Photo: Bruno Vincent / Getty Images
For the past dozen years, I’ve been into mental health, both as a reporter and as a person living in a head. One big, fundamental, and easily overlooked point about mental health – something I really got it – is that we are all just one very bad day away from becoming our own version of Britney Spears on this pulled out stretcher of a villa in front of the world.
If you had this very bad day, here’s what you would likely learn: Our mental health system is extremely broken. As for the nature of this brokenness and how we can do better than what we have, I filled in a book try to answer such questions, and finish a second one. But if you had to put it all together, the big problem is this: Right now, our mental health system is based on violence. Violence against the person who is considered incapable of acting, for example because they have been diagnosed with a “serious mental illness” such as bipolar disorder or schizophrenia. There is intense discussion as to whether such psychiatric diagnoses are medically meaningful. What psychiatric diagnoses are certainly: Legal terms.
In the event that a court ruled that you are incapacitated after such a diagnosis, you may be deprived of a number of rights. Perhaps you have now been prevented from participating in your own medical decisions, including psychiatric and reproductive decisions. You may be prevented from making your own financial decisions. Maybe you are now excluded Choose, in possession of a driver’s license, Sign in your name, including just one credit card; it can go on and on. Sometimes a court will tell you that you are no longer allowed to see your own children. I’ve heard people who pay attention to this cross between disability and law refer to this event as a “civil death.”
It is difficult to estimate how many people are affected by such situations, both because of patient data protection and because data collection in this country on human rights violations by “mentally ill” extremely poor. There is no centralized database tracking involuntary obligations, one of the classic ways a person is relegated to this lesser legal status. What data exists suggests that it is becoming more common: A study from UCLA last fall found that involuntary commitments exceeded population growth three to one over the past decade. “This is the most controversial mental health intervention – you are deprived of your freedom, can be traumatized, and then stigmatized – but no one could say how often this happens in the United States,” said David Cohen, a welfare professor who teaches the study said in a press release. A current estimate extrapolated that over a million Americans are committed involuntarily each year.
I have interviewed many self-identified psychiatric survivors over the past several years, attending the World Hearing Voices Congress, taking part in protests outside the annual meetings of the American Psychiatric Association, and traveling here and abroad to find better answers. Most psychiatric survivors have at some point learned the hard way how much can suddenly be withheld from them. You tend to know what it feels like to become someone who is considered to be no longer able to make their own decisions. Someone who has to consent instead. Often because a doctor or family member said this, or a court said this, or for some or all of the reasons listed above. Sometimes a person is placed under a “guardianship”, as Britney did, or a “guardianship”. Such arrangements have drawn increased control Recently, however, this situation has become much more extensive: What we are essentially talking about is the potential we all have to lose basic civil rights – as long as this paradigm of forced psychiatry persists.
Why and however it happens to you, the gist is this: when you are consumed by this system, your personality is apparently shrunk. And since you often cannot sign anything yourself, you cannot even hire a lawyer to help you. Britney Spears herself has to rely on a court appointed attorney for this reason, as many were surprised to see Framing by Britney Spears Documentary.
Here’s something that people who have not experienced such a scenario usually don’t know: there is no real way to prove that you have a mental illness or not. These diagnoses remain biologically unfounded, more a metaphor than medicine. This was even admitted by the then head of the National Institute of Mental Health in 2013. (“Contrary to our definitions of ischemic heart disease, lymphoma or AIDS, DSM Diagnoses are based on consensus across clusters of clinical symptoms, not on an objective laboratory measure, âwrites Dr. Thomas Island in An entry on the NIMH website. “In the rest of medicine, that would be tantamount to creating diagnostic systems based on the type of chest pain or the quality of the fever.” This makes it possible to maintain the status quo, which in practice tends to generate abuse of power, however it is constituted – be it brainwashing the American public for the benefit by Big Pharma or the seizure of Britney’s property and personality by anyone nominally charged with taking care of them.
