Updated March 13, 2025
Recently, I’ve come across several groups on Facebook and elsewhere that claim to be for the rights of the mentally ill. They talk about defending their rights through lawsuits and online campaigns. They also support the banning of a doctor’s rights to give psychotropic medication/psychiatric treatment without consent. These are either well-intentioned people with little grasp of logic or no experience with those with serious mental illness or just plain antipsychiatry nutjobs.
I admit I fell for one of these groups at first glance. But upon further reflection and research I’ve come to the conclusion that these people don’t have a leg to stand on.
Doctors Give Medical Treatment Without Consent All the Time
Consider this, if a person comes into the emergency room unconscious, the doctors do whatever it takes to save that person’s life. No matter what has happened to them, or what their diagnosis might be, the doctors try to save them. The patient cannot give consent. They are unconscious. This treatment might, in fact, kill the person, but the doctors try their best even though the person is not able to give consent at that time. (There are legal exceptions to this like a do not resuscitate order, but those are the rare exceptions.) Doctors make hard decisions. They do it all the time. It’s their job.
Doctors do this because it’s their job to do what is in the patient’s best interest to the best of their abilities. That’s why we have doctors. We have them because these people know how to make complicated, medical decisions that we can’t make ourselves. They went to a decade (or more) of school for just this reason.
Why Shouldn’t a Doctor Care for the Mentally Ill the Same Way?
Now consider the following, a person is brought into the emergency room, probably by the police, in a psychotic episode. This person might have been running around naked, or screaming into the air, or otherwise behaving erratically, possibly dangerously, and clearly unwell. This person does not have the ability to give consent to medical treatment. Their brain is currently not their own. They are a danger to themselves, and possibly others. (That is how they ended up in the emergency room in the first place. If they weren’t a threat, they wouldn’t be there.) The patient is screaming not to give them medication in between threatening the ceiling tiles.
If a Mentally Ill Person Can’t Give Consent, the Doctor Has Only 3 Options
Theoretically, the doctor has three options.
- The doctor releases the patient. The patient doesn’t want treatment, so they are released. The person, though, is possibly a danger to themselves or others, so the police may have to act — not good for the mentally ill person. Even if the police don’t, the person can easily do any number of horrible things before they come out of their psychotic episode. The person might die. The person might hurt someone else. Believe it or not, many doctors care about that stuff.
- The doctor can put the person in a padded room and leave them there until they come out of their psychotic state. This would likely be without their consent too, but doesn’t involve any type of “treatment” per se. But how long is reasonable to leave a person restrained or in a padded room? What are doctors supposed to do with that person? Healthcare workers are supposed to somehow attend to the person’s needs like for food, water, and going to the bathroom all while the person is tied to a bed, or in a cell-like room? That sounds ridiculous, impossibly difficult for healthcare staff, and not particularly humane.
- The doctor can treat the person. Yes, this means medication. Probably a fairly heavy antipsychotic to calm the person down so they aren’t a danger to anyone around them and to bring them out of the psychosis.
Are you really suggesting that one or two is better than three?
Not Medicating People Without Consent Only Sounds Like a Good Idea
See, not medicating people without consent sounds like a good idea, but in the real world, it just doesn’t work. It doesn’t work because we don’t have any better ideas. If it were simply a matter of blinking them into safe sanity I would be all for it, but so far we haven’t developed genie technology. No one likes the idea of medicating someone against their will. But mental illness is hard. Many times, there are no other options.
I agree that once a person is stabilized and can once again appreciate their situation, they can choose not to consent to further treatment. I’m not suggesting they be medicated forever. And quite frankly, if the person were to never leave their house and never hurt themselves or others, they could be as psychotic as they liked with no bother from me or anyone else. But when you show up in an emergency room insistent on killing yourself or threatening to stab the blue men sitting on your shoulders, something has to be done. If there wasn’t a serious problem you wouldn’t be in the emergency room in the first place.
No one likes to have anything done against their will, I get that. Me neither. But just like you might be in a horrible accident only to wake up and find your arm amputated out of medical necessity, you also might find that after losing touch with reality you wake up to find yourself medicated. This is a bad solution, but again, I’m not hearing any better ideas. No one wanted to amputate an arm, and no one wanted to medicate the person either.
[There is this sneaky belief that doctors want to medicate their patients. That they take secret pleasure in forcing colored tablets down a person’s throat or injecting them with a substance. I don’t believe this to be true. While there’s certainly no accounting for everyone, I don’t think anyone is satisfied with that solution; it’s just that we don’t have a better one.]
So Yes, It’s Stupid to Think that Doctors Shouldn’t Be Able to Medicate You Without Consent
That is their job, in the case of mental illness and in the case of any illness. So, the next time someone spouts off against the evil doctors prescribing evil medications I suggest you ask that person what they want the doctor to do after they have a heart attack and their heart has stopped. I mean, you wouldn’t want hundreds of joules of electricity to be pumped into your chest without prior consent; that would just be inhumane.
[This argument, by the way, completely glosses over all the legal ramifications of consent, which I did on purpose, as I’m not a lawyer. I will say, though, that medicating a person without consent isn’t as easy as suggested above, particularly when lawyers take an interest.]
People should NOT be medicated with ANTIPSYCHOTICS against their will. [moderated]
It’s not a question of whether or not people with psychosis should receive involuntary treatment during an acute episode- it’s a question of ensuring people receive treatment with the right medication, or if this is not possible [moderated] then patients should not be involuntarily treated.
As someone with schizophrenia who has suffered from countless episodes of psychosis, and who is currently being subjected to involuntary outpatient “treatment” with antipsychotics, my strong preference is to be treated with CBD and benzodiazepines but if I had to choose between antipsychotics and no treatment then I’d much prefer no treatment. And this is despite the fact that psychosis is an extreme form of torment.
I do get how distressing it is to not have my needs and preferences considered as a mental health patient. However, that’s wildly different from when a doctor is deciding whether or not to treat me without my consent. Where I live, this only happens when a person is a danger to themselves and it’s very difficult to get admitted to any hospital for other psychiatric reasons.
Personally, I don’t see how this is different from when a person arrives at ER with a heart attack or being unable to breathe. In all 3 cases, the wise physician (hopefully) will be acting to preserve the patient’s life because the patient is unable to make informed consent at the time. Even though I would rather not be resuscitated in such a situation, I think this is important because I don’t want to encourage doctors to ignore patients in severe distress.There’s already enough homeless people with untreated health problems.
First i can understand what this article is saying as a person who suffers from mental illness,but lets do an article on what medical negligence is!!
I went to an emergancy room with a severe reaction to lamictal! on 2 seperate occasions i was made to sit in the lobby without being checked by a triage nurse,for over 2 hours!!! i walked out deciding to make an appointment with my regular gp. the 2nd day i went back and was made to again sit in the lobby for over 2 hours ,when i did get into a room in the er ,i was made to sit for 1hour before they sent a so called”student doctor” in to see me?! then she came back 45 min later with another “student doctor” when asked if i was not allowed to see a doctor that is board certified ,the “student doctors ” got attitudes ,rolled eyes ..were complete smart asses and stormed out of the room .after another 45 min of waiting to see a doctor,i finally got up and left. Now ,when i talked to my gp’s nurse the next morning the doctor in the er said i was there for only 45 min then left,when i have paper work with check in times and a picture of 2 er clocks saying when i walked out.my regular gp will not see me.
I for one happen to suffer from bipolar I ,and G.A.D (anxiety for those who do not know) you tell me,If you were placed on lamictal and the side effect sheet says RARE BUT SERIOUS REACTION…BRUISING ,BLEEDING,FOR NO REASON,and you go the the er because you wake up bruised from head to toe and with veins so swollen both arms are completely black and your veins are bulging you would not be stressed and upset ,nor would you want a board certified doctor to look at you and as soon as possible?Yes Bipolars do tend to exagerate(in my case my husband made me go to the er!!) Yes ,Bipolars can hallucinate,or have delusions…however if that is what my problem was ,how could my husband have noticed how bad it really was?He has no mental illness.
Being a person whom also works in the medical field ,i happen to know that in all Emergency rooms ,doctors offices and most nurses stations there are a P.D.R (physicians desk reference) which is about medications ,uses of those medications ,proper dose,and side effects .While at the er on both occasions not one single staff ,nurse nor “student doctor ” knew what my medication was nor how to pronounce it!! I had to repeatedly tell them what it was ,what it was for …why did they not look it up in the pdr?! Lazyness!!
I can tell you because i heard the “student doctors ” and had clear view of them say in the hall just out side of my glass walled room ” she can wait until we decided she is seeing the doctor because her attitude sucked and was offensive!!” There it is ,I am bipolar so to cover their own offended asses ,they lied to my gp about how long i was actually back there!! Oh by the way as somebody who has been around enough doctors they “Have each other;s backs”!!
Make sure if you ever have a bad reaction to medications ,to try to go immediatly to the er ,ask for a psych nurse if your hospital has one.Demand your doctor be notified as soon as possible or use them cell phones to call your doctor from your er room ,that is rite notify your doctor yourself since half of the er doctors will not do so until they have seen and treated you!!
one more thing note that if you are not treated with dignity ,respect or in a professional manner notify your hospital board as soon as possible and make a complaint! and Know the term Medical Negligence!!
http://legal-dictionary.thefreedictionary.com/Medical+negligence
have a nice day:)
I can’t say enough about how wrong this article is. A lot of the psychiatrists are running a scam, where they are shaking the patient’s hands, saying two or three words to them, then charging them thousands for “psychiatric counseling, therapy, evaluation, and diagnosis.” Anyway, that’s what it said on my bill when I got it, after being released on two different drugs that caused a reaction so toxic I couldn’t think straight; so when the bill came, I thought, “he rubbed my arm when I was in the hospital, so I guess it’s warranted.”
Either way, I thought we had paid the bill, but maybe I lost it/ misplaced it. Then my husband and me, who could barely make ends meet, got a letter in the mail saying we were to appear in court if we couldn’t pay the whole thing at once. $6,000. For a week’s stay where I wasn’t even allowed a razor to shave the hair on my chin (I have excess hair). I walked around with a beard on my face; (maybe they thought “we have an extra patient, it’s a guy”; but no one thought to help …
The drugs almost killed me…I think by the mercy of God I am still alive. God save us all from this Nazi regime…
natasha, this is a very bad idea indeed; I was hospitalized once for being involved in a family dispute, and, despite all evidence to the contrary, dr’s had me pegged as mentally ill. my time there was of no use to me whatsoever, and even rather traumatizing as I had a dr insist on giving me a drug which made me suicidal, despite my protests. I was never, even in the first place a threat to myself or others, and placing me in the hospital did not protect me from those who were truly a threat to me. I know there are people who need treatment, but in my city, the hospital was the place where people went when law enforcement decided not to protect the rights of the most vulnerable (but lacked the evidence to book them).
