Podcast: The rise of forced treatment and abusive guardianships

From PsychCentral: “There is a common misconception that, due to the closure of asylums, only ‘dangerous’ people are admitted to psychiatric wards and hospitals. We also believe that forcing someone with “mental illness” to undergo treatment is rare. However, every year millions of Americans are subjected to psychiatric detention or forced treatment.

Well-meaning family members often try to “help,” but end up traumatizing and permanently damaging their loved ones. Join us as investigative journalist Rob Wipond explains how most states have expanded their criteria for someone’s psychiatric detention well beyond “imminent harm” and that, in practice, this could happen to almost anyone. Join us for a two-part special episode of Inside Mental Health.

Gab Howard: What about parents, most of the people pushing for these kinds of laws and this kind of intervention are parents of adult children with “mental illness” and they claim to have a view of their children’s best interests, to know their children and know that this will be helpful. Now, you’ve talked about problems with doctors or hospitals, but often it’s family members who push for it, not the medical establishment.

RobWipond:Yes. So, I have a couple of concerns about that that are really profound. And one of the biggest is that this is obviously a very important group. This is the strongest lobby group in America and Canada that has reshaped these laws. The family members are very vocal and very passionate about trying to forcibly drug their loved ones. And they’ve influenced legislation across the country. So, this is the dominant voice on these issues. And one of my biggest concerns is that almost never when these families speak do they seem to be aware that some families are abusive. . . you have to look at America and what we know about family abuse and know that it is very common. Child sexual abuse, physical abuse, parents themselves having emotional difficulties of different kinds. And so, you have to be aware of that if you’re going to lobby lawmakers to expand the powers of families, to make sure that anyone else in the family is forcibly medicated, heavily sedated against their will. You need some sort of level of accountability and oversight to ensure this isn’t being used nefariously and abusively by a family member who doesn’t have the best of intentions in mind. And that’s very common and this is what I’ve found, is her doctors just don’t have the time or the resources to do, you know, a thorough investigation of a family and really figure out what’s really going on here. So, they often take testimony at face value, go, oh, is that how Person X was behaving? All right. You know, and this testimony is enormously powerful.

. . . The other piece I want to highlight is that this creates a huge rift in families that can go on for years and decades. And often they are really struggling because they have no other resources. This is the only thing available today. If you want help for someone who is really struggling, people are educated and taught to put them in a mental hospital. And as one psychiatrist told me, I think a lot of families are delusional about what we can do up here. We don’t really solve people’s problems. We just cure them. And there’s a percentage of people that it helps, but there’s a very large percentage that doesn’t really make a huge difference in their lives. And so, then families start lobbying these doctors, keep them longer, do more, and then they’re going to sue if these people aren’t healed. . .

Gab Howard: One of the things that worries me so much about forced treatment is that it is ultimately harmful. You only have one bite of the apple, right? And forcing someone to do something only works while you’re forcing them. Once you stop forcing them, they no longer trust you. They no longer trust the system. They no longer trust the process and will not ask for help. And, well, frankly, they’ll stay away from you. They will stay completely away from the mental health system. They will likely avoid everything and start getting no treatment at all. So, family members who say, look, I know they need treatment, I know this is what’s best for them and that’s why I’m doing it, even if it’s not what they want — I just have to say, okay , but is this the long-term solution you’re looking for? Or did you only solve the problem for a year, two years, or hell, five years? And that’s really such a short amount of time, especially if your loved one is showing symptoms at the stereotypical age of 16 to 24. Let’s say you get them stable. . . from 24 to 29. What happens from 29 onwards? They’re just going to be very, very traumatized. . . they avoid everything and achieve nothing. And it really seems like your data is confirming that this isn’t a good long-term solution.

RobWipond:Yes, and that’s such a good point, a very important point that it really only works once. Because, okay, now that you’ve done that, those people will never feel safe calling anyone. Because they know there is this extreme risk of being subjected to something that has traumatized them. So how can you believe this as a — like, I ask these practitioners, who I’m frankly amazed that psychiatrists aren’t the ones speaking out against forced treatment, because I think you see it every day. But instead, what they did was expand it, right? Their justification that it’s clearly failing a giant segment of their own patient group — it’s clearly not working for them — their reaction is, okay, we need this more. We have to do it longer. We have to get in first, we have to make them younger. . . Everything right now is moving towards expansion and expansion and expansion of the amount of time and the degree of force. And I’m saying it’s time to look the other way. It’s time to back off and go, look, there’s a huge segment of the population of these patient groups that this doesn’t work for. All it does is push them away. They are afraid to seek help even when they do [want] It.

And that’s also what I want to emphasize. We shouldn’t equate aid with force, and that seems to be what we are doing. When we have this dialogue, we say, oh yeah, if we didn’t send the police out, we wouldn’t help them. Well, wait a minute. There are many other ways to help someone who is in trouble. I’ve seen people, I’ve been with people in extremely high distress states, and you can still find ways to talk to them. You can still find ways to connect. And that’s what we need to do much more as a culture, as a society.

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