Involuntary Commitment 

AIR DATE: Monday, May 24th 2010
POSTED BY: JULIE SABATIER

The family of Keaton Dupree Otis would like to see changes to the civil commitment law. Otis was fatally shot by Portland police on May 12 after he fired at officers from a car. His family said in a statement that Otis suffered from a mood disorder and they called for changes to the law when it comes to commiting someone for mental health treatment against his will. Specifically, the family said they'd like to see an expansion of the definition of "a danger to self or others," which is one of the key criteria for involuntary commitment.

County mental health staff are responsible for conducting investigations into civil commitment requests when family or friends call for help with a loved one they think is suffering from a mental health crisis. The person conducting the investigation recommends a civil commitment hearing if they determine that someone is suffering from a mental illness and that that person is also a danger to themselves or others or unable to care for their own basic needs.

These criteria were adopted in Oregon in the early 1970s. Before that, it was relatively easy to have someone involuntarily committed to a mental institution and the practice was often abused. The debate about how to strike a balance between protecting patients' rights and looking out for their wellbeing continues now, even decades later.

Does someone close to you suffer from a mental illness? Do you? Have you had experience with the civil commitment process? What was that like?

GUESTS:

Tagged as: mental health · shooting · state hospital

Photo credit: Benny Lin 0724 / Creative Commons

Civil commitment is a fancy way of saying at least I don't have a criminal record or felony status, but the difference between being locked up in state hospital vs. a jail cell isn't much. The civil commitment process is for families or neighbors or society at large who do not want to manage and live with people who have mental illnesses. Send someone with a mental illness away, give a person a 180 day commitment to Blue Mt. Recovery Center in Pendleton, Lane Shelter Care in Eugene, or the state hospital in Salem. Then, give someone drugs and scare a person to death who has to go through a hearing in front of a judge and jury of psychiatrists. The care of the mentally ill in this country is still in a mess. Making the commitment process easier for people who supposedly care for "patients" is bogus. 

 I'm very sad that the young man was killed in a police shooting. I wish something more could have been done to protect him, but sending him away wouldn't have been a good way to help him in the long run.

Anne Kornfeld —

Let us be clear, we are talking about the seriously mentally ill - 

  • Who cannot meet their basic needs or access services which provided for them.  
  • Who cannot fend for themselves on our unhealthy and unsafe city streets.
  • Who cannot diagnose or treat their own illness. 
  • Whose interactions with police, service providers and other citizens may be fraught with peril for both parties. 

Compare the plight of the mentally ill in our society with that of the mentally retarded. With the latter, we don't do a very good job, but at least we don't condemn them to wander the streets alone and helpless. We provide for their basic needs.

The situation of the mentally ill is quite different. In the name of personal liberty, we condemn them lives of squalor, abuse and loneliness. This is an unsustainable state of affairs

My own nephew is schizophrenic and has been living on a hellish merry-go-round of a kind that many listeners will recognize. For a time he will be in a stable living situation, taking his meds and living a fairly normal life. A kind and spiritual person when he is on his meds, soon enough he decides that he doesn't need them anymore. Then the voices convince him that someone is trying to get him. A fight ensues, he lands in jail or a mental health facility, remains there for a few days, until he is stable enough to be released. Then the cycle starts all over again. His mother has witnessed this series of events for decades now. All involved can only watch helplessly while the story is repeated year after year. A terrible toll falls on the family of such persons.

Yes, the situation before was also bad. Some facilities allowed patients to be neglected and abused. But that need not happen again. We can and must provide the mentally ill with the stability, security, services and medication they need. With long-term treatment, many can recover and resume independent lives. That rarely happens in the current system because we've allowed wishful thinking and denial to prevail over truthfulness and compassion. Liberty? The chronically mentally ill are not free in any sense of the word, but enslaved by both illness and circumstance. Let us finally have the courage to stand up and end this insane status quo. 

- Ian Macrae

Milwaukie, Oregon 

imacrae —

I look forward to a civil discussion about a controversial topic, and I am honored to be invited as a guest for Monday's show. My heart goes out to everyone impacted by the tragedy that has led to this discussion.

While this "Think Out Loud" is two days away, I can commend OPB now for seeking out and including a voice representing mental health client organizations. I am on the board of a state-wide coalition of organizations run by mental health consumers and psychiatric survivors called Oregon Consumer/Survivor Coalition (OCSC). 

In the general disability movement with which we are allied, there is a saying "nothing about us, without us." In so many other topics -- labor, immigrants, gay/lesbian, women, etc. -- a public discussion would automatically include a representative from an organization of that constituency. The same needs to be true in mental health. Those of us diagnosed with psychiatric disabilities do have our own groups, and we are united for human rights, empowerment, choice, recovery, and alternatives.

I'm not saying we all have the same answer. I'm not saying there is an easy answer. But it's important to have a voice from those who have been through mental health care in these dialogues. Anyone wishing to reach me may e-mail to me at oaks@mindfreedom.org. I am also director of the human rights group MindFreedom International, and on the board of United States International Council on Disabilities. 

I'm also an individual who has experienced involuntary psychiatric care. I was one of those diagnosed with serious psychiatric disorders, including schizophrenia and bipolar, by a dozen psychiatrists. I've been on the "sharp end of the needle." Solitary confinement in a psychiatric institution was my recruitment room to become a community organizer in this field the last 34 years.

I know from personal experience there are better ways to help people than the overwhelmingly profound trauma of forced psychiatric interventions; I look forward to sharing that perspective, and hearing others.

- David

David W. Oaks

board member, OCSC

director, MindFreedom International

board member, USICD

Eugene, Oregon

davidwoaks —

I think the way to consider involuntary commitment is the way public health epidemiologists look at infectious disease: rate of frequency, mortality rates related to the present situation, etc. How great of a problem is it for society at large? Not every 'problem' requires a solution at public expense and by imposition of yet more gov't in our lives. 

