Spotlight on Institutional Psychiatry

Irit Shimrat
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Spotlight on Institutional Psychiatry is a one-time newsletter that I compiled and edited in the spring of 2018. It is comprised of several articles written by an ad-hoc group of psychiatrized people and our allies in Vancouver, Canada, as well as some of the work of artist and psychiatric survivor Ronda E. Richardson. Taken together, these articles and artworks constitute our responses (both direct and indirect) to a scathing 2017 report written by lawyer Laura Johnston of British Columbia’s Community Legal Assistance Society (CLAS) — Operating in Darkness: BC’s Mental Health Act Detention System.

Here in BC, CLAS’s Mental Health Law Program provides legal representation for people who are in hospital against their will. The program’s primary mandate is representing “involuntary patients” at legal appeal proceedings (review panel hearings). These generally take place within three weeks of committal.

Here I must note that many “involuntary patients” have no idea that legal help is available, even though hospitals are officially obliged to let us know. Never — in all the times I have been brought to hospital in handcuffs, by police, stripped naked, injected, tied down and put in solitary confinement, then eventually released into the ward’s general population — has any staff member mentioned that I have a right to a hearing to review the legality of my detention.

During a review panel hearing, as CLAS’s report states, the detainee is likely to be wearing pyjamas or a hospital gown, while every other person in the room is in a suit. Most often, the legal representative’s role is to argue against a psychiatrist whose aim is to prolong the term of detention. Needless to say, the deck is stacked against the “patient,” and Operating in Darkness makes this clear.

I have never seen anything like this report. Within its pages, CLAS representatives not only highlight their frustration at being unable to do their jobs effectively, due to the draconian regulations mandated by the BC Mental Health Act and related legislation; they also detail the outrageous rights violations to which psychiatric inmates are routinely subjected.

It is stunning to see such a powerful condemnation of psychiatric “hospitalization” coming from a group of people who are neither psychiatric survivors nor antipsychiatry activists. And CLAS’s report does not mince words. It consistently refers to “hospitalized” mental patients as “detainees,” and demonstrates that what happens to us when we’re inside is a matter of human rights, rather than of “medicine” or “care.”

So, let me tell you a bit more about the report’s contents; about what makes BC’s “mental health” (and related) legislation so bad, and the constitutional court challenge CLAS has launched to seek redress for its victims; and about what’s in Spotlight on Institutional Psychiatry, why we created it, and what we hope it will accomplish.

The CLAS report

Operating in Darkness paints a vivid and galling picture of what happens inside BC’s psychiatric hospitals and wards. For example, it details the ways in which restraints and seclusion are used against psychiatric detainees. (Yes! They actually use the word “against”!) It also points out many other ways in which standard psychiatric procedure contravenes our fundamental rights, as mandated by the Canadian Charter of Rights and Freedoms. The report specifies that restraints and seclusion, particularly when used as a disciplinary measure, “can amount to a violation of the right to be free from cruel and unusual treatment or punishment.” Obviously, our right to freedom of movement is violated through the use of detention, seclusion and restraints. But the report also notes that the right to life, liberty, and security of the person is routinely abrogated by “non-consensual physical touching and forced administration of psychotropic pharmaceutical agents.”

Here are just a few quotations from Operating in Darkness, categorized by subject:

Total control
“Staff have absolute control over where you go, what you wear, what and when you eat, when you bathe, when you sleep, what restraints you are placed in, whether you are placed in seclusion, and which psychiatric treatment you are administered.”

Punitive use, and harmful effects, of restraint and seclusion
“… restraints and seclusion are used … as a routine admission procedure, a psychiatric treatment method, a coercive tactic to elicit cooperation with involuntary psychiatric treatment, a disciplinary measure, a behaviour modification tactic, and for staff convenience.”

“There are no criteria in the BC Mental Health Act and its regulations that define, govern, or establish oversight of restraints and seclusion use against detainees. This absence is particularly concerning in light of the fact that regardless of why they are used, restraints and seclusion can cause harm to individuals and create or contribute to mental health problems.”

Incapacitation by drugging
“… it can be very difficult for detainees to access the practical tools necessary to make a complaint, such as a phone, a computer, or a pen and paper. It is also difficult for someone who is experiencing mental health problems or negative feelings as a result of an involuntary detention, while under the influence of psychotropic pharmaceutical agents, to sustain the focus necessary to conceptualize and organize their complaint, present the complaint in a way that others will understand, file the complaint, and participate in the complaint process.”

What makes BC’s mental health legislation worse than the rest of Canada’s?

In BC, and only in BC, we who are in hospitals against our will are thereby automatically deemed to “consent” to treatment. A September 2016 article published in the Georgia Straight (Vancouver’s free weekly newspaper) explains: “under the BC Mental Health Act [MHA] … patients admitted involuntarily are ‘deemed to consent,’ meaning treatment decisions are entirely at the discretion of doctors.” The article quotes lawyer Melanie Bernard (who sits on the board of directors of the Council of Canadians with Disabilities) as saying, “In all other jurisdictions in Canada, adults are presumed to be capable of making treatment decisions. What we see in BC’s outdated law is that there is no assessment of the patient’s capacity. Involuntary psychiatric patients are just presumed to be incapable of consenting and health care providers can impose treatment at will. That violates their right to liberty and equality.”

As a result of this “deemed consent” stipulation, psychiatric “patients” in our province — and nowhere else in Canada — can be subjected to the use of force in the absence of a “competency test.”

And it is not only the MHA that discriminates against us; so do other pieces of health-related legislation. All other (actual or potential) BC patients are allowed to decide in advance (while deemed competent) what can or cannot be done to them by doctors, in the event that they become unable to make treatment decisions due to unconsciousness or incapacitation. They can appoint a representative of their choice: a trusted person who will uphold their wishes. They can fill out an “advance directive” form, which specifies what treatments they will or will not accept. And those decisions will be respected by doctors and hospital staff. “Involuntary psychiatric patients,” however, are explicitly excluded from all of these protections.

