Thursday, October 18, 2018

Comments by Tina Minkowitz, Esq.

Showing 100 of 195 comments. Show all.

  • It’s wrong to make generalizations. Some of us need solitude more than relationships. Or we need both and need to not have to imbibe the mental heath mantra that ‘we all need to reach out’.

    What I think is problematic about the kind of self-care that makes a show of itself, is that it’s defensive and it relies on a mental health prescription to do something that the person finds necessary. Also it can amount to a mental health labeling of the people you decide to avoid.

    How about if we all acknowledge a variety of human needs and predilections, and don’t make general prescriptions for anyone else’s well-being?

  • Your reply went to both places but it is easier to reply here. I stand by my comment, as the right to health understood without a duty to health amounts to a right to obtain good quality health care acceptable to the person, as well as to have the preconditions for health such as clean water and food. There is nothing wrong with economic and social rights per se; the right to housing does not mean that the government should forcibly house someone who wants to live outside.

  • i agree that one of the needed avenues for work is to continue to challenge the psychiatric belief system and its practices. That is part of the story, to remove the ‘bio’ entirely from the belief system – as a friend pointed out to me, the New York Times has recently published an article stating flatly that there is no such thing as chemical imbalance related to madness or psychiatric labels. This should be promoted widely.

    it is difficult to say ‘the UN’ has resolved an issue in a particular way when there are different bodies in the UN that continue to contradict each other. In ordinary discussions, we might say ‘the UN’ to refer to what any Special Rapporteur says, etc., but it becomes confusing when they disagree. it is probably best to talk about the specific body or mechanism or agency of the UN has done a particular thing, e.g. the UN Human Rights Council has said… or the UN Committee on the Rights of Persons with Disabilities has said…

    I would like to believe that the CRPD standards are gradually winning in the UN, but there are still some holdouts. One of the avenues I think is necessary is to remind them of where the CRPD came from, and take seriously the leadership of survivors as was done in the drafting process. We are not alone; we have allies in the UN and elsewhere and they are needed and make important contributions, but too often they have been listening to each other and ignoring those of us with the real expertise.

  • Thanks for finding the silver lining at least in the resolution; I read it a little differently than you do but agree that the ‘freedom in health’ as proclaimed in the resolution is something to hold the UN and governments accountable to.

    Freedom is freedom; health is health. Individuals have a right to get health care they need; in the US where people die in a system that can deny them easy treatment for lack of money, the right to health care is real, and it is absurd to talk about a right to illness. A right to illness could be invoked to deny desired treatment and allow the person to die, just as a right to health is invoked by some psychiatrists to justify forced interventions. A right to illness on the other hand can be invoked to support your freedom to refuse treatment irrespective of whether or not you are actually ill – it is a way to avoid the dispute about whether the illness is real, whether the doctor is right or wrong. And a right to health can be invoked to demand that societal resources be equitably distributed so no one has to do without health care.

    All human rights are rights held by the individual, and cannot be legitimately invoked to justify the deprivation of some other human right to the same individual. That is a managerial approach to human rights that subverts the true purpose. If freedom from forced interventions is part of the right to health, this is both a cobbling together of a right to integrity of the person with the right to health so that we acknowledge a right to integrity, to be free from unwanted intrusions, in the context of health care; and it is also possibly an argument that such freedom is also part of what the right to health itself means, that there can be no health without integrity and freedom from forced interventions. I do not think either of these is bad; but I do think that forced psychiatry has to be taken beyond and outside the context of health care because it is a regime that has nothing to do with health and instead is for social control – management of people who are viewed as unruly or disruptive for one reason or another, active or passive. For that reason I support, as WNUSP proposed in its statement in the meeting, a framework of reparations for forced psychiatry as a widespread and systematic human rights violation, as the way forward to have the conversation that all the survivors in the meeting wanted to have: implementation of our full human rights throughout society, and end to legalized discrimination/ subordination/ torture.

    Regarding WHO, this organization has called for the abolition of forced treatment and no longer recommends that countries adopt mental health legislation. This has been a huge shift for WHO. I cannot fully endorse their training materials but there are parts of those materials that clearly uphold the CRPD standard of no force/coercion. In fact, Michelle Funk from WHO is a better supporter of the CRPD and abolition of force at this point than Nils Melzer, for the reasons I described.

  • We need to help people get off drugs and help people stay away from psychiatry in our communities; I agree with you about neoliberalism but also agree with the commenters about forced psychiatry needing to be addressed as well as the business/ ‘pill mill’ aspect. We can also do a lot on community level to persuade people to not call the mental health system on each other as an enforcer, and not call police on each other unless there is a situation that truly calls for police involvement. To remind each other that calling 911 is calling in armed state power, and it’s not friendly or helpful; to help or support someone we have to let them be who they are and work with them not against them.

    This kind of community work can make a difference potentially to both building support to abolish the mental health laws and incapacity laws, and to letting them fall into disuse.

  • I am not sure it is a deference to corporate psychiatry, rather I’d say to institutional psychiatry. In the case of UN human rights mechanisms that monitor compliance with the prohibition of torture, they have been accustomed to working closely with psychiatrists. Psychiatrists and other doctors accompany them on visits to places of detention, usually prisons, to verify if a person has been tortured, and they act as witnesses to torture and support victims. This institutional collaboration makes it even more difficult for many human rights experts that deal with torture to open their minds to accept that psychiatry in its ordinary and routine work is simply torture. One thing that helps us make the argument however is the fact that human rights experts have long acknowledged that forced psychiatric drugging and psychiatric incarceration of people who are viewed by some psychiatrists as sane would quality as torture and other cruel, inhuman or degrading or degrading treatment. To say that the same abominable acts when done to someone psychiatrists have labeled as mad is actually beneficial to the person, manifests discrimination in treating people with psychosocial disabilities as subhuman. Special Rapporteur on Torture Manfred Nowak in 2008 managed to acknowledge this discrimination and other factors that justify addressing forced psychiatry in the framework of prohibition of torture, but the institutional bias still exists in these mechanisms generally.

    Also, though I sounded an alarm in this post, I don’t think we have failed; it is one side of the struggle that we have always to keep our eyes open to see the obstacles. So long as we are fighting, we become free in the struggle and keep creating more space and more allies.

    Regarding how UN decisions are made: it has been said that there many UNs, each part of the UN can operate independently. The Committee on the Rights of Persons with Disabilities still emphatically supports the abolition of forced psychiatry, and can be expected to do so into the future. The Office of the High Commissioner for Human Rights, which hosted this meeting, has a complicated role; it is the secretariat for the CRPD Committee and for other human rights treaty bodies, some of which continue to oppose the CRPD standard; it is also the secretariat for the Special Rapporteurs, and has its own staff who advise on particular topics, including a disability adviser and a health adviser. The OHCHR disability adviser is Facundo Chavez, who moderated the first panel in the continuation of Day 1; he knows his material and supports the CRPD standard, and the High Commissioner himself articulated the CRPD standard of abolition when he spoke in the opening panel.

    The different parts of the UN speak to each other and try to harmonize their standards. This meeting was also responding to a resolution of the Human Rights Council, which is a UN body made up of member states, i.e. governments. Brazil and Portugal have been sponsoring resolutions on human rights and mental health, and the last resolution called for OHCHR to arrange this consultation. To the extent that the UN member states retain a degree of power over the secretariat, including funding, they make their influence felt. It can be difficult for human rights experts whether in OHCHR or treaty bodies like the CRPD Committee to oppose states parties, but it is their role as independent experts to pronounce the standards they believe to be correct.

    Meanwhile none of these actors can ignore civil society, both those whose rights are at stake – in this case users and survivors of psychiatry – and those who have structural power and interests in either opposing or regulating the exercise of those rights. (I’m thinking of psychiatrists but also of lawyers and academics who may support state interests or view themselves as intermediaries between state and people who are seeking to change long-standing discrimination embedded in law.)

    International law itself is complicated, especially human rights law at the global level. We do not have a global court that can make binding rulings on human rights violations complaints by individuals. (Human rights courts do exist in some regions; at least one such regional court, the European Court of Human Rights, has refused to accept the full CRPD standard of abolition of forced psychiatry and substituted decision-making.) At the global level, human rights law depends for its impact on the willingness of states to adopt and/or enforce the standard in its domestic law.

    International law is a good area to see the dynamic between law and politics, they overlap and merge into each other in a different way than in domestic law. And ultimately it is a tool we use. Sometimes there are openings that allow international law itself to change; we had that in the CRPD and it continues to open doors.

  • I think it’s a great article that lays out a vision of abolition. It can’t do everything – can’t solve the problem of capitalism for instance. It sounds to me like Au Valencia is coming from a viewpoint that is libertarian as well as grounded in social solidarity. While the perspective and tone is confrontational, the substantive points made capture in clear and plain language the demands our radical movement has been making for a long time. I noticed that this article posted by official MIA account on facebook was getting over 100 shares to which I added my own. Au Valencia has done great work here that deserves our attention. How to take these steps, is all our responsibility. Personally I hope to see activists working for state-level legislative abolition of psychiatric force/coercion, lawyers working on strategic litigation theories and plans, and more. It is wonderful to see the clear thinking of more activists envisioning abolition.

  • Hi Judi –

    I replied to you at length elsewhere and won’t repeat it all here.

    But for MIA readers I will say that
    1) I agree that SSRIs are dangerous and the kinds of risks you mention here, especially early death, should be publicized.
    2) I focus on neuroleptics for a few reasons. Neuroleptics are used against people to control them, they are called a chemical straightjacket and chemical lobotomy for good reason. Neuroleptics cause both psychic apathy and intense physical/mental suffering (akathisia) at the same time. No one likes neuroleptics, some people tolerate a small dose to suppress voices or something else in their minds that is deeply troubling to them. But mostly people are dosed with neuroleptics against their will, whether by outright force or by intimidation or incentives/disincentives of some kind. For this reason people taking neuroleptics have usually been out of sight out of mind of society, news media, who think of us as the crazies locked up in institutions. They don’t market to us, they market to those who want to control us. That has changed somewhat now as neuroleptics are being given out like candy for all kinds of things, horrifying. But I still think it’s the dominant characteristic. While on the other hand antidepressants are marketed to people and some people like taking them, enjoy the effects and say it makes them feel very good. Debate about antidepressants is on the level of awareness-raising and letting people know about what the harms are that your doctor won’t tell you – less about countering the ideology of institutionalization. It sound like in your case you were forcibly drugged with an SSRI – so I suppose that there is a lot of crossover and it’s not all one or the other.

    My personal experience was being drugged with neuroleptics, so i come with a deep knowledge of that. I am open to including all the psychiatric drugs, which as you remind me, all cause some form of brain damage, in a call for abolition/replacement with nontoxic alternatives.

  • The terminology gets developed for particular purposes – for me ‘forced interventions’ was a way of talking about the whole group of them, drugging, shock, restraint and solitary confinement, and the lockup itself, without using the term ‘treatment’ which of course is a lie that is offensive to the reality. We can use the word torture, but it was necessary to make an argument about what it is that we mean when we say psychiatric torture. See Manfred Nowak’s report as Special Rapporteur on Torture from 2008 (can search for UN Doc # A/63/175), and my work on torture, which you can find on the CHRUSP website Resources page or on the CRPD Course website under Segment 2.

    On the terminology and concept of disability- I think that disability captures the element of discrimination, the ‘on account of factor’. Why are these forms of mistreatment targeted at certain people and not others? Psychiatric labeling ties into an ideology of fitness and unfitness, that treats any impairment or infirmity as meaning the person is an inferior human being whose rights do not have to be respected, who can be treated as expendable.