Yes, of course, virtually every aspect of society has its issues, but  fiddling with the existing situation is not always warranted by the degree of importance of the matter.  How many people are actually affected?  How many annual cases of demented persons harming themselves or others are we talking about?

We have a way in the US of letting ourselves go slightly daffy over a single instance of some tragic event and immediately call for a costly and upsetting overhaul of existing systems or processes.

At times like this, when we are all emeshed in a declining economy and suffering from ever more intrusive Govt, every change in procedure and cost of doing public business must be justifide by hard evidence, and not sentiment alone.  

Gereng —

I appreciate being on this morning. Anyone wishing to contact me is welcome to at oaks@mindfreedom.org

What is better is that there is now a state-wide coalition in Oregon - OCSC - that unites more than a dozen mental health consumer/psychiatric survivor groups. While there are differing perspectives in mental health, it's time to include the 'other side of the story.'

I appreciate being a guest on today's show. But note that for the first two thirds we heard from three guests who all essentially supported involuntary commitment, with small differences about opinions about psychiatric drugs. There was an appearance of consensus that everyone agrees forced treatment is the way to go.

In the last segment did we hear a voice of mental health client organizations. I want to say there are many articulate representatives doing great work.

Our spirit of empowerment needs to be heard by family members. Because families with a member in crisis ought to DEMAND more than just a court order and a bag of pills. Why settle for that?

Why, for example, does one need to be in Finland or another Scandinavian country to have the proven "Open Dialogue" approach? In fact, why have Oregonians never even heard of this model, that lessens the level and time of drugging, and has a better rate of success? (To read about that, see the new book by Bob Whitaker ANATOMY OF AN ILLNESS, you can look it up in Amazon, or see an article about this on the MindFreedom International home page.)

I hope everyone reaches out to groups like OCSC and MindFreedom International (just google us, we're based in Eugene). We need more than reform. We need a nonviolent revolution in mental health care.

This begins with civil dialogue about all the various perspectives, and including a voice from mental health client organizations as part of that discussion.

Thanks,
David
David W. Oaks, Director, MindFreedom International
www.MindFreedom.org
Board member, OCSC and USICD

davidwoaks —

The Otises want an expansion of civil commitment criteria, to include "additional significant symptoms." That's cause for alarm. Since we already have the means to address danger to self or others or the inability to care for oneself, what, exactly, are these "additional symptoms" that might warrant the drastic step of commitment?

Hearing voices, perhaps? Acting more flamboyant than usual? Being quiet or secretive? Impulsivity or poor judgment?

Parental worries that, however we might sympathize, have no ground except in hindsight?

How about becoming fixated on religion, muttering prayers, giving away possessions, and conversing with birds? Do we really want a law that would threaten St. Francis?

Our commitment laws may not be perfect, but if we widen the net, we do so at our own peril.

Jenny Westberg

jwestberg —

I had a friend with mental illness who sadly commited suicide last year. He did seek treatment but felt like the treatment facility he was at wasnt working for him as he felt normal compared to the other people at this facility. Another problem he faced in this was his family faced with the social stigma of mental illness in the family sought to hide his disease and lied to everyone about him, and his condition.

Last summer after a 8 month hiatus of not hearing from him in any way he called all of us. (a group of about 8 friends all close knit) and we had a few weeks of going out and him finally sharing with us (the friends) his true problems with mental illness.

Two weeks later I was called and told he had shot himself at home.

should he have been commited even though treatment "wasnt working for him?"

Its a question for the ages. He wouldnt go to treatment, his family wouldnt send him to treatment who else is there to regulate that?

Mental illness is very difficult not only for the person who has it but for everyone else becuase of social stigma against mental illnesses and becuase treatment for mental illness is isolation from population bases often and moving into a community of mental illness. In a community of the mentally ill there is no 'normal' or accepted behavior role models for the patients to really stay in touch with.

For involuntary commitment to work for that for any commitment for mental health to work there needs to be a better base of health care for it and with that said theres just no money for it being put out by states or bussinesses. Those dollars go to sexier problems like cancer awareness or muscular dystrophy, not to say these diseases dont also need funding but there again lies the social stigma against mental illness.

I feel that involuntary commitment is very much like a hiding of mental illness. moving the disease away from the public eye for treatment with no clear direction. Mental illness is a life chaging battle and you need a social support group to help you. I'd like to see a change in the commitment process that not only commits the person with the mental illness but also commits the family and friends to come and help be a part of treatment in helping that person accept, and learn how to cope with their disease.

a plan like this may have saved my friends life.

Lunoshard —

Are you prepared to pay higher taxes for better and more expensive staff and expanded and improved facilities? Solving perceived problems of this kind inevitably lead to higher taxes. 

Public health services compete with every other area of gov't. With so many people without jobs and steady income and with tax revenues already unable to pay for existing services the idea of piling on yet more Govt costs makes sense ONLY if the problem is of crucial importance. There is no free lunch nor improved govt service that is not going to cost more money.  Are citizens willing to be taxed at higher rates to improve treatment of people only marginally productive?  It is a question that is more relevant today than formerly.

Gereng —

Why does our culture continue to separate the brain from the body? What lab testing protocol is in place when initially "treating" someone who has been taken into custody who may do harm to themselves or others? Is anyone "brave enough" to check the Copper/Zinc levels (zinc is needed for the synthesis of GABA - gamma-aminobutyric acid, a "calming" neurotransmitter that combats overloads of norepinephrine), malabsorption (laculose-to-mannitol test), food intolerances, levels of metallothionein (filters metal toxins at the intestinal and brain/blood barrier), etc. Why are we not wondering WHY someone snaps? Why are we eager to ignore every single possible biological cause of "mental illness" and quick to prescribe drugs which will very likely make the symptoms worse or cause even more problems?  