Investigative journalist Rob Wipond wrote about some of these problems in a Focus magazine article to which he gave the startling title, “Escape from British Columbia.” This refers to the fact that some people have had to run away from home, to other provinces with less dreadful mental health laws, in order to avoid being force-treated. Wipond notes that the number of people committed to psychiatric facilities in BC has doubled since 2002. In 2015, 13,641 people in British Columbia were psychiatrically incarcerated. “Though statistics weren’t available,” he adds, “it’s widely believed that the use of ‘Extended Leave’ has increased even more dramatically.

“Extended Leave” is BC’s euphemism for psychiatric parole: what the U.S. calls “involuntary outpatient committal.” Elsewhere in Canada, as in the U.K., the term “community treatment order” is used. Basically, under such an order, if you do not comply with treatment, you can be put back in hospital.

Since writing this article, Wipond has obtained statistics indicating that BC imposes community treatment orders far more frequently than do most other provinces and countries.

Wipond echoes Operating in Darkness with regard to the unfairness of review panel hearings, and gives further details: “A person in BC can appeal a committal to a three-person tribunal. Hearings are not open to the public, not bound by rules of court process, and notoriously erratic. Patients are often forcibly drugged [before attending] hearings. Though every patient has a right to a legal aid lawyer, hundreds annually cannot get one because government hasn’t provided sufficient funding.” Unsurprisingly, fewer than one-fifth of patients win these appeals.

Charter challenge

In the same article, Wipond draws attention to a constitutional court challenge launched by CLAS in September 2016, which highlights some of the terrible effects of BC’s mental health legislation. The Council of Canadians with Disabilities is a co-plaintiff.

CLAS argues that the BC MHA violates the Canadian Charter of Rights and Freedoms. Wipond quotes Laura Johnston, the author of Operating in Darkness, as saying that people leave BC specifically in order “to avoid our deemed consent laws,” and that “forced treatment which is imposed unilaterally by a doctor with no checks or balances and no recourse to anybody else is unconstitutional.”

One of the individual plaintiffs in the CLAS suit is 66-year-old Louise MacLaren, who has frequently received forced treatment, both in hospital and at home, over a period of decades. Quoting from CLAS’s affidavit to the court, Wipond writes, “According to the submission, MacLaren experiences ‘extreme anxiety’ when forced to undergo electroconvulsive therapy (ECT), which causes her ‘confusion and disorientation’ for weeks afterwards, and permanent memory losses.” The submission further states that, in 2010, “staff administering ECT forgot to place a mouth guard in Ms. MacLaren’s mouth during the treatment. Ms. MacLaren shattered her teeth due to the convulsions in her jaw.” (Note this use of the active, rather than the passive, voice: we read, not that “her teeth were shattered by the treatment,” but rather that she shattered her teeth — as if it were her fault.)

The other individual plaintiff, a 24-year-old Vancouver man with an advanced degree in music, has been forced to take “antipsychotic” (neuroleptic) medications in his own home. As stated in the affidavit, the drugs cause “involuntary movements, muscle stiffness, muscle pain, and loss of dexterity, all of which impede his ability to play the piano… [which] is such a fundamental aspect of his life.”

How can legislative change help?

As many of you reading this know from your own experiences, mental patients everywhere are routinely locked up in hospitals and brutalized by psychiatric staff, regardless of what “mental health” legislation may or may not permit. In my view (and I am not alone in this), all such legislation is discriminatory by definition, since its primary purpose is to permit the incarceration and forced drugging of citizens who have committed no crime, on the grounds that we are perceived as mentally ill and in need of treatment — despite the absence of any medical evidence that mental illness exists, and regardless of the myriad ways in which psychiatric treatments damage our brains, bodies, minds, hearts and souls.

What would really help, of course, is banning forced “hospitalization” and treatment, as opposed to tinkering with the rules that govern exactly when and how psychiatrists can deprive us of our liberty and bodily integrity. In B.C., legislative reform could, in some cases, protect individuals through the use of advance directives, representation agreements, competency hearings, etc. But the explicit repeal of legislation authorizing the use of force in psychiatry would make an enormous difference in so many people’s lives.

It would also bring BC into compliance with the Convention on the Rights of Persons with Disabilities (CRPD), ratified by Canada in 2010. The CRPD guarantees the right not to be committed to a hospital or other “mental health” facility; the right to leave a facility when you want to; the right to be fully informed before consenting to treatment; the right to refuse treatment; the right not to be put in physical restraints or solitary confinement; and the right to supported (not substituted) decision-making.

Our hopes for Spotlight

We who created Spotlight on Institutional Psychiatry were thrilled to see legal representatives writing so frankly about what they regularly witness in psychiatric facilities. In particular, we commend CLAS’s recognition of the facts that hospital staff have total control over our lives; that restraints and seclusion are used for patient control and staff convenience, and can worsen or even cause “mental health problems”; and that psychiatric drugs can make it impossible for us to think, focus and function.

The primary purpose of Spotlight is to encourage people to read Operating in Darkness. But we also wanted to provide a supplement to the report, detailing, in our own words, how we — a handful of people who have been devastated by psychiatric treatment, a family member horrified by the suffering psychiatrists inflict, a cleric whose effort to provide sanctuary was stymied by a lobby group, and a progressive journalist alarmed by what’s going on in BC — have observed, experienced and been affected by the outrages described in CLAS’s report.

In Spotlight on Institutional Psychiatry, you will read about the lack of response to CLAS’s report on the part of the “mental health” establishment, some of the specific harms caused by psychiatric drugs, the hell of psychiatric solitary confinement, the long history of oppression in the name of “care,” a few of the many non-psychiatric ways of dealing with unusual emotional states, and the family lobby group that advocates for increasing the use of force in psychiatry. You will also read a proposal for a new psychiatric diagnosis — aphorismomania, or definition-madness: a condition suffered by psychiatrists, whose symptoms include the impulse to “join random nouns derived from Ancient Greek in order pass them off as medical terms” (e.g., “schizophrenia”) and to “diagnose hypothetical physiological abnormalities … for which there is no scientific evidence.”