    For some of us, the subjective anguish we go through in our lives or divergent habits or beliefs really mean we are different in ways that society treats as an impairment even though we don’t necessarily experience it that way. (Some people who are born with physical characteristics different than the norm also do not see themselves as impaired.) For this reason, and also because many of us reject the concept outright but nevertheless were treated as inferior human beings based on psychiatric labeling, we use the terminology of ‘actual or perceived impairment/disability’.

    Also some of us are highly affected in terms of what we can do in our lives or how we live, because of the anguish or divergent habits or beliefs, and may need accommodation or supports from others. It does not have to be a shame or secret to have these needs. Ideally we would live in ways that it was naturally accepted people are all different and have whatever needs we have, but so long as we live in a society that has concepts of ‘normality’ and acceptability that some of us remain outside of, there’s a need to name that as discrimination to be remedied.

    Be that as it may, even if you still disagree with the term disability – if you can find other ways of framing legal theories to abolish forced psychiatry that will have any traction, that will gain adherence and understanding in the legal community, I’d certainly support that as complementary. In my experience in this movement, everything we tried earlier, simply talking about forced drugging as an abomination that should not be done to anyone, failed because society shrugged its collective shoulder and said, so what? Because it is done to ‘those people’ who are not seen as real people worthy of rights protection. Naming the discrimination knocks on the door more insistently, and I don’t know any other way to name it besides disability, which I think is accurate for the reasons stated.

  • Agree with the commenter above ‘a girl called colleen’. The conclusion ignores entirely one whole area of study and findings, the traumatic effect of coercion in the mh system per se. There is no way that better packaging can ever negate that and it is offensive to try, akin to the old misogynist advice to women, ‘if rape is inevitable relax and enjoy it.’

    I will point out two additional ways that the post here, or perhaps the study itself if the author is following the study’s self-characterization, is offensive to survivors of forced psychiatric interventions and promotes an incorrect standard of human rights.

    1) To refer to coercion of ‘service users’ is offensive and misleading, as it characterizes survivors of forced unwanted interventions as people who are ‘using services.’ If it’s unwanted I’m not using it, such language obscures agency and victimization.

    2) To say that ‘human rights violations … *may result from* involuntary hospitalization’ is to imply that involuntary hospitalization itself does not violate human rights. This is incorrect. Ireland is a state party to the Convention on the Rights of Persons with Disabilities, which is authoritatively interpreted to prohibit involuntary hospitalization/institutionalization based on actual or perceived psychosocial disability. Recently the CRPD treaty body said in a General Comment on Article 19, living independently and being included in the community (excerpts, with ** around the most pertinent sentences):

    27. Legal personality and legal agency are the basis of the realization of independent living within the community for persons with disabilities. Article 19 is, therefore, linked to the recognition and exercise of legal personality and legal capacity as enshrined in article 12 of the Convention, and further explained in the Committee’s general comment No. 1 (2014) on equal recognition before the law. *Further, it is linked to the absolute prohibition of detention on the basis of disability as enshrined in Article 14 and elaborated in the respective guidelines.*

    48. The obligation [to respect the right to live independently and be included in the community] also requires States parties to repeal and refrain from enacting laws, policies and structures that maintain and create barriers in access to support services as well as general facilities and services. *It also entails the obligation to release all individuals who are being confined against their will in mental health services or other disability-specific forms of deprivation of liberty.* It further includes the prohibition of all forms of guardianship and the obligation to replace substituted decision-making regimes by supported decision-making alternatives.

    83. Involuntary institutionalization on the basis of impairment or associated circumstances such as presumed “dangerousness” and other factors as elaborated in the Committee’s guidelines on article 14 is often caused or increased by a lack of disability specific support services. Implementing article 19 thus will ultimately prevent violation of article 14.

    Advocates in Ireland and everywhere need to know their human rights and defend the full meaning of the CRPD, and not be misled by the professions that are still invested in coercion.

    For those of us in countries that haven’t yet ratified the CRPD, take heart in knowing that other parts of the UN are gradually coming around to the same point of view, as the Working Group on Arbitrary Detention showed in their recent report on the US. I blogged about this and link to the WGAD report and recommendations, here: https://www.madinamerica.com/2017/10/un-to-usa-forced-treatment-prohibited/.

  • The Working Group on Arbitrary Detention can deal with detention based on discrimination of any kind. In the case of older people it is often a combination of age and actual or perceived disability but it can also be age alone. The WGAD has spoken out against forced treatment in the mental health context because of the linkage with arbitrary detention, which is their particular mandate. People in skilled nursing facilities might be in a situation of detention if they can’t leave; you would need to check and compare with how the WGAD defines detention, this might be a place to start: http://www.ohchr.org/EN/HRBodies/HRC/RegularSessions/Session30/Documents/A_HRC_30_37_ENG.docx

    But that is only one of a number of UN human rights mechanisms that we can address. Here is the web page for the UN Independent Expert on the enjoyment of all human rights by older persons: http://www.ohchr.org/EN/Issues/OlderPersons/IE/Pages/IEOlderPersons.aspx. You might want to write to her about the problem and give her information about how it is taking place, whether in the US or in any other countries you know of. There is also other work at the UN on the rights of older persons described here http://www.ohchr.org/EN/Issues/OlderPersons/Pages/OlderPersonsIndex.aspx including a process to create a new treaty, that is taking place in New York-based meetings roughly once a year, https://social.un.org/ageing-working-group/index.shtml. Get involved and bring this abuse to their attention; I am trying to stay involved but it’s difficult to relate to a second treaty process after the CRPD one. I can advise about human rights law and how to frame these issues to relate with the legal concepts and framework.

  • I started a long reply to you last night and then closed my browser by mistake and lost it all.

    Therapy or recovery is not a remedy for forced treatment, the remedy is abolition and a full and comprehensive effort to make reparations to victims/survivors. Governments may never make reparations as they should, which is not just individual compensation but a comprehensive approach to looking at the harm that has been done by human rights violations, to individuals and society as a whole, and working on whatever needs to be done to repair, at the economic, social, cultural, communal and individual levels. But we are working on that repair, through our human rights advocacy, I have come to understand this recently. The first step of reparations is to stop the violations and guarantee that they won’t continue, and in addition we need to allow all of us to come forward and say what we need once the harm has stopped and we are not threatened with it any more.

    Individual healing from the traumatic effects of psychiatric violence as well as the effects of psychiatric drugs and procedures is part of what some of us need, and for some people it may take the form of therapy. For others of us, it is inconceivable to go to the profession that harmed us to help with healing.

    In general, therapy is something that some people find useful as a space to explore what they need to do to change their lives and heal from trauma or destructive life patterns, others go to 12 step programs or peer support or use psychiatric drugs or have a spiritual practice or muddle through. No disrespect to any of these ways, they are all valid and also all can have their down sides and don’t work for everybody. Therapy in particular can be criticized as giving up power to another person, but that may be really the Freudian analysis paradigm, and a lot depends on the individual needs of a particular person, their situation, their personality, and the person they end up with as a therapist. For me therapy is not an option so my understanding of it is theoretical at this point.

    The recovery approach I have been looking into a little bit as it appears in the WHO training modules (http://www.who.int/mental_health/policy/quality_rights/guidance_training_tools/en/) and I think it has some value for transforming conventional mental health services; primarily in opening up the possibility that people can change their lives and that the focus can be on what the person wants to do and not on what someone can label as being ‘wrong’ with them. But it’s not for everyone, we can’t assume that recovery-based mental health services are the answer to what everybody needs in a time of distress or life problems or altered consciousness. So the challenge is to find ways to create proactively a framework for the kinds of services people want and need in various circumstances. I have been thinking about this in context of the work of the CRPD Committee that recently produced a General Comment on Article 19, living independently and being included in the community (http://www.ohchr.org/Documents/HRBodies/CRPD/GC/CRPD_C_18_R_1.docx), to which I made submissions initially and on the first draft of the GC. I am planning to write a blog post on this General Comment as it has helped to clarify some of my thinking about various elements both more mainstream and what I’ll call utopian, in the sense of thinking about ideal ways I’d want society and life to be organized rather than particular alternative practices.

    I’ll close here, re your comments about treatments being done on a minor, I agree with you that there should be some kind of oversight to ensure minors aren’t being given medical treatment with destructive effects. CRPD says that children have a right to have their views about any matter concerning themselves be given due weight in accordance with the child’s age and maturity, without any discrimination based on disability. Also the CRPD Committee has said in concluding observations that children should not be subjected to involuntary psychiatric treatments. It could make sense in addition to have safeguards to protect the minor’s ability to stand up for him/herself and ensure that explanations are given in a way that she/he can understand to express his/her will and preferences.

  • The USA is not monolithic, I’d say. Some state legislatures and municipal governments have enacted legislation to support human rights treaties and work to comply with them at that sub-federal level. Also right now the federal government is not in good shape, but I know that ADAPT and others promoting the Disability Integration Act have not given up. I haven’t been able to really keep up with the things going on in federal administration, so couldn’t say if within any relevant agencies there are people who are approachable.

    It’s also not only the Right, there has been even in Center politics an attitude towards human rights treaties that takes the US as an example for the world to follow rather than one participant among a vast number of others who are all subject to the same standards, and that fails as often as any other country does. There’s a very skewed attitude towards human rights here, especially noticeable when compared with other countries at a similar level of economic development.

    In any case, there are a growing number of organizations that are promoting human rights and using human rights mechanisms, and we have been part of that. US Human Rights Network both does its own advocacy and plays a coordination role in some of the UN processes, and folks from our movement who have participated in that have made some connections and helped to raise awareness with those other activists. So a lot of work, and worth to keep doing. Thanks for your question.

  • Not sure what you are saying in your first two paragraphs. Re the Southern California organization, it’s a great initiative and could be copied by people in any other states or cities. The early movement if you remember was organized small scale, with city-based organizations. We have national and international organizations and campaigns that are already on board, and that has helped people to connect more locally.

    And ‘angry mental patient’ – maybe you haven’t encountered that stereotype directed against you? I sure have, and it has been combined with gender stereotypes that women aren’t supposed to express anger, in my case. That stereotype is embodied in the ‘danger to self and/or others’ standard in commitment laws, which the UN has repeatedly condemned (because we have brought it to their attention). It is also embodied in the discriminatory and cynical gun-control laws that we have called psychiatric profiling, and in the readiness of police to shoot to kill people, mainly people of color, whom they consider to be ’emotionally disturbed’.

    Re suggestions of what to do, there is quite a lot going on internationally, some of my international work is done now through the Absolute Prohibition campaign, see http://absoluteprohibition.org which also has a Facebook page. Nationally there is a challenge for organizations and independent activists to work together, and I am hoping to connect with those who want to collectively figure this out. It’s not rocket science really, just setting a few things in motion and seeing where people are already starting to move in good ways.

  • It’s hard to get free when there are people who hang these labels on you and are still in your life.

    I think that together we are stronger. Some survivors are lawyers and we have lawyer allies as well; it can make a difference to have somebody willing to step in and go to bat for you when you are vulnerable, once in my experience just knowing that a friend of mine would be able to help in this way allowed me to calm myself and get out of a bad situation. In political organizing and activism, in civil disobedience we would be taking risks but a psychiatrizing response would likely backfire on the state because it would show the social control use of psychiatry for what it is.

    That’s one avenue, and there can be many others. We don’t have to take any action we don’t feel right about or prepared for, and even if we are hiding, there are ways to contribute e.g. to participate in a collective advocacy campaign by helping to write or come up with ideas.