Zonulin —

Are you willing to pay higher taxes to provide for improved handling/treatment of these people? That is the critical question- NOT whether better treatment is needed. There is virtually no Govt service that can't be improved if more money is available.  

Gereng —

It isn't civil rights that are limiting treatment for people with severe mental illness.  It's money.  We have a chronically underfunded community mental health system, a state hospital under investigation by the US Department of Justice and a $2.5 million shortfall coming up in the next state budgeting cycle.  We need to use the money we have more wisely by investing in housing and wrap-around services for adults and children in the community.  Forced treatment in a huge facility is a costly failure, not a solution.

esurient —

Many of the comments on this page capture my concerns:

* To make it easier to commit, we need to feel confident that the services we have in place as a community for the committed exist and work. Despite having many caring and qualified individuals working in that system, we lack the funding and global community support we need to make it effective.

* We as a culture don't treat the mind and body as one. Despite many studies showing mood disorders and several mental illnesses as stemming from poor nutrition and emotional support, we put time and effort on creating band-aids rather than addressing the core influencers on the cause. I can't help but think of the geyser in the Gulf. We can keep trying to pump out the oil or we can work to stop it. In the end, where is our energy best spent? Clearly you need one while you're working on the other, but the latter is where our core focus and energy needs to be spent.

* As our culture moves away from being social and community focused into every-man-for-himself (see many conservative agendas) our collective health and well being decline. No matter how "independent" you want to be and think you are, we'll not address any core cultural and societal issues without the global support of each other. The act of committing someone comes from asking for help- not the convenience of getting rid of an inconvenience. Unfortunately, due to under funding and lack of community awareness and education, this support is hard to find. And when you do find it, it can be difficult to work together. Getting my brother's doctors, social workers and legal representatives to meet with me on a regular basis so we could collectively create a support plan for his release was worse than I can imagine pulling teeth from a baby would be.

juellez —

As I mentioned in each of my messages on this subject...talking about improving a public service without testing this against other needs in terms of MONEY is rather foolish. Everything can be improved and everything is broken in some degree, the question always comes down to a competition for the most limited and limiting resource...money. 

Today we learn the disasterous situation of the state budget. The state can not finance current programs, much less spend money improving anything else. We learn-among other things- that one third of Oregon's high school kids need MORE than four yrs to graduate! If I had to prioritize the state's expenditures certainly addressing  the problem of ignorance among teenagers is more urgent for the state's economy than expanding or improving the state's capacity to house the mentally handicapped.  

Gereng —

I had a daughter that had a psychotic break a year ago and was surprised at what little me and my wife could acually do to help her. Thank God she was still able to sign paperwork to allow at least the information on her care to be realeased to us. We still had no control over what her direction of care was going to be but after talking to her appointed lawyer and looking at the mental health facilities available to her if she was committed, i was scared to death. As in other commentors in this blog have said, there is no adaquate programs or treatment facilities in oregon. Commitment is not the answer when there is no place to send your adult child to? We were lucky and in the bend area there is a program for outpatient mental care that just started 2 years ago for young people that have psychotic breaks that have led to schizophenia. Its called EASA and it has been a godsend because of the support not only for the patient but the family as well. These are the kind of programs that should be instituted all around the state and get to these young adults early before they become worse and end up on the streets.

JB —

I am one of hunderds of parents or family members in this community who have watched helplessly as our loved ones have been impacted  by a severe mental illness.  The "patient rights" movement, while laudable in it's ideals, misses the main dilema when dealing with the issue.  People suffering from many mental disorders have severe cognitive deiciencies as well as disordered thought processes.  It took years for my children to gain the insights necessary for them to stablize using medications. 

I understand that psychactive drugs are terrible.  They dull the senses, impact libido, cause tremendous weight gain and cause great fatigue.  To many, the thought of trading in the perceived "joy" of a manic episode for the side effects for thes drugs is an easy one.  They chose to go un-medicated and un-treated.  An intervention by the family and the community is required to protect the patient, the family, and the community from the devastation caused by these diseases.

I once heard a mother comment in a support group that she was relieved that her son had been sent to the State Prison in Salem where he could finally get help for his illness and addictions.  Is the criminal justice system really the only way to end the cycle?

Psychiatric patients need the loving support of families and their communities so that they can find a road to recovery.  Civil Commitment is not an effort (as suggested elsewhere in this blog) to get them out of site, but to help them find the stability needed to gain the insight needed to deal with their challenges.  Many who lose the battle with mental illness could have been saved had they been compelled to take medications or seek treatment. 

Every year, we watch sadly as families lose their children to mental illness and "Die with their rights on".  Rights imply competence.  We must consider cognitive capabilies more broadly and compel treatment with a broader view of the term "harm to themselves or others"

Dave

thunderbeast —

Well said, Dave.

I have been advocating for my son (dx'd schizoaffective in 1998) for many years.

He has been on the streets during episodes of florid psychosis and unassailable until the inevitable crisis ensues. He has been hospitalized on the average of 1.5 X per year because he finds the psychiatric meds intolerable and stops taking them.

In late 2009, he exprienced his first arrests and a night in jail, followed by a court-ordered diversion program. He and I are grateful that treatment was provided in lieu of more jail.

However, his compliance with medication has done little to improve his quality of life. He is following the doctor's (and court) orders, but he feels the very real consequences of the chemical strait jacket.

I have come to understand during the past 12 years that his choices are limited to being psychotic or being robotic.

The medical model does keep him from being a threat to society but now he is a threat to himself because he faces every day the desire to take his own life due to the debilitating side effects of his meds.

There is no good answer.