One day, perhaps, outsiders will be able to hear and believe our own psychiatric horror stories, told in our own words. Meanwhile, however, we need all the help we can get from people who have sufficient status to be taken seriously.

We hope that legal professionals will read both Spotlight on Institutional Psychiatry and Operating in Darkness, and will be moved to speak out; that “mental health” professionals will take note of CLAS’s bold stance on the devastating effects of forced psychiatric treatment; and, above all, that psychiatric survivors will feel encouraged and inspired by our efforts.

Bonus radio show! On May 22, activist Irwin Oostendie, host of the program “Democracy North” on Vancouver’s Co-Op Radio, interviewed Rob Wipond (who wrote the introduction to Spotlight on Institutional Psychiatry), Ronda E. Richardson (whose brilliant illustrations made Spotlight so much more striking), and me. You can listen to the show here.

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76 COMMENTS

  1. Great post, report and newsletter. I hardly think BC is the only place where things are getting, it would seem, worse, but, at least, you are taking some kind of action, and, in other places, perhaps people can manage to find a way to follow suit.

    That “deemed consent” for “non-consent” is obviously a total crock, and I would hope that it can be challenged by legal action someday.

    In the USA we have “conditional releases” which I imagine are much the same as what you refer to as “extended leaves”. The detainee is released under condition that the former detainee take drugs and perhaps get counseling and/or some kind of day “treatment”.

    When I was on the wards, years ago, there was this telephone number of a paralegal posted to the wall. A psychiatrist told me it wasn’t a good idea to call the paralegal, 1. because your case would be lost, and 2. because your sentence, your term of detainment, didn’t officially begin until any legal challenge had been settled. Such would have meant, as you can imagine, a longer term of commitment. Like the court hearings you mention these legal appeals transpired in what amounted to a kangaroo court atmosphere. Forewarned and knowing better, I watched someone give the phone number a buzz, and lose their case. The “doctors” warning, in that case, had been prophetic.

  2. “You will also read a proposal for a new psychiatric diagnosis — aphorismomania, or definition-madness: a condition suffered by psychiatrists, whose symptoms include the impulse to “join random nouns derived from Ancient Greek in order pass them off as medical terms” (e.g., “schizophrenia”) and to “diagnose hypothetical physiological abnormalities … for which there is no scientific evidence.”

    The next DSM, the DSM-VI, should have only one “diagnosis”: aphorismomania. But what will be the “cure”?

    • In my more pessimistic moments I envision the DSM-VI. A series of volumes that fill an entire shelf. The DSM-10 will fill a warehouse. In that dystopia psychiatry and government will have fully merged and proclaimed psychiatry the new state religion of America. All other religions are mental illnesses. And at least 90% of the population will be diagnosed as mentally ill. The upper 10% will include the psychiatric overlords/priests and those who work for them.

      • Rachael
        while suffering drug induced psychosis after being involuntarily detained and drugged in a Canberra (Australia) institution, I had almost precisely that vision/dream/hallucination…whatever. The psychiatrists were the “gods” and ONLY what they deemed acceptable was acceptable and was accepted as acceptable by government. These “gods” sat at a high table and handed down “treatments” to those admitted because they didn’t, in some way, conform. Their word was law, and I had broken that law.

        In some ways I am glad I had the vision, as I henceforth (apparently) complied with treatment and was released in 5 weeks, rather than the six month “sentence” initially imposed by the godlike shrinks at a mental health tribunal “hearing” (with another three of “outpatient treatment”), and in the years since have become psychiatry and “medication” free.

        The withdrawals were horrendous, but it’s coming up to 15 years since I was in very much the situation of the kangaroo court the author describes…drugged, denied legal representation…not even allowed a pencil and paper or a phone call or a shower or clean clothes, and never informed of my rights or of the harms of “treatment”. Bastards.

        I moved interstate and still avoid doctors, and will never have any of my medical history transferred, despite now being in my 60s. I know I have a medical condition that is worsening, but going to a doctor isn’t an option any more.

        I have new friends who don’t know my history and live a normal life…but I really do have some very major trauma responses that make life….problematic, to say the least.

        Vancouver sounds like Canberra. I hope human rights win!

          • Yes, I am glad my misanthropy is relates mainly to the medical profession…including nurses and anyone who claims that the “mentally ill” are dangerous and/or need to be made to take medication and/or follow the medical model. I just avoid them like the plague.

  3. “One day, perhaps, outsiders will be able to hear and believe our own psychiatric horror stories, told in our own words. Meanwhile, however, we need all the help we can get from people who have sufficient status to be taken seriously.”

    The fact that these true stories most often go unheard and unheeded is one of the greatest tragedies that results from psychiatric deception and oppression. Psychiatric slavery is enforced right before our eyes, yet very few are willing to do anything at all about it. It is an injustice of astronomical proportions. I feel to repeat Thomas Jefferson’s bold statement regarding chattel slavery in connection to the need to abolish psychiatric slavery:

    “And can the liberties of a nation be thought secure when we have removed their only firm basis, a conviction in the minds of the people that these liberties are of the gift of God? That they are not to be violated but with his wrath? Indeed I tremble for my country when I reflect that God is just: that his justice cannot sleep for ever: that considering numbers, nature and natural means only, a revolution of the wheel of fortune, an exchange of situation, is among possible events: that it may become probable by supernatural interference!”

    • You mention needing all the help “we” can get from people who have sufficient status to be taken seriously. But sometimes it just takes persistence, even if one doesn’t have a “name.”
      I’ve been writing to a reporter my son knew (he was killed by Zyprexa) at the L.A. Times with supporting information about the various drugs that cause suicide/homicide, moved to do so by the various mass shootings. In return, so far, I got silence – which I am used to …however, today, Karen Caplan, Science Editor at the Times, wrote a column about drugs that cause depression and other behavioral changes including suicide. Whether I helped her look into it, I’ll never know, but I’ve sent her column on to a couple of people who do have “names”, asking them to follow up with her.
      Also, my persistence (and that of others) got a warning for diabetes/hyperglycemia/death on Zyprexa and the other atypical antipsychotics.
      However, I will say that the progress is so glacial as to be totally disheartening at times.