  • Thanks for your comment.

    I believe that when we abolish forced treatment, and commitment, as a legal matter, when we make it illegal, it will be much harder to threaten anyone into complying with these tortures. This can come in any number of ways, legislative repeal/abolition, judicial decisions, and/or more policy-oriented administrative or programmatic approaches.

    It has been very effective so far to work with and through the UN. The negotiation of the Convention on the Rights of Persons with Disabilities provided a global forum and a fulcrum to gain leverage over the political/legal issues in all countries at the same time. The UN for better or worse, and whatever its flaws, is a place where at times governments come together with high aspirations and want to do the right thing. Even if they are still violating those standards at home, when they come together they learn from civil society (ordinary folks and advocates who come) and they get inspired. They send their human rights-oriented people to these meetings. So that was an amazing first step, and then the UN human rights system has a number of independent expert mechanisms that helps to hold the governments accountable for what they signed up to.

    It’s a long haul, but we have comrades in many countries working for the same things, and it is worth it.

  • I think that your post is a derail from my subject, and is not at all what I have in mind.

    I do not share your views on immigration, and if you reference the Nazis you should know that their targeting of Jews and others they considered non-Aryan was similar to the hostility against immigrants that is being fomented here and in Europe – by groups including prominently the neo-Nazis. So I consider your reference to that era dishonest. Yes, they targeted people labeled with psychiatric diagnoses and other people with disabilities who were institutionalized first, or rather got the idea for extermination camps from the deliberate killing of people with psych labels and other pwd by psychiatrists. But you are twisting it around to make it seem like we are endangered by other people who are actually victims and not at fault.

    Frankly I think the moderators should delete the comment as it is really inappropriate, but that is up to them.

  • old head,

    You say ‘alternative to starvation,’ yet tell that to the woman I know, a professional and human rights advocate, who cannot imagine her life without psychiatric drugs and doesn’t want to. She isn’t starving, by any stretch of the imagination. Nor are psych drugs all she does, she is aware of needing certain kinds of support in her daily life and she has someone to give it to her.

    On the other hand, I also know many people who are in an in-between place, who are looking for something, would welcome a drug if it actually got rid of the ways they feel terrible, hate the adverse effects, would welcome enthusiastically something better. Psychiatry hasn’t worked for them but nothing else has either, they are desperately unhappy and haven’t connected with anything that lets them live in peace.

    The way you describe psychiatry, I don’t think you are separating the coercive institutional and legal aspects from the paternalism (which can be equally present in therapy), and from any possible elements that give anybody something that they need.

    I entirely agree that abolition of psychiatry as a social control institution cannot be subject to development of alternatives. Abolition of legalized coercion is the first step, then there are other collateral ways that it operates as social control. That is what CRPD requires.

    And, in its current form psychiatry as a profession, as a social institution, cannot be separated from paternalism and legally-empowered coercion. Organized psychiatry does not want to liberate itself from its deified status and struggle as ordinary human beings, I suppose they aren’t sure they’d have anything to offer. This doesn’t seem to me any different the way it operates, than white supremacy and male supremacy; it takes a willingness to let go of hierarchy and not see it as part of one’s own identity, to find an identity that doesn’t depend on being above someone else. I think it can be done.

  • Hope this reply posts in the right place, replying to old head.

    In my view, Miranda requirements on involuntary commitments would just be another procedural reform that makes little difference in the end and reinforces the legal and social legitimacy of that abusive practice. Involuntary commitment is a creature of law and it can be destroyed by destroying the laws that allow it to happen. Few psychiatrists would be willing to risk arrest and lawsuits for false imprisonment, if the commitment laws did not give their acts the stamp of legality.

    Re delegitimization again, how would you accomplish that? Who, what institution(s) give psychiatry its current legitimacy as a medical profession, and could take it away?

  • Thanks for the follow-up information.

    It makes sense that the western middle class, who would be in charge of those kind of programs, would have little ability to understand the need for food as simple. Yet we don’t even have to go to an African country to see the impact of hunger on students; in the US this is the reason for the school lunch program, and periodically politicians have to be reminded of hunger as a reality.

  • Look forward to hearing more.

    Re-reading your comment I definitely agree with the point about expert witnesses and see that as overlapping between the CRPD requirement to eliminate legal capacity deprivations based on ‘mental capacity’ assessments, and the delegitimization of psychiatric diagnosis as any kind of science.

    I agree that psychiatric diagnoses are not science, not neutral or objective in any sense, and this is something that can be worked on.

    Re the question of neurotoxins as medication, I think you have to find a way to distinguish from chemotherapy for cancer or else to deal with both in the same way. And I would wonder about the possibility advanced by Joanna Moncrieff of prescribing based on drug effects and what the person wants rather than diagnosis. That would wreak havoc with insurance under current US system, don’t know how it would work in other countries, but would be closer to what I am advocating or groping towards, in terms of return to the ‘art’ and honest science of medicine.

  • Not sure what you mean – that after abolition of psychiatry the same drugs can be available to people? And abolition of psychiatry being its delegitimization as a profession? So the drugs would be… just an option for people to try and figure out for themselves?

    I still wonder about how the abolition would be accomplished and what would come in its place.

    I am mindful of Michelle Alexander’s warnings in The New Jim Crow or the cautionary message that is implied from that book, that a terrible institution might just take other forms if the basis isn’t rooted out.

    This could apply both to abolition of legalized forced paternalistic interventions such as psychiatry (what is required by CRPD) and to abolition of psychiatry (which wouldn’t necessarily eliminate forced paternalistic interventions).

    I suppose that abolition of psychiatry would be accomplished if there is a strong enough movement, but I also believe that if psychiatry’s legalized coercive power is taken away, the nature of the institution would have to change. Still hoping to understand how people envision the delegitimization.

  • I have a sense of frustration at this proposal, much as for me personally it would be fine if psychiatry lost its accreditation and the neurotoxins were banned. My frustration is in two parts:

    1. I don’t see much possibility of it happening. Despite all the scandals, institutionally I see psychiatry continuing to rehabilitate itself and sell itself both as happy pills, or last resort way out of terror, and social control. Also, the rest of medicine is becoming institutionally more like psychiatry and so will have less ability to criticize it.

    2. People want psychiatry, and its neurotoxins. And I can’t tell them that they’re just wrong. Our bodies are all so different from one another, what feels good, what tastes good to me is vastly different even from what works for my partner. If some people feel their spirituality is enhanced by SSRIs and others are dampened down by them, as a recent study found, what does that tell us? What is spirituality, is it the same thing or different for the two groups?

    I’m interested in what can be done, because ultimately I do think we need to have a real shift back to sustainable and holistic ways of doing everything. But, similar to how I feel about western medicine – re western medicine I have friends who survived cancer because of chemo or radiation, and who are kept alive in progressively disabling conditions because of medications and assistive devices, and I have friends who use psychiatric medications as their choice and cannot and do not want to stop. I don’t want to dictate to anybody what their health choices should be.

    Do you, or anyone in this conversation, have any thoughts on how to address this tension? In terms of what I addressed in this article, it has partly to do with the relationship between autonomy and quality.

  • I don’t think ‘we’ are to blame for what news media do any more than ‘we’ are to blame for what government does. That’s a navel-gazing trap that lets the actual perpetrators off the hook.

    If you mean that we need to seek out the best news outlets we can, and use critical thinking on all of them – including those that are promoting themselves as reliable and ‘non-fake’ – I entirely agree with you and have said as much myself in many places. Not sure how that relates to autonomy and quality in health care, are you making a connection?

  • I don’t know if you misunderstood me or if you simply disagree. As far as I can tell in the U.S., given our economic system, political system and other factors, single payer makes more sense here than a hybrid as in what ‘uprising’ in their comments here calls Obamneycare.

    Irrespective of where we go in creating a system that actually provides for universal health care – which the ACA does not, and for the record ACA remains a giveaway to insurance companies as well as doing a lot of good in getting people health care who wouldn’t have it otherwise- irrespective of how we get there, my point in this article is that universal access is not the sum total of health as a human right.

    I am not very interested in debating the economic justice aspects of this, particularly in this forum. I prefer to focus on the points made in the article about the need for a movement to reclaim autonomy and power with regard to our own health, and to promote quality from the perspective of those who are using health care – both of which necessitate a movement that is independent from health care providers, and that we do not have right now, or if we do it is not very visible or active outside the context of psychiatric survivors and related groups.

  • That says a lot about western donors’ priorities. I wonder about some of the details of where the interests and pressure are coming from, at what point it is direct complicity with an industry, versus assumptions and agendas that just are not responsive to what people are saying about themselves and their needs. Why do the donors have this agenda, in other words? That would be worthwhile to figure out.

  • I think that is part of how the control is rationalized, and also how control can be accomplished without specifically coercive laws. That is a danger of a possible second-stage coercion even if mental health commitment laws are absent or not applicable. I think probably you are right that in addition to being a rationalization it is a mindset that ignores the way that capitalism and economic inequality socially and politically constructed and legally enforced, so that poverty and the ‘need’ for food stamps appears natural and thus responding to it is optional in any sense.

    The US has never accepted the concept of economic, social and cultural rights, unlike most other countries in the world including European liberal democracies. This has to do with the history of international human rights and the Cold War, but remains a persistent part of our political culture. Economic justice rears its head periodically as a legitimate human rights demand, currently we are seeing this with the support for single payer health care, but legally and politically these rights are still largely treated as charity here.

    It has been revolutionary for many people in the US to learn that housing, health care, adequate standard of living, are human rights and not just grants that can be conditioned on some kind of good behavior in the eyes of social authorities. This helps us to see these needs as dignified, as entitlements not in a cramped sense of ‘undeserving’ as the term sounds in the US but opposite, as something we have a right to just by being born. The same as we have a right just by being born, to not be abused by anyone whether a public official or not.

    In my view, economic/social/cultural rights as human rights, and the concept of indivisibility of all human rights (a principle established in the 1993 Vienna Declaration of Human Rights and frequently invoked in international human rights work), strengthens both freedoms and entitlements, and should stand in opposition to the misuse of entitlements to coerce compliance. But the power and temptation is always going to be there, so it requires political consciousness and activism to keep opposing. It is a real, material power even though it is socially constructed and kept in place by law and custom.

    Hope that is useful as a response, appreciate both your comment LavenderSage and also Julie’s reply.

  • I think a lot about the lessons from history about the racial caste system in the US, that Michelle Alexander drew out in The New Jim Crow, and others are also exploring in various media. Eradicating the relations of exploitation and oppression, the political hierarchies and their economic and social roots and manifestations, takes more than just abolishing one highly destructive institution. That is true with regard to racial justice, it’s true for the abolition of patriarchy, and it’s true for the abolition of forced psychiatry.

    See my reply to Julie above also, it is not the end and I do not intend for this to be a doomsday last stand, just a warning. There is a lot of work to do, and people should read the report in full and see what they think, more to explore beyond what I’ve said. Also interesting initiatives that can move us in the right direction, in the US I have been supporting the Disability Integration Act (www.disabilityintegrationact.org) and may blog about that sometime.

  • Good question, and maybe my post could be misleading in one respect. While this is the latest development, and it is significant for good reasons – his critique of biopsychiatry is far-reaching and more detailed than anything that has ever before come out of the UN – it is not the last word from the UN, and the Special Rapporteur on Health is not the UN mechanism that has final authority over the subject matter.