Thank you for pointing out that lack of resources leave few options for people who so desperately need more support.

avahayes —

I see Mindfreedom as primarily a civil rights organization.  I do not see it out there fighting for the kind of services people with serious mental illness do need.  I see EASA and Peer Wellness programs (Benton County) and the small Romprey Peer Wellness contingent at the State Hospital as examples of small beginnings in Oregon.  If everyone on Civil Commitment had to go to OSH, that would not be good--local treatment is far preferable. (As it is, to get into OSH right away, you have to commit a crime and become a forensics patient.)  Actually EASA is a great model to deal with first break patients, and should be extgended to all counties.

I have people close to me who've been 'round the block with meds.  All have taken "med holidays," under supervision or not.  Some have thrived for quite awhile before relapsing ( 2 yrs, 4 mo in the case closest to my heart).

I don't know of anyone on the atypical anti-psychotics who has tardive dyskinesia.  They are managing now to find an atypical for you that doesn't cause weight gain, if you have a doctor who has the patience to try.  But I don't know any schizophrenia patients who've been able to stay off meds permanently.  I'd like to read about the Scandinavian/Finnish system and will take your suggestion to read Bob Whitaker.

Thanks for your response.

Dianne Farrell

NAMI Mid-Valley

diannemfarrell —

As someone who conducted or was otherwise involved in dozens of precomittment investigations and emergency hospitalizations in rural Oregon,  I am in favor of changing our civil comittment laws. Having said this, I do not believe it is the comittment laws that are the problem. Rather it is the scarcity of resoures for the mentally ill at the time of crisis that leads to the trajedies we have seen recently. It is not uncommon for there to be no avaiable hospital beds at the time of need.  This has the unfortunate result of either the person is sent away with inadequate support and treatment or is incarcerated. Neither of which is acceptable and will only lead to furhter trajedy and poor treatment. Sadly, police officer's & emergency departments are all too familiar with the lack of resources for those who need involuntary treatment. As both inpatient and outpatient resources for the mentally ill dwindle (especially in rural Oregon), the burden is transferred to local emergency departments and Jails.  Both are not equipped to provide for the needs of the acutely mentally ill.

Without referring to any specific case, I would like to offer my support for police officers who deal with the mentally ill. The accutely pschotic or manic individual is highly unpredictable and is rarely infulenced by reason. I have witnessed law enforcement skillfully handle several volitile situations with potentially violent individuals and averting trajedy. Their's is a difficult job with little thanks and by and large they do it very well.

This is a highly complicated issue with many aspects. We need to address whole mental health system, specifically the lack of resources in addition to the civil comittment laws in order to make changes and avoid tragedies.

Oregon lawmakers might look to Washington State for a model of civil comittment laws.  Their approach strikes a balance between the rights of the individual, public safety and ensures due process.

Jim,  Hood River

JimP —

What I really think we need is an intermediary step between no help at all and commitment to a mental institution.  Something like a probation system for people who need mental help.  Each person would have a psychiatrist to check in with regularly and get treatment, though they might still live independently and have a job.

My other concern is that emergency or low-cost psychiatric help is nearly impossible to find in Portland.  A friend had a mental health emergency last year and despite my best efforts, I could find no help for someone who had no insurance.  The school he was attending offered him an appointment months out, and then refused to treat him based on an old seizure disorder (when he was a child).  We ended up staying with him ourselves until he felt like he could support himself because we didn't want to call in a 5150 as being in a hospital would not have helped him.

What I'd really like to see is funding for easy to find, less expensive mental help.  Therapy is so expensive, and it's very hard to get into the system without insurance.

robynthegeek —

I'm reading from Mental Health Law in Oregon from Disability Rights.  The criteria are, as stated "danger to yourself or others" or "unable to provide for own health and safety."  As noted, the number of successful commitments is very low (7%).  Is the problem here judicial misinterpretation of the law's intent?  Do we need a rewriting of the law?

I want to note the possiblity of Assisted Outpatient Treatment.--you agree to accept treatment under the judge's order.  That's easier to accept--if the patient is amenable, and if he/she isn't, they go to the hospital.

At present the law is not being used to it's fullest extent.  The danger to oneself or others is often not considered unless the attempt has already been made.  I know something about this thru my work with NAMI Mid-Valley.  (And have an ill family member.)  The bind is apparently that the county doesn't have the money to pay for the needed hospitalization....

Dianne Farrell

diannemfarrell —
Am I correct in assuming that, in the past, involuntary committment was an "easier" process? If so, for what reasons was it made more difficult? Perhaps those reasons still exist?
seeker —

One of your guests said that she "prayed" for her son. That indicates an irrational belief in an imaginary supernatural being, which in my opinion is a mental aberration itself, a delusion.

I wonder if anyone has studied the numerical difference in occurences of mental illnesses between the religious and people who restrict themselves to reality, or as they are otherwise known, atheists or anti-theists.

I suspect that religious training causes a huge percentage of mental problems that end up in the offices of psychologists and psychaitrists, and over a wide range from mild to severe. That does not mean that atheists are immune but that they are far less likely to have mental problems.

Tom D Ford —

Hey Tom, I'm with you.  I had an older cousin. a lovely woman, a certified multi engine aircraft pilot, and holding an MA in library science.  When her mother became ill some yrs ago, my cousin became increasingly religious. About 6 yrs back she became a recluse, cut off contact with the rest of the family, sold all her property and gave the proceeds to some piddling little back water church whose pastor took advantage of her evident mania.

In my work overseas, I couldn't help but note that deeply held religious superstition goes hand in glove with poverty, violence, unbelievable cruelty and all round ignorance.

Gereng —

can Sally's son go to a group home after the state hospital?  

pamelamontague —

The mental health system in Oregon is broken.  It is like the facades on a movie lot.  It looks like it should work but when you walk through the door there is nothing there. 

