Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.
Wednesday, August 06, 2014
Sectioned -- on involuntary treatment in the U.K.
In America, people enter the hospital involuntarily in a process known as civil commitment. On the other side of the pond, in Great Britain, it's known as being "sectioned."
My thanks to Mental Health @sectioned_ on Twitter who linked to this BBC radio program called "Shrink Wrapped" (not, not, not Shrink Rap) and a one-hour show on being Sectioned -- they interview a psychiatrist, a patient who has been sectioned roughly 10 times, and the police. Here's the Link if you'd like to listen. The issues sound to be the same on both sides of the Atlantic Ocean. If you'd like to listen, it may only be available for a few more days.
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In Massachusetts you get sectioned too. I believe that this is technically the part where they can make you go into a hospital for an evaluation, but I'm not sure.
Commitment is a more involved process here. It's more likely to happen when you're talking about somebody who has been in an acute-care hospital and is being sent to a State intermediate care bed. Those orders are for about 6 months.
Not very informative except in one sense: the psychiatrist explains how easy it is in the UK to involuntarily commit/section somebody, compared with the hurdles that exist in the US. The same is true all around Europe.
Article 5 of the European Convention on Human Rights, which is the text that governs the decisions by the European Court on Human Rights -ECHR-, contains and explicit exception to the right to liberty that reads,
"e. the lawful detention of persons for the prevention of the spreading of infectious diseases, of persons of unsound mind, alcoholics or drug addicts or vagrants;"
According to ECHR case law, deprivation of liberty of persons of "unsound mind" is not even a violation of a fundamental right.
On the other hand, the US Supreme Court has determined that even when involuntary commitment is done legally in the US, it constitutes a violation of the fundamental right to liberty and it applies to it a high standard.
All speakers, including the victim, spoke in favor of involuntary commitment. It should not have been hard to find some UK victim to speak of the negative consequences that come to involuntary commitment. I guess that's what you get from the government's official broadcast service!
I think this comment belongs here.
We got the sad news that Robin Williams took his own life.
While we do not know yet whether he was on any kind of psychotropic drugs, the reason the comment is relevant here is because of the matter of involuntary commitment.
Robin Williams' struggles with so called "depression" were known for years. Nobody ever proposed to involuntarily commit him in order to prevent him from taking his own life.
While his celebrity probably contributed to his life struggles, it also gave him immunity from the threat of forced so called "treatment".
So this is another important aspect in which coercive psychiatry is unjust. If you are poor, you are screwed. If you are rich and famous, you are immune. In a way, the same was true for Howard Hughes whose high social status protected him from coercive psychiatry at a time when "need for treatment" was a valid reason for locking up somebody in the United States.
I am very sad about Robin Williams. We don't know anything about what treatment he did or did not get, but I'm going to go out on a limb and suggest that since he was open about his struggles with addiction and depression that he got voluntary care for these conditions, in which case a discussion of forced care is irrelevant. If he made his suicidal intentions known to others and they didn't commit him because he was rich and famous, then that is truly tragic -- often a brief hospitalization helps someone get through a rough moment, and perhaps such an intervention would have allowed Mr. Williams another 40 years of life, and allowed us to benefit from decades more of his talent.
I don't think there is much to speculate on here, we just don't know. My heart goes out to the family and it feels so tragic to have him die so prematurely.
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