Editor’s note: This article was previously published in The Seattle Times.
As someone who has experienced the trauma of involuntary mental health treatment, I am deeply concerned that the city of Seattle is planning to expand the use of this ill-advised intervention. Specifically, one of Seattle’s 2025 legislative priorities — “Improve the reasonable use of involuntary treatment by increasing system capacity and making the Involuntary Treatment Act a more effective and useful tool for first responders” — runs counter to the groundbreaking policy directions that are underway in King County and at the state level.
For example, the King County Behavioral Health and Recovery Division is implementing the Crisis Care Centers Levy, which will offer “better places to take people than jails and emergency rooms.”
At the state level, the governor’s office — with leadership from the House, Senate, and the Department of Health and the Health Care Authority, among other departments — has been working to develop a five-year strategic plan for behavioral health. This is being accomplished through the Joint Legislative and Executive Committee on Behavioral Health. (I am a JLECBH community member, but the thoughts here are my own.)
The JLECBH Charter indicates that it is “[e]establishing an anticipated inventory of future services and supports … with a specific emphasis on prevention, early intervention, and home or community-based capacity designed to reduce reliance on emergency, criminal legal, crisis, and involuntary services (emphasis added),” among other actions.
There is ample evidence that voluntary, engaging, effective, and accountable services promote wellness, recovery, and community success for people with even the most daunting behavioral health challenges. Across the nation, states and communities have created successful service models, including peer-led engagement teams, crisis respite centers, and crisis stabilization alternatives to the avoidable use of emergency and inpatient care and contacts with the criminal legal system. These approaches successfully engage people in individualized services that promote their dignity and choice rather than lead them to reject services that they perceive are coercive.
There is also evidence that inpatient psychiatric care — especially when it is involuntary — can be traumatizing, and may lead to an increased risk of suicide: In one meta-analysis, “the post-discharge suicide rate was approximately 100 times the global suicide rate during the first three months after discharge.”
The evidence is also clear that people of color and immigrant racial minorities are disproportionately subjected to involuntary approaches. This perpetuates health disparities and discrimination that our state and communities have been determined to address.
These interventions also conflict with Title II of the Americans with Disabilities Act, which states that people with mental health disabilities have a right to treatment and services in the most integrated setting appropriate. Applying this Olmstead mandate, the United States Supreme Court has held that the unnecessary institutionalization of individuals with disabilities in hospitals or other locked facilities is a form of discrimination prohibited by the ADA.
The behavioral health field is at a crossroads. At a time when Washington state policy leaders are advocating to plan and fund a best-practice continuum of crisis-care development and management, we must not introduce antithetical, retrogressive policies. Potentially increasing involuntary treatment, when we should be encouraging empowering, person-centered care, fails those individuals with behavioral health challenges. The current behavioral health system has been labeled “broken” and trauma-inducing. No one should be forced into failed mental health services, so we must all work together to create a system that promotes wellness and recovery for those it is meant to serve.
“Don’t Include Involuntary Commitment as a Treatment Tool in Seattle” … nor any where else.
Since today’s “mental health” industry is a scientifically “invalid,” iatrogenic illness creating system, not a system that promotes health. See my previous comments for links to the medical evidence of this sad reality.
And today’s “mental health” system is being used for criminal purposes … like covering up easily recognized malpractice for incompetent doctors, and medical evidence of child abuse, for unethical pastors … both of which happened to me.
In a free market economy, no one should ever be forced to pay for unwanted “treatment.”
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We have a well documented accout of this very abuse. The award-winning documentary Death by Medicine tells the story of malpractice covered up by civil commitment. Patient is now permanently disabled. We are Dave and Cheryl from. DBM. We are not alone. This happens more often than anyone realizes.
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We need you posting here MORE, please!
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I could barely read this article as it kept talking about “behavioural” health. Whose behaviour are we talking about and which behaviours exactly? Are we talking about those with neurological illness such as schizophrenia/psychosis? Psychological disorders such as personality disorders or eating disorders? Or situational problems such as job dissatisfaction or grief? It is important to use accurate language as lumping together these three groups into one immensely stigmatising and misleading label helps no one (except psychiatrists who are kept in business by the concept of “mental illness”).
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“Behavioral health” always seemed like a bizarre term to me. Behavior doesn’t have health. Beings have health, not actions!
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So-called “schizophrenia” is NOT a “neurological illness”. Delusions & fantasies are psychological, not neurological….