    The Committee on the Rights of Persons with Disabilities will continue to their work and presumably will continue to condemn all acts of forced psychiatry. This Committee currently has pending two individual cases that deal with forced psychiatry, and they have a chance to say what is required for justice at the individual level. (I submitted an amicus brief in one case, that can be found here: https://dk-media.s3.amazonaws.com/AA/AG/chrusp-biz/downloads/313551/CHRUSPthirdpartyDaniels.pdf.)

    Also the Office of the High Commissioner for Human Rights, the Special Rapporteur on the Rights of Persons with Disabilities, and at this point the World Health Organization, are upholding the absolute prohibition of psychiatric commitment and forced treatment in their work. Recently WHO sent a letter to the government on Korea, opposing their proposed new mental health act because it maintains provisions that allow commitment and forced treatment, contrary to the CRPD.

    In my post, I thought it was necessary to address the dangers of a gradualist approach that Dainius Pūras has adopted, precisely because the report also has value for its critique of biopsychiatry. Ideally there could be spaces for discussion among all concerned, and this will be difficult to do given the state of the survivor/user movement internationally at the present time, so we will see.

  • Great article. I would like to point out however, that there is certainly a connection with the dedicated advocacy being carried out by my friend and colleague Hege Orefellen, lawyer and survivor, and others including Mette Elingsdalen and Liv Skree, who have been using the international human rights framework since 2006 or so to bring pressure on the government to abolish forced interventions. They have worked through WSO and independently, and Hege now is running a pro bono law project through the International Commission of Jurists Norway branch, supported by retired Supreme Court justice Ketil Lund. By consistent human rights reporting in all the UN mechanisms available to them, as well as participating in law committees and consultations of the government, individual and systemic advocacy, and publicity in the media, this has certainly contributed significantly to the willingness of the Health Ministry to consider drug-free alternatives in psychiatry. As Bonnie and Oldhead say, it is a reform and does not fundamentally change the system; psychiatrists are still at the pinnacle of power. But I think it can be significant, in demonstrating that not only drug-free alternatives but also respecting freedom of choice and the right to refuse unwanted treatment is ethical, responsible, and not the bogeyman that mainstream psychiatry wants to paint it as. There is a synergy as Jim Gottstein illustrated in his three-part approach to change, between law reform, alternatives, and public awareness-raising.

    I also cannot refrain from pointing out a gender dimension in this article and the situation described. All the psychiatrists mentioned are male, two psychiatric nurses are female, and all the patients interviewed are female. The patients’ stories show quite a bit of gender oppression in how they got there, and the placement of men in positions of power similarly belies Norway’s stated commitment to gender equality. Dismantling the authority of psychiatry, in my view links up with dismantling patriarchy and other hierarchical systems of social organization; these dismantling are synergistic too and it is useful to recognize where the systems connect.

  • Two comments:

    1. You ask, ‘Who will remove psychiatry’s compulsory powers?’ In fact, this is easily done from a technical standpoint by repealing legal provisions that authorize those powers.

    Law like psychiatry is a creation of human beings, psychiatry does not have any inherent powers to violently act on anyone’s bodies. It is given those powers by law, and law in turn must be accountable to both political processes and to fundamental principles of human rights set out in constitutions and in international human rights law to the extent that any country’s political and legal system provides for this.

    In 2006, the Convention on the Rights of Persons with Disabilities (CRPD) set out a number of rights and principles that require the abolition of psychiatric commitment, forced treatment and substitute decision-making. I was actively involved in that process and represented the World Network of Users and Survivors of Psychiatry in proposing and explaining these provisions that were successfully enacted into the treaty. At last count, 172 countries are states parties to the CRPD, and it is legally binding on them as a matter of international law. (Many of them do not treat it as binding in their domestic courts, but some do; some even consider such human rights treaties to govern on a par with their domestic constitutions.)

    The committee of independent experts that is elected to monitor compliance with the CRPD, the Committee on the Rights of Persons with Disabilities, has interpreted and applied its provisions to require an end to substitute decision-making and the absolute prohibition of forced treatment and of deprivation of liberty based on actual or perceived disability. They have said that states must repeal legal provisions such as those in mental health laws allowing deprivation of liberty based on factors such as danger to self or others, or need for care or treatment. For more information and resources, you can start at http://www.chrusp.org, an organizational website of the Center for the Human Rights of Users and Survivors of Psychiatry.

    2. (This comment is both to the author of this blog and to the book she is writing about.)
    If we look only at psychiatry as a modern phenomenon, we lose the history of how societies have dealt with what they perceive as madness, and how modern day societies that do not have a large psychiatric or mental health professional presence deal with madness. There is some good and some bad; in some societies people may be tied or chained to trees or locked in sheds because the mother of the household needs to go about her duties and can’t care for them. This is seen as the woman’s duty and the family or community participate in this dehumanization as, in in some other countries families and communities participate in the dehumanization of people through psychiatry. They do not see alternatives, and participating in dehumanization perpetuates their perceptions of the person as warranting such treatment, and affects the person in many possible ways, but all of which do not allow them to break out of how they are seen by others. (Again, this is true in both psychiatric and non-psychiatric settings.)

    In some societies there are traditions of madness being seen as shamanic initiation or leading to shamanic initiation. This is fine, such practices should be supported and have also inspired many in other cultures to have a different view of the spiritual crisis and/or emergence that madness can be.

    That leads me to two points about what is missing from a Marxist analysis as described here. First, patriarchy as a system of oppression prior to, intersecting with, absorbed into, parallel to, and/or competing with capitalism appears to be overlooked. Feminist Marxists have called attention to this blind spot in mainstream (male-dominated) Marxism for at least decades. I find the book ‘The Sexual Contract’ by Carole Pateman to be useful in understanding how patriarchy was transformed by capitalism. Patriarchy also is implicated in psychiatry and it is not enough to acknowledge that psychiatry reinforces women’s oppression. Patriarchy has been analyzed as a system, similar to capitalism, that in some part can account for psychiatry (e.g. in Mary Daly’s Gyn/Ecology). I do not think that either system fully accounts for psychiatry, but certainly we need to look at all of them. (In addition, institutionalized racism, or what I have heard described as racism as a practice, similarly can provide a partial account of the development and existence of psychiatry as a system of social control.)

    Second, there is something that I think is separate from any other framework of system of oppression, that leads human beings to treat some members of a society as too different to be accepted in the community. It is a widespread phenomenon that I think is accurately described as disability-based discrimination, or simply exclusion of members of the community (also including older people) that appear to be weaker or who are made weaker by others’ reactions to them. We can talk about specifically how capitalism treats disabled people as ‘useless eaters’ and patriarchy puts disabled people under the control of male heads of the family or their surrogates, while making women responsible for either care or abuse/neglect, and for carrying out both the abuse/neglect and as directed by the patriarchs and other the measures they dictate for management and control. It would be interesting to look more deeply at Feminist-Marxist analysis of how women, and other subordinates like non-psychiatric mental health professionals, are roped in and have an intermediary role in the oppressive system. And, to look at how psychiatry came to serve patriarchy in an era of capitalism, by transferring social control and the abusive/neglectful care involved, at least in part from women in the family to a monetized system and its employees. And yet, without an ‘intersectional’ attention to disability-based oppression/disablement in particular, I cannot expect that either feminism or marxism will pay attention, and so I wonder what the material basis is of disability-based oppression as such, and what more we need to address in theory and practice, beyond simply rising up for liberation.

    So to conclude (linking up with my #1 above), there’s a linkage with law and custom both in state and non-state societies, in thinking about how societies respond to distress and difference. Law both reflects and replicates a social and economic and political order (and a sexual order, and perhaps an ability order of some kind). I think that law is an important site for change while at the same time recognizing and being vigilant about the underlying systems that will act to recreate themselves if we do not make deeper change (Michelle Alexander has made this point more emphatically and concretely than any other writer I’m aware of, in The New Jim Crow). Thanks for this blog and for the discussion.

  • Yes, agree.

    I don’t think that we will necessarily ‘as a movement’ make decisions together, on this website or anywhere else. But who knows, maybe something will coalesce and we will only know when it happens. We have to be alert to what moves us, and what inspires us. Many good things are happening in other parts of the world, and MIA is still America-centric, for example.

  • kindredspirit,

    I agree with you about groups that try to get taken out of the DSM sometimes doing that at the expense of everyone else. I am active in feminist and lesbian groups, where it is something I struggle with at times, to look at the ways that, for example, many lesbians are still being psychiatrized for their sexuality alone, or because someone suspects their sexuality. And at the same time not differentiate, not make that the sole issue facing lesbians who have been psychiatrized, because many of us are psychiatrized for other reasons, labeled in ways and circumstances that aren’t apparently related to being lesbian. That is how I approach it in this situation that I relate to personally, and I think it can be done in other intersectionalities also.

    I know a couple of psych survivors who have gone to Standing Rock, and think it is a good energy to connect with, however we relate it to the psych survivor aspect of our lives and work.

    Take care,

    Tina

  • I really do not mean to say that everyone needs to blast their experiences in the world. Part of the violation committed against us was putting all our private experiences on display, to be picked over by people who were hostile to us. Decisions about what to be public about are personal and situational, in my opinion.

    It can serve the movement for people to come out publicly, but I think for too long we have acted as if telling our stories is the most important thing. Sometimes it can be better to, for instance, write a pseudonymous blog, or help others get out of psychiatry, or any number of things that can be done quietly.

    Having said that, I do think that if one is getting active on these issues, speaking out, I do ask the person to come out as a survivor and not pretend they are just an ally.

  • Rachel, thanks for being here and doing what you are doing to save yourself.

    I don’t think that disobedience means flinging yourself at everybody standing in your way, making a big show. It’s how we care for ourselves and decisions we make in every moment, what will serve and preserve the sacred in us, and in others and in the planet. Sometimes that is deception, and I have no problems with it as a means of preventing forced psychiatry.

  • Yes, speaking out is the first step. Those in a position to speak out without risking their own bodies and lives have an obligation to do so. At a minimum. And we have to hold people in the movement – by which I am including allies, not only survivors – accountable for how they act on their ethical positions, and for whether they take a position opposing all forced psychiatry to begin with. There is no middle ground on this, I am tired of coddling people and being expected to treat someone as my friend when they refuse to support my basic human right to not be subjected to torture and arbitrary detention. (Note that all discriminatory detention is considered arbitrary detention, so using this term doesn’t mean we’re just asking them to follow their own laws, all psych commitment is arbitrary detention under the CRPD standards.)

  • Hi AntiP,

    Regarding rights and duties, I will speak about international human rights law, a system that has developed over time with certain principles and aims to be above and beyond the laws created by states. It is above and beyond because it talks about duties that states have towards the people.

    It is true that people also have duties to each other, and it is basically to treat one another as we want to be treated. So the Universal Declaration of Human Rights says we all have duties to each other, without which no one would enjoy their basic human rights. But people labeled by psychiatry have no more duties than anybody else is, and we sure don’t have a duty to accept subordination to psychiatry, we don’t have a duty to accept being locked up or forcibly treated. The duties that governments come up with, that might be what they post in psych wards, are how they want us to behave there. So I’d say take that with many grains of salt. They might have the power to enforce those ‘duties’ against you, the power to punish you if you don’t do what they say. And they may be supported in that by the country’s domestic law, but they may not be; what they claim to be your duties might be only the policy of a particular institution.

