tag:blogger.com,1999:blog-26666124.post7909647429441532522..comments2024-03-18T03:28:36.581-04:00Comments on Shrink Rap: Are We Not Thugs?Unknownnoreply@blogger.comBlogger81125tag:blogger.com,1999:blog-26666124.post-58865781863879350712011-06-24T02:13:33.896-04:002011-06-24T02:13:33.896-04:00OMG! Today I had an ER nurse tell me psych patient...OMG! Today I had an ER nurse tell me psych patients are demon possessed and that they do not have a medical problem and should not be medicated. Also she used to work in a psych ward. I think she needs to go back - as a patient. I can't figure out why she chose to work in place so diametrically opposed to her viewpoint. <br /><br />Here's what scares me, and it's not the prospect of being involuntarily committed if I need it. It's lack of access.<br /><br />I'm scared of needing to be hospitalized and being so sick I can't figure out how to make it happen. That happened to me once a long time ago on a weekend when I couldn't get my therapist or doctor on the phone. It was a waking nightmare. I can't imagine any hospital being worse than the way I felt. By the time Monday came I was well enough to avoid hospitalization - barely, but I don't ever want to feel that way again.<br /><br />Now I work in a nonclinical position in a small hospital where there are no mental health providers, and from what I've seen the ER staff has an incredibly difficult time finding beds for psych patients. It's not for lack of trying. The nurses spend hours at a time, shift after shift on the phone calling a list of hospitals trying to find one anywhere to take these patients. Psych beds just aren't available. So when psych patients show up, either on their own or with law enforcement, they get evaluated by a psychiatrist over a remote television. After that the ones who are to be committed usually spend days waiting for a bed. Occasionally patients have waited over a week. Few get transferred in less than 24 hours. During this time they receive no mental health treatment whatsoever. Being one of those patients? Needing help? Going days on end without seeing a psychiatrist or therapist? That terrifies me!<br /><br />Mostly I'd say the ER staff are good people and dedicated professionals, but occasionally their reactions to psych patients can be shockingly ignorant. No matter what the ER staff's qualifications, if I were sick enough to need committing, I wouldn't want to be in an ER guarded by police. I'd want to be in a psych ward or hospital where I could get the treatment I needed.<br /><br />So no, I don't think you're thugs. I think of you more like guardian angels, and in response to the quiz, "Heck Yeah! I'd want to be committed if I were dangerous or suicidal or otherwise so sick I couldn't take of myself." I just hope if it ever comes to that I don't spend a week stuck in an ER being babysat by the police, although I guess, that's still preferable to being alone and suicidal.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-48143764873216385732011-06-14T15:58:45.964-04:002011-06-14T15:58:45.964-04:00Reverend King was peaceful.
His words were inspira...Reverend King was peaceful.<br />His words were inspirational.<br /><br />But when I read his words, I don't see them as particularly 'respectful'. <br /><br />In my mind, there was a double-edge sword to what he had to say - <br /><br />... "I have a dream that one day the state of Alabama, whose governor's lips are presently dripping with the words of interposition and nullification"... <br /><br />Rather than you and I going back and forth on this subject, maybe we could agree to let Dr. King have the last word.<br /><br />The 'March on Washington: I Have a Dream' -<br /><br />http://www.mlkonline.net/dream.html<br /><br />Duane Sherry, M.S.<br />discoverandrecover.wordpress.comDuane Sherry, M.S.http://discoverandrecover.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-21930051577871236652011-06-14T15:28:32.093-04:002011-06-14T15:28:32.093-04:00"Freedom is never voluntarily given by the op..."Freedom is never voluntarily given by the oppressor; it must be demanded by the oppressed." - <br /><br />Reverand, Martin Luther King, Jr.Duane Sherryhttps://www.blogger.com/profile/10482281700165504817noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-87998317748138471852011-06-14T06:05:45.609-04:002011-06-14T06:05:45.609-04:00Duane, in the word's of the Supreme Court &quo...Duane, in the word's of the Supreme Court "I respectfully dissent." With emphasis on the 'respectfully.'ClinkShrinkhttps://www.blogger.com/profile/13316134491751195651noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-27998160866532133592011-06-13T20:31:49.907-04:002011-06-13T20:31:49.907-04:00ClinkShrink,
