A Remarkable Feat: A Psychiatric Patient Changed the Law on Restraints

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It is extremely rare that anyone succeeds in changing the horrible laws we have in all countries about forced treatment with psychiatric drugs and belt restraints. I shall therefore tell a story from Denmark. It is so unusual that his obituary was written by a journalist and published in a national newspaper.

Silas Dam (photo courtesy of his mother)

Silas Dam killed himself this summer, only 24 years old. But in his short lifetime, he made a contribution that will benefit many psychiatric patients in Denmark. He entered a settlement with the Ministry of Health in December 2021, which obliged the government to amend the Psychiatry Act, so that the rights for psychiatric patients subjected to belt fixation were improved. Silas also got the ministry to commit to making an effort to improve the treatment of people with autism.

Silas had autism and came into contact with the psychiatric system at a very young age. He was admitted to hospital several times and spoke openly about his experiences with the aim of improving the treatment that people with autism receive when they meet the psychiatric system.

He argued that people with autism were mistreated and greatly harmed when they—voluntarily or forcibly—were treated with strong neuroleptics that made them feel worse. He pointed out that people with autism can have anxiety attacks and panic attacks, which may require sedative medication, but they generally do not become psychotic and therefore do not need to be treated with neuroleptics.

Silas experienced himself the harms of forced medication and restraints with belts. At the beginning of 2019, he was subjected to belt fixation at a psychiatric ward. He considered it unjustified, and although it was approved by both the district court and the high court, he brought the case to the European Court of Human Rights in Strasbourg with the help of a lawyer.

For another Danish patient, the Court had ruled that the belt fixation he had experienced was in violation of the Human Rights Convention’s prohibition against inhumane treatment, as it continued even though the patient was completely calm.

Bed with restraints. Orange colored photograph

Silas’ case was very similar, and to avoid another defeat at the Court in Strasbourg, the Ministry of Health offered him a settlement with a compensation of DKK 90,000. But the money was not important for Silas. He wanted the settlement to benefit other patients and demanded that the Ministry of Health acknowledge that the belt fixation was a violation of human rights, which documented serious problems in the psychiatric wards.

Silas also demanded that the Psychiatry Act be amended so that the permanent guards who keep an eye on belt-fixated patients were required to make notes about the patient’s condition several times every hour. And he insisted that the government should ask the National Board of Health to draw up an action plan for autism.

After a lengthy negotiation, the Ministry of Health accepted Silas’ demands. The Psychiatry Act was amended, and guards must now make a note every 15 minutes about whether a belt-fixated patient shows signs of danger or not. If the patient is calm, he or she must be released from the belts.

In Iceland, seclusion and restraint were abolished in 1932 and never used again. That year, psychiatrist Helgi Tómasson took the shackles, straightjackets and other physical restraints that existed in the mental hospital, Kleppur, and burnt them in a furnace—all except one set, which he sent to the Parliament where it is still on display. This should be done in all countries.

For his efforts, Silas received a very prestigious award, the Kafka award, which is given to a person who has made a special effort to strengthen the legal position of weak social groups in society.

Silas lived in a youth home for the last period of his life. He was proud to receive this honor but was stigmatised by his experiences and sometimes found it difficult to thrive. He therefore chose to end his life. In a farewell letter, he apologised to his parents and relatives and explained why it had to end that way for him. The note read: “Psychiatry killed me, belt fixation killed me, forced medication killed me.” He added: “Share my story.”

Silas’ mother contacted me in October and wrote: “I witnessed what the psychiatric drugs did to him. He described it carefully. I hope that you will want to hear about the side effects and possibly use the information in your lectures. I do not think his case, despite his passing, is over yet.” In another email, his mother explained:

“Silas fought with everything he had in him right to the end. During the belt fixation, he was forcibly medicated with both Abilify and Stesolid [diazepam] at the same time. In addition to the horror of having a towel stuffed in his mouth, he described that the medication made him drowsy, everything spun around, like standing on a merry-go-round where you have no option of getting off. He was given additional forced medication, which meant that he could not remember his mother, father or siblings for six months. The memory gradually returned and he started a battle so that others would not have to go through what he had gone through. Psychiatry could not recognize an autistic anxious meltdown and therefore forcibly medicated him, without entering a dialogue, with psychosis medication. However, the medicine had done irreparable damage. He couldn’t sleep or get his head straight. The way to get off the carousel turned tragic. My son has told of another inpatient who was so wrecked by medication that he trudged on the floor all day drooling and couldn’t even hold his cutlery when he had to eat.”