    Now about rights. Also with rights, we have the same rights as anyone else. This is the single most basic premise underlying the Convention on the Rights of Persons with Disabilities. Governments that ratify the CRPD undertake an obligation to not discriminate against anyone based on disability. It is clear from the negotiation history and many of the CRPD’s provisions that it is intended to cover psychiatrically labeled people, and I don’t think there is serious disagreement on this any more. The CRPD says that everyone has legal capacity (right to make decisions) and the right to have others respect their will and preferences; that there can be no deprivation of liberty based on disability (psych commitment or similar regimes); that we have the right to free and informed consent in health care, and to not be tortured or otherwise ill-treated; and that we have a right to be provided with supports if we choose them, for living in the community and also for help with decision-making; these supports are not to be imposed against our will.

    Many governments and academics try to find ways to make the CRPD fit with psych commitment and forced treatment, by ignoring some of what it says or not taking the totality of all provisions; these are often deliberate moves rather than misinterpretation, especially post-2015 since the Committee on the Rights of Persons with Disabilities issued substantive interpretive guidelines on Article 12 (legal capacity) and Article 14 (liberty and security of person). So we fight back.

    You can contact me through this website by email, if you want to talk more about your country situation and prefer to do it more privately.

    Regarding the rest, I don’t think I’m saying anything that has to be kept private for security reasons. Yes, if psychiatry is watching this blog, they may know that a level of resistance is being encouraged. But I believe it is a kind of resistance that builds our stamina and rises, it is not an aggression that they can respond to by making us feel bad or doubtful about ourselves, or provoke us into escalation that lets others paint us as bad and scary. If we are to be scary, it will be for our spiritual power. And like other non-violent movements before us, we rise because of our ethical commitments, because everything stems from that, and that is exactly where psychiatry is weak. They cannot win, because they are wrong.

    I’m not naive, violence happens and will happen and you know, violence is already happening against us just as it was happening and continues to happen against Native Americans, just as it happened and continues to happen against African Americans before, during and after the civil rights movement. It’s about how we act, how we meet the systemic, endemic violence we are surrounded by and find ways to stay grounded in our own love and the power of the sacred, however we relate to that.

    All the best,

    Tina

  • The reason why strategically there is a move to label him psychiatrically – feelers being put out in mainstream media, politicians, in addition to garden variety folks and psych professionals who covet a role for themselves – is that it is one possible avenue to get him out of office. You mention this, but I think it is worth going into more detail about why psychiatric labels are connected to the idea of unfitness for office.

    The constitutional provision at issue, the 25th Amendment, doesn’t specify what it takes to judge the president to be unfit, but the term ‘inability’ or ‘unable’ is also used. According to wikipedia’s version of the legislative history and motivation (I haven’t taken the time to research further), this is not about a judgment of the president’s competence in the sense of meeting job requirements, but rather competence in the sense that amounts to a physical or mental disability.

    We shy away from making job requirements for the president (in the sense of qualities or competencies to do the work of being president), it’s political and there’s the idea that people have a right to choose whoever they want as a political leader. Yet, it would make a lot more sense if everything that we now lump into the idea of mental disability or mental incapacity would instead be referred to an examination of what we actually see as an impediment to a person carrying out the job. There is something to our sense of the current president’s unfitness for the office he has been elected to, in terms of his belligerent character as someone who deliberately taunts and targets large numbers of individuals and groups with his hostility, as someone who is ineffective at communicating about policy issues, as someone who is maintaining numerous situations in which he has a financial conflict of interest with his office, and more. And, maybe we want job descriptions, but if we don’t (and that would require a constitutional amendment) we are stuck with this president unless the congress goes through with impeachment, which requires more people to act.

    Ultimately what’s going on exposes the bankruptcy of ‘mental capacity’ evaluations as a whole, and is a good example for all of us of how psychiatric diagnoses function to invalidate people, violating their rights to enjoy legal capacity that are guaranteed by the Convention on the Rights of Persons with Disabilities, Article 12. (Yes, I’ve linked this up with CRPD. If this interests you, google and read CRPD General Comment No. 1, especially paragraphs 13-15 that reject the invalidation of people’s decision-making by virtue of ‘mental incapacity’ or ‘unsound mind’ judgments. Read all of it, see also the section on support, and paragraph 42 which says plainly that forced treatment violates both legal capacity and the right to be free from torture and ill-treatment.)

    I have one other point that goes to the overall context politically. There are (at least) two ways we can respond to the current situation, two ways we can understand the lessons to be drawn. One is to blame ourselves for not electing another candidate; another is to look at the flaws of the political, economic and social system that was problematic before this election and remains so albeit with much deeper problems and in deeper crisis than ever before. We are good in crises, we wake up and look at each other, draw together and take care of each other. There are lessons also from Standing Rock and what is ongoing there, and all the movements that pre-existed the current administration including ours, needing to reinvigorate ourselves and having some synergistic potential. I am not in any way saying ‘bad is good’ but there is a great deal in the balance and many ways we can respond to the bad, some of which may have the potential for deeper and lasting change than others.

  • Hi.

    It’s not clear what reform of mental health legislation you are supporting. Since you mention lack of capacity assessments, I guess that you support the kind of reform that is designed to subsume commitment and forced treatment in mental health under the framework of legal incapacity.

    Are you aware that legal incapacity laws are also discriminatory? The Committee on the Rights of Persons with Disabilities, monitoring body of the Convention on the Rights of Persons with Disabilities to which UK is a party, has elaborated on this in a General Comment, http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CRPD/C/GC/1&Lang=en.

    Among their points:

    13. Legal capacity and mental capacity are distinct concepts. Legal capacity is the ability to hold rights and duties (legal standing) and to exercise those rights and duties (legal agency). It is the key to accessing meaningful participation in society. Mental capacity refers to the decision-making skills of a person, which naturally vary from one person to another and may be different for a given person depending on many factors, including environmental and social factors. Legal instruments such as the Universal Declaration of Human Rights (art. 6), the International Covenant on Civil and Political Rights (art. 16) and the Convention on the Elimination of All Forms of Discrimination Against Women (art. 15) do not specify the distinction between mental and legal capacity. Article 12 of the Convention on the Rights of Persons with Disabilities, however, makes it clear that “unsoundedness of mind” and other discriminatory labels are not legitimate reasons for the denial of legal capacity (both legal standing and legal agency). Under article 12 of the Convention, perceived or actual deficits in mental capacity must not be used as justification for denying legal capacity.
    14. Legal capacity is an inherent right accorded to all people, including persons with disabilities. As noted above, it consists of two strands. The first is legal standing to hold rights and to be recognized as a legal person before the law. This may include, for example, having a birth certificate, seeking medical assistance, registering to be on the electoral role or applying for a passport. The second is legal agency to act on those rights and to have those actions recognized by the law. It is this component that is frequently denied or diminished for persons with disabilities. For example, laws may allow persons with disabilities to own property, but may not always respect the actions taken by them in terms of buying and selling property. Legal capacity means that all people, including persons with disabilities, have legal standing and legal agency simply by virtue of being human. Therefore, both strands of legal capacity must be recognized for the right to legal capacity to be fulfilled; they cannot be separated. The concept of mental capacity is highly controversial in and of itself. Mental capacity is not, as is commonly presented, an objective, scientific and naturally occurring phenomenon. Mental capacity is contingent on social and political contexts, as are the disciplines, professions and practices which play a dominant role in assessing mental capacity.
    15. In most of the State party reports that the Committee has examined so far, the concepts of mental and legal capacity have been conflated so that where a person is considered to have impaired decision-making skills, often because of a cognitive or psychosocial disability, his or her legal capacity to make a particular decision is consequently removed. This is decided simply on the basis of the diagnosis of an impairment (status approach), or where a person makes a decision that is considered to have negative consequences (outcome approach), or where a person’s decision-making skills are considered to be deficient (functional approach). The functional approach attempts to assess mental capacity and deny legal capacity accordingly. It is often based on whether a person can understand the nature and consequences of a decision and/or whether he or she can use or weigh the relevant information. This approach is flawed for two key reasons: (a) it is discriminatorily applied to people with disabilities; and (b) it presumes to be able to accurately assess the inner-workings of the human mind and, when the person does not pass the assessment, it then denies him or her a core human right — the right to equal recognition before the law. In all of those approaches, a person’s disability and/or decision- making skills are taken as legitimate grounds for denying his or her legal capacity and lowering his or her status as a person before the law. Article 12 does not permit such discriminatory denial of legal capacity, but, rather, requires that support be provided in the exercise of legal capacity.

    I have copy/pasted this long quote rather than pulling out only one or two sentences so you can see the Committee’s reasoning in context. They also later in the document specify that “the provision of support to exercise legal capacity should not hinge on mental capacity assessments; new, non-discriminatory indicators of support needs are required in the provision of support to exercise legal capacity.” (para 29(i)).

    A wide range of support is contemplated:

    17. Support in the exercise of legal capacity must respect the rights, will and preferences of persons with disabilities and should never amount to substitute decision-making. Article 12, paragraph 3, does not specify what form the support should take. “Support” is a broad term that encompasses both informal and formal support arrangements, of varying types and intensity. For example, persons with disabilities may choose one or more trusted support persons to assist them in exercising their legal capacity for certain types of decisions, or may call on other forms of support, such as peer support, advocacy (including self-advocacy support), or assistance with communication. Support to persons with disabilities in the exercise of their legal capacity might include measures relating to universal design and accessibility — for example, requiring private and public actors, such as banks and financial institutions, to provide information in an understandable format or to provide professional sign language interpretation — in order to enable persons with disabilities to perform the legal acts required to open a bank account, conclude contracts or conduct other social transactions. Support can also constitute the development and recognition of diverse, non-conventional methods of communication, especially for those who use non-verbal forms of communication to express their will and preferences. For many persons with disabilities, the ability to plan in advance is an important form of support, whereby they can state their will and preferences which should be followed at a time when they may not be in a position to communicate their wishes to others. All persons with disabilities have the right to engage in advance planning and should be given the opportunity to do so on an equal basis with others. States parties can provide various forms of advance planning mechanisms to accommodate various preferences, but all the options should be non-discriminatory. Support should be provided to a person, where desired, to complete an advance planning process. The point at which an advance directive enters into force (and ceases to have effect) should be decided by the person and included in the text of the directive; it should not be based on an assessment that the person lacks mental capacity.

    You will see that they include advance directives, but as some of us have pointed out, advance directives are problematic if they are meant to bind the person’s will at the time an event occurs; since the person retains legal capacity at all times, it’s not clear that having provided at an earlier time for something to be done towards them would legitimize for instance the use of force to accomplish it at a later time when they refuse the intervention.

    These two paragraphs reinforce the right to legal capacity as persisting at all times and being unqualified; support is not a control mechanism but a means of exercising a will that the person has formed at some level; the person can always override a misinterpretation of his/her will by the supporter, and no person can be obligated to use support.

    18. The type and intensity of support to be provided will vary significantly from one person to another owing to the diversity of persons with disabilities. This is in accordance with article 3 (d), which sets out “respect for difference and acceptance of persons with disabilities as part of human diversity and humanity” as a general principle of the Convention. At all times, including in crisis situations, the individual autonomy and capacity of persons with disabilities to make decisions must be respected.
    19. Some persons with disabilities only seek recognition of their right to legal capacity on an equal basis with others, as provided for in article 12, paragraph 2, of the Convention, and may not wish to exercise their right to support, as provided for in article 12, paragraph 3.

    Here is what the General Comment says specifically about abolishing forced psychiatric interventions and the need for independent support and non-medical alternatives in mental health context.

