Three crucially important words: Against Medical Advice

Here are some thoughts from TTWS reader Lisa, about her experience with psychiatric treatment and commitment. In response to some emails I'm getting, I'm NOT ON ANY SIDE on this one. I want to present different stories and let people make up their own minds. I have written variously on this subject -- from being an advocate for more stringent involuntary commitment criteria to being an advocate for the reverse. I have a lot of feelings on the subject, most of them complex. I'm not pro or anti anything.
I think the problem is that sometimes the treatment itself causes more harm. Medication didn't have a lot of utility for me, in fact it made me worse. The more meds they added to my cocktail, the worse my depression got. The repeated hospitalizations left me more and more despondent.Leaving the hospital AMA was one of the best decisions I ever made, and thank god the laws were such that I could do that. Thank goodness I could make the decision to stop seeing my psychiatrist and stop taking my meds. Because for me, treatment was a disaster. While under psychiatric care, I went from receiving academic awards in grad school, to dropping out. I became a revolving door mental patient, in and out of the psych hospital. Getting away from psychiatric care was the right decision for me. I am five yrs med free and psychiatrist free. I am employed full time. I still struggle with depression from time to time (which is what led me to a psychiatrist in the first place), but it is manageable. What would have happened to me if the laws had been different? What would have happened to me if I was prevented from telling my psychiatrist, "Adios."
And this comes from Alyson:
It isn't prison or hospital. TAC keeps saying that but it doesn't make it true. It would take over 300 people being force treated or euphemistically "AOT"'d to prevent one arrest for a non-violent crime according to a very reputable study by the Cochran research group, hardly a radical group. So are we prepared to have more than 300 people force drugged to prevent one arrest for a non-violent offense?TAC's other argument is that people are sick, they need help. Well, yeah, all kinds of people are sick and need help and a lot of them don't get help because it isn't available, they aren't insured, or they have been so abused in the past that they are afraid of asking for help again.
What about all the people with medical illnesses out there who are non-compliant? I don't buy into the theory that someone who risks amputation or death by not taking care of his or her diabetes is making a rational, competent decision while someone who decides not to take neuroleptics is clearly making an irrational, incompetent decision.
I have kidney failure. I'm lucky enough to be off dialysis for now, but in the future it will be my choice whether to be on it or not. If I decide to die like Art Buchwald (I won't but hypothetically), the state can't do a thing about it nor can my doctor. But if someone says I'm psychotic and deteriorating and not going to die, the state and a doctor can force me to take drugs? How does this make any sense at all. I am the same person in both instances.


Comments
Let me state right at the outset that I am against forced treatment of supposed "mental illness". I am against it vehemently and unequivocally. First it's a matter of human rights. The Universal Declaration of human rights contains these tenets that are violated by forced treatment:
3. The right to life. We all have the right to life, and to live in freedom and safety.
4. Slavery – past and present. Nobody has any right to make us a slave. We cannot make anyone our slave.
5. Torture. Nobody has any right to hurt us or to torture us.
6. We all have the same right to use the law. I am a person just like you!
7. We are all protected by the law. The law is the same for everyone. It must treat us all fairly.
Those who are deemed "mentally ill" are not treated fairly. They are denied their right to make decisions for their own lives.
And what this really is amounts to slavery. Those that can be labeled "mentally ill", and there is never proof of a mental illness beyond the subjective opinion of a psychiatrist, can be placed by forced treatment into the service of the psycho-pharmaceutical industry as a cash cow, so to speak.
If someone commits a crime, they get to go to jail for it. To do anything else just leads the society into chaos and violates the human rights of the criminals and the rest of society.