Silas was killed by psychiatry. I have described on Mad in America that Tuva Andersson, whose problem was anxiety, was also killed by psychiatry. Millions of people have been killed by psychiatry, many of them through forced treatment. Why do we accept this?

In 2014, the United Nations Special Rapporteur Dainius Pūras, who is a psychiatrist, called upon all nations to make forced treatment illegal, but not a single country has done anything. Recently, the UN Office of the High Commissioner on Human Rights declared his work “groundbreaking,” but leading psychiatric organisations have been very hostile and disdainful. A common linguistic strategy was to represent the special rapporteur, and, by association, the United Nations, as unscientific and biased while current practice in psychiatry was presented as intrinsically scientific and ethical.

The reactions to Pūras’ reports by psychiatric organisations have been analysed in an instructive article. They included the usual falsehoods, e.g. that antipsychotics emptied the asylums and made it possible for people to live normal lives, and that “pharmacological treatments have been shown to reduce the risk for suicide” (avoiding mentioning which drugs they were), with no references, only vague statements like “an extensive body of data.” The correct, so-called assumption that psychiatry is guilty of human rights violations was called “absolutely slanderous as it attacks an entire professional community without distinction and—what is more—is absolutely not evidence-based.”

The reactions were full of strategic ignorance, in which the psychiatric organisations appeared to be completely ignorant of any evidence that psychiatric drugs do harm—a tactic enabling denial of liability. There was also a lot of conceptual “bullshitting” in which “rituals of politeness are foregone entirely, and we are faced with the raw assertion of power or authority in brusque gestures and commanding tones” with false statements like, “Advances in neuroscience are occurring at a remarkable pace.” Not unless one by remarkable pace means close to a standstill, as far as value for patients is concerned.

Sorry for being blunt but this must be said: The psychiatric profession continues to kill their patients in huge numbers and get insulted when the United Nations tries to stop it. This is a profession beyond repair. It should be closed down. Immediately, as an emergency.

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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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33 COMMENTS

  1. Very good story that everyone needs to read! Iam from the US and have been in a similar situation when hospitalized for mental health. Most think stuff like that only happened 50 years ago but it has never stopped. I am so proud of Silas and the difference he made!

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  2. It’s extreme and inhumane to think you you can hold someone captive in a hospital for weeks or months on end without healthy food, proper counselling, lifestyle changes, company or proper exercise. But it is also extreme to think you can just let people be out in the world when they are experiencing severe mental health crises, for example psychosis (I realize the person in this article was not experiencing psychosis). In the short-term, they need to be somewhere safe and healthy for them and others, and the healthy part isn’t happening for patients in these psych wards.

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    • No one in psychosis or with any other condition should be held captive by anyone, anywhere. Also, why should “others” have any say in the rights of the person?

      Don’t speak over people who are having the experiences. This is disability discrimination. Saying that people with psychosis or other unusual states don’t deserve to be free, partly for the sake of others, is cruel.

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      • It’s easy to say that until someone is beheaded on a public bus or a person kills 5 of his friends at a party. Or someone stabs to death the daughter of a woman trying to ‘help’ him. All things that happened locally. Real people. Also very dead. I could look up their names for you.

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        • These are tragic incidents however you have to prove psychiatric treatments reduce the risk of these incidents happening to have a valid argument. If you have that please let us know.

          I have a counter argument. Trieste in Italy has only ten psychiatric beds and they are in a general hospital but it has crisis centres that are open 24 hours a day across the city and these centres provide excellent social support. They do not have the sort of violent incidents you are writing about because people’s needs are addressed before people are so distressed they become violent.

          Conversely so called antidepressants increase violent outbursts.

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        • Acts of violence can arise from many beliefs and mental states, both those labelled “psychotic” or “altered”, and those that aren’t. People have killed for national independence, environmentalism, etc, but we don’t forcibly constraint and medicate people holding to those beliefs simply because they could motivate violence. Doing so to people who are in states we label “psychosis” simply because some aspect of that state may motivate violence is arbitrary.

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        • Please look up their names, as I would like to research the history of these people and what prior contact, if any, they had with the mental health system or other authorities/carceral systems.