    42. As has been stated by the Committee in several concluding observations, forced treatment by psychiatric and other health and medical professionals is a violation of the right to equal recognition before the law and an infringement of the rights to personal integrity (art. 17); freedom from torture (art. 15); and freedom from violence, exploitation and abuse (art. 16). This practice denies the legal capacity of a person to choose medical treatment and is therefore a violation of article 12 of the Convention. States parties must, instead, respect the legal capacity of persons with disabilities to make decisions at all times, including in crisis situations; must ensure that accurate and accessible information is provided about service options and that non-medical approaches are made available; and must provide access to independent support. States parties have an obligation to provide access to support for decisions regarding psychiatric and other medical treatment. Forced treatment is a particular problem for persons with psychosocial, intellectual and other cognitive disabilities. States parties must abolish policies and legislative provisions that allow or perpetrate forced treatment, as it is an ongoing violation found in mental health laws across the globe, despite empirical evidence indicating its lack of effectiveness and the views of people using mental health systems who have experienced deep pain and trauma as a result of forced treatment. The Committee recommends that States parties ensure that decisions relating to a person’s physical or mental integrity can only be taken with the free and informed consent of the person concerned.

    There is more that is worthwhile to point out, but I will invite you to contact me through MIA if interested in exploring how this framework answers particular questions. I will also point you to a follow up document, the CRPD Committee’s Guidelines on Article 14 (liberty and security of the person) which links up the question of non-discrimination in relation to liberty and security (which you are addressing in this article re mental health legislation) and legal capacity: http://www.ohchr.org/Documents/HRBodies/CRPD/GC/GuidelinesArticle14.doc.

    All the best,

    Tina Minkowitz

  • Hi Otto. Thanks for speaking out. We need every voice and comparatively few in our movement speak openly from the perspective of having been in forensic psychiatry.

    You are in Canada, which has ratified the Convention on the Rights of Persons with Disabilities. It sounds like you may already be aware of international human rights, but I can put you in touch with survivors who are working on reporting about forced psychiatry of all kinds, as a human rights violation under this treaty. I will try to email you through this site.

    The UN expert committee (Committee on the Rights of Persons with Disabilities) which monitors this treaty has said a number of times that forensic psychiatric commitment and forced treatment in the prison/jail setting is a violation of CRPD, the same as other psychiatric commitment and forced treatment. They have mentioned restorative justice, so long as it does not involve coerced mental health treatment as a supposed diversion, as an alternative to prison to be pursued.

    The CHRUSP website has links to UN materials and some of my writings and those of others, if you are interested to look into the international human rights aspect further. http://www.chrusp.org/home/resources

    All the best,

    Tina

  • Please see this very powerful group of presentations by Hege Orefellen (WNUSP), Liv Skree (WSO), Reshma Valliappan (WNUSP and The Red Door), Guri Gabrielsen (Head of Dept, Norwegian Equality and Non-Discrimination Ombud), and Mette Ellingsdalen (WSO). These are the presentations from a WNUSP side event on CRPD Article 6 – Violence Against Women and Girls with Disabilities: Intersectional and Double Violence in Medical and Institutional Settings, 19 August 2015.

    http://www.treatybodywebcast.org/crpd-14-public-side-event-on-violence-against-women-and-girls-with-disabilities-intersectional-and-double-violence-in-medical-and-institutional-settings-world-network-of-users-survivors/

  • Great article. Important for international work also, where the exact distinction between community mental health and real community is very much at issue in the application of Article 19 of the Convention on the Rights of Persons with Disabilities, on living independently & being included in the community. I address this in a submission to the CRPD Committee for their preparation of a General Comment on this provision. https://dk-media.s3.amazonaws.com/AA/AG/chrusp-biz/downloads/302948/CHRUSPArticle19.pdf.

    I am going to share your article and also hope it can be translated as it is an issue everywhere.

  • You’re right; while I can’t control what anyone posts and I will do my best to give a meaningful response to anything that warrants one, I am not intending to debate the demands.

    What you propose sounds like what law enforcement is mandated to do, and if that is the intent then I agree. Police are a horror in the US and almost everywhere, and we need social change on many more axes than just ending discrimination based on psychiatric labels or psychosocial disability/ unusual behavior or appearance/ choose your respectful wording. I believe that many of the survivor-developed alternatives in mental health, such as Intentional Peer Support, together with some of the work being done on Restorative Justice, along with comprehensive overhaul to stop the war mentality of police encountering people of color, holds hope for a better approach to situations where people are endangering others or have harmed others.

    Sarah Knutson also has a post on MIA on this topic, giving an example much publicized in the press of an approach that worked: https://www.madinamerica.com/2013/10/tuff-love-necessary-public-safety-alternative/.

    To clarify about the demands of the Campaign. The absolute prohibition of commitment and forced treatment is already established in international law under the Convention on the Rights of Persons with Disabilities. The Campaign is meant to demonstrate support for this standard and to share knowledge. It is in a sense a friendly campaign to strengthen the work of the Committee on the Rights of Persons with Disabilities, and also the Working Group on Arbitrary Detention which has adopted the CRPD standard.

    If there are demands, they might be: for governments to enact laws and policies abolishing forced psychiatry, for judges to act in accordance with the absolute prohibition (as the WGAD and CRPD Committee called on them to do, see materials linked on Campaign website for more detail); for psychiatrists to accept the removal of their delegated state power and become merely treating professionals….

    What you propose, if it is as I understand it, and isn’t intended to actually go after people who haven’t done harm but are just perceived as annoying or alarming by someone else, then it is a good point, and maybe you are going even farther than I thought at first and proposing abolition of prison as a punishment or accountability measure, which it would be very interesting to explore further.

  • The idea that only a spiritual take on the question will resolve it is a dismissive response to a fundamental question of social justice and comprehensive human rights. Positing a choice between prison and forced psychiatry is the liberal left non-answer to the human rights disaster that is forced psychiatry – a collusion between state power, financial power, and medical violence. Survivor knowledge together with allies have created something new in the CRPD – a right to support plus freedom. A right to reasonable accommodation plus equality and dignity in all aspects of life.

    If you are interested in exploring the issue further please see my blogs on this website; I have discussed the question of criminal responsibility and many other issues.

  • Hi spinoff,

    I’d like to address a few things here. I started writing something that got deleted by mistake so please bear with me if anything seems disconnected.

    First, your comment on your role as a parent and that your son will never be a survivor. When I say survivor, I do not mean “person who has ‘recovered’ from ‘mental illness.'” I mean a survivor of psychiatric oppression and abuse. Your son certainly is a survivor, and he has his own knowledge of what that means. Even if he is still being severely oppressed, and even if he is struggling to deal with his own disability or impairment and get the right kinds of support and accommodations to make a satisfying life for himself, he is still a survivor as I understand it. Many people in the survivor movement reject the notion that you have to somehow overcome disability in order to qualify in some way; and this is one of the things I believe that the disability rights framework contributes to our movement.

    The specific abuse you mention, that your son was excluded from the services on the basis of your (and his?) choice not to use antipsychotics, is against the CRPD and I am glad to know that you won a decision from the Supreme Court in this regard. I would be interested to see the decision if you can provide a link (I can read the Spanish).

    A few possibilities for you to look into:

    Cindi Fisher does some great work connecting with parents in the US, she has some other demands on her time now but you may want to link up with her, as I think the challenges are not so different. This is her website: http://www.mentalhealthrightsyes.org.

    You might want to connect with ENUSP – European Network of (ex-) Users and Survivors of Psychiatry to find out whether there are good organizations and resources at the European level dealing with autism. I know of organizations of autistic people in France and Germany, and also Autistic Minority International which is based in Switzerland and advocates at the UN. If you cannot find these with a google search send me an email through this website and I will try to connect you.

    The CRPD Committee has been sensitized to the situation of autistic people, through the efforts of the organizations I’ve mentioned, and they are also sensitized to the issue of harm being done by psychiatric drugs.

    If you and your son do not succeed in getting satisfaction from the courts, you have the option of making an individual complaint under the CRPD optional protocol, which Spain has also ratified. You could submit the complaint on behalf of your son but you would need to have his consent or document why his consent should not be required. Given the standard in General Comment No 1 I would expect that the Committee would not accept the severity of your son’s disability as a reason to not require his consent, so this is a further encouragement to pay attention to his will and preferences in this respect as well as in other areas of life.

    One last possibility, is that I’m aware of a Hearing Voices group that put on the international Hearing Voices conference in Madrid this past year. Even if that is not an issue for your son, it could be a good group for you and your son to connect with as support for alternatives to the psychiatric medical model.

    All the best,

    Tina

  • Yes I absolutely agree we should start discussing in a semi-organized way what kinds of legal research and training are needed. I am hoping to organize something with other survivor lawyers as a place from which some of that could begin, or a place where it could be centered. And this would need to be open to collaboration with non-lawyer survivors interested in thinking about it together. There may well end up being many forums, but this is something I am hoping to do.

    All the best,

    Tina

  • I don’t understand your point. In fact, under constitutional law there is no distinction between the classifications of mental disability and physical disability. There is a high degree of discrimination against us, which is political and seeps into law but is not based on any rational legal distinction that can stand up to scrutiny. This seems to be the position you take also at the end of your comment, so we agree on that.

    You are saying that you would prefer to talk about people labeled as mentally ill being a suspect class without bringing disability. If that works, I have no problem with it. But what we have seen in the past is that the classification of mental illness itself is problematic – it operates as a negation of the person and imposition of a narrative on their experiences that is delegitimizing. Those of us working on this in the international movement so far have all chosen to use the disability framework as being more flexible and friendly to our interpretations and less wedded to the medical model and prejudice. This was certainly the case in the UN. The “Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care” of 1991 is in the procedural safeguards paradigm; although it’s not characterized as a non-discrimination instrument per se it does include provisions on non-discrimination – and they are all non-discrimination within a discriminatory framework that has us as deserving inferior rights. It’s possible that post-CRPD one could create laws explicitly dealing with non-discrimination based on “mental illness” or an equivalent classification that would actually be human rights based and do away with forced psychiatry and substitute decision-making. See my post on what CRPD compliant mental health legislation would look like, as a related hypothesis. I wrote that in response to repeated questions asking me in essence to plug the loophole, to see if there was a possibility that the CRPD standard of absolute prohibition could be met within the context of a mental health law. But since I wrote it, everyone who has commented on the subject in our movement has said that they think it’s better to work for national legislation that is comprehensive disability rights legislation and includes people with psychosocial disabilities, legal capacity reform, and abolition of forced psychiatry. I think this is for two reasons, it creates a larger constituency that is harder to marginalize and it situates our rights more clearly as part of a theoretical framework (legal theory and doctrine, legal philosophy, politics of non-discrimination) that is somewhat accepted.

    Reasonable accommodation, mainstreaming/ inclusion and participation, acceptance of diversity and not penalizing that diversity, autonomy meaning we get to have the final say while using as much support or as little support as we want, that is all hugely relevant to abolishing forced psychiatry and would be much harder outside the disability framework.

    All the best,

    Tina

  • Thanks for your response, BPD Transformation. Stay tuned re law reform, it will be a huge project to challenge the destructive politics in our country but even there I am hopeful that our vision can be seen and heard as another part of the progressive vision many movements are building now, like BlackLivesMatter, Idle No More, feminism, anti-hate of all kinds (e.g. support for Syrian refugees, rejecting bigotry).

    All the best,

    Tina

  • Hi Oldhead,

    With regard to feminism it is something I am developing as an aspect and area of my work, and I won’t debate it for the same reasons I don’t debate the abolition of forced psychiatry. I don’t debate my human rights. I advocate and fight for and defend these rights. My intellectual stance, my theory and practice is just not about debate. People who find debate useful should go ahead and do it; I have learned from hearing people debate an issue respectfully but I also see how quickly debate turns disrespectful, and it becomes exhausting to engage with it. I trust that my work will be useful or not on its own terms.