I find this all very scary. I’m currently trying battle through a severe depression, it has crippled my life in every aspect. I immediately reached out to family and friends. My doctor stepped in when I failed a random depression screening. He immediately started giving me max dose depression meds, added another the next time, and doubled it again last time I went to see him. Needless to say, I nearly died at home, and have not fully recovered. We had scheduled a shrink apt., but she was a no show, and I got reschedule for mid Nov. I don’t know how I made it through last week alive. And I’m sad I did. I got perfect life, just this. I know I can eventually get through this on my own, I’m just hurting my family in the mean time. I’m scared because these doctors are so sincere and they try so dang hard, but they’re only doing me harm. I’ve been honest the whole time, but some of us just need time (a blowjob would help to) to get through a really tough time. We don’t need someone jumping in and acting like a reckless hero, please stop trying to kill me, please stop trying to take away the one little shred of control I have left.
This article isn’t about you, you are free to choose to take or not to take medication. It’s about people who are being forced to take drugs, either while they’re in hospital or through involuntary injections as an outpatient. Rarely people with other conditions are given very short term involuntary treatment while they’re in hospital, but it is almost always people with psychosis who are on the receiving end of this practice.
My experiences with the ER have varied. On the one hand, if I were to be drugged for “my own personal comfort” I am not sure the psychological repercussions could be justified. Especially knowing how little documentation is required and how little mental health training ER staff is privy to or required as normal course work. I have left the hospital after days, weeks, and even months on separate occasions just to find out very minimal information on my stay upon requesting records. I am in Quality as a career, and nothing irks me more than thorough and proper documentation. If I am unable to make a decision due to my state of mind, I would like to have full access to the reasons, observations and procedures taken. I’m afraid that what is considered reasonable documentation is not enough for me, and I fear giving up my rights for an assumed treatment is dangerous. I have many drug interactions that could be complicated by a generalized judgment call and that could affect my long run progress. Discomfort is not pleasant in the moment, and of course the next course of action, actual psychiatric emergency care is also not enough regardless of the duration of the hospitalization. I am very proactive in my recovery, but the spaces and holes in my memory alongside the various drugs I have had to take have left me in total darkness. And like I said there is no psychological treatment in the hospitals I have been to. I am observed, given medication if I choose, but there is nothing done to treat or address my problems. What started as situational psychosis was eventually diagnosed as schizophrenia and I feel because my situation was never addressed. I was observed like a monkey or lab rat, and told to talk to staff if I had a problem. I requested to talk to a therapist and was always I formed there wasn’t one on board at the hospital. And records I have requested post crisis to help me find better alternatives for the future were always incomprehensive. It is a nightmare having mental illness at times but I fear giving away any more of my rights and especially if there is no assurance of accountability. The idea of a lawsuit seems pointless since the case would be based on records. And on a final note the movie “One flew over the cookoos nest” proposes thought of what can happen when an individual or facility is given power to make a judgement call based on gray area rather than something as easy as a broken bone.
As someone who lives with a mental illness, and who has been detained under the Mental Health Act here in the UK, then I agree with the point of your article.
I myself have at times in the past been in situations where I lacked the capacity to consent to treatment, and posed a real danger to myself. Under those circumstances I am now glad I was treated, even though I could not consent to it, and may even have resisted the treatment at the time. Now once I regained capacity to consent then yes, I wanted to be involved in descisions about my care and discuss treament options with my doctor.
I wil not deny that this power can be abused at times, I have been subject to that once myself, however at this moment in time, personally, I believe it is the best option available at times for some people. It may not be the perfect answer, but for me, it was better than the alternative.
I respectfully disagree with the article on the basis that we are yet to find a sufficiently nuanced system of medical care that can seperate those in need of medication from those who are not in need but who would benefit from it.
By that I mean those in need to be individuals who are in extreme discomfort and are unable to make rational decisions and who have not left previous instructions on the matter (perhaps analagpus to a DNR in ‘physical’ medicine).
My own experience has been one of doctors automatically believing manic depression to be the cause of every physical ailment I had. In the UK I only got the right to sort on a jury or be a company director around 3 years ago. For most of my life the police have had the right to hold me without charge so long as they say they believe me to be a danger – with no need to supply evidence.
The fact is that mentally ill people, even unmedicated are less likely to harm others than mentally ill people and yet your suggestion, well meaning as it is, seems to suggest that we be given even less rights this more dangerous portion of the population.
I do accept that there are times that any of us may need to be medicated against consent but for conditions that are not immediately life threatening this cannot be the domain of any one professional and should not be the say of that professional at all if a living will exists or a next of kin can be located.
Non-consentual medicationfor a not immediately life threatening condition must remain the absolute final recourse I an imperfect society.
As someone who retired from the medical field and who also has a mental illness, I have to disagree with you on this Natasha. The main reason is that it’s puts us a step closer to Nazi Germany and what Hitler did. If it was a perfect world and all doctors were Christians and put their patient’s interests above the interests of their pocketbooks, it might be a different story. It’s interesting how this country never learns from mistakes. Also, the number of people with a mental illness presenting to ERs who are a threat to themselves or others without the help of street drugs is astronomically small. I’m afraid writeups like this only perpetuate the stigma that we are out of control monsters that need to be locked up in padded walls. I suppose you would also favor the return of barbaric 19th century insane asylums.
While I appreciate the intent and direction of your column, the three choices are not what you describe under current law. The state can restrain (involuntarily commit) someone because they are dangerous or meet some other commitment standard. However a doctor can not medicate someone for that reason. A doctor may only medicate with consent. If consent is refused, the doctor can’t medicate. If the person (as described in your post) is actively psychotic, a hearing must be held to determine whether they have capacity/competency or not. That is the choice you did not mention that the doctor has: hold a hearing to determine whether the person has capacity. If they don’t, then they may be medicated over objection until competency is restored. It is not a great choice, because it takes a while and during the interim the person remains in the ‘padded room’ you describe. On the other hand, no one wants to give a doctor carte blanche to medicate someone. It’s a tough issue. Thank you for writing on it.
regarding the 3 options. option 1 of sending patients back out. lets go to other conditions in emergrncy rooms. there is mandate to treat all dangerous conditions of all patients with life threatening presrntations. it is not just those in crisis like shock over a missing leg “no ill be fine,really.” it is for what if left until tomorrow return to regular clinic might get worse. i got 3 stitches for a 5 day old cut i could not keep closed with commercial acrylic glue. i was not asked to make a next day appointment. i asked to not be e.r. Treated and was assured i was not. when we fought the bill the excuse for the lie was “mandate to treat any serious condition.”
An emergency is an emergency. It makes me nervous but that neuroleptic saved my life.I didn’t stay on it but it calmed me fast!This a good thing.I was thankful that I could be helped.
I have serious issues with forcibly medicating. Around here even if doctors have your chart the minute they see bipolar on it they assume you know nothing and refuse to listen making notes of incoherent or I radical behavior. Had an e.r. doctor nearly kill me TWICE in one night due to this. I was screaming, I was hostile – I WAS IN PAIN. Kidney stone, yet he decided I was manic and drug seeking after glancing at my tattoo and upon giving me the numbing agent they use before the shot my throat closed, next thing I knew I’m waking to a tiny nurse struggling to get an I.v. in and a needle being pulled from my rib cage. After all I’m bipolar and screaming that it feels like something is trying to claw its way out of my side so surely I had no clue what I was talking about when I listed all canes – nova, Lida, carbo on my allergy list as well as penicillin, lamictal, morphine and shellfish. I’m strapped to the bed in pain and can hear the mouthing between the nurse and doctor about what to do with me. He gave me another shot and this time when I came to I’m naked, exposed and he’s standing overbke with paddles and not only does my side hurt but I felt like my chest was on fire. Finally I remembered my uncle sometimes worked security there on his days off from the city police department so I, not them but me, myself and I started screaming for security. The doctor didn’t call off my screams for security I guess from assuming the guard would agree to lock me in a padded room or something. Sadly it wasn’t my uncle working but once I blurted my uncles name the guy actually stopped assuming I was manic and crazy and asked me what the problem was. It took a rn overhearing metell the security guard iI was having pain by my right hip gat was so intense it felt like I was being clawed from the inside for someone anyone to keep the doctor from killing me for good that night. She gave me a shot for pain, called for me to have a MRI and made my day when she congratulated the doctor for not checking the appendix or for breaks or kidney stones before stopping my heart twice due to his mentalism as she handed him my MRI reading. Worst part I was charged for 2 ADRENALIN SHOTS all because rather than even try to assess the problem, he like many others had the notion that a mental imbalance means stupid and we couldn’t possibly be there for any other reason.
I think you might get a bit of a different perspective if one invokes Foucault here. He astutely asserts that the “mentally ill” are simply the individuals in a society that refuse to conform to societal mores, and that the state’s job is to warehouse the mentally ill so that the rest of society can continue on its trajectory unimpeded by the people who were giving the society so much trouble. So forcing these people to take psych medications when they might merely be contrarians, anti-social, dissidents, or enemies of the state would be unethical.
There is a lot of gray area around the definition of “psychotic,” besides. Someone that a psychiatrist at Stanford might consider to be having a psychotic break might be considered by an psychiatrist at CIIS (i.e., Grof) to be having a mystical experience. A psychotic person might need medication, but a dedicated mystic might need spiritual counseling. Which one needs meds: the psychotic, the mystic, or both? And if both, where does the political power to forcibly change a mystic’s consciousness through psych medication stem from? Certainly not from John Locke, whose political philosophy underlies American culture. So changing a mystic’s consciousness forcibly through psych meds could reasonably be construed as a violation of that person’s civil rights (and really, un-American).
So simplifying the issue to an analogue of “person break leg, doctor fix leg” -> “unusual cognitive state, force person to take medication because doctor believe person is crazy” handwaves away a huge volume of moral questions that frankly, you haven’t answered.
Hi Kris,
Actually I wouldn’t. I don’t buy that people are mentally ill simply because they don’t fit into society. I am not mentally ill because of society, my illness is relevant because of the effect it has on my life, not society at all. Society can quite happily let people off themsevles left, right and center and have no qualms about it whatsoever, but doctors are trying to help these people. The mental health system is trying to actually give them a life whereas society couldn’t care less.