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Hey, don’t bad mouth involuntary commitment too soon – I promise you, one day you lot will be banging the doors down to get into the madhouse given the reality of America political and social life, and involuntary commitment may be a means of jumping the queue. If you want help presenting at the psychiatrists office just take some LSD.
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“Don’t Include Involuntary Commitment as a Treatment Tool in Seattle,” nor anywhere else. I agree, “The current behavioral health system” is “’broken’ and trauma-inducing. No one should be forced into failed mental health services, so we must all work together to create a system that promotes wellness and recovery for those it is meant to serve.”
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“There is also evidence that inpatient psychiatric care — especially when it is involuntary — can be traumatizing, and may lead to an increased risk of suicide: In one meta-analysis, “the post-discharge suicide rate was approximately 100 times the global suicide rate during the first three months after discharge.”….”….wow. wow. wow…..but look,
There is ALSO evidence that suicide and homicide are both often fatal!….
“involuntary treatment” = assisted suicide/homicide by bullying….
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Hi Laura –
I agree 100%! As a 30 year police officer, with the last 5 years being on a mental health unit, I have witnessed this first hand. Now I spend my time teaching police cadets about the alternatives to involuntary commitment. Thank you for posting this – we absolutely must do better!
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The ONLY thing that I EVER got from psychiatry & psych drugs was:
IATROGENIC NEUROLEPSIS
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There is a need to investigate why Glucose-6-Phosphate Dehydrogenase Deficiency would appear in a hospital’s records in 2020, 2021, 2022 and 2023 as a COVID-19 emergency measure, without patients or the public being informed, nor, apparently, most doctors. In the meantime, medications contra-indicated for people with G6pdd continued to be administered. When hemolysis results from those medications, or other triggers, such as sone foods, chemicals and pesticides, mental state can be affected. In the meantime, consequent changes in mental state are unrecognized as such and treated with antipsychotics with other adverse effects. Also the charade that most people with G6PD Deficiency are asymptomatic continues and few deaths are attributed to G6pdd. The public is largely in the dark and medical education is inadequate for doctors to recognize symptoms or take into account effects of medications that are contra-indicated or should be used with appropriate caution, or would warrant prior testing for G6pdd.
After 2023, G6pdd was deleted from hospital records, without patients ever knowing it was there, or if, seeing it, just assumed, like many doctors, that it ‘just’ related to diabetes. The source of the ‘history’ of G6PDD and those who knew of it, remain silent. Privacy, meanwhile, protects everyone but the patients.
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…another traumatized person from involuntary treatment…
I have been called to use my life for the “mentally ill”. This blog site has given me more impetus to get moving. The last two decades of my life have led me to health, but I have not yet completely shed the horrendous dx. How can I help others by encouraging the treatment that so damaged me?
It is not that I haven’t had competent healers… but working in the field as long as I did broke my heart.
A wonderful psychiatrist in Seattle wrote to me “I’ve always admired your deep faith.” He attended my solemn vow Mass. My current provider said, “you are religiously preoccupied.” I am now trying to teach him the gifts faith can give… whether or not I am successful, I pray for his illumination. He did say he would never force medicine on me. Bless all you who suffer in this way, keep on truckin’!⁰
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It seems there is a failure to distinguish between mental state and what is called ‘mental illness’. A mental state can be an adverse effect of a medication that is then seen to be mental illness and treated with antipsychotics. Or, in the case of a person with Glucose 6 PD Deficiency, a mental state might, at times, be a function of hemolysis, a breakdown of red blood cells that can be triggered by infections , foods, medications, and/or other hazardous exposures. Infections may then be treated by antibiotics that are contra-indicated for people with G6pdd, further worsening their mental state. Medications for blood pressure, pain, etc might also trigger hemolysis in people with be Glucose 6PD Deficiency and be reflected in changes in mental state and behaviour. These are then often interpreted to be mental illness.. and, THE BEAT GOES ON.
Most people with G6pdd are said to be asymptomatic – is that only because of a failure to recognize symptoms staring doctors in the face and a lack of knowledge and awareness about G6pdd in healthcare and by the public? I would be curious to know if people with G6pdd are disproportionately represented among the homeless, unemployed…. because of failures in health systems…. The status quo serves some better than others. Inequalities in Health persist or grow. How valid are some pharmaceutical studies if they have not controlled for G6pdd or its variants and who inputs into that?
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