
How to Help Save the Mentally Ill from Themselves - pavornyoh
http://www.nytimes.com/2015/11/17/opinion/how-to-help-save-the-mentally-ill-from-themselves.html?ref=opinion&_r=0
======
empressplay
It's sad what happened to the author's son, but historically laws allowing the
state to 'interfere' with a person's psychiatric care choices have had some
not insignificant amount of abuse. The author seems to want to expand "threat
to themselves or others" from the current interpretation of physical violence
/ suicide to simply acting against their own best-interests, and while I
understand how they came to that position, it's far too nebulous a test to
guarantee perfectly sane, rational people won't be medicated or locked up
simply for acting counter to common expectations.

~~~
jpatokal
Obligatory:
[https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry_...](https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry_in_the_Soviet_Union)

Particularly:
[https://en.wikipedia.org/wiki/Sluggish_schizophrenia](https://en.wikipedia.org/wiki/Sluggish_schizophrenia)

...which allowed people who weren't crazy, but showed subtle signs (like, say,
questioning Communism) that they _might_ become crazy, to be locked up "for
their own protection".

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teslabox
Medicine does pretty well with popping my friend out of her psychotic states.
But people on the traditional treatment programs never truly get better,
they're just on the treatment merry-go-round for decades.

"The Doctor Isn't In" succinctly describes Psychiatry's big problem:
[https://news.ycombinator.com/item?id=10315705](https://news.ycombinator.com/item?id=10315705)

~~~
cbd1984
> But people on the traditional treatment programs never truly get better,
> they're just on the treatment merry-go-round for decades.

You could say the same thing about a lot of neurological disorders. Or things
like Type 1 Diabetes, come to that.

~~~
bjwbell
A lot of people can and do get better. I can't comment on whether traditional
treatment works for that or not. Personally I think treating the person is
more helpful in the long run.

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SCAQTony
Here is a summary of the Bill:
[http://murphy.house.gov/uploads/MHOnePager2.18.15.pdf](http://murphy.house.gov/uploads/MHOnePager2.18.15.pdf)

Here is the text of the Bill:
[http://murphy.house.gov/uploads/HR3717%20Bill%20Text.pdf](http://murphy.house.gov/uploads/HR3717%20Bill%20Text.pdf)

Here are speeches and interviews about the Bill:
[http://murphy.house.gov/helpingfamiliesinmentalhealthcrisisa...](http://murphy.house.gov/helpingfamiliesinmentalhealthcrisisact#Bill)
Information

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throwaway13245
I have had the experience of being taken into inpatient psychiatric care
against my will. I fit the profile of someone that needed inpatient
psychiatric help, but it would only be given to me if I was deemed a threat to
myself or others. The doctors spoke with my family about possible things I had
done that would fit that description, but I hadn't done anything to imply
that. Finally, the doctors recommended to my family that they accuse me of
danger to self or others anyway so I could get the "help I needed." They did
and I was admitted.

So there are apparently ways to work around it if you really want someone to
be an inpatient. Perhaps sometimes that's a good thing since wanting to kill
people isn't the only prereq for needing help. Unfortunately I am now labeled
as someone who needed to be locked up as a danger to self or others when I
wasn't.

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bjwbell
I'm curious, are there any studies that show antipsychotics not being harmful
vs no medication in the long term (5-10yrs)?

~~~
xkcd-sucks
Pretty much all antipsychotics, including the newer "atypicals," cause tardive
diskinesia in about 30 percent of patients who are treated for more than 5ish
years. The other side effects can be nastier, but TD is arguably the worst
because it's permanent.

------
qwerty_asdf
Related:

[http://www.nydailynews.com/news/crime/man-found-dead-tent-
er...](http://www.nydailynews.com/news/crime/man-found-dead-tent-erected-
motel-room-article-1.2065448)

------
DanBC
> Most critically, the Murphy-Johnson bill provides incentives to fund
> expanded treatment, called assisted outpatient treatment, or A.O.T.,

If you decide to websearch for this be aware that AOT often means "assertive
outreach teams". They're different, although they work with similar people.

> only for those with a long history and pattern of proving a danger to
> themselves or others.

This tends to mean at risk of killing are trying to kill other people, or at
risk of dying by suicide. I'm not sure if the author's son would fit the
definition.

> The specifics of A.O.T. vary by state, but judges can order patients to
> undergo treatment while they live in the community instead of in prison or a
> hospital.

In the UK "community treatment disorders" don't seem to reduce rates of re-
admission to hospital.
[http://www.thelancet.com/journals/lanpsy/article/PIIS2215-03...](http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366\(15\)00231-X/abstract)

> But A.O.T. is not carte blanche: It still requires court action and has
> strict criteria to limit treatment to the most seriously ill.

It's pretty scary. I'd want to see more details of the checks and balances
involved.

> Samhsa has used much of its budget to deal with less pernicious conditions
> like trauma and stress.

Author is severely wrong here. "Trauma" covers stuff like borderline
personality disorder, which can be a debilitating illness, with a high suicide
rate, and high rates of accidental death, and a lot of very severe self harm.

Also, early intervention is important.

> It has also funded activist groups that oppose medication

That's not outrageous. Medication often fucking sucks, and there's not much
evidence that it works effectively. It's often better to give people
techniques to live with their illness, and keep people engaged with MH
services, than to just give them a depot injection every six weeks.

> and mainstream psychiatric care for the seriously mentally ill.

Again, you don't have to look too far to find serious unwarranted interference
with human rights when you start looking at MH treatment. This isn't just
force feeding, or forced medication, or restraint and rapid tranquillisation,
or detention in hospital against your will, but the lesser (still important)
stuff like being fully involved in decisions about your life - what you eat,
what you wear, how you spend your money, where you live.

Without details of the groups it's hard to know if they're idiots or
reasonable.

~~~
e40
>> It has also funded activist groups that oppose medication

>That's not outrageous. Medication often fucking sucks, and there's not much
evidence that it works effectively. It's often better to give people
techniques to live with their illness, and keep people engaged with MH
services, than to just give them a depot injection every six weeks.

I know two people who absolutely cannot live without their meds and both are
currently off them. One is homeless and the other is about to be homeless.
Your knee-jerk reaction to the statement to which you are replying seems to
indicate to me you've made up your mind about this, regardless of how much it
helps or hurts.

You know how shit works in the US. Lobbyists can oppose the most sane things
for completely stupid reasons. People that "oppose medication" seems to me,
based on my experience, like completely stupidity. That's an extreme position.
The other side (always medicate) is also extreme.

~~~
steve-howard
Medication has some pretty serious side effects, and while the upside can
outweigh the downside it's absolutely reasonable to oppose forcing other
people to take medication.