Moreover, it’s not about psychosis, per se, it’s about being a danger to yourself or others. Your example of someone having a spiritual experience is not relevant unless that experience was driving them to harm in which case, yes, it would be a problem.
– Natasha Tracy
Okay, slightly off topic, but maybe you can help. First, I live in the US am without any history off mental illness. Where and how can I get a card or bracelet that states I am refusing all treatment. This is just in case I am unconscious and someone calls 911. I don’t mind being moved out of the way, but I cannot affort any treatment and I definately don’t want to be undressed.
I’m a 45 year old male who has not seen a health care provider for at least 15 years (discounting prison, where your glorious medico brethern go to great lenghts not to find anything wrong–but you don’t believe that). I have several old injuries that keep me in pain, and with all the stress I’ve experianced, I believe my life will not be long. My sincere hope is that I will be allowed to expire with some smigen of dignity.
Thanks for your help.
PS You are mistaken about the padded rooms in jail. Usually, they strap the crazies into chairs where they cannot move. I’ve seen these chairs take many a tumble down a stairway, the CO yelling, “Whoopsy daisy,” each time. You never see health care folks engage in a torture so unsophisticated though. I have seen nurses tell some kid that he was taken to be raped, that they’d bring him right back to sew up his asshole, and on and on until the kid freaked out and was shocked and beaten till he shit himself.
Yeah, dr. Babe, why don’t you do me a solid and tell me how to avoid you folks.
Hello John,
For the record, I’m not generally inclined to help people that are so rude. But seeing as you asked…
If you wish to refuse medical treatment it is a legal matter that will have to be handled by a lawyer.
– Natasha Tracy
Wow! This is a great post! I am going to speak from a first hand experience here so bear with me.
Back in 1997 (I was 17 at the time) I had gone to visit my boyfriends parents in a little town about 4 hours away from where I live. I had been bitten by a spider and was given Benadryl for the first time in my life. I started having an out of body experience and had my first ever panic attack. I didn’t know it at the time, all I knew was that I couldn’t stop running around or I would start seizing.This was in the middle of the night. I finally got up the nerve to wake up my boyfriend and tell him that I needed to go to the hospital. Unfortunately, the only hospital around was 45 minutes away. While in the car I had to literally bounce around the car and keep my limbs moving or I thought I was going to die. We finally arrived at this little Podunk emergency room where there were only two rooms. When I got there I was nearly incoherent and had to run in place to keep my body from jolting. The nurses finally took me back to the room and started screaming at me and my boyfriend saying “What are you on?” and asking my boyfriend “What did you give her?” He kept responding I only gave her Benadryl, I swear. All I could do was shake my head yes. The nurses kept saying “I bet she’s on LSD” and told me that if I didn’t calm down they were going to have to strap me to the bed. I tried so hard to calm down but once I stopped running in place I started having a seizure. The next thing I know I was strapped to the bed and all I could do was scream out “HELP ME PLEASE”! By this time they had called in the police and were questioning me like I was some type of murderer. Thankfully my boyfriend called my parents and thankfully my dad was a lawyer. My parents jumped in the car and headed towards the hospital. I stayed strapped to the bed seizing for four hours while I waited for my parents to arrive. That was the longest four hours I had ever experienced in my life! I was so scared and thought the police were going to take me away and lock me up and I seriously thought I was going to die or my heart was going to give out.
Once my parents arrived my Dad took things into his hands and had some paperwork notarized saying that he was in charge of my medical situations because I had been diagnosed bipolar with ADD, PTSD, OCD and other mental “illnesses” and tried to take my life more times than I can count. So, since I had done that my parents took legal action to make sure that they were in charge of my doctors visits and medication. My father ordered the doctors to stop standing around and to do something to calm me down. The doctor finally came through with a heavy dose of haldol and something else, I think xanax. I finally stopped panicking for a moment but my body was still flinching uncontrollably. Once I gained a little bit of composure I started screaming at the nurses and drove myself into another panic attack. Again, thankfully my father was there and ordered the doctors to hit me up with another dose that knocked me out but my body kept flinching so bad that I couldn’t control my limbs. I guess when you are in a state of panic for such a long time and tied to a bed your body just uncontrollably starts to do that. To this day I still have nightmares about that instance that can drive me into a state of panic in an instant, especially if I am sleeping and feel like my sheets are too tight or even if I have had a stressful day.
After that instance I continued to have panic attacks so bad that they would cause me to have seizures. My psychiatrist finally put me on xanax, which I became addicted to after a few years of taking it. Needless to say I ended up in numerous hospitals and finally on my last visit to a psych hospital (I was having over 30 panic attacks a day with seizures) I screamed out in the middle of my agony “NO MORE SHOTS”! I had a feeling that the medication was just masking the reasons why I was having such bad panic attacks. My psychiatrist admitted me and put me on 1200 mg of seroquel along with a bunch of other meds. While in the psychiatric hospital I continued to have panic attacks that made me see actual spiritual warfare in front of my very eyes. I could see angels and demons fighting for my soul. I thought I was going crazy because there were no windows in my room and I continuously saw darkness and light fighting each other. In one of my deepest bouts of panic I remembered something a friend had told me that if you were to say in the name of Jesus I command you to flee then all evil will flee because they are scared “crapless” of the mention of His name. I screamed at the top of my lungs “Father, I give EVERYTHING to you and in the name of JESUS I command all evil to leave”. it was like lightning struck down from heaven and at that moment the darkness fled from my room and my room was lit up with an amazing, spectacular light that was so warm and inviting. I saw hundreds of angels filling my room to the brim and felt a peace like never before come over me and calmed my seizing in an instant. At the time I thought I was just seeing things but I knew that the panic was gone. That was the day I decided to embrace Jesus Christ as my savior.
The panic attacks slowly decreased in severity and finally were controlled enough by medication, meditation and prayer for me to go home. Once I was home I still had panic attacks but never as bad as they were before. I set out on a quest to get to know God better and the more I did the easier it was for me to help myself in the midst of my panic attacks. I’m not saying that becoming a Christian is going to make you all better I’m just explaining my journey. To this day the moment I begin to feel like I’m going to have a panic attack I begin to call out to Jesus and every time he always helps… of course it always happens in his timing and not mine.
The reason I write all of this is because I can see both sides of the argument. I honestly think that if the doctors in the first hospital were to give me a shot of something to calm me down right away then I might not have started seizing as bad as I did. On the other hand I understand why they wouldn’t treat me because they thought I was a drug addict and I wasn’t…yet! However, there was no need for them to strap me to the bed because I was not going to hurt anyone, I just needed to run in place. So, for the sake of argument I agree with you that when someone is out of their mind then they need help from a doctor in the form of medication. I also agree that the United States is way behind in the form of helping those that need psychiatric medication and can’t afford it. I pray that this changes but I have a strong feeling that it might not.
I want to thank you for this wonderful post and I wish you the best of luck with these trolls that have no idea what they are talking about because they have never been there. I think your blog is the shit and I love every topic you tackle. May God bless you in all that you do!
Would you mind if I were to post a link to this article on my blog? I will not copy and paste all that you wrote, I just think that it is a wonderful topic that everyone with a mental illness needs to think about.
Another note: I now carry around a list of medication and a list of what I have been diagnosed with in case something like what I mentioned above ever happens again. I think that everyone who has to take medicine should do this in case of an emergency situation.
Keep up the amazing work that is you and I will continue to follow your posts.
Much Love and abundant blessings,
Kimmy
Hi Kimmy,
Thanks so much for your comment and sharing your story. I’m sure other people appreciate hearing another real-world perspective.
I can’t imagine how hard it would have been to be in the situation you were in – out of your mind and strapped down. (And, for the record, antihistamines do really funny things to me as well but I figured this out really early on in a small dose and have avoided them ever since.) Like you, I can understand why they did it – they were doing the best they thought they could do – but I also understand what it would have been like from your perspective – hell.
To be clear, I’m not suggesting that religion and spirituality aren’t really helpful for some people, as obviously they are helpful for you. I believe in using what works and not taking tools away from people so if shouting to Jesus works for you then it works for you and I respect that.
And as for my post, of course you can link to any post you like – feel free to pull a quote or two if you like as well, just don’t copy and paste the whole thing.
Again, thank-you for sharing your experience and your opinion – yours is exactly the kind of voice from which I think people need to hear.
– Natasha Tracy
Doctors should have no right to treat someone without his or her consent. If that person is a threat to others then he or she needs to be incarcerated. I would much rather be in jail then be treated in a hospital against my will. I was tied down and forced to receive treatment in a medical hospital and it was the most horrifying and dehumanizing thing that I have ever gone through – not to mention totally pointless. If you want the hospital to treat you against your will when you are having a psychotic episode (or not of sound mind) that is fine. Just don’t force it on everyone else!
Hi Brianna,
I respect your opinion on this but I think it’s important to remember that prisons have no capacity to deal with people who are danger to themselves or others. People in that state can’t be allowed in the general population as they are a danger to others and can’t be left alone in a cell as they are a danger to themselves.
I don’t think that’s much of an option unless prisons come with padded rooms, and they don’t.
– Natasha Tracy
I agree. I do not think people should be medicated against their will and for the author to be slamming people who have these views is uninformed. It is also not just the worst patients who are told they will be medicated against their will. Someone needs a dose of the real world.
Currently, due to the massive growth in psychiatric drugging of children and youth and the current targeting of them for even more psychiatric drugging, Children are virtually always forced to take these drugs because it is the adults in their lives who are making the decision.
I found this quote here: http://www.psychrights.org This is the real thing, not someone tripping on street drugs like PCP… in the E.R making a mess of things getting treated against there will, who cares.
I know many adults who have huge resentments over being drugged in school with ritalin against there will as kids, what about that ?
Hello Informed,
Personally, I despise the idea of giving psychotropic medication to children but that doesn’t mean it’s always the wrong thing to do. Sometimes it’s appropriate to medicate children, but it is up to the individual situation.
And yes, parents have to make the appropriate choice in that situation. Some parents make bad choices on all fronts. That’s just the way parenting is.
– Natasha Tracy
There is a BIG difference between a psychiatrist trying to tell you there is something wrong with you and treating you with no evidence in a private setting, and a doctor treating you at the E.R. for an episode of irrational behavior due to substance abuse. Do not mix up these two very different and opposite scenarios.
In the E.R. scenario, a doctor first draws blood to check for substance abuse. If that is negative, MRI or a CT scan is ordered in case of stroke or other type of brain damage. In the E.R., a doctor cannot legally place someone in a padded room or give anti-psychotic medications without following the above. If it does happen, you can expect the party will file grievance within the time frame by the statute of limitations. Know YOUR rights.
