said, so what? Because it is done to ‘those people’ who are not seen as real people worthy of rights protection. Naming the discrimination knocks on the door more insistently, and I don’t know any other way to name it besides disability, which I think is accurate for the reasons stated.

      • Agree 100 % with most of the last paragraph above. Whatever terms we happen to use, the problem is discrimination and prejudice. “Disability” though, I have several issues with from the onset. For starters, it defines this relationship of an individual to receiving government SSDI checks. Then there is the matter of, if you are saying “mental illness” is a myth, how can you say “disability”, without confirming and reliable tests of one sort or another, in many cases, where so-called “mental illness” is concerned, isn’t a myth as well? I’d like to see many people with jobs and purposeful lives that the present system denies such, and I see the “disability” excuse as one of those reasons for such denial. I suppose you could call it cynicism in action.

  2. I’d also be interested in hearing how this international, UN-based action can be used to put pressure on domestic U.S. practices. What response, if any, has the American Psychiatric Ass’n given….????….
    Forced drugging, forced Electro-Cution Torture (“ECT”), and armed kidnapping of so-called “mental patients” is still going on right now….

  3. Thank you for this important resource that so clearly explains the key issues Tina. Will share widely.

    I am writing here to ask everyone involved in this movement, to please seriously, reconsider the need to include the dangers of anti-depressants as equally important as the warnings about the dangers of neuroleptics.

    As per the documented medical facts, in the 3 months I was on them, I suffered 3, back to back, near-death Adverse Drug Events (ADE) as a result of anti-depressants
    1. extreme suicidal ideation with a plan, on Prozac alone.
    2. A near-death bout of Serotonin Syndrome in which I was in and out of consciousness for 4 days, unable to walk or call 911
    3. In isolation at the ER, I was drugged almost to death over a 7 day period (first without my knowledge) and then against my right to bodily integrity and the right to refuse “treatment”. It was clear that I was dying and as per the chart, begged and literally fought to protect my life without success until succumbing to Neuroleptic Malignant Syndrome, causing total organ poisoning, resulting in a 10-day coma and numerous diseases of the heart, liver, lungs and brai
    4. Two days later, after barely surviving coma, I was drugged with a neuroleptic and suffered a stroke

    As a vulnerable person, I was repeatedly coerced, misled under the guise of “education” and outright lied to into taking drugs, that I did not want or need for an imaginary “bi-polar” label I do not remotely fit the criteria of, against the rules of the fraudulent DSM. I was left with numerous permanent, progressive diseases that have dramatically altered my life.

    This is why I find the never-ending claims about which drug is the “worst” counter-productive and dangerously misleading. Anti-depressants are just as dangerous as neuroleptics in that they can kill anyone, at any time, at any dose. The dangers of taking them are under-considered and all too often completely dismissed, in comparison to the warnings about neuroleptics, which in part, allows for the in discriminant use of anti-depressants to continue largely unquestioned. This is problematic and must be rectified. With all due respect to those who take this position, please do not discount or exclude victims of anti-depressants, as part of Prohibition.

    As per Peter Breggin (who was my expert witness) ALL psychotropic drugs are neurotoxic and have been known to cause brain injury for over 40 years, in as little as 2 days in ALL people. They were never intended to be used for longer than 2 days, in the most extreme cases, under strict supervision, which as we all know, is not how they are used.

    I was/am, admittedly a brain injury survivor during the time that I was tortured by psychiatry. Despite the fact that all psychotropic drugs are contraindicated and unapproved for use in this vulnerable population, we are drugged without question or consideration of our higher risks of death and suicide. Persons with histories of diagnosed and UN-diagnosed brain injury, make up between 50 and 80% of persons who are homeless, in and out of prison and in and out of psych wards. Because most blows are to the head and face, abused women sustain brain injury at alarmingly high rates. Contrary to their best interest, they are automatically labeled as “mentally ill” and forced streamed into the ‘MH’ system where they and their children are labeled and drugged. The cycle is endless.

    Below are the first few articles in a list from a google search for “how many people die from taking anti-depressants?”
    Thank you

    Antidepressants may raise death risk by a third – Medical News Today
    Sep 19, 2017 – A new study suggests that common antidepressants may pose a serious risk to health; they drastically raise the risk of mortality. As many as 1 in 10 people in the United States take medication for depression.

