Open Season on Mental Patients


Editor’s Note: This is the first part of an essay adapted from Irit Shimrat’s keynote speech delivered at the 2014 conference of the National Association for Rights Protection and Advocacy. The author was invited by Jim Gottstein to give an updated version in a recent virtual event. The second part can be read here.

I named this talk “Open Season on Mental Patients.” But I could just as well have called it “Open Season on Humanity.” No one is safe from psychiatry’s project of medicalizing and treating just about every variation of human emotion and behaviour.

Especially in danger, as always, are those viewed with suspicion and contempt by the powerful, including Indigenous people; Black, brown, Asian and other people of colour; big, loud young men of any race; immigrants; refugees; people with physical disabilities; women and sexual minorities; old people; millennials; teenagers, even small children.

The particulars of psychiatric treatment—labelling, incarceration, solitary confinement, shackles, drugging, electroshock, and the less obvious violence inflicted on those leading silent, terrified lives under community treatment orders—cause a staggering amount of damage to far too many minds, bodies, and souls.

Media of all kinds are always screaming at us about the current “mental health crisis.” And there is, in fact, an ongoing crisis. But it’s not what they imply. Unbearable conditions of poverty, discrimination, abuse, neglect, and all the other ills that plague our society are driving more and more people into states of alienation, despair and insanity, which are then attributed to supposed medical conditions, to be treated with drugs.

Creating and maintaining an atmosphere of despair, anxiety and panic drives clicks, but that’s not all it does. It also facilitates the marketing of various means of individual and collective social control, from drugging away your own troublesome emotions to having troublesome humans shut up, shut down, and put away.

Psychiatry’s witting and unwitting minions—including police dealing with situations seen as being caused by mental illness—produce untold suffering through their oppression of some of our best, brightest and most sensitive citizens, and non-citizens too.

In British Columbia, where I live, police have literally broken into people’s homes—no warrant required—because some acquaintance has reported what they perceive as strange behaviour.

Not only physicians and family members, but friends, neighbours and even random passers-by can trigger legally sanctioned home invasions—which may end in incarceration and forced drugging, simply on the grounds that a person is deemed “incapable of appreciating her need for treatment.”

And way too many mental patients end up being killed by police. Predictably, the most common victims of such murders are poor, and many are Indigenous. I think of Chantel Moore, a First Nations woman who was just 26 years old when police officers entered her home to conduct something called a “wellness check,” in 2020, and ended up shooting her dead. And there have been many other such murders.

Wellness checks are just one example of the ferocious increase in psychiatry’s power to inflict forced or coerced treatment, not only in hospital but even in the community, where it is administered by Assertive Community Treatment (or ACT) Teams, under outpatient committal orders.

British Columbia boasts Canada’s most regressive mental health act. The criteria for involuntary admission include the stipulation that you require “care, supervision and control in, or through, a designated facility,” either in order to prevent your “substantial mental or physical deterioration,” or for your own protection or the protection of others.

These criteria are so vague and all-encompassing that, in essence, anyone can be locked up for anything. And, of course, once you’ve been made into a mental patient, any unusual behaviour, however harmless, is way more likely to trigger psychiatric interventions.

“Extended Leave” is my province’s ugly euphemism for outpatient committal. When you’re on Extended Leave, you are technically free. Legally, however, you’re still under hospital care. At any time, a warrant can be issued for your arrest and re-incarceration—or, as they put it, “recall to hospital.”

The state is, in essence, splitting persons. You’re at large in the community, but, at the same time, you’re legally detained.

You can’t run away. You can’t hide. You can’t go underground. Your only recourse is to leave British Columbia—and how could you afford that, and where would you go?

In effect, Extended Leave transforms the entire province, notably including your own home, into a designated facility.

And what if you have no home? The cops are empowered to show up at one emergency shelter after another, demanding the list of names of people staying there. If it’s winter, and you’re staying off the street so you don’t freeze to death, they can track you down.

When you are obliged to “attend” your ACT team, your schedule doesn’t matter. They set an appointment and then tell you about it. You either show up, or risk being “recalled.”