Psychiatrists openly admitting at the 2006 APA convention that they have no scientific tests to prove mental disorders are illness or disease, and that psychiatric drugs do not cure anyone.
http://www.youtube.com/watch?v=UHu7Ik36128
It can’t get much clearer than this.
“chemical rape”, “Inquisition”, .. what about “holocaust”? I haven’t heard that one yet. But, when you think nothing is wrong with you, but that you are trapped in a situation where you are going to be poisoned, then that is how you feel. To anyone else it sounds hysterical, insane. But the fear and the terror are very very real.
When I read these comments on here I felt angry – but forgot how I first felt and behaved on my first admission. To admit one’s own insanity is a very difficult thing
Hi Sarah,
You’re absolutely right, admitting one’s own illness is extremely difficult and some of us really don’t remember what it was like to live in such extreme denial, confusion and even psychosis.
Thanks for your comment.
– Natasha Tracy
I have been the victim of a “chemical rape” in the name of treatment, I still have PTSD.
While you may be speaking of extreme cases… unfortunately these doctors are human beings and as such are subject to being biased, and influenced by the biases of their peers. It is not a great stretch to rationalize if it is ok to medicate psychotic cases, shouldn’t it be then ok to just medicate someone who refuses drugs if it placates someone with connections? Too often mental illness is an excuse to elicit complacency and deal with the inconvenience of a challenge to an established belief system. I have been in this system, and I know what giving complete strangers the authority to strip someone of their personal power and completely humiliate them does to the psyche. Like others above, dealing with valid psychological issues then has the added barrier of distrust borne from experience. I have been medicated without my consent, and unfortunately once a precedent such as this is set others in the position to medicate do so without hesitation or regard to the patient’s input or contemplation of the course of treatment. The blatant result here is that the system/specialty in place to heal ends up causing damage not outweighed by the benefit of their action in an immediate situation. Many of us never completely recover–it’s often because we are not permitted to. Mental health does not seem to be as rigorously protected as physical health, so if anything, there needs to be more stringent regulations regarding treatment of patients presenting with mental issues–and while I am on the topic–some of those regulations need to require mental health professionals to request physical health work ups: a lot of physical illnesses present with mental symptoms. To just treat someone with psychotropics instead of finding the cause of the problem is to treat the symptoms and not the disease (the dogma medicine adheres to these days). Socially and legally, the mental health field is in a unique position in regards to protection of a person’s constitutionally granted freedoms–perhaps the only field that can openly violate these rights: unfortunately mental illness is a social disease. People are given diagnoses based upon their inability to function within the society they live. It is not difficult to see from here how easily a person can be oppressed (as we Americans are want to do when an individual or group presents ideas differing from our own–look at the civil rights movement, Tuskeegee, japanese camps, native american deaths etc.). The oppression is complete as the person’s constitutional rights are stripped and they are left without legal recourse. In the case of continual medication based upon precedent, how does a person fight it when they don’t know who it is, and the police are trained to side with the mental health professional? It just continues and the person suffers in silence and isolation. Aren’t those forms of torture? Legal torture, and a class of citizens unprotected by the constitution.
Hi anonymous,
I have read your post carefully, twice, and I agree with every single sentence, except that it may not always be possible to obtain physical work-ups from acutely psychotically ill patients.
Your concerns here are very close to my heart, because unfortunately this world does not work like it should. A person experiencing psychosis needs medicine though, because otherwise they are a real danger to themselves and others, and (as I understand) the psychosis is more damaging to the brain than the medication. The person with acute psychosis is often paranoid, terrified, delusional or otherwise impaired for consent. When I had psychosis, I had a full understanding of the implications of my treatment without consent, due to my knowledge and experience – and this knowledge made me even more scared and paranoid – I thought I was being poisoned in a concentration camp, rather than being given a sleeping pill at the local hospital. The difference here is in the intent – the medication is given with the intent to heal, rather than hurt. The fact that it served their convenience – I was much easier to manage with the sleeping pill than yelling in the ward at 3am – is a bonus, not the primary purpose in medicating.
But I have seen the abuse of power that can happen in the medical and disability world, and the effects are exactly as you describe them.
Unfortunately, requiring consent from highly psychotic patients will not change this abuse of power. It simply needs to be highly regulated as you say.
You also mention that mental illness is a socially created disorder. I believe it has both social and physiological origins, which interact. Medications help, to treat the physiological side and also the physiological problems created from the social side.
Love, support, and tolerance are extremely important in the treatment of mental illness. Without them the medication will not be effective.
Quite a few years ago now I was admitted to a State Psychiatric Hospital because an assumption was made at a local general hospital. I arrived early in the morning at the psych hospital which meant the psychiatrist was woken and was annoyed. Ater a VERY brief interview which consisted of me saying there was nothing wrong with me, I was certified. I was given sedative medication, against my will. I specifically did not want it because it causes respiratory depression. I asked for Asthma medication because I had asthma and this was refused. I was locked in a room with just a mattress on the floor. By 7.30 in the morning I had asthma so bad I could not speak or move, my fingers were blue. I was advised that I could have no treatment until a doctor came at 9.00. The doctor came some time after nine, an ambulance was called and I was taken to the same hospital that sent me to the Psych hospital. I had a respiratory arrest and was in the hospital for 4 weeks. I also had concussion, which was what I was seeking treatment or in the first place. When I was able to contact my family they sought and received apologies on my behalf from the doctors at both hospitals, which would not have helped had I died. Being treated against your will only works if the process is absolutely transparent and takes into account all possible alternatives and assesses physical risk. There is no stock answer to whether or not a person should be treated withot their consent. I became ill last week in another state and needed psychotropic medication. When I went to obtain the prescription I asked for only one of the drugs I take as I was afraid of advising them that I have bipolar disorder. That earlier incident, now 20 years in the past, still affects how I view psychiatric treatment and the power imbalances inherent in the system to this day. I am fortunate that I obtained enough degrees so that I can work in the system and know it as a consumer and a treatment practitioner. It cannot reasonably be compared with the system that treats physical illness.
I dont mean to sound disrespectful but the author of this article is out of touch with reality. I suggest you do some research on illness. In all of those extreme cases you mentioned early on in the article ex. Running naked, in a wild state, they are locked down until they are evaluated by a doctor. They can refuse medication but the doctor has the right to keep them locked up if they are a threat to themselves or others until they comply. Second very ralely do any mentally ill people who do get locked up for a few weeks get tied to the bed or are locked in a cell. They are in normal rooms and have tvs and recreation to help their days go by while they are there. And thirdly most illnesses that have phsycotic states dont last hours, most come back to reality in minuites or seconds unless they are diagnosed with schizophrenic. These things are stigmas and are frightening to the public. Most people with illness arent like how you decribed at all. I dont know ow you came to these conclusions but I’m sorry they are wrong.
No, sorry, but I believe you are the one who is wrong here. The article is not about most people with mental illnesses, it is about extreme cases where treatment without consent is practiced. If you read more of this blog you will see that the author has a balanced viewpoint. I don’t believe she is promoting a distorted view at all.
There is another post here that mentions that fact that medications are used as constraints of convenience. I have no doubt that this occurs. It happens in nursing homes too. But I think what the author is trying to say is that sometimes its necessary to give medication without consent because the person is psychotic and can’t give consent, and they need the medication. I think your point might be a good one for a series of posts on ethical practice and is beyond the scope of one post.
I have worked in a psychiatric facility, volunteered in a psychiatric facility and in the community and been admitted to a psychiatric facility, both on a voluntary and involuntary basis. I’d say Natasha is fairly correct here within the scope of what she is talking about, but it doesn’t mean that some of the posters here haven’t raised good points.
I have a young friend who has been in hospital permanently with schizophrenia following some family-sanctioned drug use in his teens. He is a great person but there is no doubt he is in need of care. He hates being under his involuntary protection order because it is boring and restrictive. He is given his medication under supervision but he still manages to spit it down the sink half the time. One day he ran away, sold an asset at the pawn shop, bought a ticket to another city, and lived on the streets for three months until he went to the community centre for help. He was then promptly returned to care by the police. It’s awful to see this free spirit so detained and restrained. But without this order he would be on the streets and probably dead. At least he has his own little unit, 24 care and future planning, and as great a freedom as possible. And little by little, he is making progress.
The issue of consent is an important one and may I suggest it as a blog topic-series?
Hi Sarah,
It’s a good topic for a series, I’ll put it on my list.
I’ve had a few tweetchats lately about issues of consent and people are strikingly reasonable about it in general.
– Natasha Tracy
HI Mentally Ill for…
I’m not sure what makes you think I’m talking about mentally ill people in general, but I’m not. I’m talking about emergent cases, as I said. Few people are brought to the ER acutely psychotic, but when they are, something needs to be done. That’s the point.
– Natasha Tracy
Interesting point of view that is rife with misinformation and fear. You make good points and leave out many.
Psychiatrists and medical doctors drug people whom they think have a mental illness – sometimes- for their own convenience. Drugs are often used as restraint beyond the time medically necessary.
I suggest you volunteer in a psychiatric facility for a solid year. If you come out of that experience with the same opinions, I’d be surprised.
Appreciate the article. Good to know what people are thinking.
I am so pleased to live in country that does not penalise impoverished mentally ill by making necessary medication unaffordable. US should get it’s act together. BTW a “well respected” professor of psychiatry in my state is currently facing criminal charhes and other sanctions for treating (at least one so far) a woman who was hospitalised, with an experimental drug. The drug has not been approved. It had horrendous side effects. His threat if she did not agree to this was to have her involuntarily detained in a public mental hospital. Not all doctors are benign, some even believe themselves above the law.
Hi Kathe,
“I am so pleased to live in country that does not penalise impoverished mentally ill by making necessary medication unaffordable. US should get it’s act together.”
I tend to agree. In Canada anyone who can’t afford it can get many psych meds for free. It’s heartbreaking to hear of other countries (including the US) where this isn’t so.
And you’re right, not all doctors are good people. I say it all the time, there are bad mechanics, pizza delivery people, hairdressers, and yes, doctors. It’s unfortunate, but true. But I don’t believe they show up in any greater amounts than anywhere else in life, in fact, they probably show up less as they are held to a higher standard than most other professions.
But, of course you’re right. There are bad doctors and I hope the one you mentioned gets prosecuted to the fullest extent of the law.