And the next issue is whether or not drugs, shocks and all the other brutal, damaging treatments of psychiatry actually work. We can carry on that debate indefinitely because what "works" means is not very clear. In asylums of old, heavy, brutal treatment and drugs made patients quiet. Well, beaten and poisoned into apathy might be a quiet condition but it's never a healthy condition. Drugs are just peachy for covering up symptoms and making a person act the way you want them to act, in the short term. In the long term, they kill you, quickly or slowly. Go talk with someone whose been on a psych drug for years. If you can't stomach that, go to www.mindfreedom.org
Posted by: Doyle Mills | October 2, 2007 08:22 AM
A fascinating fact that is left out of almost all debates on forced outpatient psychiatric care, is that the typical procedure we are discussing is forced neuroleptic psychiatric drugs, also known as anti-psychotics. Mainstream media have almost entirely ignored a fact that is now well-established in the medical literature in the past 10 years: Long-term high-dose use of neuroleptics can cause brain SHRINKAGE. I'm not exaggerating. That's what the researchers call it themselves. For instance, a monkey study shows brain shrinakge after two years of use of about 8 to 11 percent! Those very interested can go our web site at www.mindfreedom.org. Go to 'knowledge base' then 'psychiatric drugs' then 'neuroleptics' and look for the folder on brain damage. You have to see that monkey study, it's well written, but there are dozens of other studies: brain scans, autopsies, and other animal studies. Democracy needs to get hands on with the mental health system, because obviously corporate media and psychiatry have failed, horribly failed. Again, I'm pro-choice: Many of the members of our non-profit CHOOSE to take neuroleptics, despite knowing the risks. But when it comes to forced neuroleptics, it's in the same class as psychosurgery. There are proven non-drug alternatives that are hardly ever offered, unless one lives in Finland. And meanwhile... World Health Organization shows your best chance of FULL recovery from these problems is to live in poorer countries with LESS access to the psychiatric drugs. This issue is complex. It's more than about the 5 percent or so who are labeled as "seriously' mentally ill. This is about society, about humanity... And it's this debate amounts to debating forced psychosurgery to the higher level part of the brain for thousands upon thousands of people. Yeah, that's startling. But in a society that claims to love science, they ought to crunch the numbers, look at the data, and see the "inconvenient truth" staring us in the face in the mental health system.
Posted by: David W. Oaks | October 2, 2007 11:50 AM
Regarding Lisa's decision not to be medicated for depression: One of the most important things that I gained from volunteering on a project with NAMI was a better appreciation for the relationship between spiritality/religion and recovery. While many clergy may be ignorant and ill-equipped to handle mental health problems (and even cause/feed illness), a positive religious community may be tremendous help for patient and family. In fact one of the things that religion sometimes offers is that critical community support. Perhaps the one-to-one doctor-patient relationship--especially with hospitalization--can sometimes be dangerously isolating, therefore undermining clinical intervention.
Posted by: Ayana Duckett | October 2, 2007 01:47 PM
The financial incentive behind forced treatment can never be emphasized too much. The careers of many people depend on government and insurance payments they get for "treating" people who don't want to be treated - and they get paid just as well no matter what damage their treatments do. They fight tooth and nail for the perpetration and expansion of forced treatment because their careers - sometimes very comfortable and lucrative careers - depend on it. The religious-like zeal with which these monsters agitate for the expansion of forced treatment throughout the United States reminds me of what I have read about the zeal of early nineteenth century slaveholders to expand the number of states that permitted slavery. As Doyle says, they see those of us with psychiatric labels as little more than a potential cash cow.
Posted by: Kent | October 3, 2007 12:30 AM
Dear Liz,
It happened to me once again while reading your website and one of the comments. I spilled my drink while nearly choking on what I’ve just read. I’m sorry but it’s not about pro or con, it is about the truth. I seem to remember reading a statement previously along those lines on your blog site. Maybe you can remember the exact quote and post it again.
“Again, I'm pro-choice: Many of the members of our non-profit CHOOSE to take neuroleptics, despite knowing the risks.” --- David W. Oaks
Is the fact that Mr. David Oaks is “pro-choice” in this instance because it’s “Many of the members of our non-profit…?” Does one have to be a member of his group to be allowed “pro-choice?”
I guess this same “pro-choice” attitude of his doesn’t also apply to ECT. He’d rather advocate for banning the therapy despite the fact there are individuals who benefit from the therapy and hopefully were informed, un-coerced and knowledgeable of the risks.
Something bothers me about folks who speak with forked tongues and bandy about alarmist PR and media type sensationalism through the use of inaccurate terms such as “psychosurgery” in this instance. The use of drugs is not surgery.
While Mr. Oaks is sharing monkey brain studies and shrinkage I’ll share some ECT information by way of Dr. Yvette Sheline demonstrating neurogenesis.
How’s about I create a new media term like “social-psychosurgery” as in a patient having a serious mood disorder that withdraws and cuts themselves out from daily functioning as well as life. Is this not a similar “psychosurgery” that Mr. Oaks is alluding to? Are they not entitled through whatever means they choose to achieve wellness without others calling for the banning of their chosen treatment option? Contrary to some of Mr. Oaks’ thoughts I don’t know about Democracy needing “to get hands on with the mental health system.” What I see needed is more funding instead of cut backs to improve patient access to the health care of his/her choice. I see the need for greater funding for research into mood disorders and the science of the brain. I also see the need for caring, compassionate and qualified professionals who truly give a damn about the wellbeing of this seriously ill population of patients. I could go on but why bore anyone.
