Podcast: The Rise in Forced Treatment and Abusive Guardianships

From PsychCentral: “There’s a common misconception that, due to asylum closures, only ‘dangerous’ people get committed to psychiatric wards and hospitals. We also believe that forcing someone with ‘mental illness’ into treatment is rare. However, millions of Americans are subjected to psychiatric detention or forced treatment every year.

Often well-meaning family members are trying to ‘help,’ but end up traumatizing and permanently damaging their loved ones. Join us as investigative journalist Rob Wipond explains how most states have broadened their criteria for psychiatrically detaining someone far beyond ‘imminent harm’ and that as a practical matter, this could happen to almost anyone. Join us for a special two-part episode of Inside Mental Health.

Gabe Howard: What about the parents, the majority of people pushing for these kinds of laws and this kind of intervention are parents of adult children with ‘mental illness,’ and they claim that they have insight into their kids’ best interests, they know their children and they know that this will be helpful. Now, you’ve been talking about problems with doctors or hospitals, but family members are often the ones pushing for this, not the medical establishment.

Rob Wipond: Yeah. So, I have a couple concerns about that that are really deep. And one of the biggest ones is this is of course a very important group. This is the strongest lobby group in America and Canada that have been reshaping these laws. Family members are very vocal and very passionate about trying to forcibly drug their own loved ones. And they have influenced legislation around the country. So, this is the dominant voice on these issues. And one of my biggest concerns is that almost never when these families are talking do they seem to have any awareness that some families are abusive . . . you have to look at America and what we know about family abuse and know that it is very common. Child sexual abuse, physical abuse, parents themselves who have emotional difficulties of different kinds. And so, you need to account for that if you’re going to lobby legislators to expand the powers of families, to make sure that someone else in the family gets forcibly medicated, heavily tranquilized against their will. You need some sort of level of accountability and oversight to ensure that this is not nefariously and abusively used by a family member who doesn’t have the best of intentions in mind. And this is really common and this is what I found, is that it’s doctors just don’t have the time or resources to do, you know, an extensive investigation into a family and really figure out what’s truly going on here. So, they often just take the testimony at face value, go, oh, that’s how Person X was behaving? Okay. You know, and this testimony is enormously powerful.

. . . The other piece I want to highlight is this does create an enormous rift in families that can go on for years and decades. And often they’re struggling really because they don’t have any other resources. This is the only thing that’s available today. If you want help for somebody who’s really struggling, people are coached and taught to admit them to a psychiatric hospital. And as one psychiatrist said to me, I think a lot of families have illusions about what we can do up here. We don’t really solve people’s problems. We only medicate them. And there’s a percentage of people that does help, but there’s a very large percentage that it really doesn’t make a huge difference in their lives. And so, then families start putting pressure on these doctors, keep them longer, do more, and then they’ll sue if these people aren’t cured . . .

Gabe Howard: One of the things that worries me so much about forced treatment is that it is ultimately harmful. You only get one bite at the apple, right? And forcing someone to do something only works while you are forcing them. Once you stop forcing them, they don’t trust you anymore. They don’t have faith in the system anymore. They don’t have faith in the process anymore and they’re not going to reach out for help. And, well, frankly, they’re going to stay the hell away from you. They’re going to stay the hell away from the mental health system entirely. They will probably avoid everything and start getting no treatment at all. So, family members who are like, look, I know they need treatment, I know this is what’s best for them and that’s why I’m doing this, even though this is not what they want — I just have to say, okay, but is this the long-term solution you’re looking for? Or have you only solved the problem for a year, two years or hell, five years? And that’s really such a small amount of time, especially if your loved one is showing the symptoms at the stereotypical ages of 16 to 24. Let’s say that you get them stable . . . from 24 to 29. What happens from 29 on? They’re going to be just very, very traumatized . . . they avoid everything and they get nothing. And it really seems like your data is backing up that this is not a good long-term solution.

Rob Wipond: Yeah, and that’s such a good point, very important point that it really only works once. Because, okay, now that you’ve done that, that person’s never going to feel safe calling anyone. Because they know there’s this extreme risk of being subjected to something that traumatized them. So how can you believe in this as a — like, I ask these practitioners, that I’m frankly aghast that psychiatrists aren’t the one speaking out against forced treatment, because I think you see this every day. But instead, what they’ve done is they’re expanding it right? Their justification for the fact that it’s clearly failing a giant segment of their own patient group — it’s clearly not working for them — their reaction to that is, okay, we need it more. We need to do it longer. We need to get in earlier, got to get them younger . . . Everything right now is moving towards expanding and expanding and expanding the amount of time and the degree of the force. And I’m saying it’s time to look in the other direction. It’s time to back up from that and go, look, there’s a huge segment of the population of these patient groups that this is not working for. All it’s doing is driving them away. They become afraid to seek help even when they when they [want] it.

And that’s what I want to highlight, too. We should not equate help with force, and that seems to be what we’re doing. When we have this dialog, we say, oh yeah, if we’re not sending the police out, we’re not helping them. Well, wait a minute. There’s a lot of other ways to help a person who’s in distress. I’ve seen people, I’ve been with people in extremely high states of distress, and you can still find ways to talk with them. You can still find ways to connect. And that’s what we need to do way more as a culture, as a society.”

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