– Natasha Tracy
Ben,
“You use extreme examples, and even in these examples they do not necessitate long-term treatment against will. The person should be tranquilised, and treated for an acute condition, and should not be forced to continue treatment without consent.”
I never suggested long-term treatment without consent. I suggested stabilizing treatment. And for the record, tranquilization would also be against the person’s consent, and you seem fine with that.
– Natasha Tracy
People can choose to sign a non-resuscitation waver. Imagine if this was ignored by a doctor, who assessed he new better.
You use extreme examples, and even in these examples they do not necessitate long-term treatment against will. The person should be tranquilised, and treated for an acute condition, and should not be forced to continue treatment without consent.
Once the patient is stabilised from an acute event they should be reassessed, and then choose whether they want to continue long term treatment.
This post reaks of we know better and that people are crazy; if you hear voices and recognise it is not normal then you cannot be crazy; as you would never have inferred it is not normal.
It is a slippery slope telling people you know best. Kind of like a medical dictatorship.
I have been forcibly committed and treated involuntarily. I have had multiple total psychotic breaks and was once almost killed by the Police. My child was injured the time I was arrested.
If someone poses a demonstrable danger to themselves or others I believe that “settling” them out with medications is better than jail(most of the time).
I think that medications can be life saving but I also believe that there are times when people are over medicated , an experience I have had a number of times.
Advocating for the humane treatment of people with mental health issues helps provides check and balances to the system.
I think blindly accepting the psychiatric system as completely ethical is a challenging notion for me to wrap my head around. I think there are as many “clock punching” psychiatrists comparative to “clock punching” Walmart cashiers.
I think sometimes the problem with psychiatrists is that they do not understand the concept of informed consent and look for quick solutions while not covering all the bases. Sometimes they fail to notice potential exacerbating problems and over treat symptoms with medications instead of good old fashioned talk.
I had a really good psychiatrist who died a couple of years ago. Who before altering medications would ask pertinent questions like, “why do you think? or “what is you opinion.”
Sometimes all I needed was a week of Benzos to get me over the hump, a couple of times I needed completed medication changes.
I am not anti-psychiatry and I get that there are “nut jobs” but I also understand that there are professionals who believe and have had success taking non-medicated approaches for the treatment of psychiatric illness. By that I do not mean, “walks in the park”. :)
Hi Jake,
I think checks and balances are an integral part of the system but I think the ability of doctors to treat without consent is critically important. As you said, applying medications in these situations can be life-saving.
Over-medication is a problem that I recognize and I do think it’s something to be avoided. Unfortunately, it’s a really tough one. Medicine, in all walks, comes down to judgement calls and we’re just not going to all agree on some judgement calls of others.
And yes, there are successes in non-medicated treatment in some cases, I just fear that 99.9% of people in North America don’t have access to them. They are more common in places like Europe. While I’d be all for moving working models of non (or less) medicated treatments to North America, it’s just not what we have to work with right now. Although I hope we get there.
– Natasha Tracy
Natasha
You followed me on Twitter and when I read your BIO, my first reaction was to follow you back. I commend anyone willing to write about dark periods they go through because I think the act of doing so is brave.
Then I looked up your site, and my heart sank. I need look no further than comments like “These are either well-intentioned people with little grasp of logic or just plain anti-psychiatry nutjobs.” and “Doctors should treat the mentally ill without consent” to know who I am dealing with, here. I have unfollowed you on Twitter, and I have also blocked you. I do not want any part in helping to promote your philosophies.
I am not a hateful person. As much as I am (passionately) against ECT, I believe people have a right to their opinions and if someone chooses to do ECT, they should be supported in that decision. Likewise with psychotropic drugs. I don’t believe in spreading or encouraging anger, either. I simply choose not to have any part in helping to promote you.
Your blog, your (incredible) dis-respect for those who have suffered at the hands of our mental health system (ie. “anti-psychiatry nutjobs”) and the fact that you encourage forced treatment, all made me feel incredibly sad. I have never been locked up, forcibly drugged or taken medication of any kind, but I have struggled with depression off and on all my life, and I believe passionately about preserving the dignity of all people in whatever way possible. I find your views overwhelmingly disheartening.
I strongly suggest you look up (and read) a book called The Center Cannot Hold: My Journey Through Madness. The author tells a compelling story about her experience of “treatment” in the States (much of it forced) in comparison to the help and support she received in Britain, and how each affected her life’s journey. Her name is Elyn Saks, and currently, she is a professor at the University of Southern California Gould School of Law and an adjunct professor of psychiatry at the University of California.
Jessica
Try not to take things so literally all the time. It will open up your mind.
so people who are against compulsory treatment are nutjobs? Interesting. What if the consultant who decides you are ill is the nutjob and is acting out some crazy little either drug or natural psychosis of his own? It can happen. I have no mental health problems, I’m just old and therefore this idiot assumed me gaga I have just recently gone through a nightmare after attending A and E for an injury, This consultant insisted on assessing me for a none existant hip injury. I was in pain and feeling faint and was mauled about by this man and his staff who dared not contradict him. He then tried to have me mentally assessed,with a security guard to stop me leaving. I managed to get someone to collect me and we fled when backs were turned, but it was terrifying. No No compulsory treatment, except for mad doctors.
Hi Roslyn,
Actually, I said, people in certain groups were, “at best, these people are well-intentioned with little grasp of logic, and at worst just plain anti-psychiatry nutjobs.” So, a variety of things.
It is certainly the case that some doctors are irresponsible. I could not argue otherwise. As there are many fine doctors there are also bad doctor, just like there are good plumbers and bad plumbers. That’s just humanity for you.
However, this is not the common case. Most doctors are conscientious human beings that take treatment, particularly without consent, very seriously, and apply it only at the appropriate times.
Certainly people have had bad experiences with this, and I’m sorry you are one of those people. Many people also credit their treatment without consent for saving their life.
– Natasha Tracy
Sorry I took so long to get back, I’ve been following up my complaint against the hospital.
You dismissed my comment and others by saying there are good and bad doctors. I’d agree, but what we are talking about are bad systems that not only allow, but perpetrate bad things to happen. I know there are “good” doctors who are well and lengthily educated and who believe they are doing things in the best interests of their patients, but that isn’t the same as saying they ARE doing things in the best interests of their patients, or are in a position to know how. The Inquisition burned people to death for their own good. It is only from our standpoint that we can see this as appalling. If we allow a system to develop that allows bad things, treating without consent with damaging drugs etc. (look up the side effects of the drugs you see as harmless. they are anything but, and some can cause great damage for those with certain conditions or sensitivities.) small step by small step, eventually, we will have well educated conscientious staff doing exactly as the system expects them to do, only it will be appalling. Remember the Soviets? Their system changed so that well educated conscientious caring staff saw dissidents as suffering from mental who must be treated against their will . Their system, their ideology, would not let them see anything different. That is why people must fight any attempt to take away the rights of a person to consent.
I’ve been medicated without consent before. I was shot with a big dose of Geodon because the doctors thought it was necessary. I imagine I was acting some form of crazy to get that to happen. I use to end up off my medication because I couldn’t afford it. I’m also Agoraphobic so I tend to flip out when I’m away from places I feel are safe. Bipolar has kicked my butt, and I gratefully have state health insurance now which covers my medications. I’m taking Saphris and Zoloft and staying on top of being responsible. I’ve been hospitalized 5 times in the past 3 years and now I hope to never see the inside of a hospital again.
It’s scary to think that it has only been a year since I nearly had a successful suicide attempt. I overdosed on a massive amount of alcohol and Xanax. I landed myself in the ER as a comatose patient who had to be put on a ventilator because I was unable to protect my airway. I would have most likely died if it wasn’t for my Dr which I called after my OD. He’s the one who sent police to my home. The hospital transferred me after I was stable to psychiatric care but before the transfer I stuck a metal fork in a light socket, and later went on to make a noose out of bed sheets. I was insanely depressed and even with medication I was going crazy.
In the middle of crazy I don’t know what’s best for me anymore, but when they dosed me with Ativan in my IV to stop my massive panic attack I was grateful. I hate being sick.. Bipolar compounded with PTSD, Panic Disorder, and Borderline Personality disorder is ridiculous. This year, I thankfully have my kids back again and am trying to hold it together. I was an Academic Honor role college student two terms ago, but I was starting to lose it and had to drop my classes. I’m at a point now that I have to deal with my issues by going to counseling and staying medicated. I don’t think I’m fixable, but I love my kids so I have to try. It’s sad that sometimes that love isn’t enough to protect me from depression and manic episodes.
Hi Stacey,
Thank-you for sharing that.
“In the middle of crazy I don’t know what’s best for me anymore, but when they dosed me with Ativan in my IV to stop my massive panic attack I was grateful.”
I think that’s a common experience for people in that situation. And most people come out the other side, and realize it was best for them, at that time. Even if it is really scary.
You might not think you’re fixable, but it’s the trying that matters. And obviously you’re doing that just fine.
– Natasha Tracy
If you force medicate any patients you will be brought to justice.
[moderated]
I SUGGEST YOU STOP SPREADING PROPAGANDA.
[moderated]
OK, I have tolerated your threats quite long enough thank-you.
If you do not follow the commenting rules seen here, I will no longer allow you to post comments: https://natashatracy.com/bipolar-burble-blog-commenting-rule
In short, start acting like an adult or find another playground.
– Natasha Tracy
I have to concede – I hate the idea of this, but it’s saved my life many times. IF I ever end up that ill again, I’d want them to do whatever it takes again. I so wish there were an alternative that worked. I so wish groups fighting against said treatment could stop ‘fighting’ and come up with the alternative. Shah. X
Shah,
I hate it too. It scares me. But unfortunately, medical realities are rarely pleasant. And like you said, it has saved your life no matter how much you might not like it.
And yes, if there were an alternative I’d be all for it. I just don’t see one.
– Natasha Tracy
Well thought out and shared Natasha, I am in complete agreement with you! I applaud your courage and integrity here.
Hi Elizabeth,
Thank-you for your kind and supportive words. I appreciate it.
– Natasha Tracy
ITS AGAINST THE LAW TO FORCE MEDICATE.
[moderated]
END OF LINE
You may not threaten people here. If you wish to add to the conversation I suggest you stop yelling, stop threatening and make an argument or else take your outrage elsewhere.
– Natasha
ITS AGAINST THE LAW TO MEDICATE WITHOUT CONSENT.
IF YOU KNOW OF A DOCTOR WHO DOES THIS REPORT THEM ONLINE, TO THE FACE BOOK COMMUNITY [moderated]
REMEMBER FORCED MEDICATION IS A CRIME. ITS AN ACT OF POISONING.