      • i am so sorry that you lost your son to zyprexa. thank you for your persistence; it’s great that caplan wrote about this horrible drug’s dangers in the times, and that you helped get a warning on it. yes, progress is inevitably glacial. every accomplishment on our side should be publicized and celebrated.

  4. The hospitals could bring someone like you with them to visit a nearby hospital that employs peer specialists.

    Peer specialists can do much when employed within organization but vital to employ more than one. Preferably a handful simply because one peer specialist will get treated unfairly and unprofessional by many of the colleagues and the more support the better.

    There are obviously additional reasons hiring more than one peer specialist is beneficial.

    • Sure, it must be a big shot in the arm for the “treatment” business, that is, it would encourage “mental illness” industry expansion (i.e. further medicalization). The more “sickies”, the more potential employees, the more advertisements for “sickness”, as well as the function impairing drugs that go along with it, supplying more new recruits as “sickies”, and a greater “need” for more recruits as employees. However, were the “peer specialist” to actually be an ‘investigative reporter’ in ‘disguise’, and should he or she come equipped with a spy-cam, then, maybe then, we could actually get somewhere.

      • Eventually a few of the peer specialist’s after proving to be competent and valuable could move in the direction of the first peer run respite.

        Then there would be an alternative to hospitalization and even forced hospitalization.

        This mentality on change is better than tyraids from your home computer about how you know best.

        It takes persistence. When working with persons in authority mumbling under your breath in order to stay calm and taking the high ground over and over for them to understand and for them to try something different.

        • After working seven years to change attitudes in the state “hospital” where I now work I’m beginning to think that peers would do better to leave the traditional institutions and the system and band together to create places like you refer to here. We’d have more leeway to do what we’re supposed to do with people. But this entails having money and no one in the city where I live will give money to anything like this. You can’t get the funding for this kind of work.

        • Sorry to remind but what is now labelled ‘peer run respites’ has been around longer and has preceeded the phenomenon of ‘peer specialists’ working in the system to make it better. In the light of that historical development it looks like ‘peers’ are much more likely to ‘prove competent and valuable’ to end up within the system as peer specialists than to create our own sustainable alternatives.

          • Don’t you think this “peer specialist” phenomenon, together with the “peer respite” thing, and so forth, that goes along with it, has more to do with the increasing ‘medicalization of everyday life’ taking place in the world today than it actually has to do with “making the system better”? Being a part of the “mental health” system, it’s a big part of the expansion of that system. Looky here, now we’ve got former inmates in the treatment game, for money, and the numbers, as one would expect, keep rising. It’s a business, and once you’ve started a business, you don’t want it petering out. No, that would mean no more “peers” “sickies” “consumer/users” [nor “peer provider”/manufacturers], it would mean more “mentally healthy” self-reliant people, or liberated “consumer/users” instead.

        • No, just a potential plan of action, however there are other instances where using a spy-cam would be effective without the risk that may or may not come from a visit to an institution. Psychiatrists (and other social control freaks) are pretty easy to damn by way of their own words, all you need is for somebody to catch them at their own game.

          • Many of them write articles condemning themselves by their own double speak and self contradictions. I’m trying to curate a bunch of stuff for the appendix of a book I plan on writing.

    • I doubt that it would be possible for someone to sneak a camera in to someone locked up. Where I work they make visitors take everything out of their pockets and leave them in a locker. Then they wand the person to see if they still have anything on them. Then they make them go through a metal detector. Then, in the visitation area they have guards that constantly watch everyone in the room. And if that isn’t enough they have cameras and microphones everywhere in the visitation room and if they suspect anything they immediately go to the film and play it back.

      And for the person who is the supposed “patient” they’d better be a very good actor because they give anyone that they suspect of what they call “malingering”, pretending to be “mentally ill” all kinds of oral exams to detect whether or not someone is pretending to be “mentally ill”. They supposedly have a method of detecting whether or not your hallucinations are valid or not. I’m not so sure that this has any validity. And then of course they watch you on film to see if you stay in character or not. The reason all of this developed is due to the fact that many people who’ve committed crimes like murder, often claim to be “mentally ill” so that they won’t be prosecuted and sent to prison. We have a very large forensic population at the “hospital” where I work.

      And, if anyone was successful in getting a camera onto the unit and was actually able to take pictures the federal government would probably prosecute them for violating the HIPPA regulations about “patient” privacy.

      The security procedures for visitors deal not only with keeping things from being brought in to the “patients” but because of the possibility of an active shooter situation. With the number of mass shootings that have taken place there is increased concern that someone might be motivated to carry out a mass shooting in the “hospital”. At times, when I’m very pessimistic about life, I’m surprised that no one has tried something like that yet. There is certainly enough righteous anger against the system and places like the “hospital” to motivate such an attempt.

      • The fake “peer specialist” might work. Don’t show any victims’ faces. Just the perps. They’re the villains who have no moral right to privacy. Not sure HIPPA covers them.

        The very way they treat their peer specialists as “mentally ill” mascots and token “nutters” would be quite a show. Condescension at it’s finest. 😀

        • If you were to check, it’s institutions that get penalized under HIPAA for security breaches, not individuals so much. That’s why all this hoopla over imaginary ‘shooters’ anyway. Security slipped if one gets in, and then the institution becomes liable. Want to hurt the institution? Film away!

          • No doubt, about the losing jobs, and so, I wouldn’t pin the investigative journalist detail on “peer specialists”. That was an fanciful leap. If you get into the institution with a spy-cam, you don’t want to be an employee of that institution if you can help it. The institution doesn’t want to lose money over somebodies mischief, and it will take the necessary steps to prevent that from happening. They have less power though over people who are not in their employ. Getting the dirt, as long as it still is dirt, I think that it has to be possible.

            I’ve seen where these institutions have been monetarily penalized, to the tune of over a million dollars, over missing hard drives as a violation of HIPAA regulations. Okay. Don’t look at me. I don’t have the data.

