From: Barbara Lamar <shabrika@juno.com>, Fri, 8 Sep 2000
>>On Fri, 8 Sep 2000 14:40:02 EDT QueeneMUSE@aol.com writes:
>> To be honest, these folks don't KNOW they need it,
>> and often they *like* themselves the way they are... so *someone*
>> has to take them in and get them started, because they haven't the mental
>> faculties to do
>> it themselves!
>It makes me uncomfortable to think that if I happen to be sitting out on
>a curb looking weird and unkempt I could be forcibly picked up and
>injected with psychoactive drugs. So there are people who like
>themselves as they are, are happy as they are, and are not hurting
>anyone.. (You know what? This is more than I can say for a lot of solid
>citizens. )
It makes me uncomfortable too.
Let's further this discussion because there's a lot of issues
involved. I think that this is a good arena to think creatively of
some solutions that lie between the "forcibly picked up" route, and
the "leave them alone" route.
Let's assume that that person is acting and talking in ways that are
"harmful" (huge spectrum of meaning from harrassment and verbal
abuse to others, destroying one's own life goals, etc.), and at the
same time that person: 1) is convinced that they are perfectly fine
(as Nadia says: they *like* themselves the way they are), and 2) are
good at convincing any social worker or neighborhood policeperson
that they are fine.
If you are unsuccessful at convincing them to voluntarily admit
themselves to a hospital/institution, then, today, there is very
little that one can do. You would have to petition the courts, in
order to have the person put in a hospital, and it's often a messy
and long process. If the police stepped in and determined that the
ill person is a danger to himself/herself or others, then that person is
put in jail. Next, a psychiatric evaluation is performed and that
person is held for a few days. If the person is determined to be
ok, then he/she is put back on the streets. If not, then he/she is
put in the hospital.
It might be better for the ill person and the family members/friends
if the involuntary committment process could be changed so that
friends and family members are given a larger role and the
random-ignorant-policeperson given a smaller role. That might might
make the process less vulnerable to mistakes or to overzealous
actions by single individuals. For example, if, 3 family members and
3 friends/colleagues/neighbors could give statements about the
mental state of ill person, then perhaps the committment process
would be quicker and less cumbersome. And if the forced hospital
stay was just a few days (until other tests and evaluations
determined that more time was needed), instead of weeks (with that
person being lost in the beaucratic maze), then less mistakes might
be made too. Any solution that weighs in favor of ("individually
adapted to") the ill person's local environment would be better than
all-encompassing laws and mandates.
Another issue involved here is what constitutes an "mental illness".
In the 1960s a well-known libertarian and psychoanalyst named Thomaz
Szaz held that mental ilness was a social constract rather than a
symptom of disease. (_The Myth of Mental Illness_) His view was that
the mentally ill person is expressing their difficulty with a
situation in their own life, in their "own language", which might or
might not be understandable by any other person around. His theory
was widely circulated, and is discarded now. As much as I respect
Szaz for his other opinions and ideas, and I offer that he may have
explanations for some of what he's seen in the psychiatry field,
he's wrong in big ways with some of the diagnosed mental illnesses.
For example, the evidence that schizophrenia is a brain disease is
overwhelming.
Probably most people here (including myself) would cringe at the
idea of "forced 'anything'", but in the situation of a person with
an acute mental illness (such as schizophrenia), the benefit to the
person and friend/family is overwhelmingly large. The
hospitalization accomplishes several things. It enables the health
professionals to observe the person in a controlled setting, so that
other medical illnesses, that might be causing the symptoms can be
ruled out. If medication is started, then the medical staff can
watch for side effects. Also the hospital stay offers the family and
friends a brief rest from what is often extremely stressful and
harrowing days/nights leading up to the ill person's hospital stay.
I know that it's dangerous when oppressive governments see mental
institutions as a convenient tool with which to supress
"indesirable" voices in the population. The former Soviet Union was
probably best known for using mental institutions this way. Because
the concept of forced institutionalism is such an fragile (and
emotional and dangerous) concept, it's a perfect example for
libertarians and anarchists to think about and address in order to be
prepared for the future when we have more minimal government (call
me an optimist).
To close this note, some of you may or may not know that John Forbes
Nash, Jr., the mathematical genius and winner of the Nobel Prize in
Economics (1994, for work in "Game Theory") was a paranoid
schizophrenic for about 30-40 years of his life. He received his
Nobel prize when he was approaching age 70, for work that he did in
his 20s and 30s, with long periods of his illness in-between. He
benefited from early traditional antipsychotic drugs (and he refused
any drugs after 1970), but for him, it was an episodic illness, with
periods of acute psychosis followed by periods of relative calm when
the symptoms diminished dramatically. He was involuntarily committed
several times by family members or colleagues, he never voluntarily
went to the hospital. I wonder alot what his life would have
been like if he was not been involuntarily committed to those institutions
by the people who cared about him. His years from age ~60 show his
illness in a dramatic remission and his colleagues call him "recovered".
He is perhaps, one of the rare schizophrenic cases that goes into
remission. (The initial diagnosis by doctors of his illness can be
trusted.) He believes that he willed his own recovery: "Gradually I
began to intellectually reject some of the delusionally influenced
lines of thinking which had been characteristic of my orientation.
This began, most recognizably, with the rejection of
politically-oriented thinking as essentially a hopeless waste of
intellectual effort." The book: _A Beautiful Mind_ by Sylvia Nasar
is a really nice story about his life.
Amara
********************************************************************
Amara Graps email: amara@amara.com
Computational Physics vita: finger agraps@shell5.ba.best.com
Multiplex Answers URL: http://www.amara.com/
********************************************************************
"Sometimes I think I understand everything. Then I regain
consciousness." --Ashleigh Brilliant
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