    They Cause 40,000 Deaths a Year – But They’re Handed Out Like Candy
    May 3, 2011 – There are many reasons why they don’t work the way most people think they work, or want them to work.

    Study finds antidepressants increase risk of death | New York Post
    Sep 14, 2017 – I think people would be much less willing to take these drugs if they were aware how little is known about their impact outside of the brain, and that what we do know points to an increased risk of death.” The study also found antidepressants aren’t harmful to people with cardiovascular diseases, like heart .

    Antidepressants Overdose – Side Effects of Antidepressants – Treatment
    Tricyclic antidepressants (TCAs); this type of antidepressant is the second leading cause of death from drug overdose in the U.S. (Anafranil, Sinequan, Tofranil, Pamelor, Norpramin); Selective serotonin reuptake inhibitors (SSRIs); this type is currently the safest and most commonly prescribed antidepressants (Celexa, …

    Do Antidepressants and Other Psychiatric Drugs Kill a Half Million …
    Dec 6, 2016 – Executive Summary. Antidepressant use is very high; An anti-psychotic drug, Abilify, is the number one best-selling drug (by revenue) in the US; People who take psychiatric drugs have much higher death rates; Psychiatric drugs appear to be so ineffective that the higher death rates couldn’t possibly be …

    Antidepressants Tied to a Significantly Increased Risk for Death
    Sep 21, 2017 – “The common wisdom is that antidepressants are safe and effective, and by treating people with depression with antidepressants, we can save lives. However, research over the last decade has shown that antidepressants are much less effective than we had thought.

    New research found antidepressants may increase risk of early death …
    Sep 17, 2017 – They found antidepressant (AD) users had a 33 per cent higher chance of death over people not on the drugs. They also had a 14 per cent … carry a risk of increased mortality.”

    Antidepressants raise the risk of an early death by 33% | Daily Mail …
    Sep 13, 2017 – They believe the protective impact of the drugs among patients with cardiovascular disease has been masking the impact on other patients for years. But the scientists stressed that although the relative risk of death was high

    Antidepressant use linked to higher risk of premature death: study …
    Sep 18, 2017 – A study led by researchers at McMaster University in Hamilton, Ont., found that the risk of early death increased by 33 per cent in people who take antidepressants, compared to non-users.

    Treating Antidepressants Overdose | Drug Overdose Treatment
    Can You Die From an Antidepressant Overdose? – If you or someone you know is abusing antidepressants and is at risk of overdose, call 1-888-319-2606Who Answers? to learn more about recovery options. Antidepressant overdose can be fatal.

    • Hi Judi –

      I replied to you at length elsewhere and won’t repeat it all here.

      But for MIA readers I will say that
      1) I agree that SSRIs are dangerous and the kinds of risks you mention here, especially early death, should be publicized.
      2) I focus on neuroleptics for a few reasons. Neuroleptics are used against people to control them, they are called a chemical straightjacket and chemical lobotomy for good reason. Neuroleptics cause both psychic apathy and intense physical/mental suffering (akathisia) at the same time. No one likes neuroleptics, some people tolerate a small dose to suppress voices or something else in their minds that is deeply troubling to them. But mostly people are dosed with neuroleptics against their will, whether by outright force or by intimidation or incentives/disincentives of some kind. For this reason people taking neuroleptics have usually been out of sight out of mind of society, news media, who think of us as the crazies locked up in institutions. They don’t market to us, they market to those who want to control us. That has changed somewhat now as neuroleptics are being given out like candy for all kinds of things, horrifying. But I still think it’s the dominant characteristic. While on the other hand antidepressants are marketed to people and some people like taking them, enjoy the effects and say it makes them feel very good. Debate about antidepressants is on the level of awareness-raising and letting people know about what the harms are that your doctor won’t tell you – less about countering the ideology of institutionalization. It sound like in your case you were forcibly drugged with an SSRI – so I suppose that there is a lot of crossover and it’s not all one or the other.

      My personal experience was being drugged with neuroleptics, so i come with a deep knowledge of that. I am open to including all the psychiatric drugs, which as you remind me, all cause some form of brain damage, in a call for abolition/replacement with nontoxic alternatives.