          This NY Times article is about multiple cases of people experiencing crisis who were failed by the system that is meant to help people in crisis and who then became violent:
          Behind 94 Acts of Shocking Violence, Years of Glaring Mistakes https://www.nytimes.com/2023/11/20/nyregion/nyc-mental-illness-breakdowns.html?unlocked_article_code=1.FE0.f8iK.pGTASdvEWuBQ&smid=nytcore-android-share

          The solution is not a solution.

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        • The fact that you would write this comment under this article really says a lot. Did you read the article? Do you have any thoughts about Silas Dam… what he experienced and accomplished? How he made clear that psychiatry killed him?

          Please provide more information about the cases you cite.

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        • Sorry to hear about these deaths Candice… In my opinion, the tragedy of these forced so-called ‘treatments’ is that psychiatrists think they can apply them and still have a rapport or therapeutic alliance with the people they lock up and restrain chemically. Of course this power makes too many seem very arrogant and hostile – not best way to be helpful

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  3. Psychiatric assistance did save my life.
    However, some medications are
    IMO used as behavioral RESTRAINTS
    to make life easier for the system.
    I was put in large amount of antipsychotic
    That made me a zombie for about ten years.
    I also was put in a straight jacket when what I needed was time to get calm.
    This was 30 years ago.

    Psychiatric intervention did help.
    But I became fat which, as one with a severe eating disorder, made me suicidal.

    I do not blame psychiatry.
    However, the thought of the practice
    Being brought into view of human rights watch is fantastic.

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  4. Thank you Peter. We are many in Denmark who grieve the suicide of Silas. Yet grateful for what he managed to do in his short life for the many who are trapped and lost in psychiatry. I met Silas outside the houses of parliament where he had vowed to sit outside everyday for the next if I remember correctly couple of years so that he could win his case.
    I love your bluntness and yes psychiatry is a profession beyond repair…

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    • The average “seriously mentally ill” person, most of whom have received years of drug “treatment”, die 15-20 years younger than the general population. There are, of course, multiple reasons, but psychiatric drugs and ECT are high on the list.

      The antipsychotics are known to induce diabetes and other metabolic issues, and to increase heart disease. If you think inducing diabetes doesn’t kill people, you are confused.

      Sometimes, psychiatry does kill.

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      • True. And sometimes psychiatry cures the paranoid or bizarre behavior to an astonishing degree. It (medication) is working on the symptom, not the cause much of the time, and superficially, but it is working. We all need more studies to discover how long it works by itself, or whether it just gives us time to work in counseling to resolve the causal problems with people who are not totally damaged either by trauma or the drugs meant to relieve it.

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    • They both kill. Stigma does kill. Psychiatry promoted stigma. Created stigma. And uses stigma as one of their excuses to kill. Their tool kit only has killing tools in it—neurotoxic drugs, ect, TMS, psych surgery. Killing tools are also called weapons. Police carry weapons too. Thats ok. But then Police need to be controlled. They should not be given free licenses. The same for every profession. psychiatrists need to be controlled. They are not gods. They are not perfect. That is ok. But—They need to be held accountable every single time they harm a patient! That is not happening. Very very rarely, does a psychiatrist hurt one patient then stopped from ever doing so again. This needs to change. A long long time ago!

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  5. What do you purpose we do to treat individuals with psychosis who are a clear danger to society? There are people who are mentally ill and hypersexual, sexually violent homicidal, violent, delusional and antisocial and refuse treatment? Do we keep packing them in prisons where they are victims of abuse? Do we let them continue to harm others without intervention ?

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    • On this website there are blogs about psychiatric systems that reduce the chance of distressed people becoming violent. One blog is about how Trieste in Italy deals with mental distress, the other is about Own Dialogue.

      Here in the UK for decades there are calls for psychiatric staff to talk down, rather then restrain patients in psychiatric hospitals. Despite this being recomended repeatedly the level of restraint remains high.

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    • No shawn. This is what we should do—We LISTEN to these people you are talking about—the hyper sexual delusional, homocidal, psychotic …
      People. Not JUST listen to the psychiatric profession who do not use science to guide their decisions.

      There are other ways. No one is listening to those ways. Psychiatry is very content to NOT change. To not listen. Obviously Not many, certainly not enough people are being helped by their treatments—drugs, ect, TMS, brain surgery.

