Coercion

Changing the mental health and psychosocial support system in Germany requires public debate about the ways our society should help and support people in mental crisis and with chronic mental health problems. We believe the driving force behind all help and support should be humanitarianism and respect for inalienable human rights.

European citizens from 27 different countries will soon go to the polls to elect their representatives in the European Parliament for the next five years. As an advocacy organisation, we see those elections as an opportunity to call on current and future European leaders and policymakers to bring mental health to the heart of European policies.

I am a psychiatrist who believes that involuntary treatment is rarely effective in the long run but I am also a psychiatrist who sometimes forces people into hospitals against their will.

In a MIA survey of people who had been patients in mental hospitals, nearly 500 respondents told of an experience that was often traumatic, and frequently characterized by a violation of their legal rights, forced treatment with drugs, and physical or sexual abuse. Only 17% said they were “satisfied” with the “quality of the psychiatric treatment” they received.

New analysis of post-discharge suicide rates finds estimates 6 times higher than recent studies.

When I first heard of the proposed “Helping Families in Mental Health Crisis Act of 2013” (H.R. 3717)”, I felt relieved and thought “maybe somebody has finally got it!” However, as I read and processed the words I realized just how much Tim Murphy didn’t get it. Is this mental health system broke? Yes it is. Can it be fixed? Yes it can. But we must do it collectively and with the experience and voices of those with true lived experiences including their families and allies. I stand with millions of others who have shown through our resiliency that our movement is real, has saved lives and most of all we have people that can give voice to what really needs to be changed within the system. If only people will listen.

The FDA approved the prescribing and sale of a new hi-tech compliance-monitoring “antipsychotic” drug this week. A new chapter in human darkness has descended — one that is applauded by the alliance of control addicts that made it happen.

This week a commentary, written by members of the University of Pennsylvania Department of Medical Ethics and Health Policy and titled “Improving Long-term Psychiatric Care: Bring Back the Asylum” was published in JAMA Online. The authors recommend a return to asylum care, albeit not as a replacement for but as an addition to improved community services and only for those who have “severe and treatment-resistant psychotic disorders, who are too unstable or unsafe for community based treatment.” The authors seem to accept the notion of transinstitutionalization (TI) which suggests that people who in another generation would have lived in state hospitals are now incarcerated in jails and prisons. While I do not agree, I do find there is a need for a safe place for people to stay while they work through their crisis.

Both Michel Foucault and Thomas Szasz dated the beginnings of a distinct Western institutional response to madness to the late 1500s-early 1600s. But while for Foucault it started in France with the creation of the public “hôpital général” for the poor insane, for Szasz it began in England with the appearance of for-profit madhouses where upper class families shut away inconvenient relatives. Regardless of their different ideas on the beginnings of anything resembling a mental health system, both authors agree that it was characterized by the coercive incarceration of a specially labeled group.

Tom Burns, M.D., Psychiatrist and Professor of Social Psychiatry at Oxford, recently said of Assisted Outpatient Treatment (AOT) that “compulsion added to otherwise decent care makes no difference.” This was no easy conclusion for Burns, who for twenty years “argued ardently” for Community Treatment Orders (CTO’s), which are described as the British version of California’s newly passed AOT laws. "I worked for more than 20 years to get the CTO law passed," he said. "I thought such laws were going to make a difference, but they don't."

I am a survivor of forced psychiatry, and I bring this perspective with me as a human rights lawyer. People with disabilities have a right to be as we are and not to have our bodies and minds made over to suit other people. We alone have the right to decide whether a medical treatment will support who we are or detract from who we are, and that is why free and informed consent is the essential requirement.

After 25 years of chronic emergency, 22 mental hospitalizations, a stint at a “community mental health center,” 13 years in a "board & care," repeated withdrawals from addictions to legal drugs, and a 12-year marriage, I plan to live every last breath out as a survivor, an advocate, and an artist.

MIA's Peter Simons interviews David Cohen, PhD, on his path to researching mental health, coercive practices, and discontinuation from psychiatric drugs.

