The other side
Okay, I haven’t received an email yet saying it’s okay to run the following, so I’ll just say it’s from an advocate for SB 226 (not a legislator). The advocate writes:
I read your blog on AOT today and was curious to understand more about your comment … “Is Senate Bill 226 the answer? I can’t say.”
I honestly just want to understand – what are are your concerns about this type of legislation? The length of time? – the initial period is just six months which is not very long but might be long enough for prescribed medications to start really working. That too many people with mental illness would qualify? – statistics from Kendra’s Law show less than 1%. The way it is implemented? – follow-up is in the community wherever the person lives, not in a hospital. Most hospital stays these days are barely a week, anyway, hardly enough time to stabilize and think clearly enough to continue medications when discharged.
If you believe with the intent of the proposed law, that severely ill people should have treatment and SB 226 would require that they do if they have a history of hospitalizations, what is your hesitancy? Since this bill is meant only for the small minority of those whose lives are the most desperate and sad situations that yo u can imagine, (short of those who end up in jail or prison, which is often what happens with untreated mental illnesses) I don’t know why you wouldn’t think an assisted outpatient treatment law wouldn’t be the answer. What do you think a family member should do when their loved one is psychotic, talking to themselves, following the voices in their heads, becoming parinoid and delusional – other than wait until something dangerous occurs?
People who most often are affected by AOT lack insight that they have an illness and therefore do not want any treatments, especially medications. One of the best-known experts on AOT is Dr. Xavier Amador, and if you haven’t read his book, “I’m Not Sick, I Don’t Need Help,” it explains what this means for an individual, and for his family and friends who want to help them. Pages 31 and 32 of the latest 2007 edition of the book talk about the research about poor insight and the connection to the frontal lobe dysfunction in the brain.
liz | 4:40 PM | Uncategorized
I know why I don’t like forced treatment (unless someone was dangerous to themselves or others) and that is because the definition of ‘mental illness’ can be very subjective.
Someone who is gay might also be called “mentally ill”. I’ve heard politicians say (very seriously) that an opposing party needed “mental health treatment”. A well known singer (over 21) in the 60’s was declared incompetent by his mother and given a lobotomy. He had several top selling albums by then. Who knows about the other’s that experienced a similar fate because they were crazy enough to like rock & roll.
That was well-intentioned therapy at that point in time. Even if lobotomy’s aren’t performed today, no one knows what the long term effects are – just as the standards for where the line is drawn between ’sane and insane’ change.
My cousin had bi-polar and at times talk about being an astronaut, among other things. I didn’t like being around him because he usually smelled when he was like that.
He married a medical doctor who worked getting him stablized and keeping him on meds. The first time I saw him on lithium, I wanted to scream and tell him to stop! His eyes were dead. His voice was flat and lifeless, there was no energy or passion. He took forever to answer a question. That was over 20 years ago.
I questioned if I’d take meds in his shoes. I couldn’t blame him if he didn’t want to feel like a zombie. I remembered it so well because it was the first time I questioned what ‘life’ was.
Obviously things have changed since then. But all too often, the patient has been blamed for treatment failures and rather than research why or how, bad treatments have been used way too long – often due to outside financial interests. Why has someone relapsed, what would work, how can we help – the patient seems to be the LAST one asked, even ‘crazy’ they know something.
Mental illness is not the same thing as being retarded, stupid, undisciplined, impulsive, obstinate, or needing the treatment of a child. It can’t be willed away or stopped by “picking yourself up by your boot straps”. What my cousin taught me was the last thing mental illness was is weak.
A number of countries with non-profit mental healthcare systems don’t use medication as first line treatment for mental illness. I looked at why medication was accepted in the U.S. and it’s called TMAP (www.bmj.org). Rather than find a number of interested and concerned industry proffessionals, I found more of a made-for-prime time movie with big insurances and big pharma’s.
I’m not saying that’s all bad, but there’s reason for extreme caution. Just because someone isn’t keeping their apartment clean and won’t take a shower, or living on the streets by choice, may not mean that forced treatment is warrented or will work. Our efforts would probably be better spent understanding why they relapsed, including dragons, spaceships, aliens and what they needed, why and how to prevent it from happening again.
Forcing treatment takes care of a short moment in time – and that’s usually all an insurance company cares about. For many, often that’s all the family cares about as well. It makes whatever is uncomfortable, seem better.
For most people in the mental health system, public or private, the only way someone with mental illness has to getting an inceased level of service or more appropiate care, is to ‘act out’. This bill could make it benefical to set the bar low and forcing more inappropiate treatment, preventing someone from having access to better and more appropiate (more costly) care.
Isn’t it interesting this bill is up on the heals of mental health parity?
The reality is that lot of genuis hides under the label of “mental illness”. The very definition of genius doesn’t include being “normal”. That threatens an awful lot of people.
In response to SB226 advocate, as you know the concept of lack of insight is disputed. Many, many people labeled as mentally ill accept their diagnoses and take the medciation they are prescibed. The few who choose not to do so have that right.
