"How about we try this..."

I wonder if the voice in the psychiatrists' heads has ever spoken those
words to them when they're about to force medication on someone going
through a crisis.

I think it just doesn't happen. I think their only reaction to a severe
crisis is to pump the person full of toxic chemicals. It's all they know.

The medical profession forgets things. It forgets that salts from
alkaline springs which contained lithium were used by the Romans in the
treatment of mania; the dose levels would have been at
quasi-homoeopathic levels compared to the use of lithium today however
the Roman doctors still found it effective regardless. It was Karl Lange
in the late 19th century who began re-researching the potential to use a
toxic chemical to treat a behavioural disorder but only in the mid-20th
century where it became used in general treatment.

chlorpromazine was the first psychiatric medication to be licensed by
the FDA in the US somewhere around 1952 (or perhaps '54). Before then
they didn't use medication. Psychiatrists and therapists actually
interacted with patients before then. It's a totally insane idea to an
NHS psychiatrist.

Back in the day psychiatrists needed to be creative and willing to try
different things to help people through whatever they were going through
or change whatever behaviour was judged abnormal by society (it's worth
noting that the UK used to pathologise and hospitalise unmarried
mothers). They had to ask the question of the title of this piece.

Emil Kraeplin used to think schizophrenia was virtually untreatable and
patients had little chance of recovery. Bleuler and many others proved
him wrong and changed his mind. They achieved recovery using
non-pharmacological approaches and ultimately a lot of trial and error.
Medication gave them an easy answer. The profession became lazy. It
turned to evermore dangerous medications such as clozapine. It forgot
there were other options. It forgot the most disabling and distressing
condition was treated by people a century ago without medication.

Today the voice in their head is either silent or ignored. They're too
risk averse and driven by outcome measures unrelated to patient
experience and truly positive outcomes. They use the rhetoric of
promoting recovery yet don't in practice. They lack the imagination to
try new things, the complacency of an easy answer to the solution of
controlling behaviour and forget that people have a right in the choice
of treatment - regardless of whether the Human Rights Act (which I'd
wipe my arse with for the way it guarantees fuck all psychiatric rights)
doesn't give this basic right to psychiatric patients.