Extended Leave has been compared to prison parole. But parole is finite, whereas Extended Leave can last a lifetime. All it takes is for one doctor to sign a new form each time the previous one expires.

There’s nothing else like this in our society—this status of a human being who is not physically confined, but who can be re-incarcerated at any time, on the word of a physician—and even if she’s adhering to conditions.

Police officers, often undercover, are essential to ACT teams. Each team also includes at least one mental health professional and, sometimes, a peer, who provides personal support. But even if there is a peer, she is in a subordinate position, and unlikely to be able to alter the intended outcome of an intervention.

Friends who have been subjected to Extended Leave have been devastated by the intrusion, into their homes, of officials whose job it is to monitor their behaviour and ensure treatment compliance. And even if you are compliant, the team may visit (with no warning) to check up on you, or on the state of your home.

A messy apartment can be used as evidence that you’re “in danger of deterioration.” And, as always, the threat is much worse if you are not white, or not English-speaking, or not “ordinary”-looking, etc.

And then, if you’re not compliant—say, you’re not showing up for team appointments, or your blood tests show that you’re not taking your drugs—the team is legally allowed to enter your home by force, grab you, pull your pants down, and administer an intramuscular injection. (As those of us who have had been vaccinated against Covid know, there are other injectable muscles in the human body, but psychiatry prefers the gluteus maximus. It’s more humiliating.)

I know of people who are afraid to spend time in their own homes because this might happen to them.

And what about these drugs you can be made to take against your will?

The drugs most commonly administered by brute force are neuroleptics, also known as antipsychotics. Long-term use of neuroleptics can crush your dreams, your hopes, your desires, what you had thought was going to be your future. It can delete or diminish the self you knew. And virtually all neuroleptic use is long-term. What mental patient hasn’t been told she has to keep taking these drugs for the rest of her life?

And let me remind you of some of the short- and long-term physical effects of neuroleptics: akathisia; dystonia; dyskinesia; dizziness; dehydration; constipation; sexual dysfunction; blood vessel hemorrhage; osteoporosis; diabetes; heart, kidney, liver, pancreas, abdominal, and other organ damage; neurological damage; seizures; obesity; parkinsonism; neuroleptic malignant syndrome; decreased life expectancy; sudden death.

As for cognitive effects, it’s very common for these drugs to cause withdrawal psychosis when you go off them. And they also commonly cause confusion; memory problems; problems with focus, concentration, and thinking; anxiety; distress; and “paranoia.”

Let’s talk about paranoia for a moment. The classic meme is of someone who mistakenly thinks they’re being followed or surveilled. But it should be recognized that mental patients often live under a terrifying level of actual surveillance.

My friend Fred once said to me, “As I get older, I realize, I’m not paranoid. The nice, kind nurse, is trying to get information from me. After she finishes sympathetically listening, she goes into the nursing station and writes everything down. When I try to get out, it’s all used against me.”

So, why does Fred keep getting locked up? For one thing, like me, he has some unusual ways of looking at the world, and doesn’t always hide that. Also like me, he sometimes gets so angry about injustice that he behaves in ways that upset people. As a white mental patient, I have been persecuted a little bit. But Fred, who is Indigenous, has been persecuted a lot—in his case, for failing to conform to white norms.

But what if normality is overrated?

And what if “bizarre” behaviour that causes discomfort or suffering to oneself or others is not, as psychiatry claims but has never been able to prove, the result of a chemical imbalance in your brain? What if your perceived craziness is actually a natural response to the craziness of the world we live in? And, what can we do for ourselves and each other, if and when we’re lucky enough to avoid, or escape, psychiatry?

Support systems and coping mechanisms are vital to this discussion—and these can be of use, not only to psychiatrized people, but also to those of those in danger of being psychiatrized. Which is, of course, absolutely everyone.

In my view, the number of so-called alternatives to psychiatry is infinite, because people keep coming up with new ones. Among the many that have worked well for me are:

  • Traditional Chinese Medicine
  • Aromatherapy
  • Reflexology
  • Various breathing techniques
  • Feldenkrais and other body-awareness and integrated movement disciplines
  • Physical activities, such as yoga, tai chi, bicycling, swimming and dancing
  • singing
  • Listening to, or playing, music
  • In general, being outdoors, even in the city
  • Writing, drawing—any creative activity; and, most importantly
  • Human contact, and the choice of who to have that contact with. And when, and where to have it.