Anyone, whether a diabetic off his insulin or a purported depressive off of his medications who commits a crime should be punished. Our prisons are indeed hell holes and the conditions should be improved, talk thereapy and behavior modification of someone convicted of a crime should be available in prison, and in fact if available would probably make prisons safter and cheaper to manage.
There’s no indication that people labeled as mentally ill who stop taking their medication become violent. The TAC website has a list of such purported occurances, each of which can be accounted for in other ways, primarily among them, the tendancy of people caught commiting serious violent crimes to plead mental illness as a defense, people who’ve never been in the system before not because the bar was too high, but because they were not mentally ill.
As for family members of people with severe mental illness, love and support and family counseling are in order and, lets face it, financial support if possible. If a relative is physically disabled and his relatives kick him to the curb, wanting all legal control of his life and no financial or emotional responsibility, those relatives are shunned by society for the irresponsible sort that they are. I don’t get why this should be any different with those labeled mentally ill.
The idea that the mentally ill become violent to family members if unmedicated in any significant numbers is false. Most violent crimes are commited by someone known to the victim, and the vast majority by people not labeled as mentally ill, even after the fact.
If SB226 passes, the consequences will be disasterous as people in emotional distress will hide it so as to avoid losing all control of their lives. I would imagine that this will mean an increse in suicide and other desperate behavior as the draconian SB226 takes away all control from it’s victim, robbing them of all hope and all autonomy.
Making quality housing, jobs, and anonymous supportive treatment available in a nonjudgmental setting is the way to solve the problem of the severely mentally ill and is much cheaper than having the system forcibily manage the lives of miserable people who hate every moment of treatment.
The idea that AOT means that doctors miraculously choose the best treatment as opposed to the cheapest is absurd. The idea that people in distress because of previous bad experiences will be enslaved by a system in which they have no voice, an atrocity.
And those family members who push the idea that mental illness is a genetically passed on biological defect and who, unlike the relatives of most people labeled mentally ill, are so unable to relate to each other that they file petitions for forced care should be as carefully and rigorously screened for “mental illness” as the identified patient in the family and of course also should be subject to forced drugging.
A Law such as this one scares me to death as I see myself as a prime candidate for forced treatment. What I know of my past I have learned from family, friends, newspaper articles, photo ablums and the like, so details of my life prior to 2006 are sketchy at best and really are based on others interpretation and not my memory. I should note, I come from a very large family (13 brothers and sister). I am the only one who has ever been diagnosed with a mental illness. Sometime in the 1990’s my GP wrote a prescription for an anti-depressant because I apparently seemed mildly depressed. According to my sister, it was a time in my life when I had just moved out of state and was dealing with college. Apparently niether one of us thought medication was necessary, I thought if it was prescribed I needed to take it. So I did.
From there it appears everything spun out of control. One suicide attempt after another. The more medication I took, the closer and closer the suicide attempts became. Then came Electro-convulsive shocks treatments and more suicide attempts. I was the exceptional patient. I did exactly as my doctors suggested, one medication after another, one shock treatment after another. While I believe I had doubts about my treatment and was concerned about my real problems starting after taking an antidepressant were ignored by my doctors. I truely believed the doctors knew best and would only do what was best for me. In December of 2006 after 1 1/2 years of shock treatments at a rate of about one every other week I refused any more and two weeks later I went off all 13 psychiatric drugs cold turkey and ended up with severe drug withdrawls that placed back in a hospital. My doctors immediately wanted to start the shock treatment again, but I refused and was then threatened with a long term treatment facility if I would not consent to more shocks. The third day into my hospital stay the doctor asked if I was prepared to go to a long term facility. I looked the doctor in the eyes and stated “I hope you do the right thing”. I then consented to go on one medication (only with the hope I could avoid a long term facility). The doctor then stated “I am changing your diagnosis from severe depression to “drug withdrawl” and released me the next day. After returning home I went off all medications and have not attempted suicide since. My life has absolutley no meaning as I have almost no memory of my life prior to stopping ECT. My three college degrees are worthless. I no longer know how to do my job and do not have the cognitive ability to relearn it or any other job. Am I depressed now? You bet your ass! I am severly depressed. I am quite aware of it and my family and friends believe I am using very sound judgement by not taking medications. I live a very meaningless life now. I can’t work, I can’t cook, I drive places and constantly get lost, I forget just about everything, I can’t discuss old times, movies, politics, music, hobbies or anythingelse because it was erased and I retain few new memories. Yeah, I’m depressed. Talk therapists won’t see me because I can’t remember, and organize things well enough in my brain for therapy to be benificial. So they just refer me back to Psychiatrists who can only offer me more medication and shock treatments. I know for disability I will need to be seeing a Psychiatrist and know, without a doubt, if they had a law like this one, I would be in court because they would determine I was not using sound judgement for refusing their treatments. Anything I had or my family and friends had to say about my judgement regarding treatment would be meaninless to the court over a psychiatrist’s opinion. What good would forced treatment do me or society?
Reply: