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 http://recoveryfromschizophrenia.org/ 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 treatment (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 liberty 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 claims This book documents a large body of evidence suggesting that while psychiatric drugs often appear to help in the short term, The long term effect on average is to make the problems worse GD = Guided Discontinuation MT = Maintenance Therapy 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 state” ◦ 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 spirit ◦ 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 good Joining an advocacy group like MindFreedom is one way to help make sure these issues get addressed!