medico-legal framework repealled. it is....not just. But I know a small
amount about the risks the framework is there to protect against.
I ended up rewriting my response today from scratch as is my way.
There's a few bits which are pretty cheeky for what's meant to be a
professional list..but that's part of what I have to do. All this
professional bullshit is another thing which creates disability and is
part of the suppression of the mentally ill and our ways of expression
by the constructs of the post-Industrial Age. I can easily take out the
inappropriate stuff but it has to remain in. It may be inappropriate but
this is an irrelevant subjective judgment often used by automotons as a
way to devalue the core message and not listen to what the mentally ill
are saying. It is a way for automotons to feel superior because they
know what professionalism is and the mad...well the mad are just mad.
If I have to stand toe to toe against the people and organisations I
respect then so be it. I ain't got nothing to lose.
"
Bear with me. I'm in a bad mood this morning.
You pose an excellent question. My response will be in a few parts. Part
1 will be a facetious response. Skip past it if you don't want your time
wasted.
1) Those at risk of harming others?
- I would give them nice offices and good salaries and prestige. I would
make them take the Hippocratic Oath then ignore it. I could call them
psychiatrists. They could also work for Big Pharma too, the industry of
death and subjuagtion which sells drugs for behaviour which cause
illness and death.
- I would make them generals and give them medals. I would give them the
weapons to take life.
- I would give them huge salaries and massive bonuses, the finest
buildings and anything else money could buy. I would call them city
traders - because the result of their gambles and the current financial
crisis will lead to death, illness, disability and suicide across the world.
- I would give them the job of executing another human being. America
still uses capital punishment so I guess they'd have to move over to
your side of the pond.
2) To truly attempt to try and answer you question:
- I would need data. Off the top of my head there are about 1,000
homicides in the UK every year (and 6,000 suicides) of which (in a very
bad year) about 100 are by persons with a pre-existing diagnosis or have
been in contact with UK mental health services in the last year. Roughly
95% of homicides are by men (75% of completed suicides are by men
however women attempt suicide a lot more than men across the developed
world). I would seek to understand what circumstances lead those people
to the point where they took someone else's life as ell as the things
which happened in their life such that their type became pathologised by
psychiatry as "at serious risk of harm to another."
I would probably break own the thinking to answer your question into a
few areas. I am focusing the the risk of violence and homicide rather
than the risk of suicide however the thought process may be similar.
- prevention of states of being where risk of violence and murder is
high. I would guess a lot of violence and murder is done in the heat of
the moment rather than through pre-mediation. Both are relevant when
thinking about prevention. Ask the question why are 95% of homocides by
men and it is my guess that some of them are due to loss of social
status or circumstances (or risk of) and some are due to the inequities
of their (often female) partners and others are a result of the
unwritten systems of justice in the criminal underworld. There may be
other reasons which are common in the developing world.
There is the problem of the risk of harm to another during a period of
acute psychosis. This is another of the reasons for coercive psychiatry
and prophylatic medication strategies. I went through acute psychosis
unaided and unmedicated. I know the dangers and the dangers are very
high. They're the dangers which Abraham/Ibrahim faced in the bible
story: he came close to killing his son during an experience which today
would be called psychosis. I have no good solution to this other than
training people to handle psychosis. This means inducing psychosis under
controlled conditions using enthogens (specifically to recreate the bad
experiences rather than the pleasant experience of psychosis which
enthogens usually create). Obviously paradigms such as Soteria are other
options (I think there are better ones detailed in John bola's review in
2009 -
http://psychrights.org/research/Digest/Effective/PsychoSocialMoreEffective2009Psychosis.pdf
- because the Soteria data showed a high rate of suicide compared to the
other paradigms).
Relating to this I think there's a dire need for a total revision of the
psychopathology and treatment of schizophrenia. I mean a fundamental
shift in the paradigm. However this is not relevant to the current question.
I'm talking about prevention and this an come in a number of forms. It
can be by identifying at risk people or it can understand that everyone
is at risk of harming another if pushed far enough. It is ensuring
society's structures are designed to ensure people do not suffer too
much. The statistic is 1 in 6 people in the UK suffer depression,
anxiety or stress every year at work (I guess this figure is from the
Adult Psychiatry Morbidity Survey but I'm not sure). These are some of
the precusors to emotional and physical trauma wrought upon another; a
parent has a bad day and takes it out on their child or partner. 1 in 4
people every year suffer common mental disorders in the UK (and if I
remember right it's about 1 in 5 every year and 1 in 2 in a lifetime in
the US) whereas developing world nations have significantly lower
incidence rates. These states if taken too far or for too long can push
people over the edge and that's what I believe can cause at risk states
in all people.
