American Snakepits

When I was in a psychiatric facility," a survivor testified, "because I questioned conditions, I was dragged into solitary confinement and held down on a bare mattress, forcibly injected with powerful psychiatric drugs, and held in solitary confinement. And I found since then that this is routine, that this is happening all over the - all over the psychiatric system. Usually forced psychiatric drugging occurs behind institutional walls, but in the last few years coerced drugging is now out in the community."

Earlier in 2000, the US National Council on Disability released From Privileges to Rights, a damning indictment of the chamber of horrors that passes for psychiatric "treatment" in many parts of this country. Make no mistake, this is not a report about what is right with the system. There is no attempt to strike a balance here. Rather, by having survivors come forward with their stories, the NCD has adopted a procedure that has worked so well for South Africa and other countries as part of a process of truth and reconciliation.

As the NCD put it, they "heard testimony graphically describing how people with psychiatric disabilities have been beaten, shocked, isolated, incarcerated, restricted, raped, deprived of food and bathroom privileges, and physically and psychologically abused in institutions and in their communities. The testimony pointed to the inescapable fact that people with psychiatric disabilities are systematically and routinely deprived of their rights, and treated as less than full citizens or full human beings."

The NCD described the situation as a "national disgrace," and called for drastic change.

"People with psychiatric disabilities," they note, "even when they vigorously protest treatments they do not want, are routinely subjected to them anyway, on the justification that they 'lack insight' or are unable to recognize their need for treatment because of their 'mental illness.' In practice, 'lack of insight' becomes disagreement with the treating professional, and people who disagree are labeled 'noncompliant' or 'uncooperative with treatment.'"

Listen to one survivor:

"I spent 15 consecutive months on Unit 5 North. This was the single most traumatic experience of my life. The treatment consisted of an unrelenting, 24-hour-a-day attack on my personal autonomy and self-esteem, which I believe only exacerbated my symptoms."

Protection and Advocacy Systems, according to the report, responded to 34,000 cases regarding abuse and neglect in 1998, and have conducted 5,000 death investigations over the past 20 years, a mere "tip of the iceberg," according to the report. As many as 81 percent of women have been physically or sexually abused in institutions. Listen:

"Eight men jumped on top of me and wrestled me to the floor. They held me face-down on the floor, restrained me, and then shot me up [with] Thorazine. I then waited in restraints for hours until they thought my behavior was appropriate to be released. I remember begging with them like a dog to release me. I was totally powerless and at their mercy."

And you wonder why many people don't voluntarily seek treatment?

Recommendations

What makes the NCD report so unique is it is virtually the only study based on the testimony of users of psychiatric services rather than those with a vested interest in the system and with ties to suppliers. Thus, it comes as no surprise that the NCD is less than sanguine about ECT and the disease model of mental illness. Following are the NCD's core recommendations:

1. Laws that allow the use of involuntary treatments such as forced drugging and inpatient and outpatient commitment should be viewed as inherently suspect. Public policy needs to move in the direction of a totally voluntary community-based mental health system that safeguards human dignity and respects individual autonomy.

2. People labeled with psychiatric disabilities should have a major role in the direction and control of programs and services designed for their benefit.

3. Mental health treatment should be about healing, not punishment. Accordingly, the use of aversive treatments, including physical and chemical restraints, seclusion, and similar techniques that restrict freedom of movement, should be banned. Also, public policy should move toward the elimination of electro-convulsive therapy and psycho-surgery as unproven and inherently inhumane procedures. Effective humane alternatives to these techniques exist now and should be promoted.

4. Federal research and demonstration resources should place a higher priority on the development of culturally appropriate alternatives to the medical and biochemical approaches to treatment of people labeled with psychiatric disabilities, including self-help, peer support, and other consumer/survivor-driven alternatives to the traditional mental health system.

5. Eligibility for services in the community should never be contingent on participation in treatment programs. People labeled with psychiatric disabilities should be able to select from a menu of independently available services and programs, including mental health services, housing, vocational training, and job placement, and should be free to reject any service or program.

6. Employment and training and vocational rehabilitation programs must account for the wide range of abilities, skills, knowledge, and experience of people labeled with psychiatric disabilities by administering programs that are highly individualized and responsive to the abilities, preferences, and personal goals of program participants.

7. Federal income support programs like SSI and SSDI should provide flexible and work-friendly support options so that people with episodic or unpredictable disabilities are not required to participate in the current "all or nothing" federal disability benefit system, often at the expense of pursuing their employment goals.

8. To assure that parity laws do not make it easier to force people into accepting "treatments" they do not want, it is critical that these laws define parity only in terms of voluntary treatments and services.

9. Government civil rights enforcement agencies and publicly-funded advocacy organizations should work more closely together and with adequate funding to implement effectively critical existing laws like the ADA

10. Federal, state, and local governments must work together to reduce the placement of children and young adults with disabilities, particularly those labeled seriously emotionally disturbed, in correctional facilities and other segregated settings.

Please make sure you at least read the executive summary to this eye-opening document.

Meanwhile

According to an article in The Washington Post in Dec 2000:

"The number of mentally ill behind bars today is nearly five times the number in state mental hospitals, government figures show. And though serious mental illness afflicts 5.4 percent of US adults, the mentally ill account for nearly 16 percent of all inmates - about 284,000 people - according to federal surveys."

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