On Forced Treatment

Trigger warning: forced treatment, forced institutionalization, ableism

The New York Times has invited people to write in about forced treatment for mental illnesses, and, well, here's what I sent them. (They have had their conversation by now, it was Sunday.)

When I hear about forced treatments for mental illnesses, I think of many things. I think of the reasons that institutions are bad, I think of the problems are mental health system already has with coercion. I think of the fact that a mentally healthy person is (usually) encouraged to be assertive and to make their own decisions, set their own goals, while a person being treated for a mental health issue (or in therapy for a developmental disability like autism) is not. Instead, compliance is key, and disagreeing with the goals that the professionals set is seen as a sign of illness, not of the decision-making capacity and assertiveness that we claim to encourage for people who do not have mental health issues. In fact, this pushing of compliance above all is priming people to  need to return to the system time and again or to simply never leave. 

I also think of friends who have received forced treatment of any sort. Some of them have PTSD from the experience, and it did not cure the issues they were being forcibly treated for. Rather than helping them, it created more issues. 

Complete reform of our mental health system is needed, and forced treatment is not the reform that we need. It is, in fact, already much to easy to make forced treatments happen if you know how to work the system, and it isn't fixing things. Instead, it is making people try to hide their problems and avoid getting the help that they may well be aware of needing due to the loss of autonomy that comes with the current system.

In many cases, the choices are few.

1. Try to act like nothing is wrong and like you do not need help.

1. Get treatment that will likely be expensive and which may include the loss of significant control over your life, possibly including medications that have significant side effects, with refusal to take them due to these side effects being taken as an indication of your impairment and possibly being forced to take them because you made the informed choice not to take them.

Yes, sometimes people manage to get the help they want without driving themselves into debt or losing control over their own lives at the hands of those who think that a mentally ill person can not act in their own best interests. This is even reasonably common, but the risks are sufficient that a completely rational person  could choose to avoid treatment because of these issues, even before contemplating the stigma around mental illness. The way to fix this isn't to force people into the current system, but to make a system that will actually help people. 

Think about it. If you knew you faced a real risk of losing the right to make your own decisions about your life, would you take that risk in order to get help?

-Alyssa