Ah, choice. So essential to a livable life. And so unavailable when you seek, or are forced into, professional help at the hospital.

If you’re a good girl, you sign yourself in, go straight to the ward, take your pills, and obey all the rules.

But if, like me and so many others, you get hauled into the bin against your will and try to fight it, what you get is confinement in a tiny, concrete cell, with a steel toilet-and-sink apparatus in the corner that may or may not work, and a mattress that may or may not have a sheet on it.

By the time you get there, you’ve been stripped of all your clothing and made to put on one of those humiliating hospital gowns, open at the back. You have highly toxic drugs coursing through your veins, forcibly injected by a nurse, while orderlies held you down.

And then, if you’re even more like me, and happen to have a paradoxical reaction to these drugs, they will make you a million times crazier than you already were when the cops hauled you in.

Often, you are shackled to the mattress by means of physical restraints: straps holding you down by the wrists and ankles.

The lights, if they’ve been left on, are fluorescent and harsh. The door is locked.

In the seclusion cell, no one can hear you scream. Or, at least, no one’s going to respond.

You are left alone with your rage, terror and desolation.

The process of breaking your will has begun.

Once you’ve been made compliant enough to be released into the general population, there will, if you’re lucky, be physical and creative activities to punctuate the monotony of life on the ward. These will be framed as “therapy.”

But such activities, and all activities, are always so much more enjoyable when they’re not framed as therapy. After all, this idea that the underlying problem is a medical one remains unproven.

A nice experiment would be to offer a sampling of things known to help people feel better, and let you pick whatever appeals. A trusted friend, family member or advocate could be with you, to provide kind, gentle guidance and advice.

Mind you, when you’re “in a state,” you might be unable to choose items from a menu, even with assistance. So, it would be better to put a plan in place in advance—before problems arise.

But it can be hard even to envision common-sense prevention strategies and solutions in an atmosphere of fear and a near-universal belief in biomedical fixes for emotional, social and political problems.

It would help a lot if everyone learned about extreme emotional states early on. In my ideal world, elementary-school children would be taught to understand that bad things happen to everyone; that anyone might have a hard time coping; that some ways of coping look weird; and that difference can be greeted with curiosity, respect, and even appreciation, rather than fear or suspicion.

However, here in the real world, we can at least put an emphasis on meeting basic needs such as good nutrition, decent housing, enough money to live on, meaningful work, and adequate health care—none of which should ever be tied to “mental health services.” I’m pretty sure that, if every person in Canada had unquestioned access to these essential human rights, the incidence of so-called mental illness would plummet.

A common-sense, empathic approach can go a long way.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. No one should ever allow themselves to be fodder for the Mental Health System. We must all fight back and we must understand that your lives depend on it.

    All the more important to day as California Governor Gavin Newsom is trying to see up special courts to subject the homeless to involuntary Psychiatric Procedures. The authorities are always trying to turn poverty and homelessness into a mental illness.


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    • I have an illness that affects my mental faculties. They are MY mental factulties not anyone elses. I call my illness MY schizophrenia. I am not unlike this girl in this video. I am ill. I want to say to everyone everywhere this….only this….if you cannot be kind about the fact I feel ill then leave me alone.

      The world is horrible to the ill.

      HORRIBLE !

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  2. Promoting “alternatives” to psychiatry ignores that the purpose of psychiatry is control, not help. The idea that one needs to be “cured” of his/her human responses to a totalitarian world is the essence of the mind control psychiatry enforces among the populace.

    Psychiatry needs to go, there is nothing more to “research.” To attempt to “improve” psychiatry is to perpetuate it. And now that the “scientific” COVID lockdowns are over psychiatry is poised to “treat” the “trauma” of the victims — so look out everybody.

    Just say no!

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  3. Why don’t more Americans accept forced care’s violation of freedom for what it is?