        • When an agency experiences culture change than peer specialist’s are not token employees.

          I think Inaops should be covering value of peer specialist with great detail but they are mostly older generation. Great advocates in the past but not open to younger people’s ideas. You can look at their board and see if you agree or not.

          • The problem I see is that those in power are factually opposed to the idea of peer specialists and/or patients having any increase in power or voice. It’s possible to create little pockets of enlightenment, and I truly value and admire those who manage to do so (having been such a person myself at one time). I just think it’s too easy to co-opt or silence those whose interest is to genuinely empower the clients. Lots of clinicians talk a good game, but when push comes to shove, they are disturbed and threatened on a very deep and usually unconscious level by anything that supports clients making their own decisions and being let out from under the full control of the clinical staff.

          • Pat, I agree that if you change the culture peers won’t be tokens.

            But it takes a very long time to change the culture of a place like a state “hospital”. It’s like turning a ship in the ocean; you have to begin planning for the turn long before you actually want to turn. These places are adamant about not changing and work to keep change at the very minimum. I’ve seen CEO’s where I work who tried to bring about change in the culture and its thinking. Three of them bit the dust in seven years and we’re working on our fourth.

          • Who wants to be a “mental health” worker? Not me. First they lock you up, and then you get a job with them. What is co-optation? Buying off the oppressed, and turning them into oppressors, don’t you think? The “mental health” system is actually a very little thing, especially when there is a whole wide world out there just waiting to be explored.
            My answer? Rehabilitate this!

  6. From the report:

    “It is inappropriate for the Mental Health Review Board to
    fund detaining facilities to prepare and present expert medical evidence
    and participate in the hearing when it does not provide any funding to
    detainees to obtain expert medical evidence or participate in the hearing.

    The asymmetrical funding of parties who participate in review panel
    proceedings has a significant detrimental impact on a detainee’s right to
    a fair hearing.”

    It is not just ‘inappropriate’ in the context of people being forced to take neurotoxic drugs and all the rest of the abuse, it is a massive human rights crime.

    See PSYCHIATRIC TREATMENT AND DEEMED CONSENT TO TREATMENT on the report.

  7. It consistently refers to “hospitalized” mental patients as “detainees,”

    In the U.S. at least the accepted legal term is “inmates.” Such definitions are important to framing the situation in an authentic way, and serve to remind all involved that we are not dealing with a medical issue but a legal prosecution of those charged with having inappropriate feelings and thoughts.

    One day, perhaps, outsiders will be able to hear and believe our own psychiatric horror stories, told in our own words. Meanwhile, however, we need all the help we can get from people who have sufficient status to be taken seriously.

    No no no no no…we have always had sufficient media of our own for those who truly want to know what’s up. We always can use support from the general public and from within the “mh” world, but we are fully capable of speaking for ourselves, not “one day” but right now! An early mental patients’ liberation movement slogan was “the liberation of mental patients is the duty of the patients themselves.” We just don’t use the term “mental patient” anymore (hopefully).

    Thanks for the info — looks like things suck just as bad in Canada as here, if not worse.

    • Now that I see your profile as having been a key person at Phoenix Rising I’m even more puzzled by your comments about how “one day” people might find out about psychiatric assault, as Phoenix Rising did this sort of media education for years…could it just be that you’re feeling discouraged about the pace of things where you are, or the strategies being pursued?

      • it is not so much “just” that i’m feeling discouraged about pace and strategies as that there is no progress, no pace, and a marked absence of strategies. my point here was that all the “education” i and others have been attempting for decades has been accompanied by the steady worsening of the mental death system.

        • Who are you/we trying to educate, “mental health” workers? That could be the problem right there. The purpose and function of the “mh”system is not to “help” people but to keep them in line. (At best the former is a a strategy for achieving the latter.) The medical trappings are just that, no more. I’m sure you realize this, at least at some level. This is why I believe that strategically we need an analysis of psychiatry which also recognizes this.

          Instead of “educating” those whose salaries depend on their cooperation with/acquiescence to the “mental health” deception, don’t you think survivor energy would be better spent on devising strategies to defeat the system rather than trying to “improve” it?

          • i personally don’t give a fuck about educating “mental health professionals.” i was talking about educating the public. and i think we should be trying not to defeat (whatever that would mean) but to replace the system. i respect and admire you, oldhead, but when you say, “I’m sure you realize this, at least at some level” it makes me wonder whether you’ve actually read spotlight. i’m actually very well aware of what psychiatry is and why it is so powerful.

          • No I haven’t, but I will, and I did read your article. It’s hard to gauge public response to Spotlight ahead of time, I guess. It’s a very positive thing, sorry if I implied otherwise. I’m hoping you have an effective plan for getting it distributed if public education is the goal, as the most brilliant document in the world is useless till it’s been read and absorbed by a critical mass.

            By strategy I’m talking about the longer term, and more about principles than specifics. As you appear to be pretty clearly anti-psychiatry in your approach, I’m curious as to exactly what you have in mind when you talk about “replacing” psychiatry rather than defeating it. In the sense that, once something has been defined as a tool of oppression, why would you want an “alternative” tool of oppression? Those who compare psychiatry to slavery would ask whether those who have traditionally opposed slavery ever talked about “replacing” it as opposed to abolishing it.

            Please don’t interpret this as my being critical of what you’re doing, I totally support it and wish you well. Just looking for some strategic dialogue with someone whose work I’ve been unaware of till now. 🙂

      • Complaining is like “protesting” in that it tacitly acknowledges the authority of those to whom one is complaining as legitimate. If the people are held to the level of “complaining” rather than demanding, and taking action, those in power will rest securely in the knowledge that there’s nothing to really worry about.

        What do you see as the strategies that are not working?

