Any forced psychiatric medication treatment should be an extremely last ditch effort, when lives are truly at stake.
The force should be as little as possible, with huge inputs for full peer oversight, full reversal and appeal processes, full knowledge that psychiatric medications are painkillers and addictive, not effective in the long term.
A lot of academic literature shows that fasting and hunger cause biochemical and emotional changes that make people want to keep fasting. I know this from personal experience as well. So this means decisions are affected by this chemical and emotional state that does not accurately reflect the body’s needs.
Forced Psychiatric Medication and Biofeedback Loops
We as a society typically agree that minors and intellectually disabled people can’t legally consent to sex, marriage, financial agreements, etc, because they don’t fully understand the ramifications. So I say that someone caught in a feedback loop like this may need help to get out of it until they can see the full ramifications involved with the loop.
All four of these extreme emotional states are caused by biochemical changes that are environmentally induced, often by trauma, isolation, lack of self-care, or lack of exercise. All four of these situations have feedback loops, where the situation itself can make the causes of the situation worse.
In some very few, very extreme cases, the use of forced psychiatric medication might be able to help some temporarily regain perspective.
Some advocates take stronger positions on forced psychiatric medication
There is a group whose sole purpose is to make forced psychiatric medication easier to administer. However, they often use misinterpretations of research to make their advocacy points. Here is an example of the inaccuracies in a great rebuttal by Robert Whitaker of an inaccurate review of Anatomy of an Epidemic.
They often use the point I’ve made above that people may not be aware of their illness, and they use a term called “agnosia” or “anosognosia” which was originally used to describe stroke patients that may not understand the extent of their injury. There is some controversy about how much this term applies to people with emotional distress.
Often, people want “help,” and have sought “help,” but have not been able to access it due to health care expenses. Most people that are in extreme emotional states know that something is different. This research study on forced psychiatric medication shows that the mandatory “help” is no more effective than voluntary treatment, and any studies showing increased effectiveness can’t separate out the benefit that comes from simply making “treatment” more available to all people who need it.
Some advocates say that forced psychiatric medication is morally wrong, always, and should never be used, even to save a life. They say that the fear of forced psychiatric medication makes people avoid seeking help. They say the trauma of being forced to receive help does more harm than good in some cases.
They say that for every person who says their life was saved by forced psychiatric medication, they can find at least one person whose life was ruined by forced psychiatric medication.
The commitment orders are extremely hard to appeal or get reversed because most judges know little about mental health, and don’t know what to do with a person in recovery who might know more about medicine than professionals.
The question is, though, what about those people who do say that there are people who say that forced treatment saved their lives? I am one who made multiple suicide attempts and was glad that people stepped in to stop some of them.
If peers say that the primary element is choice, shouldn’t all options be on the table, including one that many people would endorse later on once they get out of a feedback loop that has skewed their decision making ability?
Chris Hansen’s view on forced psychiatric medication:
A great conclusion can be summarized by Chris Hansen, who works closely with Shery Mead to create and share Intentional Peer Support. She says, “My opinion is that involuntary treatment should be seen as a reportable incident- in the same way a police shooting is seen as a reportable incident (or whatever it’s called over here). Of course it will continue to happen, for all sorts of reasons. If it’s seen as a failure of the system, then there is a lot of positive incentive to work to find alternatives that work. At the moment, there isn’t a lot of incentive because involuntary treatment is an easy option.”
Chris explains further:
So here we have two truths: 1. Forced psychiatric medication is a violation of human rights, it is traumatic, intrusive and causes often irreparable damage, and 2. Forced psychiatric medication is something that many claim has saved their life, or the lives of others they care for.
Personally, I think we run into problems when we argue for ‘one or the other’. Surely we want a world that honours the human rights and dignity of al, _AND_ enables us and those we love and all to have the choices afforded to us by being alive?
My contention is that while we are arguing for the second, we lose sight of human rights, because we make violation _OK_ (some of the time). And lose the possibilities of creating change and alternatives. Is it force that folks are arguing for? Or is it alternatives and options for staying alive and connected, and for those we love to stay alive and connected as valued and respected citizens, even in the hardest and darkest of times? Surely force is not the _only_ way to do that- it’s just the only way that many of us have access to at the moment.
What I think we should be advocating for is a commitment and dedication to alternatives that _work_ for people and enable them to move on. This will be hard work, time-consuming and (initially possibly) costly (although in all likelihood the benefits will very quickly outstrip any cost). There will be little real incentive in overworked ‘systems’ in my opinion, if there is an option of coercion- it will still be seen and taken and justified and change will be slow.
If we lobby for it’s abolition, we create an environment that makes it mandatory to work on developing other ways of doing things. An example is- slavery was just plain wrong. It could have been argued that it provided ‘meaningful work’ and habitation for millions. _AND_ that there was no alternative for many. However it was only when it was no longer possible that there was an incentive to take some collective responsibility for the citizens who were now free.
And what if it was your own kid?
Let’s put this in a slightly different framework: What if this were your daughter? What would you choose then? I know that now I am glad I did not die when I wanted to die back then, the six times that I tried. Till I found furious fiery acceptance that we are all still meant to be, evidence in this world of things unseen. And with the grace of a mustard seen, I built a new life of friends and dreams…http://www.youtube.com/watch?v=lDh5hI8vJCY
So my view is that I’m going to create alternative approaches, and other advocates can work on making the existing approaches illegal. We can agree to disagree that we have different priorities and means to our end, but we are working towards the same end. We all want a world without permanent medications and labels for temporary emotional distress.