Transcript ACLU - Oregon State Hospital

Ron Unger LCSW
[email protected]
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“Stormy search for self” as a young man
◦ Sometimes “mad” but it was also a positive
emotional and spiritual journey
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Multiple family members pulled into mental
health system due to similar crisis
Became an activist for change in the mental
health system
Then became a professional
◦ To develop alternatives
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Then became an educator
◦ To increase availability of alternatives
 See my blog http://recoveryfromschizophrenia.org/
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People in mental health crisis are frequently
dangerous to self, sometimes to others
◦ “Too much” respect for their rights has been
criticized as possibly leading to people “dying with
their rights on”
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But too little respect for the human rights of
people in crisis can lead to very serious
problems that are too often ignored
◦ By looking at both sides of the issue in a balanced
way, we can find better solutions
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Between 44 and 51% were found to have PTSD
induced by psychiatric admission and
treatment
 (Priebe, Broker, & Gunkel, 1998; Morrison, Bowe,
Larkin, & Northard, 1999)
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Forced drugging, restraint, and seclusion
have been identified as inducing fear,
victimization and helplessness
◦ Also a factor: Loss of control over identity as one is
forced into the role of a “mental patient”
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Damaging person’s relationship with mental
health system
◦ Creating either
 Too much rebellion & disengagement, or
 Too much compliance
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Possibly imposing a treatment which is
actually more harmful than helpful
◦ Because of failure to listen to feedback from person
receiving treatment
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In General, unjustified infringements on
liberty
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Often mental health goals can be accomplished
without coercion
◦ Seclusion & Restraint can usually be mostly eliminated
by facilities which make that a goal
◦ Research shows making voluntary treatment easily
available works as well as involuntary outpatient
commitment in reducing mental health problems
◦ Greater appreciation of the damage done by coercive
treatment, and appreciation for the very limited ability of
psychiatrists etc. to predict violence, could lead to much
less use of coercion
 And ending it sooner, when it is used at all
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Mental Health system has pretended to know
that there exist “real illnesses” like
“schizophrenia” that are definitely not
understandable reactions to difficult events
 Despite large amounts of evidence to the contrary
◦ Has a “bible” (the DSM) of ever expanding
“disorders” invented by committees
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Human distress and confusion is real
◦ and sometimes overwhelming or even deadly
 But is not adequately addressed by applying labels and
then treating the person just based on that label
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Much of the public is convinced that mental
health problems are due to “biochemical
imbalances” that can be corrected by medications
◦ Despite the fact that no one has provided good evidence
of anything that simple!
◦ And despite the fact that psychiatric drugs create
abnormal biochemical states in the brain
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In 2003, MindFreedom did a hunger strike to
challenge the APA to provide evidence of a
biochemical imbalance
◦ More recently, psychiatry is backing off from any such
claims
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This book
documents a large
body of evidence
suggesting that
while psychiatric
drugs often appear
to help in the short
term,
The long term effect
on average is to
make the problems
worse
GD = Guided
Discontinuation
MT =
Maintenance
Therapy
See Wunderink, L., Nieboer, R. M., Wiersma, D., Sytema, S., & Nienhuis, F. J. (2013). Recovery in Remitted First-Episode
Psychosis at 7 Years of Follow-up of an Early Dose Reduction/Discontinuation or Maintenance Treatment Strategy: Long-term
Follow-up of a 2-Year Randomized Clinical Trial. JAMA Psychiatry, 70(9), 913-920. doi: 10.1001/jamapsychiatry.2013.19
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The drug will not simply correct a specific
“biochemical imbalance”
It will create what could be called a “drugged
state”
◦ and then either this drugged state or the placebo
effect may be give some relief in the short term
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In the long term, there is substantial risk that
use of the drug will interfere with resolving
the issue
◦ And there is risk of various side effects,
 including possibly permanent neurological changes,
and dependency problems.
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There is no adequate “informed choice” when
people are given only one treatment option
Options that should exist:
◦ Psychological approaches that address trauma and
life stresses
 Even for “serious disorders”
◦ Holistic options that integrate mind, body, and
spirit
◦ Social causes of mental health issues should be
appreciated as a public health issue
 Like inequality
 “In
order to recover,
 I had to believe the opposite of
what the mental health system
told me to believe,
 and I had to do the opposite of
what it told me to do.”
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We all have an ethical obligation to speak out
when human rights of people receiving
treatment are being disrespected
◦ And when treatment guided by narrow ideology
and/or profit seeking is leading to more harm than
good
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Joining an advocacy group like MindFreedom
is one way to help make sure these issues get
addressed!