  8. OK now I’ve read a great deal of Spotlight, starting with Rob Wipond’s intro:

    the report paints the picture of an unregulated, unaccountable and often abusive mental health system

    This is a tautology which I think sort of sets the tone for Spotlight. It also highlights what I was suggesting earlier about taking a naive strategic approach, and Irit’s frustration with “nothing working.” It’s a matter of expectations I think, and of what is meant by “working.” There seems to be a general belief among Spotlight authors that if people could only see how terrible conditions are in prisons, “mental” or otherwise, they’d be outraged about all the victimization going on and be aroused to forcefully demand an end to such treatment. In other words, that it’s just a matter of not knowing.

    But this is generally not true. Most people don’t care because they have been conditioned to relegate psychiatric inmates/outmates to the status of “others,” who may certainly be a pathetic, miserable lot, but obviously need to be put somewhere, or otherwise kept in check as best possible. No one really gives a shit about prisoners, nor are they expected to, other than lip service. In the U.S. gulag there are courageous and dedicated political prisoners who have been languishing since the late 60’s.

    People respond to what affects them personally, so in order for them to get worked up about psychiatry they need to recognize that they are on an emotional continuum with those pathetic people they supposedly pity, and nearly as vulnerable to psychiatric labeling and “treatment.” This they will of course resist and deny, but it’s important to take away their rationalizations that psychiatric torture and poisoning constitute medicine, and that “doctor knows best.”

    By advocating for and demanding a more humane and effective “mental health” system we lend an undeserved credibility to the false notion that we are dealing with matters of “health.” As a tactic it makes sense to demand things the system promises but can never deliver, but only in order to expose the system; it doesn’t make sense to then get angry and frustrated when they fail to deliver that which they have never had any intention of providing, and which, even if they had a clue as to how to do so, would not serve their interests.

    So why is it that anyone would seriously pursue the goal of an “improved” “mental health” system that would “help people with their problems,” any more than they would expect any other branch of the prison system to serve such a function?

    If someone asked me to evaluate whether the anti-psych movement is “working,” I would assess this in terms of how good a job it’s doing to convince survivors and anyone else interested that psychiatry is a bankrupt institution which needs to meet the dustbin of history sooner rather than later.

    • so, oldhead, as I have long known from following and appreciating things you have said here and elsewhere on mia, we are in accord with regard to the “mh system,” and all that attends it, being utterly pernicious. however, i will not apologize for spotlight, most of which i quite like. true, the reason spotlight came into being in the first place was a request for a one-time newsletter responding to operating in darkness, from someone i used to work with, who did indeed want to publicize the CLAS report as a tool for “mh” law reform. now, let me be perfectly clear: i have zero interest in helping psychiatrists and their minions become gentler, kinder murderers, or in “educating” anyone who provides “professional help.” i personally regard making money off the misery of others as a morally bankrupt enterprise (and all the more so when it’s “peers” making that money). nevertheless, i liked and still like the CLAS report’s strong, human-rights-oriented-language, and its admission that psych drugs debilitate. obviously, all of that is kindergarten-level stuff for us, but not for many of spotlight’s readers. yes, all of us know all about psychiatric abuses, but most people don’t, and as for their not caring, i think there are many different ways to help them care. in other words, i still agree with myself (ha-ha) that people who are less easily dismissed than us can be useful in saying, yup, there’s something wrong with this picture; and that this might help outsiders give a damn. that said, please let me reiterate that i am fully aware that the only purpose for the “mh” paradigm is to justify the authorization of “practitioners” to inflict damage of many kinds (including financial damage) on “patients/clients.” i may be crazy – in fact, there is no doubt – but i still think that, for all its reformist content, there is other material in spotlight which indeed indicates, just as you say, that psychiatry is a bankrupt institution which needs to meet the dustbin of history.

      • I’m confused by this particular conflict. It seems to me that the Spotlight report reframes the mistreatment and abuse of the so-called “mentally ill” as the human rights issue that it really is. I don’t expect a mainstream bunch of attorneys who are pissed at their clients’ treatment and are trying to do something about it to meet some “antipsychiatry” standard. They are fighting for the rights of their clients, and GOOD FOR THEM! I think there is a lot there that is very useful for the most radical antipsychiatrist to use, and for the mainstream language and the rest of it, I consider it simply the reality that not everyone has come to the same degree of awareness of how the system works and what’s behind it. My thought is that we should engage anyone of goodwill in this discussion, and that anyone who understands and is genuinely opposed to the status quo (as opposed to having a financial interest in the outcome) is AOK by me. If we expect everyone to be in favor of eliminating psychiatry, we’ll be preaching a lot to the choir.

      • i will not apologize for spotlight,

        I’ll have to see what this is all about when I have more time. I have never even remotely suggested that you have something to “apologize” for. Steve you seem equally of the opinion that I’m criticizing something about Spotlight. I was trying to have a dialogue about strategy, which I’ll be happy to take elsewhere if it’s not appreciated here. Don’t know what’s going on, but it feels like defensiveness where there is no attack. Irit expressed frustration about “nothing working.” So…”let’s analyze that” would seem to be the appropriate response, and a step towards getting it working.

  9. just as a matter of interest, i wonder how many of the people on mia who advocate for the abolition of psychiatry (which i would love to see but do not believe is ever going to happen) and slag those who do not publicly do so are using their real names. anyone happen to know?

    • Irit – I advocate for the abolition of psychiatry, and I made the decision early on to do so via an alter ego. As time goes on, I’m more and more convinced I made the right decision. Just this week, Julie Greene posted about her experience of being removed as a speaker at a conference as a result of someone flagging her (link below).

      Online-world campaigning is a risky business for us, it can have extremely serious real-world consequences. Choosing a pseudonym and sticking to it offers a little bit of protection and freedom to risk speaking out. Do you feel strongly that we should all be using our real names? If so, why?

      https://www.madinamerica.com/2018/06/ted-betrays-own-brand-flagging-nutrition-talk/#comment-133392

      • I don’t advocate for the abolition of psychiatry because, as far as I can see, that would mean little more than a change of terminology. I advocate for the abolition of nonconsensual coercive psychiatry (i.e. repeal of mental health law, passage and enforcement of the CRPD), or, in plain English, the end of forced treatment. Many people used to advocate (or demand) the same. The difference between now and then is that now you’ve got so many ex-patients (loosely speaking) in the “mental health” business, corrupted by the system, and colluding with forced psychiatry, that what was once a strong and principled position against force and human rights violations has become seriously compromised, and essentially, watered down, downplayed, lost, scrapped, in favor of the everyday business of colluding with oppression as usual.

