ACLU - Oregon State Hospital

Ron Unger LCSW
[email protected]
“Stormy search for self” as a young man
◦ Sometimes “mad” but it was also a positive
emotional and spiritual journey
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
Then became an educator
◦ To increase availability of alternatives
 See my blog
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”
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
Between 44 and 51% were found to have PTSD
induced by psychiatric admission and
 (Priebe, Broker, & Gunkel, 1998; Morrison, Bowe,
Larkin, & Northard, 1999)
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”
Damaging person’s relationship with mental
health system
◦ Creating either
 Too much rebellion & disengagement, or
 Too much compliance
Possibly imposing a treatment which is
actually more harmful than helpful
◦ Because of failure to listen to feedback from person
receiving treatment
In General, unjustified infringements on
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
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
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
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
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
This book
documents a large
body of evidence
suggesting that
while psychiatric
drugs often appear
to help in the short
The long term effect
on average is to
make the problems
GD = Guided
MT =
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
The drug will not simply correct a specific
“biochemical imbalance”
It will create what could be called a “drugged
◦ and then either this drugged state or the placebo
effect may be give some relief in the short term
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.
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
◦ 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.”
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
Joining an advocacy group like MindFreedom
is one way to help make sure these issues get

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