Sometimes I get so sick of the lies of biological psychiatry that I must speak out. At these moments I find silence to be a kind of emotional death: a death of my spirit, a death of my critical faculties, a death of my courage. I speak out because I am alive and I wish to align with life.

What would it take to go about abolishing psychiatry? If we truly eliminated all the horrid practices that are currently committed by the mental health system, what would the world look like? What follows are 15 ways our society would need to change before we could be confident that we are free from the tyranny of the mental health system.

In an article published by the Treatment Advocacy Center, The Shortage of Public Hospital Beds for Mentally Ill Persons, the authors (D. J. Jaffe and E. Fuller Torrey) present the idea that we have far too few hospital beds in this country, and because of that there has been a dramatic shift towards the diversion of people labeled with mental illness into prisons and homelessness. Their answer to this issue is that we should radically increase the amount of hospital beds and we should also dramatically increase our reliance on outpatient treatment in the form of mandated involuntary medication programs. As many people know here, the TAC has been highly influential politically and the authors of this paper have been instrumental in getting laws passed that mandate the outpatient use of psychiatric drugs for people who have been civilly committed.

I live a slow paced life. I meditate every morning, refuse to get a smart phone (yet), and it takes me generous amounts of time to do things. This isn't because I am “stupid” or slow to get things. Sometimes I wonder how others get so much done each day - yet the quality and vibration of what I do is unique. It needs time. How does this relate with psychiatric drugs? Psych drugs are rooted in impatience, urgency, emergency.

Recently, the Murphy Bill in the United States Congress has resurfaced as a tangible threat to the civil liberties of individuals labelled "seriously mentally ill." As many others might relate, my reaction was one of rage, sadness, and utter bafflement. Yet, here we are. Having defeated the bill once, it is back like herpes. After my frustration and anger dissipated a bit, I pondered this and was hit with a "duh" moment. Politics is not about facts; politics is about power, money, and playing on the emotions of society.

I’ve had some criticism of the recent Doctor Munchausen posts. They’re not fair on doctors. Many people have told me of lives saved by good doctors. It’s not fair to tar these good doctors with the brush of a few Dr Munchausens here and there. So there’s bad doctoring and good doctoring and great doctoring. What would great doctoring mean?

Rates of suicide in prison are significantly higher than in the general population.

I thought I would begin my blogging career with a description of how I see three elements that reinforce each other in ways that...

Garth Daniels, a 39-year-old Melbourne man, has been shackled for 110 days and forced to undergo ECT 94 times at three times a week against his will. Last year, his family asked me to provide a second opinion on Garth’s case. As predicted, my recommendations against continued ECT were quickly dismissed by the hospital. There are critically important issues at stake in this case.

One of psychiatry's most obvious vulnerabilities is the fact that various so-called antidepressant drugs induce homicidal and suicidal feelings and actions in some people, especially late adolescents and young adults. This fact is not in dispute, but psychiatry routinely downplays the risk, and insists that the benefits of these drugs outweigh any risks of actual violence that might exist.

On March 25, Joseph Johnston, Juvenile Court Justice in Boston, Massachusetts, issued a disposition order in the case: Care and protection of Justina Pelletier. The background to the case is well-known. Justina is 15 years old. Judge Johnston did not return Justina to the care of her parents, but instead granted permanent custody to the Massachusetts Department of Children and Families (DCF), with a right to review in June. The disposition order is somewhat terse and sparing in its tone, but reading between the lines, it seems clear that the court has determined that Justina either does not have mitochondrial disease or that, even if she does have mitochondrial disease, her concern about this matter is inappropriate and excessive.

Drug profitability requires three parties to work together – drug companies to make the drugs, psychiatrists to prescribe them and consumers to take them. Too often, though, patients have failed to play nicely and do their bit. They have banged on about tiresome things like adverse reactions and alternative treatments, they have expressed foolish opposition to the very concept of pharmacotherapy and questioned its efficacy. They have become medication non-compliant and undermined the profits of the pharmaceutical industry and the authority of psychiatry. They have been bad and landed themselves on a lot of people’s naughty lists and made the World Health Organization very sad and worried.