    I also want to clarify that I am not leaving work on the CRPD entirely, it’s a new phase for me but I am still involved at the international level in my personal capacity and through CHRUSP.

    With regard to survivor knowledge, there too I feel my best contribution is to speak my truths and find ways to work that I find effective. I am open to projects that other survivors initiate, and believe there is room for us all, and room to criticize each other’s work and disagree also on a principled basis, and still to work together beyond disagreements in a kind of principled pragmatism when that also is mutually agreeable. So yes, I expect to keep commenting, here and elsewhere.

    All the best,

    Tina

  • Hi Steve,

    The way I reconcile these issues is with the concept of “perceived impairment/disability.” This is recognized in the US ADA, in the WHO ICF “International Classification of Functioning” (although the ICF is hugely problematic in other ways, highly medical model in the way it describes the problems people might face in the mental realm, following DSM/ICD diagnoses from what a colleague says whose opinions I trust), in the Inter-American Convention on Elimination of Discrimination against People with Disabilities, and last but not least in the jurisprudence of the CRPD Committee although it is not in the CRPD itself.

    When I analyzed my own experience of forced psychiatry in the context of a law school human rights class (years ago before I worked on the CRPD), it seemed to me that there were three key components. One, analogous to rape, was forced drugging. I eventually formulated that as torture under human rights law, and I have been thinking recently about the close connections it has with actual rape in the sense of bodily autonomy and embodied personhood as I mention in my post, and will hope to address further in other papers. The s second component was something I conceptualized as poverty, it has to do with being treated as if you are worthless and do not merit getting your basic needs met in a dignified way. The emblematic experience was that they served us a mixture of coffee and tea that tasted vile, just because “some people like coffee and some people like tea.” We were not considered human enough to care about how our beverage tastes. The third component was the “on account of factor.” I had interned in the immigrant and refugee rights clinic and was thinking about the standard to find persecution for purposes of granting asylum, there had to be something about the person that they could not change or should not be forced to change, that somehow motivated the persecution. It seemed to me that in our case the “on account of factor” is disability. Somebody, multiple people, think that there is something wrong with us that warrants adverse treatment, and this something is not a group characteristic like race or sex but is supposed to be something that deviates from a supposed and desired norm at an individual level. With psychiatric labeling there is both a sense of fault and obliteration or obscuring of fault, because it is viewing the social and personal from a medicalized viewpoint. In any case, I think that disability is an accurate description or naming of both the reason for the persecution, and also the experiences that some of us have of not being able to fit in or to do all the things that we see others around us doing apparently with ease. So in that sense I think that the concept of disability should be able to reconcile those of us who just want to left alone, with those of us who want supports and accommodation of some kind. I don’t believe these experiences are contradictory or give rise to contradictory politics. In fact the CRPD Committee has adopted this approach of affirming both experiences in its General Comment No. 1 on Article 12 (legal capacity), saying that people have a right to support if they wish, but can also choose to claim only the right to have their legal capacity respected and refuse support. This of course is crucial for our movement.

    I hope this clarifies for you my reasoning and the background and context of how the concept of disability is used in the CRPD with respect to survivor experiences.

    All the best,

    Tina

  • I want to make a couple of comments. First, thank you for bringing this to MIA, or bringing out this dimension generally. I have lived a lot of the things you describe over a long period of time, and in ways that are integrated with my everyday life. For me, the situation of forced psychiatry itself was the final trigger to a death of self, but it took me decades of searching and healing to find meaning in and of the chaos. It is still happening but takes a different form. And the death was not completed then but also continued over time.

    Second, there are aspects of spiritual experience that cannot be discussed outside a particular context, and the privacies and separations involved in this need to be both respected and honored in some way. I do not find any psychology particularly useful, and I identify most closely with feminist lesbian practice as a self-declared witch. There is a politics to this as well as a simple separation, and I want the reality of female autonomy and separate healing/knowledge spaces to be part of the vision of the survivor movement(s) including in terms of how we deal with, and understand, spiritual experiences.

    All the best,

    Tina

  • I like your idea of a website “Psychics Against Psychiatry.” I knew that the haldol I was forced to take had left me with significant harm two decades later that remained unhealed. A healer trained in kinesiology doubted when I said this to him but agreed after he checked me energetically and treated me over several months in many ways that included nutritional advice that is still valid and useful for me today (another two decades later almost). I will post some about my own experiences in a reply to the main post.

    Tina

  • Hi Sera,

    What you describe is right on target, and I have written about some of the same things. Yet the solutions you promote are not dealing with misogyny per se but rather ethical behavior in general. I venture to say that while those are all good ideas, they are not going to address male privilege. In fact, it’s likely to be women who take in the message that they need to examine their own behavior – that is part of misogyny and female socialization, to be accustomed to thinking we are the problem, it’s ok for others to judge us and means we should change, but not ok for us to judge others – especially men – and insist that they need to change.

    There are specifics to dealing with any kind of oppression, and women in particular need to claim for ourselves the right, ability, and power to name male oppression when we see it and not to back down in the face of criticism and judgment – you’re not nice, you’re drawing attention to yourself, you’re uncool, why are you focusing on only women, you’re a “TERF”, etc. Feminism is reviving its anger, and part of this is due to things happening around the Michigan Womyn’s Music Festival and the awareness of a need for female-only spaces and female autonomy to do whatever we damn please with it.

    I am sure there will be negative comments to me, as female-only space is under attack from transgender activists, who also attack women’s freedom of speech when we dare to say that female reality can’t be trampled under males’ gender identities. That’s part of what it means to be a feminist nowadays and I won’t let it stop me from speaking. I hope that women wake up in our movement and everywhere and deal with all the misogyny by coming together, supporting each other, withdrawing our labor from men and organizations when we find ourselves being exploited, not being afraid to claim female-only space and create it as much as we wish.

    All the best,

    Tina

  • Terry Lynch and all who are doing the tireless work of debunking psychiatry’s disinformation need to be honored, and called upon as resources for the dismantling of psychiatry as a control and abuse system (i.e. enforced by state power). I see a close relationship between the denial and aggressive promotion of disinformation that is part of the medical model, the pathologizing of human suffering as being something defective in the person, and the violence psychiatry uses to get its point across and make people into the zombies they would rather deal with.

    Thanks Jim and Mary for your own tireless work in Ireland and internationally.

    All the best,

    Tina

  • Yes, I think it is a disaster that the Rules segregate our people with unequal standards. It is an ongoing struggle and many people’s thinking is still changing now; the fact that they are not saying specifically that anything involuntary is ok, means that there is room to argue as I suggested, for a CRPD-consistent interpretation. It’s hard to pick all this apart and to maintain an ability to see it clearly while feeling both disappointed and also cautiously hopeful that if the word gets out about how to read these new Rules together with CRPD, we can get closer to what we want, at least a prohibition of involuntary treatment and transfers to mental health settings. I don’t think I mentioned, but has to be read in conjunction with CRPD Article 12 and General Comment No. 1 on the question of legal capacity, because they are likely to try and justify forced treatment on the basis of psychiatrists’ judgment that a person lacks decision-making capacity; CRPD says that is prohibited and everyone has the right to make their own decisions; support and any attempt to provide support has to respect the person’s will and preferences.

  • I agree about diagnosis. I think that there is a gender dimension in this as well; even for physical health problems it is common for doctors to ignore self-reported, self-described complaints of women and to channel everything we subjectively experience as a problem into a labeling that justifies them “fixing” us by changing us in some way. In other words they tell us we are the problem, and advertising and sexual harassment and invasions of privacy and put-downs of various kinds keep telling us there’s something wrong with us. Also the same things, plus direct gaslightling by abusers, tells us not to trust our own perceptions of danger and wrongness, and to appease everyone else rather than become aware of our own needs, our own power to meet our needs, and our own responsibilities from an internal rather than external standpoint.

    Thanks again for sharing your reflections and experience.

    Tina

  • Hi Julie,

    Yes, female as well as male therapists commit acts of abuse and violence. For women, being abused by another woman can feel even more intimate as a violation.

    And an added point to what I said in response to Ben’s comment, talking about feminism as a source for my theory against psychiatric oppression does not mean that I have a reductionist view that psychiatric abuse is only done by men against women. Far from it.

    Tina

  • Hi Ben,

    There is a lot to respond to here.

    1. Feminism addresses the systemic oppression by men of women. What I am calling lesbian-feminism is not the same as queer/feminist theory. It is theory and practice grounded in the lives of lesbians in particular. In my thought and experience, and the way I understand some of the writers that I am familiar with also, lesbian existence is relevant for feminism as a whole because it centers the notion of female autonomy. This is captured in the slogan “A woman like a man is like a fish without a bicycle.” Patriarchy pays attention to women only as they might be serving, not serving, inconvenient to, etc., men. Female autonomy is central to achieving liberation from oppression for all women, but lesbian existence is both an affirmation (and inspiration) that such autonomy is possible, and a life that gives us relevant experiences and perspectives to develop what it means to live a life that can be centered as female. Lesbian-feminists are feminist lesbians who are conscious of this relevance.

    2. Judith Butler takes an individualistic view that treats gender as equally oppressive of males and of females, and I disagree with that position. I place myself generally with gender-critical feminism and radical feminism, which defines gender as a system of oppression by males of females, an imposed construct, rather than a performance based on individual identities. The sense in which I use “performative” is social and legal, similar to the way a contract is performative – if I say, I offer to fix your bicycle for $20 and you say “it’s a deal” you are not just describing something, you create a legal relationship with your words.

    3. I think the question of individual females abusing individual males needs to be addressed as intersectional oppression, with analysis of both the gender dimension and sources of institutional power in which individual women may partake. A female psychiatrist, or psychiatric nurse or case manager, is wielding institutional power over both males and females, and this can complicate the experience of female as well as male survivors, because we all expect men rather than women to be in those roles of power and we want to believe that women will do things differently. But we have to take care not to make the outrage be, “how dare she as a woman do this to me?” She is not exercising institutionalized women’s power but rather wielding it in a system that was created predominantly by men in a context that has a lot to do with men’s systemic oppression of women.

    White survivors may face similar experiences when people of color are in the roles of psychiatrist and other wielders of institutional power. We have to separate our own racism and sexism from our outrage at having been abused.

    4. A little clarity about my work, which you have mentioned supportively. It is not only that I play a role in conveying and keeping track of what UN actors have said; I have been a key figure myself in the development of the UN norms and their ongoing interpretation. It is important to claim this in part because, as a female as well as a grass-roots lawyer and survivor of psychiatric abuse, my contributions of that nature sometimes go unacknowledged.

    All the best,

    Tina

  • What a horrible thing to do to a girl, as well as just repressive of any child’s natural genius.

    The incidents of abuse pile up and up, I suppose the useful thing to do would be to get serious about compiling them into a database and issuing periodic human rights reports. I hear some survivors may be doing this at local or national level in a few places, would love to see it happening in the US. (And for these initiatives to connect with each other, and to use the materials in UN reporting and related advocacy.)

    Tina

  • That is really sad to hear about. When I was locked up I was frightened of being put in a state institution and never getting out. There are many survivors in our movement who have survived the state institutions, and the worst kinds of abuse in isolation rooms and restraints, and I have learned that we can’t lose hope for anybody.

    Do you know about the Hearing Voices Network? Their work is phenomenal both to support voice hearers and to educate the public that you don’t need to be afraid of hearing voices, there are many ways to understand this phenomenon and to work with the voices.