For every Britney Spears there is an untold number of extremely less famous Britneys trapped in their own private hells, perhaps controlled by the state or a family member. all stories sure as harrowing as Britney’s, if not more so. These are stories that we will continue to ignore until we see the full humanity of “insane” people. Our legal and medical system is designed to ignore such people. And for a long time the public had also been extremely hostile to the voices of the supposed âcrazy peopleâ. Maybe until last week.
For psychiatric survivors, what happened to Britney is commonplace, obvious, mundane. She is one of them. The press and public, however, were amazed when they heard the alleged details of Britney’s case last week: How she can’t own a smartphone. How she can’t ride in her boyfriend’s car, let alone marry him. How they won’t let an IUD be removed so they can have a baby.
All of this, of course, has negative effects Had an impact on her so-called mental health, she said – “I cry every day,” she said, also begging not to have to undergo another psychiatric evaluation (so little is she wishing for the type of mental health care offered). ). It is a perfect distillation of the fallacy of our mental health system in its constitution: it runs over and often actively harms a person in the name of âpublic safetyâ. It is a system based on curtailing a person’s rights so severely that, as Britney’s case aptly shows, all the money and fame in the world cannot free you.
This paradigm was used by compulsory psychiatry criticized for decades viewed by psychiatric survivors and their allies (clinics, lawyers, journalists like me) as ineffective and expensive. The United Nations has also broken this psychiatric framework as a human rights violation. In 2013, this special report on torture called on Member States to âban all forced and non-consensual medical interventions against people with disabilities, including the non-consensual administration of psychosurgery, electric shocks and mind-altering drugs such as [antipsychotics], the use of restraint and solitary confinement, for both long-term and short-term use. âEspecially Last month, also called for the implementation of an entirely new, human rights-based mental health paradigm.
In America, however, the coercive approach is still all we know and do everything we finance, Really. We tend to overlook the promise of mental health care. “Alternativesâ(As they like to be called). This does not include judgmental self-help groups for people hear the voices and for the who think about suicide, as well as safe houses for people in acute crises. Such approaches tend to be comparatively cost-effective and utterly hopeful – and in my experience, few Americans have ever heard of them.
The day after Britney’s testimony in LA court last week, heard around the world, I called a psychiatric activist I met, Caroline Mazel-Carlton. Mazel-Carlton, who is also a rabbi in training, works for an organization revolutionizing mental health care in western Massachusetts (and beyond) called the Wildflower Alliance. I asked her what she thought of so many people suddenly standing up for the civil rights of psychiatric patients – or at least the rights of a patient.
“It’s just a relief to me to be honest,” said Mazel-Carlton. âSometimes I even cry when people finally say, ‘This is not right. That is not right.'”
As we spoke, Mazel-Carlton seemed more focused on the actual activism of the day: this week she and a few colleagues were speaking out before the Massachusetts legislature, speaking out against a bill that expand Forced psychiatry in their state. Euphemistically referred to as assisted outpatient treatment, or AOT, such laws were passed by 47 states over the past two decades. Such laws expand the powers of the state to make medical decisions for a person who is considered incapable of acting because of insanity, for example beyond the timeframe of mandatory psychiatric hospitalization, which traditionally lasts around 72 hours. Instead, under such laws, a person who has been discharged from hospital, for example, is now controlled and monitored by the state, often indefinitely.
These AOT laws are almost ubiquitous and represent a duplication of this compulsory psychiatry paradigm; In other words, they are the opposite of any liberated mental health care vision supported, albeit fuzzy, by #FreeBritney activists. I was wondering if those who post #FreeBritney realize that there is already a robust movement for the civil rights of mental health patients that has been organizing for decades?
âI just want to say to people, welcome to this movement,â said Mazel-Carlton. “It’s one of the lesser-known liberation movements, but we’re so happy to have you if you want to fight by our side, not just Britney’s.”