The criteria for commitment are so high not only for civil rights concerns but also because there is not money and there are no beds. 

The commitment laws are as much an excuse to do nothing because there is no money to treat people effectively as civil rights.  It is an excuse for our society to do nothing to treat people with a physical problem (mental illness is usually a physical brain disease).

jivinjoe —

So I've been a friend to Phil and his family sense high school.  I totally agree with Sally about what happened to Phil.  Yes, he was living in his car and barely making ends meet.  I too wanted Phil to get help but his siguation was so bad it became so bad. 


I would have liked that there were resources in the community.  I tried to help him find jobs and held his mail in case he got job offers, stored his stuff hoping that soon he would have found a job (he liked trucking and would check in at the place that trained him often) but there was no luck there.  Also, he would spend time at the library and got kicked out because of how he was.  People just want to force the metally ill away.  I think this is wrong. 

Likely my neighbors were the ones who called up the police several times over and over for him sleeping in his car on the street.  I know that his weapons are his word and he can be rather fightening with some of the things he says he plans to do but he's never laid a hand on me in the 10+ years I've known him.


I can understand the police position too, they don't know if he has a gun or a weapon if he is in his SUV and it is all blacked out.  I was very glad that he didn't get shot dead like Aaron Cambell.  Because his siguation was very similar to what happened in portland just a short time before.

paulos —

It is  perfectly normal for the sane to feel some degree of fear and discomfort around irrational people. Nothing strange about that reaction. 

In west Africa where I lived and worked for some years, villagers commonly chained such people to very heavy logs which they had to drag around with them, thus making it difficult for the mad men to catch and harm others.  Their familes would make a shed for them outside the hut and give them food and water. If they became too violent, and deemed a community danger, a family member simply hauled them into the bush and killed them.

Gereng —

David Oaks' personal experience is from 30 plus years ago, when drugs and treatment generally were pretty much in the Dark Ages.  I'd like to hear him update his message with the rather different situation today in all respects--legally, treatment-wise.  The tragedy today is the unavailability of treatment for uninsured people without wealth--most schizophrenics.

Dianne Farrell

diannemfarrell —

Wasn't there a bill in the works a couple years ago to help get treatment for mental illnesses required in health insurance coverage, specifically schizophrenics? I wonder what happened to it.

At that time my family was struggling with trying to find a way to financially support my brother and we didn't have the money to afford his medication or proper treatment. That led to a greater deal of problems and money different states then had to spend keeping him from being a danger to others.

juellez —

Thank you Dianne, for asking for me to update my story. Every day, here at the MindFreedom International office, we hear from people by e-mail, phone and postal mail, a similar story to what I went through: Disempowerment, lack of choice and alternatives, primarily pushing drugs and more drugs as the main answer (realizing that we are pro-choice on the decision to take prescriptions drugs, but concerned about the bullying and lack of choice).

If anything, things are far worse today. Dianne implies that the psychiatric drugs are far better. Actually, I was mainly given a "neuroleptic" also known as "antipsychotic." The public was told that the newer antipsychotics were far more effective and less hazardous. Therefore the taxpayer was charged tremendous amounts to apply the newer neuroleptics. But recent studies show that the efficacy rate is about the same as the older drugs. Plus, the rate of physical twitching (such as tardive dyskinesia) is "similar," according to one of the first large comparison studies released this past February!
Today, we see neuroleptics such as Abilify actually advertised on TV! Today we even see children -- yes, even as young as one years old -- placed on neuroleptics, by well-meaning people!
If anything the myth of a "chemical imbalance" is more entrenched. Again, we are pro-choice, and many of our members find comfort in a chemical imbalance model. But the scientific jury is still out, even after all these years. There has been no actual scientific evidence showing this alleged "chemical imbalance."

We have, however, found ample evidence of a POWER imbalance.

Those who care about our constituency, should fight to make sure our voice is heard. Oregon is one of the few states NOT to support the state-wide voice of mental health consumers/psychiatric survivors! For the last eight years, there's been nothing in Oregon's budget, and Oregon is one of the few states with zero.

So in several ways things are worse.

Thanks,
David
David W. Oaks, Director, MindFreedom International
www.MindFreedom.org
Board member, Oregon Consumer/Survivor Coalition and USICD

davidwoaks —

I have a 27 year old son who is mentally ill and has been on the streets for 5 years. Last year he was discharged from a hospital after being beaten. He was discharged with out even any shoes at 1 in the morning. Luckily he was near my parents and he could call for them to pick him up. Most recently we recieved hospital bill and ambulance bill form Washington. He recieved multiple CT scans and we were only able to find out he discharged himself in the middle of winter weather. He will not stay in hospital because of  his mental illness. I have not heard from him since and wonder if in the cold of Washinton he had a coat or shoes when he left. We have not heard from him since and we usually get some contact so now I wonder if he survived after he left the hospital.   So if I could commit him I would because it least it would be a chance for him to get meds and maybe clear so he is not enduring the suffering of living on the streets. I just can not imagine it being worse than it is now for him. 

jodiegilbert —

I used to work for the Ryles Center which was an inbetween facility for mentally ill folks.  It was a short term, 2 week, facility where people could voluntarily go.  It was in Portland and was shut down because Salem wanted to save money!  Now they spend more money committing people to the hospital! ~Stuart Tait

gldnpsn6 —

It's just so sad that many people, patients and professionals, do not realize that a chemical imbalance is not due to a lack of prozac or other drugs. What CAUSES a chemical impalance? Nutrition (along with a number of other lifestyle choices) is a major key to the puzzle.

jdevine59 —

I suggest that thinking is a part of the problem. That is to say, the brain is so incredibly powerful, keeping track of and running all parts of the body, increasing, decreasing, or keeping stable all of the chemicals, including hormones, etc, that a person can "think" themselves into an out of balance situation. And what and how a person is trained to think can very much exacerbate any problems.

