Saturday 23 January 2010

People have a right to be mentally ill

Its a strange concept: the right to be ill. Its worth remembering that mental illness isn't actually an illness and but its a way of considering it. The same concept can be euphimised as mental health problems or mental distress, though the latter is an incorrect description of mental illness.

An individual has the right to go through depression, mania, anxiety, psychosis, personality disorders and every other manner of mental illness. That is a right but there is a counter argument based on the reality of that anarchic, liberal thinking which I espouse.

The mental health system is based on many things, one of which is dealing with the stigmatised. The stigmatising behaviours or the extremes of normal traits are not well accepted by the public so people became seen in healthcare settings. Mental crisis is also a real thing even though it is a result of society's maladaption to the complete human experience, i.e. a society in the future will be setup such that crisis happens in the community with no social harm and no risk to another person's life (I see suicide as something can be a rational choice but can also be an irrational one and the latter prevented, whereas murder and manslaughter should be prevented).

The maladaption of society is real but it is as changeable as the mental health and legal systems. Again I use the example of the demedicalisation of homosexuality. Or the huge change that is seen over the latter twentieth century in the application of a quasiscientific framework with the operational definitions of cluster of systems. Sadly the early twenty first century is seeming a psychiatric insanity in the development of premordibity operational definitions as part of the American psychiatric system.

It is with this change to diagnosing pre-illness states that this point about the right of the individual to refuse treatment, espeically psychopharmaceuticals, if they are definied as pre-mentally ill by the new system. Premorbid psychosis does not guarantee a person will experience full-blown psychosis or schizophrenia, but standardised treatment would likely be the chemical cosh which cause changes in a person's experience of life and have harmful physical side effects that will reduce their life expectancy.

Psychosis itself is highly misunderstood because it is understood by people who have never experienced it. The psychaitric dogma of pathologising this experience and offering treatments designed by people who have not had the experience (up until recently) are two of the reason the outcomes are so poor. It is well recognised that many cultures around the world have alternative explanations for this experience and stigmatise it considerably less than in the UK.

The new Community Treatment Order in the 2007 amendments of the mental health act meant medication could be forced on people who wanted to live free of the chemical cosh and was overused a considerable amount because of psychiatrists infringing on a person's right to free experience. Some of those people may be taking an antipsychotic called clozapine, one that is well established to induce life threatening conditions and dramatically shorter life expectancy. If I remember right one of the arguments for its introduction was to reduce the number of 'revolving doors' patients who were repeatedly hospitalised but became a tool to force medication (as is often what happens during hosptialisation anyway, even with a section 2 where there is no legal power to force treatment (if I remember right) though in practice nurses and doctors may not inform patients of that right or they will be exceptionally coercive in persuading a person that they must take medication).

The right of a person to be considered mentally ill and refuse treatment is a complex debate and I've only provided one side of the argument. I think its a strong one though and I'll make my final point.

Life may be more complex that what is understood by simplistic psychiatiry. These illnesses may not be illnesses. They may be a reaction to something that is wrong in society, and medicating them away is like dismissing criticism: its blinding oneself to a feedback channel. They may also be part of an individual's journey through life and that these experiences have purpose beyond Kraeplinean ideas of where these experiences come from. They may be part of change for the better, but if they are stopped by psychiatric treatment or mistreated by misunderstanding psychologists then the individual's journey suffers and their development may be stunted. And its all done for their best interests, of course....

"The soul would have no rainbow if the eyes had no tears."
Native American wisdom printed in Our Voice/Notre aux voix (Canadian consumer magazine).

That's an alternative view from an alternative mental health system. The spiritual wisdom handed down through the oral tradition of evolution of knowledge beats psychiatry's understanding of mental illness, in my opinion.

We have a right to be mad.

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We It comes in part from an appreciation that no one can truly sign their own work. Everything is many influences coming together to the one moment where a work exists. The other is a begrudging acceptance that my work was never my own. There is another consciousness or non-corporeal entity that helps and harms me in everything I do. I am not I because of this force or entity. I am "we"