[moderated]
REPORT THEM TO THE COMMUNITY!
DON’T TAKE IT LAYING DOWN, STAND UP, GET UP, AND FIGHT!
Hello Gagoonies,
I have allowed much of your comment through but due to the screaming and threatening nature, I have moderated pieces of it. If you wish to comment further, please no not use all caps and know that only comments that follow the commenting rules will be allowed: https://natashatracy.com/bipolar-burble-blog-commenting-rule/
Regarding your view, it is _not_ correct that “it is against the law to medicate without consent.” There are many times when it is legally and ethically reasonable and allowable to do so. People in life-threatening states are one example. Those who have been legally declared incapable of making their own healthcare decisions is another.
To suggest it is an act of poisoning is preposterous. That’s like suggesting giving someone medication to save their lives while they are unconscious is “poisoning.” That’s a doctor’s job. To save lives.
Certainly, you are free to have your view, but legally it is inaccurate.
– Natasha Tracy
My friend insists that she is taking the prescribed medication. She makes sure the nurses are watching her, but the doctor is insisting on injecting her with unexplained medication intraveinously over long periods of time. Is this a punishment or an experiment?
My friend is a quiet person who is trying to be released. She has in the past made vague references to killing herself but has never attempted to do it. She is a gentle soul and has never physically hurt anyone. She is resisting these forced injections.
They are giving her pills like haladon and clonazepam.
Hi Vivien,
I understand this must be frustrating for your friend. Obviously, I can’t say exactly what is happening but no, it isn’t punishment. They may be choosing IV drugs for a reason such as the speed at which it enters her body or the rate at which they can control her blood level. I really couldn’t say. It’s not necessarily bad and it isn’t her fault.
What I recommend is having your friend (maybe with someone close to her) sit down with her doctor and asking to have all her medications explained to her. Whatever they are giving her, she has a right to know. She should understand what is being prescribed so she can discuss it openly with her doctor. I recommend she write down all the names and dosages so she can give that information to others if she needs. She should also know her diagnosis.
I hope that helps.
– Natasha Tracy
My friend insists that she is taking the prescribed medication. She makes sure the nurses are watching her, but the doctor is insisting on injecting her with unexplained medication intraveinously over long periods of time. Is this a punishment or an experiment?
You advocate very frightening positions. Doctors don’t treat people without consent “all the time” – comparing people in extreme mental states to unconscious people is totally specious. Have you never heard of human rights? And are you unaware of the serious side-effects – like diabetes, heart disease, kidney failure and death – of psychiatric drugs. It’s immoral to force an unwilling person to take dangerous drugs. You might want to read Peter Stastny, MD’s article on whether forced psychiatric treatment violates the Hippocratic oath.
Involuntary psychiatric interventions: a breach of the Hippocratic oath? P Stastny, Albert Einstein College of Medicine, Bronx, New York, USA. Ethical human sciences and services : an international journal of critical inquiry. 02/2000; 2(1):21-41.
Hi Emma,
Yes, there are side effects, certainly. Much of what is done in an ER _can_ kill a person. It’s just that the odds of it saving them are better. (On the other hand, I know of no deaths from, say, acute haldol treatment.)
So your suggestion for what to do with a psychotic person? One who endangers others? One who is killing themselves by refusing to eat or drink?
I never said _long_term_ forced treatment was a good idea. But there are times when you’re not mentally competent to refuse treatment. And this happens in diseases outside of mental illness as well.
– Natasha Tracy
I will try one last time
Clearly you have decided to embrace this mental illness wholeheartedly and are closed minded to any possible explanations outside the accepted western medicine diagnosis.
Nevertheless i will make the effort again.
your error is to assume western medicine benevolent and scientific.
If western medicine’s world monopoly on practical biological science for human beings was in fact benevolent and scientific then your reasoning for your condition is perfectly sound.
And so is your approach to dealing with it, and so perhaps could you defend the notion of compulsory treatment of mentally ill people.
However, other than the herd mentality, what makes you think western medicine is benevolent?
Who created it?
Why have they got a mafia style monopoly on practical human biology?
Why is medical dogma the same in all western countries?
Who is the central control that dictates this dogma?
What happens to a doctor if he acts contrary to this dogma?
What makes you think theyre scientific?
Is the pathology approach of blood screens and so on for physical illness actually based on proper scientific method?
Or is it merely to appear scientific ?
for example-
Wouldnt it be more appropriate for a doctor in this day and age to examine your tissue or blood under a microscope and analyse what is there rather than send it to some pathology lab with some positive or negative test requests.
(Which is about as scientific as throwing darts at a dart board hoping you hit a bullseye.)
But have you ever seen a doctor who even has a microscope in his office?
And why not?
Perhaps, Natasha, you could examine some of the foundations you have built your beliefs on, regarding your personal health problems and mental health in general.
And then reason from there.
Benevolent means helpful, charitable, without profit. Medicine is based on a strong ethical tradition. Most medical practitioners are benevolent. Some are not, and those who break the code of ethics can be forced out and sent to jail. That is why we trust doctors and give them the power to make these decisions for us. Abuse of this power is not, should not be tolerated, but unfortunately it happens, and the system needs to be improved to guard against this. But basically medicine is benevolent. The top salaries seem high, but compare them to the CEO of the bank and other positions which might be obtained by these very smart and hardworking people who become consultants.
I’m wondering – you say medicine is not scientific but I wonder if you know what science actually is? My understanding is that it is a method of understanding the universe which assumes one objective reality which has natural laws that can be tested and understood.
You seem to be hinting at a big conspiracy of medicine that is there to control people. We scientists would say that this view is not part of the objective reality which we share. Perhaps you are caught up in such an organisation which seeks to control, and you are projecting this onto others. My advice is to get out – get out now!
I literally said this to someone today. I so wish that I had been forcibly medicated and treated until I could think coherently. It might have kept me from fucking up my life so badly and the lives of those around me. Insurances and meds for mentally ill should also be free but that is a whole other post or thousand altogether. That was another thing that kept me from getting stable. I will get off the soapbox now otherwise I will just go on and on
Hi Massiyat,
Thanks so much for your perspective. You aren’t the only one who feels that way either. People always think about treatment as “evil” but yes, it saves not only his/her physical life but everything in his/her life.
Hopefully you’re getting everything back with treatment. Be well.
– Natasha
So you propose a society where dentistry is performed on you against your will?
If you look back to the days before penicillin you will find many writers trying to think their way out of madness. A madness anaylsed in depth and which then branched out in all kinds of philosophical directions but a madness caused by the syphillis spirochette.
All of that reasoning by ingenius men came to nought when a mould was found that killed the physical cause of their mental illness.
How can any writer be oblivious of that lesson of history when so many great writers suffered from syphillis ?
Dave,
If you would like to get syphilis, feel free. Let me know how “worth it” it is.
Yes, madness can produce all sorts of results. But I also remember Van Gogh cutting off his ear and the Bronte sisters living in intractable depression and killing themselves. Sound like a good idea? Maybe you’d enjoy watching you sister, or your son cutting off her/his ear.
The lesson is this: if you want to sit in your house and enjoy madness, then that’s your business. But if you don’t want treatment then don’t see doctors and don’t get in trouble with the police because those heartless people will try to stop you from hurting yourself or others. How evil.
– Natasha
I think you missed my point.
I will try again.
Your mental illness may well just be a symptom of a phsical illness.
Mine was.
Once the physical illness was discovered and treated, the mental illness symptoms ceased.
Hi Dave,
Certainly it is the case that other issues must be ruled out when diagnosing bipolar. Off the top of my head there is thyroid, iron deficiency, head trauma, and seizures. But I do not have any of those things.
I always suggest people get a complete blood screen when they are dealing with this illness as there are things there that can complicate or cause issues. If one of those fixes your problem, great.
However, in the people I talk to, longstanding cases, they have been tested again and again.
– Natasha
how about if you are intimidated by someone (who works as a police officer) trying to make you do something against your will under the treat to put you in a mental hospital, and later you end up there helpless sedated. unable to defend yourself.
I’m telling you from a personal experience!
Hi Leo,
That sounds neither medically necessary nor legal so really wouldn’t be what I’m talking about.
– Natasha
Your trust in the Knights of Malta is misplaced.
I went to a hospital 7 years ago after 2 years of parasitic infestation I could neither treat nor get proper science through doctors to diagnose.
I could not get one doctor in 2 years to use a microscope on me. I went to over 100.
Eventually in desperation and suffering I walked into the emergency section of a hospital.
I said I will not leave this hospital until someone uses an actual microscope and a little science to see what the hell parasite I have.
I was finally told I would recieve the science I wanted, but then taken to a cell in a mental ward in this same hospital. And locked up like a criminal, I was drugged heavily then encouraged to invite my family anf friends to visit me in the mental hospital.Which i did, to my shame.
I was given other chemicals which have left me in a moronic, trance-like state to this day.
I have recently discovered that indeed I do have a parasitic roundworm that lives in any and all tissue of the body I am finally being treated for a real illness that was simply very odd, not imaginary.(roundworms are supposed to inhabit only the gut and be easily treatable, and also cause an immune reaction in white blood cell counts)
However the damage done to my mind through chemical destruction of my brain against my will , cannot be reversed.
I beg people who think they have a mental illness to look outside western medicine for a scientific cause to these symptoms.
I believe through hard experience that so called mental illness is most likely a symptom of a physical ailment.
I also believe that medical dogma behind western medicine is designed to appear scientific whilst actually preventing people from getting access to the science that might help them.
Look at who created the trojan horse of western medicine before you trustingly hand over all power to their benevolence. And do not believe them scientific, they are anything but.
Hi Dave,
I can certainly understand your feelings about the medical system give the way you were treated. It sounds awful and no doubt it was very hard for you.
However, one bad experience does not a profession make.
Me, personally, I have a very bad experience with orthodontia. I had a horrible orthodontist and went through incredible suffering at his hands, I think needlessly.
However, that says nothing about orthodontists in general. I’m not a fan of dentists, but that’s my own thing. Someone still has to fill my cavities.
– Natasha
You went to 100 doctors and asked them to use a microscope on you? Where were they supposed to stick it, up your arse?
I would suggest reading The Center Cannot Hold: My Journey Through Madness by Elyn Saks. Here is a review from Publisher’s Weekly:
…Saks, a professor of law and psychiatry at the University of Southern California, demonstrates a novelist’s skill of creating character, dialogue and suspense. From her extraordinary perspective as both expert and sufferer (diagnosis: Chronic paranoid schizophrenia with acute exacerbation; prognosis: Grave)… [ admin note: review omitted as it’s spammy] …She is a strong proponent of talk therapy (While medication had kept me alive, it had been psychoanalysis that helped me find a life worth living). This is heavy reading, but Saks’s account will certainly stand out in its field.
