An Update on the Discourse About Force Treatment
By Philip A. Kumin
After reading Robert Whitaker’s book, Anatomy of an Epidemic, I was sworn to the burgeoning masses of mental patients rejoicing in a newfound salvation. Here, finally, was someone who was on our side in the fight to elicit contentment out of a surrounding cauldron of contempt.
During the 1980’s, Congress passed several pieces of poignant legislation aimed at the betterment of mental patients and anyone who was considered to be developmentally disabled in any way. For the first time, dedicated sources of funding would pay lawyers to protect and advocate for the rights of so-named persons, and many young lawyers subsequently flocked to the opportunity to implement longstanding ideals. One facet of the Protection & Advocacy for Mentally Ill Individuals Act mandated that lawyers in dedicated non-profit law firms would be guided by the recommendations of advisory councils in their undertakings executing this law. These advisory councils were to be made up of an eclectic mixture of advocates, though mental patients would constitute a majority thereon. Patients were overjoyed at such a delinquent shift in this burden of proof, and they prayed that this would end in the demise of the forced treatment of them by the mental health system. Conclusively, opportunities were created whereby mental patients had the chance to indoctrinate attorneys to mental patient priorities.
Fast forward to forty years later, however.
The loud rhetoric of pro-forced treatment advocates has been like the rat-a-tat-tat fire of a gatling gun. These people always have the unfair benefit of drug companies hellbent in their pursuit of profits, regardless of what effect their methodologies have on the lives of patients. Drug companies never have any difficulty shrouding the treachery of what they’re doing in the self-serving trappings of stigma, and many of the young lawyers who had flocked to the protection & advocacy system have since become inured to the rantings of pro-force merely, versus gauging them. Patients worry that the tide could be turning against the cause of the abolition of forced treatment.
Jim Gottstein is a mental patient, a lawyer, an author, and the protagonist of an effort known as the Law Project for Psychiatric Rights. Jim is understandably concerned about the direction matters may be headed in. He has initiated an effort known as the Protection & Advocacy for Mentally Ill Individuals, (P.A.M.I.I.) Advisory Council Empowerment Project. The intent of this project is to better educate persons serving on the advisory committees to each of the state P&A offices, particularly the patients thereon. Regularly scheduled videoconferences are held to discuss business, and I recently had the pleasure of being privy to one of them.
Initially, routine business was discussed with occasional displays of camaraderie and hope. But there was an underlying fear of what’s going to happen in the future. Eventually the enthusiasm died down, and everyone became reflective. Jim Gottstein himself sighed and sadly stated the unspoken: even the P&A lawyers were no longer as firmly committed to abolition as they had been. This was a telling moment.
The entire discussion about forced treatment is circumscribed by the unspoken truth that nobody gives a damn when somebody else kills themselves. That’s never any skin off the bystander’s back, and there are no repercussions.
Forced treatment carries with it the force and the weight of the law. This is common knowledge amongst the public and this immediately puts a mental patient at a disadvantage on any one of the myriad of occasions in a day when somebody decides to flex their muscles in a patient’s face and bully them around. This is one of the chief arguments against involuntary commitment and forced treatment: that it neuters patients and renders them defenseless. Patients are acutely aware of this shortfall every waking minute of their lives. If they are driven to a point where they think about hurting themselves because of it, they have the reassurance (?) of knowing that no one else anywhere in society will be held accountable for forcing them to die. Where’s the justice in that? Where’s the beef? God forbid any mental health professional or other knowledgeable person witnesses them in this state of alarm: they’ll be locked up against their will, treated against their will and left to die, now a considerably greater likelihood. Patients are tired of everyone else taking advantage of patients’ orchestrated lack of legal standing. This is a lose/lose situation for us. Is there anything else we can do?
It’s loathsome for a patient to engage in a discussion with someone else about the subject of forced treatment. Considering the weight of what’s involved in this for us, it’s infuriating to see that there’s any question in someone else’s mind about the legitimacy of the desperation in our quests for safety and happiness.
And whenever any brave patient questions someone else about their feelings, there are two things which are at work regarding that person’s answer: first, the fact that this person is terrified by crazy people. The second factor is much more judgmental: to what extent does this patient DESERVE to be safe and happy in life?