I would guess a lot of the deaths in the UK are because of
action/revenge for perceived or real emotional harm. I would guess that
people forget that what they do can hurt another person emotionally
because we're all so self-involved. The emotional pain can result in
violence and death. Alternatively it can be the emotional harm caused by
the systems in society, systems which forget that people are human
beings. Be it the work structures which no longer give people safety and
stability to the harms which happen on the playground. These can often
be the precursors to 'at risk' states in individuals. Suicides are often
associated with downward changes and i guess this is something which is
a factor in homicide too. It is not lonely people but people who become
lonely who are at higher risk of suicide. It is not people who are poor
but become poor. It is not people who are unemployed but people who
become unemployed. This is where prevention and monitoring can happen
such that people's liberty and choice can be preserved.
I have already offered an example from my personal life where I struck a
girl I loved. I left out the things she did to me to lead up to my
actions. Her actions do not excuse what I did however if we are willing
to understand cause and effect then consider these when thinking about
legislation (or better means) to protect people from physical violence
and homicide then I hope better solutions can be offered. It is worth
being aware of the chain of events which leads people to kill and harm
one another. No laws protect sensitive people from emotional harm, harm
which can hurt a hell of a lot more than a slap in the face. The systems
in society can often hurt and harm just as much.
There is also perhaps the option of training people to handle those
crisis moments which can result in harm to another. People who are
trained in martial arts are also taught to use those skills wisely or
not at all. They are trained in techniques of violence and harm but a
good teacher would also show them how to manage their anger and never
use their power in the heat of the moment. Training people in martial
arts also means they have self-defence skills. It's this sort of
alternative thinking which I hope would provide the alternatives to the
medico-legal framework's protections and power.
There is also the problem of those who become created by life to be at
high risk of harm to another. Specifically it would be people who are
psychopaths (broadly antisocial personality disorder or perhaps the
sociopolitical term "persons with a dangerous personality disorder" is
more appropriate) and understand how they become. Too many centuries of
psychiatry seems to have made little headway into understanding these
poor souls. These people become through what happens to them in life and
I would guess most of them had a hellish life. This is where
understanding the biopsychosocial model of cause and relating it to
prevention strategies may be a better alternative than coercive
psychiatry. People with a diagnosis of antisocial personality disorder
are at high risk of harming law enforcement officers in the US, but this
may be because of what law enforcement officers have done to them or how
they perceive what law enforcement officers have done to them. If,
perhaps, police officers changed how they dealt with perpetrators of
crimes there may be a hope that fewer of them will be killed later on by
people with ASPD.
- what to do now, i.e. what to do with those who at high risk of harm to
another person now? I assume many of the people on this list have been
incarcerated in a psychiatric ward but I would guess very few, including
myself, have ever stayed in a high security psychiatric ward? These
really are prisons for those deemed to be at risk of violence but run by
doctors and nurses rather than by the criminal justice system. I dare
not imagine what tortures are wrought upon those patients. They are
incacerated in higher security facilities because they are judged to be
at significant risk to other patients and to staff in standard
psychiatric wards. Repealing the medico-legal framework which immorally
incarcerates them without an alternative solution may result in many deaths.
This is a very difficult question as to what could be the alternative to
coercive psychiatry in these circumstances, at least from my
perspective. From what little I know of the homicides in the UK
(irrespective of mental disorder) I would guess that most of the risk is
of harm to a specific person or small number of indiviudals. It could be
a partner, a sibling or a child. This set of individual/s at risk of
harm could be protected and the individual at risk of harm given high
levels of monitoring with rapid response services available to swoop in
if the risk turns to action. (Admittedly this is easier in richer
nations with surveillance technology and vehicles such as helicopters.
it may be far harder in rural communities). The objective would be to
preserve as much liberty without risking anyone's life.
A friend of mine was worried about a violent ex-partner. The police gave
her a panic system which would be impossible for him to notice or notice
if she activated. Once activated the police would be sent to her aid.
Her ex-partner had his freedom and, in the end, she never had to use the
system as far as I am aware. I assume she was also taught basic self
defence; again, martial arts training can teach people how to keep
themselves safe long enough to escape. His liberty and her life were
protected.
In the future bioelectronic technology may also be able to allow those
who have problems with violence and harm to exist freely in the
community without coercive psychiatry and prophylatic medication. One
thing I came across which shows an insight into the possibilities is the
research into detecting psychosis through galvanic skin response: a
mobile phone, set of keys or other device with a GSR sensor could detect
psychosis or perhaps other heightened mental states. There are many
physical responses which happen alongside the emotion which is
associated with violence and homicide. Implanted sensors and drug
delivery systems could ameliorate the risks significantly while
preserving a person's freedom as much as possible. (The technology to do
this is advancing fast. It sounds like science fiction but I've spent a
little time working in the area of advanced technology and there's a lot
of things which seem like science fiction but are soon to be realised,
for example bionic eyes to restore sight to the blind or neurochips
which can increase a monkey's IQ to 180. Artificial pacemakers are
already a mature product. Technological innovations are usually focused
on fuelling material consumerism or advancing the power of the military
however advances may also provide a hope for greater liberty and equality.)