You cite Addington versus Texas:
Du...ClinkShrink,<br /><br />You cite Addington versus Texas:<br /><br />Due process does not require states to use the "beyond a reasonable doubt" standard of proof applicable in criminal prosecutions and delinquency proceedings. In re Winship, 397 U. S. 358, distinguished. The reasonable doubt standard is inappropriate in civil commitment proceedings because, given the uncertainties of psychiatric diagnosis, it may impose a burden the state cannot meet, and thereby erect an unreasonable barrier to needed medical treatment."<br /><br />Further: "One who is suffering from a debilitating mental illness and in need of treatment is neither wholly at liberty nor free of stigma."<br /><br />My comment:<br /><br />It is said that the U.S. Supreme Court "gets the last guess."<br /><br />In this case, their "guess" was wrong.<br /><br />I believe that once the "highest court in the land" is able to clearly see the facts, the next time they're asked to render a verdict, it will be a more humane one... and one that is in keeping with the 14th amendment.<br /><br />In other words, once they are privy to more of what "treatment" involved, they may begin to understand it for what it is...<br />"mistreatmnet"...<br /><br />Timeline for antipsychotics -<br /><br />http://www.madinamerica.com/madinamerica.com/Timeline.html<br /><br />Electroconlsive Therapy -<br /><br />http://breggin.com/index.php?option=com_content&task=view&id=40&Itemid=52<br /><br />As long as you and your colleagues continue to call this "treatment", nothing will change.<br /><br />At least until the highest court takes another look.... and I think that day is closer than you and your colleagues are willing to recognize.<br /><br />Passionately,<br /><br />Duane Sherry, M.S.<br />http://discoverandrecover.wordpress.com/warningDuane Sherry, M.S.http://discoverandrecover.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-91135915051967719752011-06-13T19:02:38.637-04:002011-06-13T19:02:38.637-04:00"Involuntary admission does not equate to inv..."Involuntary admission does not equate to involuntary treatment". <br /><br />Clink is right; you can spit the pills in the toilet. No one is really looking.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-26573602636330634812011-06-13T19:00:23.589-04:002011-06-13T19:00:23.589-04:00This comment has been removed by a blog administrator.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-66272202031884987732011-06-13T05:15:34.773-04:002011-06-13T05:15:34.773-04:00Duane,
The issue is you can speak a very hard hit...Duane,<br /><br />The issue is you can speak a very hard hitting truth without insulting people.<br /><br />Mind Freedom was able to get Ray Sanford and Elizabeth Ellis released from involuntary ECT by practicing this philosophy. <br /><br />Besides, we're not in Congress as we are guests on a blog owned by 3 psychiatrists. They have asked repeatedly for civility and to keep justifying insults does nothing to advance our cause.<br /><br />AAAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-84919963445579175402011-06-13T00:08:13.741-04:002011-06-13T00:08:13.741-04:00"Whenever violence is used, and injury done, ..."Whenever violence is used, and injury done, though by hands appointed to administer justice, it is still violence and injury, however coloured with the name, pretences, or forms of law". - John LockeDuane Sherry, M.S.http://discoverandrecover.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-69359058423388883302011-06-12T23:30:30.464-04:002011-06-12T23:30:30.464-04:00Anonymous,
I think if someone was currently in a ...Anonymous,<br /><br />I think if someone was currently in a psychiatric hospital, forced to take drugs, and/or threatened with ECT, Rob's words would bring them the most comfort... To know that somebody was speaking the truth on this site, however discomforting it might be to the doctors and professionals who post here.<br /><br />This particular post is not on the subject of medicine, or even law... It is on the subject of freedom.<br /><br />The post is political.<br /><br />So it should come as no surprise that the speech (comments) are in-turn political, and heated.<br /><br />Political speech is not meant to always be polite.<br /><br />"I would remind you that extremism in the defense of liberty is no vice." - Senator Barry GoldwaterDuane Sherry, M.S.http://discoverandrecover.