Platitudes and slogans simply don’t cut it for me such as “because obviously corporate media and psychiatry have failed, horribly failed.” I don’t know what Mr. Oaks is talking about when referring to “corporate media” but I can firmly state “psychiatry” has helped and benefited not only my spouse but me too as her support person and care giver over these past 7 years after struggling some 37 years. Maybe Mr. Oaks should speak from his own personally experiences and not generalize what he thinks or believes are the experiences, wants or needs of others.
Unlike Mr. Oaks I advocate for the education of the patient and his/her loved ones and encourage hope and persistence. I am for informed and un-coerced medical decisions in collaboration with one’s trusted, caring, knowledgeable and licensed health care professional. I am also for all treatment options that can potentially benefit the patient in relative safety. I am not for abrogating the rights of individuals to make medical choices or to have access to those choices.
Hmmm…”"inconvenient truth," now that’s another good one. I didn’t know there is a need for adjectives to be affix to the “truth”. I thought the “truth” is the “truth” or is it Mr. Oaks’ “truth” that he’s discussing? Is there such a thing as the “good truth?” Maybe in Mr. Oaks’ commentary I should properly refer to his commentary as the “convenient truth” but then again the “truth” is I have differences with one or two of his and his associates advocacies and positions.
Warmly,
Herb
VNSdepression.com
Posted by: Herb | October 3, 2007 12:44 AM
My brother is currently being treated involuntarily at Princeton House. I want my brother to be able to choose what is best for himself, but currently he is unable to do so. My brother is 42 and has had a long history of psychiatric problems and incarcerations. His newest free flowing idea is to entice a police officer into shooting him. I would be an irresponsible sibling if I didn't fight to keep my brother hospitalized. Last week he followed students at Rutgers stating on the telephone that he wanted to make Headlines! The nature of the headline he spoke of would make anyone sick! The week before he was going to jump off the Victory Bridge, and I cant tell you how many times he threatened to kill my mother who has been the one supporting him all his life. There comes a time when families have the right to choose what is best for a family member. We know him best! It took a long time for my mother to even push for short term hospitalization. If left unchecked, my brother will hurt an unsuspecting individual and as of lately has become increasingly more graphic with his thoughts and ideas. We know what he is capable of and therefore, together as a family are fighting to keep him in treatment. Most days he is happy to be there and can even carry on a conversation appearing "normal" but on the days he wants out, those are the times that I am thankful he is not allowed to make that decision. Those are the days I make sure my mom is far away from him because I know ultimately one day he will try to kill her again. The brother I knew died many years ago with a tramatic head injury during a car accident at 17. What remains is hope that he may one day return. For now, caging the animal is the most humane regardless of what anyone says,,,,,if you could only have lived through what we as a family have, you might be able to see things from our point of view.
Posted by: cyndeelouwho | October 9, 2007 03:05 PM
Here's a link to an abstract of the monkey study which David referred to in his comment:
http://www.nature.com/npp/journal/v30/n9/abs/1300710a.html
Regarding ECT, two or three months ago I phoned in to the weekly MindFreedom radio news program and asked about whether or not ECT should be banned. In answering that question, David Oaks compared his position on that to what he feels about astrology - namely that he doesn't think it has any value, but if someone wants to pursue the study of astrology in their living room he doesn't want to waste his time trying to stop them. He said he would be interested in creating laws that would prohibit the forced use of ECT on anyone but still allow it for those who make an informed decision that they really want it.
It seems like it might be relevant to paste the definition of "Straw Man" here - according to Wikipedia:
"A straw man argument is an informal fallacy based on misrepresentation of an opponent's position. To "set up a straw man" or "set up a straw man argument" is to create a position that is easy to refute, then attribute that position to the opponent. The position can be oversimplified, overstated, or else distorted. A straw man argument can be a successful rhetorical technique (that is, it may succeed in persuading people) but it is in fact a misleading fallacy, because the opponent's actual argument has not been refuted."
Posted by: Kent | October 9, 2007 10:16 PM
Dear Kent,
I just happened upon your posting and I’m sitting here laughing. It seems you and I have both participated on Mr. Oaks’ radio program and have come away with somewhat similar opinions of his presentations although I’ve also saved the program to share with my readership.
I’d thought I share the same with you and anyone else having any interest in differences of opinion. My whole commentary and the radio program are contained in the below listed link:
http://vnsdepression.com/forum/viewtopic.php?t=446
Warmly,
Herb
VNSdepression.com
Posted by: Herb | October 12, 2007 04:22 AM