The far greater challenge is those who are at risk to anyone or the risk
can not be accurately reduced to a small set of people. I would guess
these are the people who end up in high security psychiatric wards for
extended periods of time. I would guess these individuals are offered
little true behavioural modification other than drugs. (The UK
medico-legal framework was amended to remove a requirement for a
treatment to be available because those with dangerous personality
disorders may not get high levels of recovery from current behavioural
modification techniques. )Their daily lives are meaningless and futile,
aimed only at filling time till they die. They would have little quality
of life, no freedom and nothing to lose. They just have the institution
as their life. This is what is wrong with the current system, be it
prison or high security psychiatric facilities.
I don't have good solutions but perhaps these options might offer some
food for thought, thought which could lead to alternatives which
preserve as much liberty for the individuals at risk but also protect
the public from harm.
Since the armed forces train killers why not shift these people into
this sort of role. It is, perhaps, better than living their life in the
confines of a high security psychiatric ward. They would be surrounded
by people who have the capability to protect themselves. Their
behvaioural modification would serve the needs of a country to have a
standing army of people ready to kill. The danger they pose could be
seen as something valuable and while this option isn't true liberty it
is a better option than the current practices of coercive psychiatry.
Alternatively get them into sports like rugby, American football, boxing
or something else. Their aggressive tendencies could be used and worn
out by the training. Their lives could gain value and they may even get
the chance to feel better about themselves. They may get the chance to
feel those positive emotions and have those positive experiences which
they didn't have in earlier life. I believe these people at risk of harm
to others are still fundamentally human and are a creation of their
circumstances and life events. Leaving them to rot in a secure
psychiatric facility does little to ameliorate the risks they pose. I
know there are better options but without these options the medico-legal
framework stands to protect the public from harm. The protection of the
public and the individuals themselves will be the argument used to stop
any repeal of the mental health laws, as well as concepts like capacity
and stuff but that's all a load of male cow excrement which is typical
of the techniques of suppression and tyranny used by psychiatry over the
years and accepted by the public and politicians.
Alternatively they could live free in the community but always have a
person with them to protect others from harm. These people could be
drawn from people trained to be elite armed forces or the sort of people
involved in protecting royalty and government officials. Alternatively
they could be protected by peers who have recovered, i.e those who were
once deemed at high risk of harm but had successful behavioural
modification, who are trained in physical comabt. I would guess someone
with SAS training (the UK's elite commandos) would have the speed and
the strength to stop a person at high risk of harming another. The
person deemed at risk of harming but who has not harmed could remain
free and the public would be protected. (I have seen this in action. I
worked in a call centre many years ago. One day a fight came close to
breaking out because someone got a promotion and someone else didn't
like it. The person denied a promotion was so angry he flipped out and
tried to attack the one who did. He ran past a friend of mine who was a
nightclub bouncer in one of the most dangerous areas in the UK
(Hillfields in Coventry which at one point had one of the highest rates
of violent crime in Europe) when not working in a call centre. With the
fluidity of motion and speed of reaction of a panther my friend
intervened. While the rest of us were aghast and stunned into inaction
by the events we saw happening he stepped up and pinned down the person
who was denied promotion. He de-escalated the situation and not one
punch was thrown. My friend had no formal training but being a street
fighter.)
The fact is the incarceration of the mentally ill is immoral and the
enforcement of treatments which kill and are fundamentally not treatment
but a form of enforcement of social norms is one of the great injustices
left to fix. The medico-legal framework is the sort of twisting of the
truth to suit sociopolitical and economic purposes which Stalin and
Hitler would be proud of. Many black men, as well as others, have died
unnecessarily as a result. But 1,000 homicides every year in the UK is
too much as is 100 homicides by a person with a pre-existing
diagnosis/who is in touch with mental health services in the previous
year. Obviously the unnecessary deaths of 1,800 old people every year
when antipsychotics were used to 'treat' (suppress unwanted behaviour)
the symptoms of dementia is also too many deaths. Discarding the
medico-legal framework without suitable alternatives will only lead to
more deaths.
This is why I would not endorse the repeal of the current medico-legal
framework without a solution to ensure that NO ONE DIES unless they want
to. Without intelligent, compassionate and wise solutions to the
problems of harm and homicide the people must remain protected. Liberty
for the mentally ill is equally important and the subjugation made
possible by current medico-legal frameworks must end as well. But before
the survivor movement attempts to tear down the establishment which has
subjugated, oppressed, tortured and killed so many of our kin we need to
have the alternatives ready. I'm sure there are people in universities
and think tanks and wherever else seeking solutions to maintain the
basic rights of humankind, protect the innocent and preserve human life.
The solutions I have offered may be unrealistic but I'm sure there are
people who can think of realistic ones relevant to each country such
that the repeal of the medico-legal framework would sail through rather
than be met with the resistance I am offering here.
Psychiatric and survivor rights are important as is the end of the
subjugation and tyranny but I will not be responsbile for any deaths in
this shit of a life.
"
--
Don't let justice be the privilege of the elite. Support the Justice for All campaign
http://www.justice-for-all.org.uk/
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