The brain does all of that operational controlling and operating out of our conscious minds for the most part, but when we initially learn something new, like walking or riding a bicycle, or talking, we are conscious of what it is that we are working out how to do, what we are training our brain to do. So if we start down some wrong path, our brain follows us down it, learning how to do that wrong path and being a brain learns it well. So I think that we can think ourselves out of balance.

And historically, some ruling people have used that ability against the population generally, with a mixed range of results, from some very mild dysfunctionality  to some devastating mental problems.

That's my hypothesis anyway.

Which seems to mean that we ought to study healthy people to see how they think, how and what they were taught, and how well their human potential has been developed, positive psychology.

What's good for people and what's bad for people and let's get on with changing all of our political, economic, business, work, education, financial, and any other systems to what is good for people.

And that's another of my hypotheses.

Drugging people to enable them to live in our dysfunctional society seems like a very wrong way to go.

Tom D Ford —

People (the media, the public, mental health professionals, virtually everyone) seems to believe that mental illness is just like physical illness.  I believe "mental illness" is just like conflict.

One person (usually the one who has connections to power or is in power, i.e., psychiatrists, family, the police, try to convince another person that they are "ill" disregarding what the definition of illness is. 

I don't believe disagreement between people can ever be defined as disease.  This is dishonest. 

But apparently I'm in the minority.

I thank Listen Out Loud for inviting David Oaks to the discussion.  Maybe next time we'll be here more from the true victims of this religion of psychiatry.

Everyone must understand that no one can disprove their "mental illness."

Thank you!

Carl

Corvallis, OR

carld —

I think it is realy easier for young ppl and yoth to admit to any kind of mental illness that could exsist with them but it has been very rough for our parents and older generation to admit to their mental problems.

Ashkan,

Bvrtn, OR

ashkankord —

too close, too painful, too much judgment from the unknowing. withdrew comments. sorry

One Clear Voice —

Please find a different peer spokesperson for sufferers from mental illness.  Meghan Caughey is VP of Mental Health America of Oregon.  She is Peer Wellness Coordinator for Benton County Health Department, which training program she designed and teaches.  She is available at 541-766-6107 or (blackberry) 541-207-8133 or meghan.caughey@co.benton.or.us.  She is not at war with medication for serious mental illness and is focused on the needs of and empowerment of those suffering from mental illness.

Dianne Farrell

NAMI Mid-Valley

diannemfarrell —

I attended a recent Mental Health series and had a chance to listen to her.  She clearly was not happy with being coerced into submission by psychiatrists.  I did not hear her say she was glad they did that.

I'm assuming also that whatever she offers as help, she would not force it down peoples throats.

However, I may be wrong.  It's not exactly clear who she is working for.

Carl Dornfeld

Corvallis

carld —

An open note to Dianne Farrell: 

1) While I can't speak for her, you will find the wonderful Meghan Caughey supports Oregon Consumer/Survivor Coalition. Her group is the latest group to join OCSC!

2) During the OPB Think Out Loud show a few weeks ago on Oregon State Hospital, Meghan and I both tried to get on the show as call-ins, and were on hold for much of the show. Neither of us was put on the show. No representative of a mental health consumer/psychiatric survivor group was put on. I'm glad with yesterday's show, this has changed.

3) I find it polarizing, Dianne, for you to categorize me and the groups I work with as "at war with medication." As I said on the show, and as I repeat many times: We are pro-choice about the personal decision to take prescribed psychiatric medication. Many of our members willingly choose to take prescribed psychiatric drugs as part of their recovery. We are united in opposing bullying, pressure, and the "one size fits all" approach of overdrugging that is currently dominating and harming so many people. We are in a peaceful war with illegal human rights violations, such as force, fraud and a lack of alternatives. 

4) Dianne, I see you signed your note as an official representative of a NAMI affiliate. Please note that many NAMI members share the concerns I raise. I have a recent column in a newspaper on the subject of this. I encourage NAMI to leave polarization in the past, and to seek common ground. I hope you share the concern of me and many NAMI members about the recent US Senate investigation that found that more than half of NAMI's funds -- more than 50 percent! -- over the past three years, on average, were directly from the pharmaceutical industry, and that this fact had been hidden even from your own members. People can read my column about this by using Google to search for this set of words -- eugene weekly david oaks opposing bully model

5) To Dianne and other NAMI members -- it's a new day! It's time to unite for common ground such as peer delivered services, empowerment, recovery, peer supported housing, employment, and other psychosocial alternatives. Many moms and dads of mental health consumers are saying their families deserve more than just a bag of pills. They deserve a full range of alternatives. Let's leave the division back in the 20th century, and move forward. 

davidwoaks —

Providing public services for the mentally ill, many of whom wander our streets as homeless persons, is not too much to ask of ourselves--the taxpayers.  We build jails....One percent of the population has schizophrenia.  That's quite a few in a town of 50,000...

Dianne Farrell

diannemfarrell —

Offering services in not the same as forcing services to me.  Also, in my opinion any "locked facility" is a jail. 