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-27211289419492701042011-06-12T22:26:31.062-04:002011-06-12T22:26:31.062-04:00Lisa: Patients can be released within the 90 days ...Lisa: Patients can be released within the 90 days if they are assessed as safe and the court approves the release. More often, they are criminally committed to a secure forensic facility but ultimately can transfer out to a regional non-forensic hospital if things go well. (And if there is a bed available---90% of public psychiatry beds in the country are occupied by forensic patients.)<br /><br />Involuntary admission does not equate to involuntary treatment. They are separate issues that usually require separate due process hearings.<br /><br />In the case of medical patients, they can be treated involuntarily if they lack the capacity to give informed consent to treatment. In this case a health care proxy is appointed to make medical decisions for the patient, or a legal guardian is appointed. So yes, it is possible to provide medical treatment against someone's will. Many states also have public health laws that allow for the quarantine of infectious individuals. This is rare, mainly because we have successful treatments for most infectious diseases now and most people willingly accept those treatments. I have heard though of a case in our state in which someone with active infectious drug resistant tuberculosis was taken into custody on a health warrant and placed in isolation. In the 1950's some states had tuberculosis asylums where infectious patients were held until the disease went into remission.<br /><br />Involuntary treatment is not limited to psychiatry. Civil commitment laws were actually modeled on these medical quarantine laws.ClinkShrinkhttps://www.blogger.com/profile/13316134491751195651noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-41450792613908101532011-06-12T19:54:54.403-04:002011-06-12T19:54:54.403-04:00Re-posted for Lisa:
I fear I am doing a poor job o...Re-posted for Lisa:<br />I fear I am doing a poor job of posing my questions.<br /><br />First, am I correct in my understanding that psychiatrists and even some of the general public hold a view that involuntary treatment has a place in the medical and legal system? From what I'm understanding, the psychiatrists writing and commenting on this blog see to be in agreement that it's a slippery slope but it has it's merits but is can be a necessary thing if a mentally ill person is an imminent danger to himself or others. Is this understanding correct?<br /><br />I presented this confabulated story and questions because I find there is a gross flaw in a medical/legal system and a public that finds grounds when involuntary treatment should be used. Why is there a system and a general consensus that involuntary treatment is sometimes necessary to protect the person or the public from the mentally ill but there is no system or general consensus that required treatment be necessary for those with physical ailments?<br /><br />There was recently a poll on the blog asking whether one would be for or against involuntary treatment (of a mental illness). The majority answered yes. If you changed it to, "If you had epilepsy (or cancer, or diabetes, or a broken toe) would you be for involuntary treatment" I believe the majority would answer no.<br /><br />I am against involuntary treatment of any kind, no matter the circumstances. I think if there is a case made for involuntary committal for one part of the population -the mentally ill who pose a threat to self or others - then there could be a case for a system of involuntary committal and medication for another part of the population. This is when the belief that involuntary treatment is a vital part of protecting the public welfare becomes dangerous. The question can always be asked, "Why can the woman in your post be involuntarily treated but Juan cannot?" Yes, I understand that some of Juan's activities can be controlled, i.e. driving. But Juan's condition poses a threat to his self and the public just as a mentally ill person could pose a threat.<br /><br />I'll be clear. I believe mental illness is a very valid medical diagnosis and I believe medications and therapies are proven to treat the symptoms in a way to give the sufferer relief, in the same way that insulin and diet give the sufferer of diabetes relief. But I do not think there should ever be a case where one could be mandated to receive treatment against their will.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-19033467243975632732011-06-12T19:54:17.951-04:002011-06-12T19:54:17.951-04:00Rob:
Those comments were just too random for me. ...Rob:<br /><br />Those comments were just too random for me. They show up on many posts with LOL and something that I can't decipher. I decided to delete them this time. Previously we've deleted spam that link to ads. There is no objective criteria. <br /><br />Lisa:<br />I didn't delete your post and don't know where it went. It is, however, still in my email trash, so I will repost it for you.Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-24334545382421974262011-06-12T15:47:30.910-04:002011-06-12T15:47:30.910-04:00The two comments you deleted at the beginning of t...The two comments you deleted at the beginning of the thread were not insulting, just crazy. Do you have an objective, measurable criterion for deciding what's acceptable and what's not? ;)rob lindemanhttp://natickpediatrics.netnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-4478099765247635472011-06-12T14:24:29.455-04:002011-06-12T14:24:29.455-04:00I do believe my last post was, "I believe X a...I do believe my last post was, "I believe X and here is why" and also, "Why is it this way and not that way?" I do not understand why it was deleted.Lisanoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-67539800727287650632011-06-12T14:09:52.698-04:002011-06-12T14:09:52.698-04:00Lisa,
Your post was not insulting.
This is not a s...Lisa,<br />Your post was not insulting.<br />This is not a subtle issue.<br /><br />Is anyone really having trouble understanding this?<br /><br />"I believe X and here is why" is fine.<br /><br />"You are an idiot if you don't believe what I do" is not.Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-78087057682657179862011-06-12T13:45:53.584-04:002011-06-12T13:45:53.584-04:00I apologize if my last post may have contained ins...I apologize if my last post may have contained insulting material. It surely was not my intent. I really do want to know why there is a difference in public beliefs on involuntary treatment for the mentally ill vs involuntary treatment for physical ailments.Lisanoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-3346567378550793332011-06-12T12:49:00.460-04:002011-06-12T12:49:00.460-04:00I fear I am doing a poor job of posing my question...I fear I am doing a poor job of posing my questions.<br /><br />First, am I correct in my understanding that psychiatrists and even some of the general public hold a view that involuntary treatment has a place in the medical and legal system? From what I'm understanding, the psychiatrists writing and commenting on this blog see to be in agreement that it's a slippery slope but it has it's merits but is can be a necessary thing if a mentally ill person is an imminent danger to himself or others. Is this understanding correct? <br /><br />I presented this confabulated story and questions because I find there is a gross flaw in a medical/legal system and a public that finds grounds when involuntary treatment should be used. Why is there a system and a general consensus that involuntary treatment is sometimes necessary to protect the person or the public from the mentally ill but there is no system or general consensus that required treatment be necessary for those with physical ailments? <br /><br />There was recently a poll on the blog asking whether one would be for or against involuntary treatment (of a mental illness). The majority answered yes. If you changed it to, "If you had epilepsy (or cancer, or diabetes, or a broken toe) would you be for involuntary treatment" I believe the majority would answer no. <br /><br />I am against involuntary treatment of any kind, no matter the circumstances. I think if there is a case made for involuntary committal for one part of the population -the mentally ill who pose a threat to self or others - then there could be a case for a system of involuntary committal and medication for another part of the population. This is when the belief that involuntary treatment is a vital part of protecting the public welfare becomes dangerous. The question can always be asked, "Why can the woman in your post be involuntarily treated but Juan cannot?" Yes, I understand that some of Juan's activities can be controlled, i.e. driving. But Juan's condition poses a threat to his self and the public just as a mentally ill person could pose a threat.<br /><br />I'll be clear. I believe mental illness is a very valid medical diagnosis and I believe medications and therapies are proven to treat the symptoms in a way to give the sufferer relief, in the same way that insulin and diet give the sufferer of diabetes relief. But I do not think there should ever be a case where one could be mandated to receive treatment against their will.Lisanoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-29257504270635192062011-06-12T12:29:08.060-04:002011-06-12T12:29:08.060-04:00Please note that I will now be deleting comments t...Please note that I will now be deleting comments that contain insults to the bloggers or to our commenters.<br /><br />Civil disagreement with our view points is fine.Dinahhttps://www.blogger.com/profile/09227988351623862689noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-34114117580589500092011-06-12T11:49:46.893-04:002011-06-12T11:49:46.893-04:00Duane,
