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.

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.

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.

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.

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.

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.

Yes, a psychiatric diagnosis can be a dangerous thing to have. But, these days, so is having any medical diagnosis. The names and words of the diagnoses themselves are not so much to blame for the harm. Rather, the harm comes through the ways the diagnoses are created and how they are used.

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

Recently, Thomas Insel, director of the National Institute of Mental Health, identified the “NIMH’s Top 10 Research Advances of 2011.” He wrote: “This has been a year of exciting discoveries and scientific progress . . . Here are 10 breakthroughs and events of 2011 that are changing the landscape of mental health research.”

Until recently the history of psychiatry was a neglected backwater whose murky depths were explored largely by psychiatrist. The impression conveyed by books such as Tuke’s Chapters in the History of the Insane in the British Isles, Macalpine and Hunter's Three Hundred Years of Psychiatry: 1535 - 1860, Berrios and Freemen's 150 Years of British Psychiatry 1841 - 1991, or Fuller Torrey and Miller's The Invisible Plague, is one that sees psychiatry and modern systems of mental health care as the inevitable outcome of progress through scientific thought, a (white European male-led) narrative from darkness and ignorance to enlightenment and knowledge.

In a new report, the United Nations Special Rapporteur on the right to health, Dr. Dainius Pūras, calls for a move away from the biomedical model and “excessive use of psychotropic medicines.”

I am not comfortable with an all-or-nothing insanity defense that is both legally and socially stigmatizing because it sets the person apart as someone who is legally determined to be incapable of being treated as a moral agent. This stigma spills over onto all people who are psychiatrized, and it is part of the conception of madness that also ends up serving as a justification for civil commitment, since we are perceived (incorrectly) as outside the reach of ordinary law.

On Wednesday, May 18th, Daniels had what was probably his 102nd consecutive episode of ECT. As always, he told the staff that he did not want it and did not consent to it; as always, he got it. Later on the next afternoon, Garth left to join his family in Brisbane. None of us have a crystal ball but his position now seems much better than at any stage in the past. Let's look at some of the facts and opinions surrounding this case.

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.

I lived through forced ECT from 2005-2006 at the Institute of Living in Hartford, Connecticut. My experience with ECT was the impetus for me to become involved in the antipsychiatry and Mad Pride movements, although I am not entirely opposed to voluntary mental health treatment. The following is the comment I submitted to the FDA on its proposal to down-classify the ECT shock device.

In spite of constantly increasing opportunities to tell different stories to the canonical story of bio-psychiatry, it can be risky for academics to voice a different perspective than the mainstream model of mental illness. In this conversation, a communication professor and a psychology professor discuss their challenges and personal experiences with going against the grain, such as what it means to be labeled “anti-psychiatry” by colleagues and responding to students upset to learn their medications may not be all they thought they were.

Audit of ECT usage, demographics, and adherence to guidelines and legislation raises concern over its continued use.

Justina Pelletier, who lived with her parents in Connecticut, had been diagnosed with mitochondrial disease, a rare and debilitating illness, and had been receiving treatment for this from Mark Korson, MD, Chief of Metabolism Services at Tufts Medical Center in Boston. In February of last year, Justina's parents took her to Boston Children's Hospital with flu-like symptoms. Dr. Korson had recommended an admission to Boston Children's so that Justina could be seen by Alex Flores, MD, a gastrointestinal specialist who had recently transferred from Tufts to BCH. But instead, Justina's care was taken over by the psychiatry department.

I do not understand how we can continue to avoid the conversation about psychiatric medications and their role in the violence that is affecting far too many of our children, whether Seung-Hui Cho, Eric Harris, Kip Kinkel, or Jeff Weise (all of whom were either taking or withdrawing from psychotropic medications) or the scores of children and adults they have killed and harmed. It is not clear what role medications played in the Newtown tragedy, though news reports are now suggesting there is one.

...but how realistic is it to expect that the biological skew of Western psychiatry can be sustainably changed one small step at a time?

Martin Harrow along with his colleagues T.H. Jobe and R. N. Faull has published another paper on the long term outcome of people who experienced a psychotic episode. Funded by a grant from the Foundation for Excellence in Mental Health Care, this paper adds to our knowledge of an extremely important and valuable study.

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

The experience with the UN Working Group on Arbitrary Detention's visit to the US is a watershed for our work against forced psychiatry. Step by step, global and national advocacy support each other as part of a worldwide movement to abolish forced psychiatry using the UN human rights framework.

Concerns have been raised about inconsistent and unreliable results, which may lead to injustices in sentencing or even wrongful convictions.