—–
These issues are complicated. However I really do believe as you seem to state that the long-term therapy and other daily supports are not there and this can lead to more crises than necessary. Imagine diabetes if you ate all the wrong foods and then didn’t take medication or exercise or lose weight. You’d be a lot more likely to have crises about blood sugar levels and even organ failure. The same thing for any chronic condition like heart disease, cancer, etc. I think mental illness works the same way. In my opinion the lack of coverage of psychotherapy by insurance so one needs to ‘self-pay’ is a major part of the problem that can lead to illness not being managed well and the person not feeling listened to and then there is a crisis, unfortunately.
Suzanne – thanks!
– N
great post!
T,
I'm not advocating doctors drugging patients without consent _in_general_ (I don't even know how they could). I'm talking about in emergent cases. It _is_ appropriate. When a person can't appreciate their situation they often because a danger to themselves and those around them. Medication is completely reasonable in that case, not to mention what is done right now for mental and _any_other_illness. If you're in danger, they are trying to fix you. Period.
As for forced ECT, I would consider that mostly a dark ages thing. The only way that would happen is if ordered by the court if your ability to consent had been revoked and a doctor thought that should be done. That's a lot of legal wrangling that has to be done before it's even an option, not to mention you'd have to be inpatient.
There are many protections both in the US and Canada to ensure a patient's rights outside of emergent situations. I have no doubt that some doctors abuse patient's rights, but that doesn't mean they are the majority.
This issue plays to people's fears and so they feel it should _never_ be right to give meds without consent. But that's just as ridiculous as saying you shouldn't be fibrillated without consent. If I were fibrillated I would die due to a preexisting implant, but that doesn't mean I think the doctors would be wrong for such an action in general.
– N
#2
9. Yes, there are many problem with medical records. I agree completely.
What we have is a big problem with no great solutions. I can understand how frustrated and angry you are with dealing with it every day. I get that way sometimes too. I understand how unfair it is and how things need to change. Believe me, I get it.
It's great to know that a passionate person like you is out there trying to make it work for people. Just try to remember than not everyone in the mental health care system has been run over, coerced, and not all doctors are unfeeling and disrespectful. You see the exceptions all day long and you think that's all there is, but there isn't. I'm an exceptional case, and I know it. Many mentally ill people get help, find medication, have successful relationships with the doctor and move forward.
Again, thanks for your comments.
– N
A.E.
Thank-you for sharing your thoughts on this issue. Obviously you care a great deal about it.
I definitely can't respond point by point, but here are a few thoughts:
1. Yes, courts can order depot injections. That is extremely rare in the mentally ill community as a whole.
2. Undoubtedly coercion is used to get people to take medication. Nevertheless, we are adults and we (or our caregivers) are responsible for our choices.
3. I believe mental illness _is_ like other illnesses and just like other illnesses, in some cases intervention is needed. I don't believe that giving antipsychotics without consent to a person in a psychosis and in an ER is degrading whatsoever. I think it's appropriate.
4. Certainly any time a group of people receives power there are people who use it badly. No argument. That isn't an argument against power, that's an argument about appropriate use.
5. Yes, life on the street is different. The homeless have many fewer options and yes, they face many challenges.
6. Yes, the system sucks. No argument. I can't get to see a psych. Even though I've recently been very suicidal. Even though I'm having problems with meds. Even though my GP has no idea what to do. Even though _she_ thinks I should see a psych. Yes, the system sucks. Many of us get fucked with it, and people die because of it. All that fucked-up environment though, doesn't change the fundamental issue: people in crisis need to be treated, sometimes without their consent.
7.Yes, of course doctors get it wrong. When you're the zebra and not the horse, you're harder to figure out. And yes, I think it's ludicrous that I doctor would tell me I'm not feeling how I feel. I often want to stuff handfuls of pills down their throats, but that's me.
8. Two things in defense of the doctors. First, they have limited tools with which to deal with these issues. Sometimes they have nothing better to offer than that which you have tried and failed. Second, many mentally ill people don't express themselves well when talking to their doctor. There are many reasons for this, but I do believe that doctors just don't always get the message that the patient is trying to send across. This isn't either person's fault, just a fact. The mentally ill often need advocates to help them during appointments. I actually suggest this for everyone.
cont…
Perfect analysis, thank you.
Back in the dark ages, not so long ago, here in the US of A… a person could be medicated against their consent if a loved one convinced a doc that they (the person) was crazy enough. Or, the doc just felt the person needed to be medicated. It had little to do with whether that person truly was a danger to oneself or others.
You could even take your wife in to receive ECT or a lobotamy, if the doc felt it the right thing to do and you agreed. While wife was just going through post partum depression perhaps.
I get that if someone is brought into the ER via law enforcement and is psychotic and off their wit's end that perhaps a good shot or two would be beneficial. I've been known to walk into my ER because I did not have a pdoc and just wanted a med to help me sleep and to ease the anxiety.. would not have wanted to be "forced" on Haldol (which I have taken in the past during psych inpatient stays and so I get the inability to pee and the shuffling).
See… in giving docs the right to medicate what they deem is a mentally ill patient with psychotropic medications, or ECT, or any other form of invasive and extreme treatment in the ER would also open the gates for any psychiatrist in their private office to do so as well. At least here, in the US of A. Seems if one can do it then all wish to do it, would not want to discriminate now would we?
By the way, there are medical disorders and illnesses, when awry, that have symptoms that can quite often mimic a form of mental illness and psychotropic meds and/or ECT, etc.. is not the correct treatment. You give a doc the ability to just force meds without consent… you run that chance that they are treating someone as mentally ill when they actually had another medical disorder.
Course now, if one was brought in because he set fire to his property and the reason being that the purple men ran into the high grass and hid when he invited them to come and roast hot dogs and marshmellows with him… and he became angry cause he was being hospitable and they were being rude guests on his property so he decided to flame throw and burn them out… maybe, he needs a shot of something. Or, the one who wrapped his legs and arms around a tree trunk, stark naked, and demanded to speak to both Elvis and Jesus and then whizzed all over the back seat of the patrol car as the deputy assured him he would be taken to see Elvis and Jesus if he'd just get in the car… likely needed a little something something as well.
The mother, with 4 children, who had no money and whose husband was an alcoholic and beat the crap out of her.. who went to her primary care physician and he asked her how things were and she honestly said… so he referred her to the mental health center for counseling, and then her children were removed by DSS as soon as she showed up because he (not realizing) called DSS and asked if they could help her… so she went into major breakdown in the lobby of the MH center and was driven to the hospital… likely got given something as well but I would have hated to know it was against HER consent.
— T
Also Police keep records of non criminal contact with person with mental health issues. There are no current regulations surrounding this procedure- each division and Province can do what they want with this information. Now if you had a heart attack and the police responded via a 911 call…your health information would be strictly confidential (By LAW!!!). But if a desperate mom calls the police because her daughter is locked in her room and thinks the family is against her…then this information can be released to future potential employers via a police check. Obviously the mom and daughter need help and supports…but 8 years later this information could bar the daughter from ever receiving an MSW in social work. Can you imagine if a potential employer called and requested health information from the police and they said you had a weak heart? Lawsuit city!
Yes you need to have a police check to work in social services – a good thing right? But it should be your choice if you want to “out” yourself to you future employer – seeing as you have never committed a criminal offense (or is being crazy criminal?). Addictions services see the merit of hiring recovered addicts…the Mental Health system however sees little merit in hiring psych survivors to fulfill salaried positions on par with other social service providers. They much prefer us to be ghettoized as paid “peers” at minimum wage (who in the world has paid “peers”?). Some of us can be “out” but many would put their jobs in jeopardy – and I’m not taking about sigma- there will always be bigoted people in the world – but rather out and out illegal discrimination against and individual with a disability. Have fun proving anything in court like a wrongful dismissal.
So believe what you want…but be sure that it’s a two tied discriminatory society here in the great country of Canada, 2010. While these statements are written from my particular slant – let’s be clear: This information is not just hearsay or stuff someone told me, or I that read on the net…I’m right there at the table when this shit goes down.
And yes sometimes a doctor does (metaphorically) tell one to jump off a cliff. You get to read the fine print of the court order on the fall down.
A.E.
My own view of psychiatry is rather dim due to my own experiences. A doctor saw me for 5 minutes when I was a teen and wrote: Paranoid schizophrenia. However I did not have Schizophrenia. Doctors like their records very much – so this disinformation followed me around for more than ten years – yep the wrong treatments continuously. The story has a bittersweet ending as sometimes it takes a bigger more arrogant doctor to tread over another doctor’s diagnosis. It's these types of happenings that attracted me to this work.
As far as consent goes…I’m not talking about a doctor talking to someone face to face about treatment etc…but rather consent on a system level. Yes the electronic age is here and there are going to be electronic health records – the infrastructure is being set up right now. Yes there will be unique identifiers to your previously “aggregate” health data. If you’ve used the hospital then YES there are assessments made on you that will be shared via you “implied” consent. That means if you disagree with a health care provider and switch services then your records will show up at the new place (like those fun filled misdiagnosis’s!). The Hospitals in Ontario use record keeping that includes labeling you “aggressive” when you simply so no to medication – even a simple "thanks but no thanks" gets you the label- and its stored forever in your new shiny electronic health record.
There is so much more to tell…my brain is bursting. For example there is no clear definition of what constitutes a “health” record. That means if you played with matches and “accidentally” burned down your aunties shed in 1982 at age 10…this could find its way into your health records and be used to deny you supportive housing at age 48. Yep even if you willfully committed a crime in the past and served your sentence and was deemed rehabilitated by the criminal justice system this information could still possibly end up in your health records…its already happened plenty! Health care information custodians are not allowed to be selective about what they keep…if it shows up in the fax or other means then we have to keep it. When some well meaning worker asks you to sign a consent for information form– then they – and anyone else they’re working with (thanks to implied consent) are getting to read these things.
continued…
A lot of my bitching comes from seeing how the system deploys its limited resources. When the multi-million dollar Assertive Community Treatment Teams were funded they had to serve someone right? Did those individuals prove to be the most difficult, volatile, seriously ill etc? Sometimes…but often the services frequently discharged those difficult individuals and opted for persons that were much easier to manage. Since just like many other regular lazy folks they like getting more money for less work.