    Shallow, selfish concepts of freedom, not for all, but for me more than you!

    (As well as disastrous mainstream media coverage of psychiatry. And drug company influence. And the mess of the profession.)

    One main reason I need justice for actual violations of the state mental health code, what I call criminal psychiatry, is the fact that unprosecuted brain rape causes inequality that plays perniciously in the marketplace. I can’t fairly compete for jobs, etc., if others haven’t been mentally violated and tortured, too, and expected to forget about it. The negative effects of criminal psychiatry are just too overwhelming.

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  4. Irit Shimrat speaks the TRUTH here….
    Both from my own personal experience, and that of my friends….
    Sure, there are minor differences in words used, specific details of laws, etc.,
    but it’s the SAME STORY EVERYWHERE….
    The pseudoscience lies of the drug racket known as psychiatry do not respect either borders, or personal boundaries….

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    • But we have known all this for years. I don’t know why people keep beating the same dead horse. Perpetual complaining, rather than fighting to eliminate psychiatry, or at least walking away from it altogether, is a symptom of dependency and emotional addiction, not liberation. Everything that needed “exposing” was exposed long ago; to do so repeatedly constitutes little more than redundancy.

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      • yinyang says, “Perpetual complaining, rather than fighting to eliminate psychiatry, or at least walking away from it altogether, is a symptom of dependency and emotional addiction, not liberation” –

        I agree. I think the most effective way to end psychiatry is to walk away, if you can. And to keep spreading the word about its horrors so fewer and fewer people turn to it. It takes a long time to gain momentum, but groundswells are what eventually make lasting change. It’s a kind of passive resistance –

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      • yinyang says, “Everything that needed “exposing” was exposed long ago…”

        Yes. However, there’s a lot of people who still don’t know about the horrors of psychiatry. But knowledge is power. It may take time, but eventually the truth will out –

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        • Glad we seem to be pretty much on the same page.

          It’s one thing to expose psychiatry with an eye on eliminating it, however, and another with the intent of making it “better.” If the purpose of psychiatry is control, making it “better” is to expand that control.

          It is a mistake to believe that simply exposing something evil will lead to its demise, which is part of the problem with MIA and similar projects, which have been exposing stuff right and left for ages now, with no discernible progress towards eliminating any of it. This is because they have always refused to take a clear stand against psychiatry or even forced “treatment.” Remember the quote attributed to Frederick Douglas, “Power concedes nothing without a demand.”

          Good reading your comments.

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          • Thank you, yinyang. I like reading your comments, too!

            It’s very discouraging that psychiatry still has such a tight hold on the public’s imagination, but – right or wrong – I look at things a little differently. First of all, I no longer expect psychiatry to change its ways – that’s a fantasy. And while MIA has yet to take a clear stand against it, it does permit comments like yours, mine, and many others to be published. This alone plants the seeds of change, and ‘change’ meaning NO MORE PSYCHIATRY!

            And I wholeheartedly agree with Frederick Douglas, “Power concedes nothing without demand”. But perhaps that demand means people no longer looking to psychiatry, a future reality made possible through websites like MIA.

            And while I may be idealistic, I refuse to let psychiatry steal my optimism –

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  5. Diaphanous,

    I am not intending to be disrespectful here, but everyone has wild ranging visions and thoughts sometimes. This does not mean that their is anything wrong with us.

    Clearly you consistently know the difference between what things you can accept as reality, and which things you cannot. So there is no reason that you should not be trusting you perceptions and judgements.

    Now that you may have been subjected to abuses, in the mental health system, and likely from other realms, would seem probable.

    That they can convince you that you have ~Mental Illness~ is just like the idea of Original Sin. It is how the abusers exonerate themselves at your expense.


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    • Are you theripizing me, dear Joshua? Kindly I enquire? You can do that if you like. If you want to perceive me psychotherapeutically as a casualty of what made other people a casualty then go ahead and feel you “know” all about me.

      The thing about the DADDY PSYCHIATRY AS ABUSER theory for EVERYONE is that like ANY theory for EVERYONE it ironically abuses what Jordan Peterson might call THE SOVEREIGNTY OF THE INDIVIDUAL.