You make some great points. But if you k...Duane,<br /><br />You make some great points. But if you keep lobbing insults like telling Jesse he doesn't have a clue or that he makes you ill, we're going to lose our voice on this blog.<br /><br />Dinah and Clink have asked for civility and we need to respect that. Actually, we need to practice that without any reminders.<br /><br />As I previously mentioned, I greatly share alot of your views regarding psychiatry but we have to remain polite. Remember, Mind Freedom, which I know you are a big fan of, constantly stresses that.<br /><br />David Oaks, the President suffered great abuses when he was wrongly hospitalized. In fact, per your suggestion to Clink to read something different besides psych times, everyone should read this account by him. It would add a whole new perspective to this debate.<br /><br />http://www.mindfreedom.org/about-us/david-w-oaks/writing/<br /><br />In spite of what he has gone through, I can't remember a time that he has lost his cool in debating people who vehemently disagreed with him.<br /><br />We need to follow that example.<br /><br />AAAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-43205923403055371302011-06-12T11:26:08.519-04:002011-06-12T11:26:08.519-04:00Locking someone up means locking them up...
It m...Locking someone up means locking them up... <br /><br />It matters not if it's a state prison, a private psychiatric hospital, or the Taj Majal.<br /><br />And without due process, it's a tryanic act to do so... <br /><br />And believe it or not, it matters not whether a shrink or social worker sees it as a tyranical act or not.<br /><br />"Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience." - <br /><br />C. S. LewisDuane Sherry, M.S.http://discoverandrecover.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-24616044566492488982011-06-12T10:06:50.521-04:002011-06-12T10:06:50.521-04:00Clink, thanks for the forensic viewpoint, I don...Clink, thanks for the forensic viewpoint, I don't know much about that area. So, when they are found insane of a crime and get 90 days, do they have to stay the entire 90 days if they've made no threats of violence and exhibited no violent behavior by day 10, for example? Wouldn't it be punishment rather than treatment to keep them past day 10 if that's when the violent behavior/threats stopped? What is the rationale behind the 90 day number as the necessary time to see if someone is still violent or not? <br /><br />LeslieAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-1533719909247043852011-06-12T09:26:03.203-04:002011-06-12T09:26:03.203-04:00Thanks for pointing me to the citation of your boo...Thanks for pointing me to the citation of your book at Earley's site. There, you wrote:<br /><br />"In simpler terms, we presume there is a 'chemical imbalance' [in mental illness], but it remains uncertain as to what that imbalance actually is."<br /><br />Several of the responses to Earley's post could be summarized by the commonplace "absence of evidence is not evidence of absence".<br /><br />The problem with this chestnut, and with the excerpt I quoted above, is that they are anti-scientific. An hypothesis, in science, cannot and must not be considered true until proven otherwise. Falsifiability is the linch-pin of science. The equation of mental illness with physical illness cannot be asserted with any degree of scientific rigor. (I have been arguing that as long as you call it "mental illness", you automatically place it in a category outside the physical body, but that is another matter). The chemical imbalance hypothesis, like all the physical explanations for mental illness that preceded it, is regarded by many in the field as religious truth, rather than as scientific hypothesis.