      If psychiatry is the answer then why, after over 100 years, psychiatric patients are still murdering and raping people????

      Bc there’s not enough access to psychiatry???
      A lot of these people who are assaulting, murdering, raping, abusing ARE ALREADY or HAVE BEEN treated by psychiatry!!! It OBVIOUSLY IS NOT WORKING AS IS!!
      But when people like the United Nations tells them, they refuse to listen or even express a desire change at all! No they just double down and insult everyone who dares to defy them.

      Just like they do to their patients.

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  6. Psychiatry is responsible for the death of my niece. Repeatedly changing her medication without the slightest concern for previous medication build up in her systems. Always another pill or two. Try this try that constantly throughout her short life that ended in suicide. A side effect of the latest medication she received. My daughter lost her baby and endured 10 years of grief and depression in and out of psychiatric hospitals, drugged to the point she couldn’t even walk or blink as her body began to atrophy because of Halperidol shots 25mg a shot sometimes 3 times a day for 4 months just for her crying while in a hospital. Restrained and forced by “caregivers and nurses” what utter destruction of lives at the hands of psychopaths under the guise of Psychiatric Professionals. It’s a shame an utter shame. Children as young as 3 years old on Abilify and other psychiatric drugs. Big Pharma and Psychiatrists hand in hand killing children and adults in the name of health care.

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  7. There is one thing that everyone is still too afraid to say aloud: the legal right to self-defense in life-threatening situations. If one were to say that aloud, it would be considered an illegal threat or a sign of psychosis, and the person uttering it would be handled swiftly.

    We all know what official parties are doing in psychiatry (psychiatrists and psychiatric nurses) or enabling it with their state-given rights and uniforms (judges and police officers). But is their permission to act and keep their jobs legal if it is based on major treason?

    Currently, attempts to defend life against authorities with state-given rights to self-defense are treated as crimes and symptoms of illness. It is a false narrative of “not being able to control their emotions.” It is not simply a matter of truth or falsehood but also a question of what should be done by the book. **** against **** is currently an obligation, but that can never be said aloud.

    Even scarier: There is also an obligation to help someone when someone is about to be severely harmed or murdered. If laws were handled by the real meaning of words, every citizen not supporting the system and the **** would be guilty of aiding a murder attempt and should be imprisoned.

    The legal system itself is a blind spot of the law system because all human groups are naturally unable to harm and judge themselves. We are currently living in a lawless world, judged and governed by people who should be held accountable for their actions as normal citizens. But we cannot really say that the legal system has failed because it has never worked as stated and as the true meaning of words.

    Trying to enforce laws and justice would currently mean a worldwide civil war, with honest, law-abiding people on the losing side.

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  8. So this comment spiraled out of control wuickly. Having suffered with psychiatric issues my entire life. Personally for me medicaton worked. The Black and White argument for or against helps no one ☝
    For me personally trying to silence my brain and find peace within myself and mind. I turned to Alcohol and Street drugs. Thankful I was a fun drunk and druggie. I kept a job and could barely keep my head above water. A child of late 60’s-70’s
    I was just Crazy ronnie. There was little if any help that didn’t come with a Significant Stigma. Was not until my 50’s I received some proper care from a no nonsense ole school DR. said try this. Life changing.
    Not drinking like an animal or snorting cocaine to keep drinking for over 10yrs now.
    Lost 50lbs. And although not 100% in my opion 75%. I’ll take it♥️
    OCD/ADHD. RX Adarall/zoloft. No arrests 15 yrs. I can see past the end of my nose now. Because Nobody lives more in the moment than an Addict . This is just my story.

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  9. This is an example of the irresponsibility of the Pyschiatric Profession. People are dying in the name of science? Sad but true. I worked as a Respiratory Therapist for 43 years, before Pyschiatric Medicine ended my career. I now collect disability. I now know of Silas and the stigmatisim that he faced. I am also a scapegoat, carrying the guilt and shame of the mistakes that my doctors made. I paid a very dear price. Silas paid an even higher one, and I weep for him.

    However, its not too late. Here in America, its not too late for TORT reform. The Pyschiatric Profession is the only medical specialty protected by the Gross Negligence Clause in TORT liability. I’m going to submit my story.

    I’m going after the state legislative houses that allow this sham to continue. We need TORT reform to end these atrocities. The era of The Wild West show of Pyschiatric Care is over.

    Will you join me?

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