Carl

Corvallis

carld —

Having a family member with a mental illness, in my case a mother  it is equivalent to taking care of a minor child, when they/she has "relapsed"  I understand the fear and the potential loss of civil rights, yet there are times, when commitment is necessary. As a child, she was a serious danger to me and my  sisters, this is no exaggeration. I listened as the mother express disappointment by the lack of holistic care in the facility where her son is housed. If we are serious as a society in wanting to provide the best care to those who need to be involuntary committed then we need to demand more from the state hospitals, we need to determine and create ways to ensure that the hospitals are doing more than just pushing medications. And we need to  be willing to fund it. If my mother, who currently is experiencing a relapse got to a point in which the intervention that I and her therapist are engaging in, failed to stabilize her and she became a danger to herself, I would seek commitment if there were no more options. I have had to go to court for my mother to prevent a commitment, about 15 years ago. Its a very sad experience. But the options that were available to her then, to prevent the commitment are not available today. Every situation is different, and despite the protestations of the advocate for voluntary commitment only, he is not really living in  the reality of all of us who are caregivers to our parents and children. His experience is valuable yet he cannot ignore that sometimes involuntary commitment its the only option when all others have been exhausted.

stellajane —

It seems for there are several issues at answer here. For Ms. Savage there is the issue of the potential for life threatening infection that needs be treated as a seperate medical condition requiring hospitalization and at which point hospitalization would be discharged to a recuperative nursing facility, the situation would deteriorate into paranoid symptomology generating into the pattern of AWOL, re-infection, and re-admission to hospital for emergency treatment then the only hope would be pattern recognition over time that the only thing that is making him worse is him, and hopefully over time each recuperative period would be longer and longer as familiarity reduces the internal pressure to run away which means the hospital must be the same each time, as must the place of recuperation. Once he stops running away, the underlying condition can be discussed, but not until he is willing to stay in one place of his own free will. Otherwise commitment is al there is. In the free will paradigm reality testing rules. If he is being poisoned in the shower, you have to turn on the shower and step in, if it is the food you have to eat it, if it is the room then you have be able to ask the guy in the room next door to swap because he will have to see when you get wet nothing happens to you, same when you eat his food, same when he swaps rooms, same for the guy who moves into his former room. This type of reality testing is tedious and labor intensive but it is the only way to engage his attention and reinforce the reality of the situation. You can not just say, you must do, and by doing so prove, in the face of each allegation, and just like with children you must be consistent and "prove" every time, and at least you will have opened dialog.

doctorpema —

I am a person who has been hospitlized against my will many times,and also hospitalized many times when I saw it as the "only way". I have been on psychiatric medication for years. I would prefer to go withour medication because of the bad, unescapable side-effects. I have been on nearly all the antipsyshotic medications. in the US. Yet, I take medication because it largely helps me do many of the things I want to do in life.

Now, for the first time in my life, I am able to work full time in the peer delivered services field. If I could do this without medication, be certain that I would. However, I have found certain limits and I know that at this time, I need to take medication, and do  my best to  minimize  the side-effects .

Having a job is terrific!I know that many people with mental health issues who would love a chance to work, but believe it is out of  the range of possiblity to be paid for anything that we might do. We need to realize that all of us have something we can contribute. The times when I have been treated with discrimination and prejudice have been too frquent and very difficult to handle. I was told many times that I could not work, and that it was out of reach to have a job.

In my work, I try to convey that we have much power and responsiblity for our personal outcome. I call this empowerment, and hope that I convey to folks that we derserve respect and freedom to make our own choices. Still, even when we are empowered and exercising of our self-determination, we need a culture around us that supports our recovery,  that respects us,and affirms our human and civil rights.

I believe that as a culture we must find better alternatives to locking people away. We do need more options, like robust peer delivered services and supports that help people before our situations end in crisis. Right now, jail, or the state hospital is too often the "solution"--and this is unacceptable.

Let us have compassion for all the persons on all sides of this discussion. And then we must act to change our culture into a place where those of us with mental health issues are embraced and supported on our recovery paths, rather than incarcerated and put out of sight. Our belief in our abilty to be well is a starting point, and we need the means to realize this belief and goal.

Meghan Caughey

Alpine, Oregon

meghancaughey —

Well put, Meghan, especially your call for "compassion for all the persons on all sides of this discussion."

Let me focus on one FACT in this whole OPB discussion.

One of Dianne's comments is, "I don't know of anyone on the atypical antipsychotics who has tardive dyskinesia." Tardive dyskinesia (TD) is a side effect of neuroleptics that can involve permanent involuntary muscular movements of the face, arms, etc. (go to YouTube and search for the phrase to see what it  looks like).

Dianne signed her comment about TD as a representative of "NAMI Mid-Valley."

Dianne is talking about the newer neuroleptics (like Risperdal, Abilify, Zyprexa, etc.), also known as "antipsychotics."

Dianne is implying that the rate of involuntary muscle movements known as "tardive dyskinesia" is less than the older antipsychotics (like Haldol, Thorazine, Mellaril) back in what Dianne calls in another post the "dark ages" before newer drugs.

On 2/19/10 Reuters Health wrote about a study in Journal of Clinical Psychiatry: "Although atypical antipsychotics have a better safety reputation than conventional antipsychotics, they actually pose similar risks of tardive dyskinesia, according to the first prospective study to evaluate the issue."

I feel certain that Ms. Farrell has compassion for people in mental health care. I hope she knows I have compassion for family members of people who have overwhelming, even life-threatening mental and emotional problems.

Compassion must include ethics.

I can understand if Dianne posted her personal anecdotal impression, speaking for herself. She did not.

For decades I've seen official NAMI representatives give out falsely reassuring information about psychiatric drugs. They're good people. But the practice needs to stop.

Elsewhere in this dialogue, Ms. Farrell claims MindFreedom has been fighting for civil rights, and has not been fighting for more mental health services, when we've actually had many campaigns on that for many years!

Enough.

Those interested in more can use the Google search engine to look up our folder on this history by searching these two words: mindfreedom nami

I call again for a "new day" when instead of division and polarization, we can unite for the need for more humane, empowering services. I've seen you Meghan as one of those unifying leaders, thanks.