We’re down here working with that guy that’s seriously ill and even though it hurts me in the gut to say…sometimes we need emergency psychiatric care for our guys and it is simply not there…even in life threatening situations.
It takes a rare psychiatrist to actually be astute enough to realize that medications can have paradoxical effects (let alone the resident on call). That all those side -effects listed for atypical anti-psychotics actually can mimic the disorders they are purported to treat. That sometimes something given to someone to “calm” them can actually create a reaction that creates severe agitation or worse. Sure the doctors read about it in their textbooks…but on the day it happens…well the lights are on but no one is home.
It’s funny that mental health experience is one of those grey areas that one’s experience counts for little. In a room of shrinks who can put up there hand and say they lived through the things that they have only read about and observed…or have actually take nearly all of the drugs currently available and know what they feel like. It’s almost laughable when doctors tell someone they shouldn’t be feeling such and such. Is this not your own experience also?
Seems all they have on offer at the ER is injectable anti-psychotics. No one is force injecting people with just benzodiazepines like Valium or Ativan. Even if you asked for that it would be viewed as “drug seeking behavior” – seeing as how a lot of people like the feeling they get from these type of drugs – and not many people come running to tell me how great their new atypical anti-psychotic feels.
Yeah I admit it’s probably a bad idea all around but remember we’re taking immediate emergency treatment not ongoing treatment options – just let’s get a handle on things right for now. And forget about the addictive class that benzos are in…getting off of any psych drug is a bit like dying. I’m sure we both know that all too personally.
As far as emergency psychiatry goes I don’t really know what can be done. Yeah- no one can just do “whatever” in modern society without some repercussions…but one would hope that we’re all considered equal under the Charter. If you told the ER you couldn’t tolerate ANY neuroleptic (since you’d tried them all before) that they might actually listen to you in the same way as when you tell them you’re allergic to penicillin. After I had an allergic reaction to penicillin no one ever suggested I should take it ever again. Not so with neuroleptics. Not even with serious side effect complications…yep still told to take them over and over…like a stupid busted cuckoo clock. And I’m glad for the experience…so when some walks into my office and tells me as such I know it’s a true (albeit horrible) experience for that person.
continued…
“Once you leave the hospital, no one can _make_ you take a drug”.
I’m afraid that this is simply not true. Maybe if you’re sharp with words or can get a lawyer, have gone to lengths to read the same medical texts as you doctor, are middle class and are a native English speaker – then you can talk your way out of taking meds.
Yes on paper we have choices and even Community Treatment Order (CTO) legislation states that individuals have to consent to being on the order – but the reality of this usually ends up as coercion. Additionally the Courts can mandate you to be on depot injections. I see it all the time…and frequently it’s totally discriminatory. We look into things like the demographics…and you better believe it’s not usually white middle class kids that are forced to take meds.
Our own schemata will influence us obviously. I’ve no intention of arguing anyone to my exact point of view (even if this were possible then the world would be boring–ha). You’ve been writing from your own personal experiences…so your reflections are accurate…but there is another world, the homeless guy kicking the can on the street…I’ve been there with him- lived that life also- and I’m writing to you out of frustration for the things I have seen. And sure I’m mad as hell (not at you personally) but rather at the generally accepted level of discrimination out there. The idea that ANY of our own would just plainly state that person with mental health conditions should be treated without their consent (and no I don’t think it’s remotely similar to regular emergency medical intervention) lowers us all to a sub class of individuals. I dare anyone to take some general statements about what’s good for individuals with psychiatric disabilities and substitute any oppressed or marginalized peoples throughout history. It’s a fun game: Those _______ shouldn’t have rights…they frighten us good and decent taxpayers…they should take behavior altering medicine…heck we shouldn’t even ask them.
Even after my little rant…I’m not anti-psychiatry. Yes there are some seriously caring doctors that we’ve worked with. However when working with severely marginalized persons, homeless, trauma survivors, the criminal justice system users etc, many of the people providing services do not have a rights based or social justice perspective (and sometimes are just the leftover bottom feeders of their profession). Think about it…where do you want to work after you get your medical degree? In a nice office or down at the jail? It takes that special someone to want to provide service when everything smells like piss and people yell and scream at you (and while I don’t like getting yelled at either – god I love those guys).
Down here on the front lines there is not much access to decent anything, let alone private (caring) psychiatrists. Rather we have plenty of arrogant small minded doctors, do-nothing social workers and terrible supportive housing workers. That’s right imagine your landlord is a Mental Health agency that can call the police on you when you say you don’t want to take your medication – happens all the time. If you happen to get a lawyer and win that fight the next step is your eviction. Welcome to the shelter or the sidewalk…the choice is all yours!
continued….
Hi Anon,
Feel free to be the dissenting opinion, I have no problem with that.
Once you leave the hospital, no one can _make_ you take a drug. The doctor isn't there with a glass of water, a tablet and a gun. Once you get out of the hospital what you do is up to and something each individual has to take responsibility for. You stopped taking pain pills, well someone can stop taking antidepressants too.
Yes, I know this is easier said than done and yes, some doctors are aggressive in their assertions regarding medication. But seriously, would you jump off a cliff if a doctor told you jump to???
Yes, there are many disabling side-effects. You'll get no argument from me on that, just as there are side-effects to all medication. That means that some people will find them intolerable and choose to get off the meds. That's fine with me. Life's a tradeoff.
And while you've said you're against it, you haven't proposed an alternative. What would you do with the psychotic in the ER?
And while you suggest that doctors don't want to consider matters of consent at any time I see no evidence of this and do not find it to be particularly believable. Obviously some doctors are immoral but I wouldn't say that is the majority.
– N
Hi David,
See, that's the thing – people refuse to look at all sides because of an _agenda_. It's much easier to be outraged than it is to think. I was trying really hard not to mention the "S" word, but now that you have, yes, Scientologists are the root of a lot of this agenda. I try really hard not to dislike any group, but any group that insists on everyone throwing their meds out the window really gets under my skin.
– N
Hi Herb,
Well thank-you. Feel free to send the zealots my way, their lack of reason tickles me.
– N
I guess I’ll have to be the one of those who has to disagree.
Yes people do get treated without their consent in emergency situations for all types of medical crisis…but in the case of mental health that easily gets extended to a lifetime of being medicated by doctors that “know” best. I’m not for a two tiered society where some Canadians are afforded the full protection of the Charter- and others (those mentally ill folks- we know who we are) are not.
I’ve broken bones and had other major surgeries…but the doctors didn’t follow me out into my daily existence or mandate that I should take powerful painkillers to treat my conditions for the rest of my life. When I requested to be taken off of pain killers– that was no problem as I had that right – because the pain of having my arm screwed together with posts was more tolerable than the side effects of morphine.
I’m surprised no one has mentioned our fabulous friend and infernal neuroleptic side effect: Akathisia. You know the good old “indescribable sense of terror and doom” dysphoric kind. I’ve talked to many doctors about that one: The reponse- take MORE medication or just wait till it wears off.
Next time any of us is treated without our consent (maybe in between the terrified pacing and reading your handy pamphlet: Urinary retention- why you can’t go pee on Haldol & other fun anti-psychotic meds) we can ask our doctor to Google “akathisia and suicide”…lots of fun studies.
And I know you didn’t go into the details of consent…but I’m a Survivor and I work in the mental health field….the system would very much like to do away with any type of express consent and just go with implied consent…so we’re all going to be screwed if we don’t stand up.
So.No.To.Doctors.Medicating.Without EXPRESS consent. We’re all equal citizens let us keep it that way. Besides I like to pee without a catheter.
Ultimately taking meds or not taking them is an individual choice…whatever improves the quality of someone’s life is important…but it has got be a free choice…I’m not a believer in force leading to healing and good relationships.
Long time reader- first time crabber. Have a good weekend all.
A
Just like the controversy surrounding Seroquel, we are dealing with a very, very sticky subject, that has both positives and negatives. Like you pointed out, if there was a better way to treat someone during a psychotic episode so that medication was not used, than that would be logical. However, at this point in time that remedy does not exist.
Rather, what we are left with is a topic that is similar to abortion, the right to die, church and state, evolution vs. science, gun rights. Everyone has an opinion on the subject, but more times than not they forget to ask the person who is suffering. Interest groups (like Scientology, or the groups that you were talking about) see the subject in black and white, and refuse to look at all sides of the topic, because that would undermine their goal.
Thank you for posting this, as I was not privy to the medication without consent topic. Maybe one day we will stumble across a new solution that will help, but at the moment, all we can do is continue debating.
Dave.
~N,
I’ve followed your blog for some time now and for several reasons one of which is a commonality in therapy utilized by my spouse and you. The other and very much important reason is your superb ability to both articulate your thoughts and present them both in writing and orally with the additional ability to rationally delve into the heart of some difficult subject matters.
This is an excellent post and presentation in my opinion although after more than a decade of blogging I can find a number of the zealots who if I directed to this post would go off the deep end after proselytizing their opposition.
Warmly,
Herb
VNSdepression.com
Great post. I agree with you, and loved the example of the three options. Right on!
Hi Midnight,
That's exactly right. You were stabilized so you could make a reasonable choice.
– N
I agree. When I have been in a emergency situation, be it mental or otherwise I am there for help not to hurt myself or others. I didn't like it at the time, but after coming out of my psychotic episodes I was grateful for the medication and the help. Now I have the choice in my medication decision.
Bec,
While I do think it would be terrible to be chemically or physically restrained I think people _would_ feel grateful afterwords. Many people are, in fact, grateful for their medication – not hearing voices, not having disturbing, relentless thoughts.
Thanks for your first-hand account.
– N
I couldn't agree more. If I was ever in such a state, I would WANT whatever can be done to be done. Even if I didn't appreciate it at the time, I would certainly appreciate it afterwards.
When I was working as a nurse, I have had to restrain patients (chemically and physically until the meds kicked in) and they have always been greatful afterwards.
Thank-you so much for your comment. I'm glad to hear that people are taking it seriously, as they should. (And I believe that they do.)
– N
Thanks for this post. I'm a resident in a psychiatry training program. We spend a lot of time learning about issues around consent from a variety of perspective. Hospitalizing and/or treating someone without their consent is something my colleagues and I take incredibly seriously!
You should take it incredibly seriously, you never know when a former patient may treat you in a manner without your consent you don’t like some day when your walking to your car one day OUTSIDE the locked doors of impatient psychiatry.
Resources for Therapists Who Are Stalked, Threatened, or Attacked by Patients http://kspope.com/stalking.php