      It is this sovereignty that gets besmeared and besmirched and belittled by bullies in all walks of life.

      YOUR SOVEREIGNTY and MY SOVEREIGNTY are ALLOWED to be DIFFERENT or we are all EXILES from the individual throne of our GOD GIVEN FREEDOM OF CHOICE.

      Happiness is shared.

      When a person puts their freedom first they want to share the elixir of freedom of choice with anyone they meet.

      I jot this as a general fridge note to anyone.

      When you truly put you first you will stop wanting to put me second but will want me to also put me first. In the way I want to put me first.

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  6. Daiphanous, I do not perceive you psychotherapeutically. We need to be abolishing the mental health system. There is no such thing as mental illness. And we should not be allowing our government to be licensing psychotherapists. It is because of these licenses that they are able to do so much harm.


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  7. “Clearly you consistently know the difference between what things you can accept as reality, and which things you cannot. So there is no reason that you should not be trusting you perceptions and judgements”

    Is what Joshua interestedly wrote. I am not irked at all that he did.

    I would like to say to everyone that there is a difference betwèen being mad and being driven mad. Anyone can be driven mad by a noisy party in their street or a boss at work. A person can feel so driven mad that they fly a small aircraft into a hotel to go out in a blaze of wreckage. They are able to fly said plane. They are articulate and communicative and perceptive. A person who feels they themselves are mad talks all day to people who nobody else can perceive. Hallucinations of people. But that person may not know during bad episodes quite how mad they are because madness jumbles their perception of themselves too.

    I have both kinds of mad.

    Alot of the time my way of coping with feeling driven mad by my madness hallucinations is to write, write, write. Not everyone with schizophrenia has this trait of scriptomania. And not many schizophrenics have managed to quit sedation pills that make perceptions of reality difficult to write about with a trembling pen and droolled on paper.

    I am living proof that Mr Whitaker is correct that coming off antipsychotics rebirths the schizophrenic into looking and sounding rather spiffing. However, the driven mad who fly a plane into a hotel also look spiffing the moment before they do so. Looking and sounding chipper whilst dying of never ending ghastly hallucinations from schizophrenia MEANS the sufferer is STILL suffering. Indeed, looking and sounding bhoyant whilst desperate inside is its own added uniquely awful layer of suffering.

    You all want me to be the liar. The charlatain. The incognito company executive buttoned up back to front to seem like a nutter. In my country it is called looking zipped up the back. I just do not seem crazy enough do I? Like psychiatry used to tell folks they were not believable because they were not sane enough. These days some women are told they are not women enough.

    I could send in my papers. My medical files documenting twenty years plus of abject torment by hallucinations, delusions, voices, paranoia. But that would be a bit of a bore. I am already boring enough as it is.

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  8. If one wants to be free from psychiatry, they must free themselves. One cannot free others. It is each person’s to call themselves what they want, even if sounds totally unreasonable to you. There are many labels that people adopt and I ask why. However, as odd a label may sound to you, it may be comforting to them. For some people like it or not, it is the basis of their identity. In most civilized societies, one can pick and choose who they wish to spend time with or identify with and yes, for some, a label, even if it’s something like schizophrenia can be useful. No matter the label or whatever, it is not my place to make a judgement or suggest that person is some kind of victim of the system. If I would do that, I become as the very system that I wish to help abolish. And the more I shout about it, the more I become the very thing I would like to see end. If you want to end something, the best thing to do is ignore and walk away from it, as many have done. One can only belabor the point of the evils of psychiatry so much. And the more one belabors that point, the more it reflects upon those who speak evil of something and not the alleged evil itself. It becomes a vicious circle that one can not depart. I truly appreciate Diaphanous Weeping’s viewpoint. It may not be my viewpoint, but it is hers and it is as valuable as everyone else’s viewpoint. It is beneficial to learn from all veiwpoints regarding any subject and not to close up one’s mind or to consider one’s viewpoint superior to another. There is more than one side to any argument. And there are as many paths in life as there people. Each person has the right to live the path they choose, no matter the cost. Thank you.

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