David W. Oaks, Director, MindFreedom International


davidwoaks —

Peter Barry Chowka,  In the late 1800s the arts of healing and the practice of medicine were extremely diverse.  As many of you know, this democratic system came to a screeching halt shortly after the publication of the Flexner Report in 1910.

Drug agents are given to teens, elderly, pregnant and nursing women (See, Amy Phlo), etc. at the maximum volumn of sales. This requires the oppression of knowledge on how to scientifically treat.  Biochemical Science soared in the 1900s. Biochemical Individuality was published by Dr. Roger Williams in 1956. As with the Herbalists crushed by the Medical Monopoly now Rogers from a new standpoint told how each person's condition calls for tailored treatment using chemicals not foreign to the body. Their OWN doctors were now in effect recreating a health restorative approach. This no more fit in with their plans than had Herbal Medicine 50 years before.

In psychiatry the advance was named "Orthomolecular," chemical tests and treatments for chemical imbalances.  By 1970 it was a success -  the same time that "antipsychotic meds" (Vera Sharav antipsychotics) and Ritalin had demontrated the money in P$ychopharmacology. The APA created a (fake) independent Report which declared OrthoMed totally wrong, for all time.  (see, Hoffer Osmond Reply)

If Dr. Janet Wozniak insisted that infants have "the disease" of "Bipolar" yet instead of this being the pretext to drug children advised Vitamin C, Magnesium and Omega 3, then it would be a different world. Involuntary Treatment - if they used scientific Medicine instead of this ersatz drug syndicate travesty medicine then it would at least be involuntarily helping.   Dr. Judith Rapoport propagandizes on the Real "single" "diseases" of ADHD and Schizophrenia. (See - Kids yield brain clues Rapoport. Note: the scientific brain scans were years after drugging started) Vera Sharav writes, “Drug manufacturers are hardly the only ones to blame — American children are being victimized by a consortium of influential psychiatrists at prestigious academic institutions.”

DanielBurdick —

The Mother's Act was slipped into to the Health Bill and so passed. This means many more pregnant women are to be drugged with chlorinated and fluorinated SSRI drugs which throw a monkey wrench into serotonin reuptake as their mode of action. Pregnant women will not receive more B-6 and DHA Omega 3 - medical science and human welfare are Not of interest to the crafters of this crime against humanity. More babies will be born dead or in need of immeiate open heart surgery. Women will be made suicidal and psychotic from the toxic drugging. Sales will increase and the nation will be weakened.

Though SSRI drugs have a place in treatment of adults whose serotonin systems are very feeble (analogous to Aricept for Alzheimer's) this is unrelated to the mass drugging campaign of the profiteers. MindFreedom's stance of wanting Psychiatry and NAMI to be nice and offer informed concent, choices, consummer voice, and alternatives is inadequate and unrealistic. The drug dealers have just spent 9 years and millions of dollars to lie and manipulate the Mother's Act into place -- showing zero human concience as to infants killed and maimed.

My letter to the Senate has excellent references to medical knowledge about post-partum dpression nd pregnacy. Such bonifide medical practice will have no place in the "Psychiatry" version being perpetrated.  http:// psychracket.blogspot.com  

Mother's medical need for Omega-3, Zinc, B-Vitamins and Vitamin C.

"The Boston Globe reports that 2/3 of children in state care in Massachusetts are being "treated" for mental illness with psychotropic drugs."{google - Teen Screen  BMJ  Jeanne Lenzer}

     "Soviet psychiatry was used primarily as a political tool to control dissident adults: psychotropic drugs were used to punish political dissidents and others the government deemed to be "troublemakers." American psychiatry is more ambitious than Soviet psychiatry ever was. US psychiatrists collaborate with government agencies by providing a seal of approval for involuntary "treatment" of persons loosely deemed to have a "mental disorder", or to be unruly. US psychiatrists also collaborate in the formulation of state-sponsored mental health policies--such as, "screening for mental illness"--initiatives which primarily target children.

DanielBurdick —

The Edge Effect by Bruce Scali and Eric R. Braveman, M.D. has some current ideas on the various neurotransmitter systms in the brain how to diagnose problems with them and strengthen them. Dr. Braverman is one for whom S.S.R.I. drugs would be one option, part of the arsenal. 

The fix in Psychiatry, the Universities, the Media and the FDA is the problem. Drugs per se are not the problem.

They certainly knew about the importance of B-Vitamins for brain health in the 1970s. Yet psychiatry remained the sole province of Drugs, Shock and Psychosurgery from then upto now. In their published Official Medical Protocols for Diagnosis and Pharmaceutical Therapy, B-Vitamins, aminoacids, and neurological antioxidants were not ever added to the chemical treatments in their arsenal - in a Twilight Zone manipulation of reality only new patented drugs are spoken of as being relevent to this topic - and that is seen in articles from Ivy Leage sources such as Harvard (Motto: Veritas.)

The documentary Hurry Tomorrow (www richardcohenfilms.com/hurry_tomorrow.htm) filmed inside a Locked Ward in 1972 shows what Psychiatry is. 

David Ingleby's Critical Psychiatry describes Psychoanalysis for the Wealthy, Drugs and Shock for the Poor. Now what we have is Asylum Medicine for All.  The Asylum patients may have been deinstitutionlized... yet now we have Head Doctor and Nurse Ratched with all the country within their purview.

In We Become Silent narrated by Dame Judi Dench, we see the FDA Director asked why a dangerous drug was approved while a related non-dangerous, amino acid supplement Tryptophan (a Serotonin precursor) was banned. The director speaks about how the supplements are not certified safe - and then he stops the camera.

psychetruth Dr. Breeding  Laws are being pushed in the US and the UK which allow people to be institutionalized without having committed a crime. Are we headed to a totalitarian state? What's the role that big pharma is playing?

 

DanielBurdick —

Comments are now closed.

Become a sponsor