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The jail system is now the biggest inpatient housing in the U.S. The Los Angelos county jail has more innmates with a mental diagnosis than any hospital. Even the Broome county jail here has more mentally diagnosed than the state hospital or the local hospital.
Forcing someone into taking treatment will work only as long as they are confined. Let me explain. The state hospital does not allow smoking in any building or the grounds. Recently I went up there and observed people hiding and smoking, despite the law.
Stopping meds or treatment is never a good idea. I say that from my own experience. I have never been forced into treatment.
How do we know if someone needs help? If they show no signs of aggression or a desire to hurt, how can we know?
We live in a free society.
After reading what I just wrote I am torn. I'm on the fence as to this question. I've been on both sides and cannot say with all certainty what would be best. Treatment should be individualized to the person. Warehousing patients didn't work. Out patient programs didn't work.
Where do we go from here?
Dave
Right now I'm still processing the news that my ex-boyfriend, who was doing so well, went off his meds. Just had a tet-a-tet with a friend about this.
What do you do when someone is actively psychotic and refuses treatment?
She suggested, "People do not always act in their best interests even if they don't have a mental illness." Her analogy was the teen girl whose family tells her to wait until marriage before having unprotected sex, who goes out and gets pregnant. A less extreme example is my father, who fails to take his fish oil gel caps even though the doctor has told him to take them.
Perhaps because I'm focused on finding solutions for people living with someone who has SZ, or for those of us diagnosed with SZ, I feel the mental healthcare system often falls short of helping people in crisis. So like Dave said, the jails have become the largest public mental health hospitals in America.
Please, feel free to comment about whether you think involuntary commitments could benefit some people, or whether the right to choose should prevail.
In August, I'll be writing a SharePost about an intriguing new alternative to hospital stays: respite care for individuals with SZ, who need acute care, where they are tended to by peers with mental illnesses instead of professional staff.
As always, your comments are welcome.
Regards,
Christina
We have the same dilemma in the circles of Scriptural (or religious) teaching at times. It is good for a person to have no influence from the outside world in order to be able to comprehend what the teaching is all about but if the person doesn't want to be confined, it would be like forcing them against their will. It is better for the sake of not imposing your will on another person to let them go even if they end up hurting themselves as a result. At least it is not your fault either way because you tried to help the person and the person refused and you are not at fault for holding them against their will because you let them go. It is the same principle. You can try to justify it by saying, "Yeah, but they are better off now." but two wrongs don't make a right. Sometimes people have to be let go. The only exception is if they harm someone because then you have to protect the person being harmed.
The whole system is flawed when a mentally ill person commits a crime, and ends up in jail. We are not criminals, yet we can do things without thinking or knowing what they mean. The people in the system should be taught to look for the signs of a person with a severe mental illness and these ill people need not be housed with others who are in fact criminals. But the problem runs so much deeper too. How are we to distinguish between mentally ill and not? I can't get my head around it... but I feel sorry for the poor people who get caught up in the system. I was there too, but luckily only for a short time- however it has far reaching implications even then. I am haunted every day by that time in my life where I was in a padded cell, with no freedom. That's another story altogether. Anyway, I think no one can be made to take meds although sometimes they really should be...... and if someones going to fall, they will fall and learn from their own errors.... nothing can stop it in the end.
Its sad that there are some who are "forced" into treatment. I was committed by the police once. I would be dead if they hadn't been called.
Earlier this year I had the opportunity to speak to the patients at the state hospital. There were some who are forced to be there. Many have had mulitple admissions, only to feel that system failed them. We used to call them "lifers." They feel justified in their anger.
I was taught the philosphy that if I did the same thing over and over, expecting different results was not a course or cause for recovery. Change is necessary. Change begins with the acknowledgement that there is a problem.
I had a bunch of AA buddies. There were about 7 of us that would pal around. All had a mental diganosis and all but me went back to drinking and drugging.
"You can lead a horse to the water, but you can't make him drink."
I understand the need for forced recovery, but it doesn't work. At least from what I've seen.
Dave
GREAT QUESTIONS. I could write a book about this topic. But here is a brief summary of how I feel. Since my brother's diagnosis about three years ago, I have thought about forced treatment non-stop. My point of view is much different than those who suffer with the illness. I have seen my brother without schizophrenia, without treatment and with treatment. When my brother is off meds and not well, I am haunted by memories from the past, during a time when he was at peace. I see how his delusions and voices rob him of his former life and inner peace. I believe in treatment because I see that recovery is possible. What I do not understand and may never understand is that when someone is so psychotic, and decides to almost run into traffic (this was because my brother thought bombs were headed towards my hotel) that a hospital would turn him away. The staff would not admit my brother simply because he popped one pill in his mouth. This happens after my parents drive 6 hours straight to the hospital and plead with the staff to take him in. Instead, my parents took him home in complete fear. This is a horrible way to live. There is no relief when he is not medicated. We know it will go downhill, every time he is not medicated. This brings me to the idea of force treatment. To me, the laws surrounding mental illness should allow for leeway or depend on the situation. In the case of psychosis, I believe that family should have some say when it comes to involuntary hospitalization. I say this because, it is not healthy for anyone involved when someone is clearly psychotic and not taking meds. Not to mention, 50% of individuals with schizophrenia have no insight that they are sick. This fact alone begs for more attention. Bottom line, the individual must WANT to get better. For many, this can take years. Our focus should be on facilitating recovery. Further more, I feel that the problems in the mental health system are pushed under the rug. Other illnesses seem to receive such positive PR and this leads to more research and better treatments. Society's view of mental illness can prevent someone from seeking treatment or accepting a diagnosis. If we reduce stigma, we can facilitate recovery. This is not a black and white situation no matter how you slice it. There are so many layers. The moment we as a society FEEL EMPATHY for those with mental illness, we may see change. We need to create laws or programs which will allow someone to reach recovery much faster and on their own terms. So I don't have any answers, just random thoughts. Recovery is an evolution. I am inspired by those who choose to evolve. They are the heroes in my mind. I will continue to fight for their dignity. Lastly, please check this site, I think you will find it interesting. http://findarticles.com/p/articles/mi_m0CYZ/is_2_31/ai_n6114723/
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