        I can see a definite need for the use of pseudonyms, in some cases, not because I am afraid of being found out, but because I have found myself targeted by forces online that would interfere with my internet access and thereby stymie my freedom of expression and choice. There’s not a lot of privacy on the internet, and some of this invasion of privacy, in the name of collecting demographic info, or so runs the excuse, is not even, to say the very least, good natured.

      • i am perfectly okay with people using pseudonyms! my point was not that everyone has to be or should be or can be “out” as a psych survivor, but rather that those of us who are “out” might sometimes get a little cranky about being trashed for being naive, tautological, etc., on the grounds that our work does not live up to the ideological standards of those still in hiding.

        • @Irit
          “those of us who are “out” might sometimes get a little cranky about being trashed for being naive, tautological, etc., on the grounds that our work does not live up to the ideological standards of those still in hiding”

          Guess you’re referring to Oldhead here? Tell me if I’ve got that wrong.

          The trouble with all this back and forth on MiA is that the written word gives little space for nuance or subtlety or tone of voice. Irit – do you remember the Madness e-community set up by Sylvia Caras in the mid-1990s? That was my first taste of anti-psychiatry activism, and it saved my life!! But it pains me to realise that over 20 years later, we are still covering the same old ground in the same old way. As far as I can tell, there is no anti-psychiatry movement for psychiatric survivors – in fact the word “movement” is a hollow joke. The very phrase “Anti-psychiatry” is defined and controlled by the likes of Lieberman, Pies and Wessely – it has been weaponised and is used very effectively to bludgeon anyone who gets in their way – Bob Whitaker, Lucy Johnstone, David Healy to name just a few.

          You say that “no one is listening outside our cozy little circle, so we can complain forever without changing anything,” and I agree. The most frustrating thing for me is seeing so much energy, strength and potential going to waste here. How do we break out of this habit of fighting each other and hollering into the void? I am at a loss.

          • thank you auntie pychiatry for articulating what i also find the question of our time: How do we break out of this habit of fighting each other and hollering into the void?

          • As psychiatric oppression is pretty pervasive, antipsychiatry is being reborn all the time. I would say we have the numbers, at least, internationally. Antipsychiatry continues to be a popular term, one could even say a force, among people who have endured the black joke of psychiatric oppression. To call ourselves a movement, however, is debatable as to be an effective movement you need organization, and that is what antipsychiatry lacks. Much of what used to be the psychiatric survivor movement has been diluted and corrupted through involvement in this “peer movement” business of aiding and abetting psychiatric oppression, that is, the enemy. In this situation, I think antipsychiatry needs to be further refashioned as a movement against the movement that exists. More specifically, the antipsychiatry movement needs to take on the “mental health” (very confusing term) movement. That movement, a very organized movement, is very much a promote psychiatry in all shapes and forms movement. We’re at square one here, that is, very unorganized. (Basically, the point at which the psychiatric survivor movement was before there was a psychiatric survivor movement.} Step two involves connecting with others, banding together, and fashioning our own groups. Not the government’s groups, mind you, our groups.

          • “Irit – do you remember the Madness e-community set up by Sylvia Caras in the mid-1990s? That was my first taste of anti-psychiatry activism, and it saved my life!!”

            I remember it very well, and loved it, but it almost drove me nuts. I was most of the way there already, and new to e-lists, and the flood of daily emails was so overwhelming that I had to quit. i avoided e-groups for the next couple of decades and still feel overwhelmed by the very few i belong to now.

            “But it pains me to realise that over 20 years later, we are still covering the same old ground in the same old way.”

            Me too. It’s sickening.

            “As far as I can tell, there is no anti-psychiatry movement for psychiatric survivors – in fact the word “movement” is a hollow joke. The very phrase “Anti-psychiatry” is defined and controlled by the likes of Lieberman, Pies and Wessely – it has been weaponised and is used very effectively to bludgeon anyone who gets in their way”

            Exactly.

            “How do we break out of this habit of fighting each other and hollering into the void?”

            The only way I know is to keep trying to get our work into the public’s view, which is of course terribly difficult, and to try to work together with those who do not want to fight.

          • For the record, Oldhead ain’t “fighting” anyone here. People who have a specific disagreement with or misunderstanding about anything I have stated here should simply ask me about it. I’m not apologizing for trying to help people make connections, or commenting on strategy. That’s what I’m good at, where my experience lies, and what I plan to be doing for the duration.

            And people who are concerned about “real” names should focus elsewhere. It’s a false issue. Those who don’t realize how dangerous this stuff can be need to study how this system operates, if only for their own safety.

          • Like I was saying, I kind of have to fight this “consumer/user” “mental patient” enslavement catch a trendy “disease” thing, but suit yourself.

            What does the Borg say? Oh, yeah. “Resistance is futile! You will be assimilated!”

            Sure, but, nonetheless, at this point, I find a steady resistance pretty easy to maintain.

          • “And people who are concerned about “real” names should focus elsewhere. It’s a false issue. Those who don’t realize how dangerous this stuff can be need to study how this system operates, if only for their own safety.”

            People on here have been wondering how the LGBT movement has gotten so far in its efforts and I’d say one major reason is because people came out, despite the obvious dangers. I believe this level of courage may be highly relevant to the success of a movement. Otherwise, one is simply putting their fear on display, and I think the “powers that be” pick up on that, and it keeps them confident.

        • those of us who are “out” might sometimes get a little cranky about being trashed for being naive, tautological, etc.,

          So now you’re being “trashed”??? Feels like if someone raises an eyebrow here it counts as “trashing.” I wouldn’t even comment except that this is clearly directed at me, and if one reads my comments, is completely off-base. If anyone wants to have a serious discussion fine, otherwise I’m outta here.