<br /><br />By all means, continue to search for your chemical imbalances, abnormalities in gene expression, and disturbances of glucose uptake on PET. Be sure to get back to us when you find objective, measurable criteria. In the meantime, I'm begging you, please stop asserting you've got what you haven't got.Rob Lindemanhttp://natickpediatrics.netnoreply@blogger.comtag:blogger.com,1999:blog-26666124.post-32276360445431264742011-06-12T06:54:45.259-04:002011-06-12T06:54:45.259-04:00Lisa: The involuntary patients I see are just the ...Lisa: The involuntary patients I see are just the ones who have been found insane of crimes, so they are criminally committed (as opposed to civilly committed) to the hospital. In our state the law allows for a 90 day inpatient evaluation of dangerousness following a finding of insanity. At the end of that time the hospital can make a recommendation for conditional release. The recommendation gets sent back to the judge who ordered the commitment. There is a conditional release hearing, and the judge (not the doctor) decides if the patient--who is no longer a defendant and is not a criminal--is still mentally ill and dangerous. The defendant has defense counsel, and the state's attorney's office and hospital attorney general also are involved in these proceedings. Other states have different procedures (some have no conditional release---they just discharge the patient outright with no mandatory outpatient care).<br /><br />But getting back to your question (sorry for the rambling lecture, I thought I needed to give some background), all the issues and behaviors you described would be considered by the treatment team when making a conditional release recommendation. The majority of my insanity acquittees look nothing like what you describe though---even when they want medication and take it voluntarily it can take months to years to get better. They just have really bad diseases.<br /><br />Roy could speak to standards for discharge for civil patients better than I could, but off the top of my head the patient you described would likely be discharged quickly, if a discharge plan could be set up fast (assuming the patient has a home to go to, a doc they can see on the outside, access to meds, etc).<br /><br />Thank you for your questions and participation; I love talking about this stuff.ClinkShrinkhttps://www.blogger.com/profile/13316134491751195651noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-34028208187656037872011-06-12T06:37:10.422-04:002011-06-12T06:37:10.422-04:00Lisa: There are lawyers reading this blog who coul...Lisa: There are lawyers reading this blog who could answer this question better than me, but off the top of my head I suspect that Juan would be acquitted of a crime, or more likely not even charged. As MovieDoc said in his comment, in order to be convicted of a crime the state has to prove mens rea (the guilty mind) and actus reus (the guilty act), and both elements must be proven beyond a reasonable doubt. Someone in the midst of a seizure has no mental state whatsoever, and so cannot have a mens rea and is innocent. At most, he might be charged with criminal negligence, if he failed to take his seizure medication and knew that he would likely have a seizure while driving. In that case the judge (not the mental health system) would require him to comply with the state's driving laws, as Jesse said, as a condition of probation. Mental health professionals would have nothing to do with this case at all.<br /><br />These types of cases are known as "automatism" defenses. Other conditions used in defenses like this are sleeping walking and night terrors. In automatism defenses the defendant claims that he killed or seriously injured somebody during some type of abnormal sleep-related behavior. I've never heard of a defense like this being successful.<br /><br />Regarding alcoholism, substance intoxication is usually barred as the basis of an insanity defense either by state law or case law. Back in the '60's the U.S. Supreme Court ruled that you couldn't incarcerate someone for being an addict (<a href="http://en.wikipedia.org/wiki/Robinson_v._California" rel="nofollow">Robinson v. California</a>). People could be prosecuted for possessing drugs or drug parphernalia, or for selling drugs, but not simply for being prone to using them.<br /><br />Weirdly enough, Maryland still has <a href="www.courts.state.md.us/reference/pdfs/adaaappendix.pdf" rel="nofollow">an old law</a> on the books from the 1950's allowing for commitment for substance rehabilitation. It allows judges to commit a criminal defendant to a program, but only to a substance abuse program (not mental health facility). The law has never been challenged and no defendant has complained about it because they want to go there. So of course, it's not *really* involuntary treatment. No mental health testimony is required or used for this.ClinkShrinkhttps://www.blogger.com/profile/13316134491751195651noreply@blogger.com