    I hope that the woman who is still institutionalized can learn about our movement and see if it is useful to her somehow.

    Tina

  • I wish you success in your lawsuits, my legal work is only on international human rights.

    Lawsuits are one way to seek reparations, and can also help to educate judges and the public about human rights and about legal theories based on non-discrimination and full equality. If you find any good lawyers, and if they are interested in bringing in human rights standards and/or legal theories, I would love to talk with them.

    Tina

  • I think it may be relevant to look at the kinds of injuries I am describing, as well as the kind and severity of ongoing oppression, in relation to our inability to mobilize civil disobedience. Putting ourselves in a situation where we will be under the control of state authorities who might use their power to put us back in the same system of abuse and torture, is daunting. It can even be an act of self-affirmation to refuse to do that just to prove a point, to refuse to expose oneself to their violence.

    Yet I think if a few people start it could be possible for more to join in, so long as there is a reason for the CD beyond the abstract idea of it. Aubrey Shomo’s acts of resistance are showing us that it’s possible to fight back using good strategy and to win. We can’t extrapolate exactly from anything to anything else, but that’s a start.

    And I welcome your decision for anti-psychiatry and demand for full civil rights, government for and by the people and to see the “elites” brought to justice. We do have the power to speak out and to fight back, having a vision of what we want when we are doing that gives us a focus which is itself powerful.

    Tina

  • Thanks for that, B. I admire those who resisted. When I was locked up, my inspiration was a woman there who kept her own clothes, very hippie-looking, rather than put on the degrading “hospital gowns” that opened either in the back or the front. And she refused to take drugs. She wrote poetry in a notebook she kept, she was from Israel and I remembered her talking to her little father in Yiddish. Eventually they put her in a straitjacket and injected her. I was transferred from that place soon after so I don’t know how anything turned out for her. But a very brief connection with this woman, whose name was Shoshanna, was one of the things that helped keep me going.

    Tina

  • I hope that those who continue to expose psychiatry’s institutional corruption both internally and of our state institutions (I want to say democratic institutions, but democracy has been a facade for some time) will be successful in undermining it’s hold on the public imagination and public policy.

    One thing I would add to your analysis, which is a little jarring to me from a human rights point of view. It’s not only that Murphy’s bill will introduce human rights violations – it’s that it will worsen existing human rights violations. Each and every instance of forced psychiatry that is going on under current laws is a human rights violation, and these laws have to be repealed or nullified, or simply discontinued in practice. We have to set the bar as high as we are fighting for – which is nothing less than the full abolition of all forced, coerced, deceptive and harmful psychiatry.

    There are potential strategies that can be worked on even in the US. I hope to come back and pursue these when I’m done with my studies.

  • Dear Someone Else,

    Thanks as always for commenting on my post.

    I agree with you that there are not good prospects for reparations. Right now it appears that the only revolutions that are allowed to truly succeed are those that can be assimilated into global monopoly-capitalist patriarchy to make the populations more governable. It is a bleak assessment and a bleak reality. I sometimes view what I do as preparing the groundwork, along with so many others, for what can come after, at a time when human beings may be more ready for being, I want to say, fully human in the sense of being aware of responsibilities for self and to others in ways that can let us live in greater harmony.

    It does seem to me that psychiatry as an industry of social control allied to the security state is strong, given the alliance of corporate rule to the security state in general, which is reducing the scope for citizenship and democracy (citizenship in the sense of responsiveness/taking responsibility for the well-being of the community, and democracy in the sense of collective decision-making; not citizenship in the nationalism sense or democracy in the ideological sense). It will be interesting to see where the critiques by Whitaker, Gøtsche and others will go, how far, and whether the CRPD requirements to abolish incapacity, commitment and forced interventions will be actually implemented anywhere. I have hopes still for what can happen in places where psychiatry does not have such a stranglehold as in the US, and in the US itself possibly hopes for changes at the local level based on strong community organizing and incorporating CRPD human rights concepts and principles.

    As for gaslighting, I agree that this is a big part of what psychiatry does, and also a big part of the way that people purporting to be our allies in the human rights field at times claim to agree with us but actually in the fine print are still allowing for forced psychiatry to continue – not saying emphatically it has to stop now, and taking action to make that happen. Some of it is actual constraints but a great deal is accommodation to what people are being told is the right way to do things, to go slow, not antagonize too much, etc. And then they don’t want to outright disappoint us but they are not coming all the way.

    What you say about corporate personhood, and the severing of the link between spirituality and law, is interesting. I have thought about the link between on the one hand granting personhood to fictional legal entities, and on the other denying it to human beings (legal incapacity, and forced treatment/commitment which is in part also a denial of legal capacity). It would be interesting to address this aspect of psychiatric abuse in some way, someone could do it graphically.

    Thanks again for your comments, it helps to think together and maybe we will find better ways to fight back and win.

    Tina

  • David,

    I started to reply to you but internet wasn’t working and reply got lost in the ether.

    It looks like you are commenting on the article that I linked in my post, rather than on the content of my post itself.

    For me, spirituality is not something that belongs to any religion, any philosophical perspective or any discipline or practice. It is as accessible to any of us, as the air we breathe. Feminism promoted this insight for example in Robin Morgan (I think) ‘s classic saying, any woman can be a witch. All she has to do is say, I am a witch, I am a witch, I am a witch. It has to do with an intentional openness and exploration, it is inside each of us.

    Mindfulness, as you point out, does not necessarily imply spirituality, but it is one way of getting there.

    And spirituality is not so far away from healing. For myself, I had a dual practice for a while, focusing on healing and also on exploring spirituality. After a certain point they merged. This is a similar theme I have found repeated in my life, that I start something new that is separate from other things I’m doing, and eventually I find that it has a point of convergence or merges into a larger pattern.

    That is actually what I am finding now with the links between spiritual and legal responsibility. It is complex and not resolved, but certainly interesting to explore.

    All the best,

    Tina

  • Replying to the reply of theinarticulatepoet below (because this website limits the threaded comment back and forth, apparently):

    Your comments are a reminder of the two potential ways to define what a mental health law is, that I was alluding to but didn’t bring out clearly enough.

    One is “Mental Health Acts” that authorize and regulate and provide for so-called procedural safeguards on commitment and forced treatment, and sometimes guardianship. This is clearly contrary to the CRPD and such legal provisions need to be repealed – not reformed.

    The other is simply the concept of legislation in the field of mental health services. It is better I think to say legislation regarding the services, than legislation regarding “mental health” – nobody’s mental health (experienced or alleged) should be the basis of legislation; as is said about reproductive rights, “Keep your laws off my body.” In the sense of legislation with regard to mental health services, I think it’s possible to have a mental health legislation that prohibits rather than permits forced treatment and detention, and sets out new policies and guidelines following from this principle and from the shift away from medical model. The question would be, whether the very concept of a mental health legislation would evoke for too many people involved the old paradigm of coercion and control, and whether they would be able to separate this definition from the other one.

    So with that in mind – if a mental health law could be devised that prohibits forced treatment and detention, etc., as I laid out in the original post – do you think it would be desirable? Or, do you think that it will just not be possible to make this distinction and people will misunderstand the intent and think we are about reforming rather than abolishing psychiatric commitment and forced treatment?

    With respect to civil and criminal laws needing to be changed to deal with situations now addressed in mental health law – what do you mean? In my view (and as I understand the CRPD), situations of conflict and potential need for support involving people with (experienced or alleged) psychosocial disability need to be dealt with in non-discriminatory fashion, including respect for the person’s legal capacity to make decisions. Support has to be offered and provided in a way that respects the person’s autonomy and choices. What need do you see for particular changes in other areas of law?

    I don’t suppose that this website will let you reply underneath me but maybe you can do as I did and reply above, if you want to continue discussion.

  • That’s exactly my approach from the beginning, rules and laws are created by humans and can be changed by humans. I did have many moments of contemplating how big a change could be brought about by what we were creating in the CRPD and checking every angle to make sure I was satisfied no one was going to get hurt in the process, if it is done the way we envisioned. Thanks for your thoughts.

  • Yes, there is a need to change both law and practice. Use of restraints – chemical and physical – is something that can be prohibited by law also, if it was possible to get the political will to make that kind of change. I know the real problem is political will.

    My aim in writing this post was 1) to say to those who think that there’s a need for some mental health legislation but may not understand completely what mental health legislation has been or what it might be, ok, if you want to legislate in the mental health field here’s something useful you can do. And 2) to say to those who want to use the concept of CRPD-compliant mental health legislation as window dressing for creating what is really CRPD-non-compliant legislation, no, if you are using this concept here are some parameters of what it has to mean. It won’t create political will if there is really none, but if there is a political will to do something and there is room for advocacy about what exactly will be done, that is the value of such a proposal.

    The CRPD Concluding Observations on Denmark said that Denmark’s Psychiatric Act violated the right to liberty and security of the person, and that the government should take measures including revision of this Act to ensure that people with disabilities enjoy this right. So you have an opening to push as a first step for a process of review, that should prominently include the psychiatric survivor community.

    I am aware of problems in Denmark that make this kind of advocacy difficult, and certainly in the US we are not there either. But I see it as a global struggle and am interested in any advance that could happen in a country where there is a review process going on and there is some potential for movement.

  • And Murphy’s legislation is of course the conventional kind of mental health law that is a tool of oppression. Do you think that even talking about a CRPD-compliant mental health law opens the door to people thinking that we can compromise? Or do you think it would be at all interesting to say to those who think the mh system and its laws are broken and need to be fixed, not “here’s a compromise where we agree to give up some of our rights but not all” but instead “here’s our vision, it can be put in the form of a law also”.

  • Nancy, thanks for commenting. Would you care to provide a link to your article? I would be interested and other readers of this post might be also.

    I would love to have ways to get together and work on how we can implement restorative justice/rights of redress for survivors of psychiatric torture. It’s a movement whose time has come.

  • Yes. Our movement has been saying it’s torture since before the 10th International Conference Principles – and we’d know it’s torture even if there was no official recognition anywhere.

    The Committee on the Rights of Persons with Disabilities is the most important official body that can start to act on these claims. While the US hasn’t ratified yet, 152 other countries have, and many have also ratified the Optional Protocol, which allows individuals to make complaints that the Committee adjudicates. They don’t have a marshall to enforce their decision but it can be a very significant step if they would direct that a country is obligated to make holistic reparations to people harmed by forced psychiatry.

    MIA readers in countries outside the US should consult this table of ratifications – http://www.un.org/disabilities/countries.asp?id=166 – and check especially the last column which shows if a country has ratified the Optional Protocol. If it has, you could have a good strategy in getting people together to bring a complaint. Contact me through MIA website if you do anything like this so those of us active at international level can advise and support.

  • We are devastated in so many ways. Honoring ourselves for surviving, is also part of what I call self-reparations.

    I’m trying to plan either a webinar, or series of webinars, and/or next blog post, that would help to carry the discussion forward to what we all might do, beyond what’s suggested briefly here.

  • I think it’s not only law but politics. Law is made by human beings; it works according to certain rules and principles, but it is malleable and provides for changes – e.g. not only by court cases in our system but also by legislation, and even constitutional amendment though we know how hard that is.

    Last night on Lauren Tenney’s radio show, Sarah Knutson and I were having some of this discussion about what could be possible using our US legal system, and I have also talked about this in some of my presentations over the past year. Maybe it is time for a dedicated slot to look at all the ways we can use human rights law and mechanisms creatively given our legal system that doesn’t allow it much scope. I will think about doing that sometime soon.