  10. irit thank you for the ‘spotlight’ and also for engaging in the discussion here. i share you stance that things are getting worse. to me each and every effort to do something against always more subtle psychiatrisation of all our lives is valuable. but we seem to be much better at microscoping each other’s work and looking for ideological divergions rather than praising our achievements regardless of their size, let alone strategising together at times of atomised and competitive ‘peer’ careers. there will never be one right way in this battle and we all have our different interests and strenghts and preferences. it is easy oldhead to lay back and perform surgery on ‘spotlight’ until you declare it wrong (!?) and it is sad to see irit justifying herself and even declaring ‘reformist content’ in that piece of work that is everything else but ‘reformist’. wtf? what is your personal contribution i wonder to bringing psychiatry into the dustbin apart from assessing other people’s work and telling us how things should be?

    • thank you for this comment, Jasna. I, too, believe that every effort each of us makes against psychiatrization is valuable, and I thank you for reminding us of that. Spotlight is not free of reformist content. One of the writers says, e.g., that the “lack of accessible documentation, among other failures of the current system, makes it difficult to study and improve the practice and administration of psychiatry.” Such views, however, are far outweighed by everything else in the publication, as well as potentially making it easier for the not-already-converted to be willing to read what other contributors have to say. In fact, I was going to put the reformist piece first for that reason, but just couldn’t make myself do it.

      • but even so irit i wonder why is it always more important to detect even tiniest traces of ‘reformist content’ among us and make a clever statement on that than to move on with our work, and most importantly with our joint work. the question is not directed to you but to everybody whose engagement stops at that level or whose comments seem more like a self-fullfiling excercise rather than a genuine effort to advance our collective thinking and action, let alone support and cheerish each other’s achievements on that way…

        • My general response to this rhetorical-sounding question is: There are clearly two camps among those who oppose psychiatry, those who want to “improve” the “mental health” (psychiatric) system, and those who want to eliminate it. This is an ongoing dialectic which should be recognized no matter what “side” of the question one is on. In reality there is no “right” and “wrong” side in that, before psychiatry is abolished, there will be a series of struggles based on basic human rights and legal concerns (i.e. “reform”) which first need to be won. The latter is what Spotlight seems primarily concerned with. So when we engage in an action it should be analyzed as to its goals, and we should be able to recognize whether we are participating in a “reform” effort or an anti-psychiatry effort in that particular instance (or a combination). That’s why it’s “important” to distinguish between the two, as the foci are different, and they obey different rules.

          • I think this is a very important clarification. We have spent way too much time attacking each other for being “too extreme” or for not being “antipsychiatry enough.” Both goals are legitimate and necessary to move forward, because however much we’d like to remove psychiatry from the face of the planet, people are suffering TODAY as part of this system, and such people need help TODAY and can’t wait for capitalism to collapse and some other better system to take its place that recognizes that psychiatry as practiced today has no place in a civil society. At the same time, it is VERY important to recognize the degree to which participation in the system suggests a degree of tacit approval of some of its principles, and that those very principles are the things that need to be tossed out!

            There are a lot of aspects to this whole process of moving in a new direction, and I agree that identifying one’s goals is important, but it’s equally important to recognize that others may have different goals and that as long as we’re all working toward ending the abuse of the “mentally ill”, having different final outcomes in mind should not keep us from working together.

          • Glad this makes some sense to you, first of all, as I was starting to feel as though I’d slipped through the looking glass with some of the responses to my comments, which were begging for some feedback, rather than “trashing” anybody or any group.

            You might not get quite everything I was saying though. (This is not a “politics vs. alternatives” issue btw, which is a different conversation.) Also I should note that, if one agrees that capitalism is the root problem, “waiting for it to collapse” is exactly the WRONG thing to do unless you’re content to wait the rest of your life. If one’s AP analysis is based on capitalist alienation as the root problem one should be endlessly motivated to defeat capitalism as their first priority, unless he/she has a financial stake in perpetuating endless misery.

            As to my main focus here, I’m saying that when people are fighting psychiatry in an institutional/enemy setting where control is in the hands of our adversaries, we have to play by their rules to a degree. But whether or not this is done in a strategic way, which recognizes the abolition of psychiatry as the end goal, is key. For example, if one can employ legalese/”psychiatrese” in a courtroom to sway a judge into believing that he/she is acting in someone’s “therapeutic best interest” by releasing them, it would not be strategic at that point to lecture him/her on the myth of “mental illness.” However to actually believe playing this convoluted game is going to lead to a “better mental health system” (or that psychiatry can be “reformed” in a positive way) is a mistake from an AP perspective, based on unrealistic hope and an unwillingness to realize that the psych system is primarily a law enforcement agency, and not designed or intended to “help” people (except sometimes as a P.R. strategy).

            In other words, when ostensibly reformist activity is undertaken as part of an anti-psychiatry strategy it becomes anti-psychiatry activity. When it is undertaken with unrealistic hopes of “making psychiatry better” the odds of it having any significant or lasting effect diminish. So it’s important to be able to identify and distinguish between the two approaches.

            it’s equally important to recognize that others may have different goals and that as long as we’re all working toward ending the abuse of the “mentally ill”, having different final outcomes in mind should not keep us from working together

            This is sort of an unnecessary “feel-good” statement I think people need to internalize as a given. What it sounds like you’re more or less saying is “we can disagree and still be friends” — but is that really necessary to spell out? However, “having different outcomes in mind” I would say objectively does impact whether and when we can work together — especially if those desired outcomes are in opposition. It shouldn’t impact upon whether or not we can be friends.

  11. OK folks, my time-tested sense of patience is beginning to fray here. If anyone has an actual point they would like to make in response to one of mine, I’m all ears. But I’ve seen too many innuendo-laden “Oldhead” references in this thread addressed to other people. If anyone wants to know what I “mean” by anything I’ve said, since there is clearly a lot of projection and/or misinterpretation going on, just ask please. There’s no cause for hostility. 🙂