The foundation of the new policy is that New York state will be able to authorize first responders to forcibly hospitalize mentally ill New Yorkers who cannot meet their own basic needs such as food, shelter or medical care.
It does bring up a tough question though: what do we do with people who need treatment but refuse to accept it?
Find a way of treating them and helping them to adjust to society without the use of coercion or a violation of their rights. That means giving them real legal representation, giving them access to courts that are open to public observation (mental health courts are NOT sufficient), giving them access to second opinions, and exhausting social supports (e.g. housing them in a safe environment) without imprisoning them.
The bar for being declared incompetent and unable to consent to treatment (which leads to forced psychiatry) is not high enough. Even coming from a psychiatrist, it is effectively hearsay in my opinion. There is not enough due process and outside oversight.
There are real side effects to psychiatry - it’s called iatrogenic illness. When somebody is in crisis, what do they prescribe? They prescribe powerful drugs, usually neuroleptics. For example, tardive dyskinesia can affect up to 20% of people who take neuroleptics. It could be permanent - look up YT videos of those afflicted. It’s easy to stereotype somebody as mentally ill if they develop TD.
It could be that somebody reacts nicely to the drugs they are prescribed. But what happens when they are released and can’t afford treatment or become non-compliant with treatment? It can lead to disastrous withdrawal and terrible side effects, that can result in more hospitalization or a worsening of their illness.
Knowing that, why would you take away somebody’s ability to not consent to treatment? Why can’t we give them access to intensive therapy, that they consent to, that properly addresses the root causes of their illness and inability to care for themselves? Why do we treat traumatized individuals by inflicting MORE trauma on them? Being kidnapped, imprisoned, and medically raped is traumatizing. Why are individuals not given the option to not consent to medication, but only consent to therapy?
I invite you to look at Soteria Houses, which is a different model of care, that successfully achieves remission in those that are experiencing first-episode psychosis/schizophrenia. If they can achieve remission with little to no psychiatric medication (and likely no life-long prescriptions) in a severe illness, without coercion or locked doors, why don’t we give more people the chance to experience that? What if they have the capacity to heal in a supportive environment that doesn’t strip them of their rights - an environment that respects their will and autonomy?
Find a way of treating them and helping them to adjust to society without the use of coercion
But this is what I’m asking - what happens to those who will never accept help without coercion?
If they are actively violent and have committed a crime, hold them until their (expedited) court date (while providing them the option to explore support/therapy and/or access to spiritual counselors), record examinations by psychiatrists/perform them with outside/impartial observation, give the accused legal representation, and let publicly observable courts decide their fate. The option of a jury, witness/family/etc. testimony, and second opinions is imperative to their human rights.
If they have committed no crime (homelessness or being unable to provide for your needs are not crimes), are not violent, and are not a direct threat to themselves or others (and there is no concrete evidence that they will be) - there’s nothing you should be able to do to violate their will.
In the latter situation, the best you can do is try to earn their trust and ensure they are provided an environment where they feel safe - providing them with every social support and alternative that they should be entitled to explore for their betterment.
But what happens when they are released and can’t afford treatment or become non-compliant with treatment?
So you might say that they cannot meet their own basic needs?
I’m sorry but you can’t just let all mentally ill people go free to do whatever they want, and you definitely can’t just throw money and houses at them and expect the problem to go away. That’s not how mental illness works. You might not like it, but there are people with mental illnesses who either need someone to be a full time carer for them - and that is either a friend/family member/care worker, or it’s in an institution. The other option is you just let them die on the streets, maybe killing some other people along the way.
It is no measure of health to be well adjusted to a profoundly sick society.
I’m sorry but you can’t just let all mentally ill people go free to do whatever they want
This is a free society. There is no due process or evidence before they are kidnapped in this instance.
I’m sorry but you can’t just let all mentally ill people go free to do whatever they want, and you definitely can’t just throw money and houses at them and expect the problem to go away.
No money is thrown at them before they get to be in the situation they are in. They are homeless because they lack funds. They cannot afford insurance or reliably access medical care. If there are public services available to them, they may not know they have access to them, or they may be under-served by them.
You might not like it, but there are people with mental illnesses who either need someone to be a full time carer for them
I have suggested multiple times that they be given all social supports that are available to them. If they require that, they should be given that option.
The other option is you just let them die on the streets, maybe killing some other people along the way.
Your characterization of people suffering from mental illness or homeless people in general being violent is not reflected by the facts. People with schizophrenia are more likely to be the VICTIMS of a crime, than be the perpetrator.
It still exists. We may not lobotomize patients or put them in insulin comas, but forced ECT is still on the table. Even if the practice has improved with technological advancements, it can still be misapplied.
Though it was almost a decade ago (and in Austrailia) this story stuck out to me as being an example of everything that can go wrong in psychiatry: https://www.madinamerica.com/2016/05/psychiatry_garth_daniels/
It’s fucking tragic.
Contesting forced treatment orders, such as forced ECT, is an up-hill battle. Even if the practice is more humane nowadays, it still results in damage if improperly prescribed in those deemed treatment-resistant.
I am speaking up for the people who are not served by the system and are effectively silenced. Psychiatrists are generally not legally responsible for iatrogenic illness/harm - proving damage is near to impossible, even in cases of clear malpractice and neglect.
I implore readers to look at https://www.madinamerica.com/ and consider reading Robert Whitaker’s books. He is not a psychiatrist, but there are plenty of psychiatrists and other mental health professionals who write or indirectly contribute to that website. I consider him qualified, but please don’t treat his voice as an authority and please use discernment when reading his works or reading anecdotes from that website. It takes a strong heart and stomach to be able to read some of the stories. If accurate and true, there are many crimes against humanity documented on that website.
There are many success stories to psychiatry. I don’t want to discount the stability and healing some individuals receive from proper intervention. Please don’t let what I write stop you from seeking out care if you are in need. There ARE good facilities that practice a leading standard of care - that do their best to not violate your will and treat you as a human.
