On Mental Illness: Forced Treatment--Good or Evil?

By Jack Bragen
Wednesday September 07, 2011 - 04:38:00 PM

I was contacted by a nonprofit agency that espouses the forced treatment of persons with mental illness, which includes forced drugging. In recent editions of this column, I have validated such an idea. Certainly, forcing treatment on those who refuse it and who are also in jeopardy of deteriorating into a dangerous state could stop a lot of tragedies from taking place.  

However, this is the type of heavy-handed approach that will make a lot of people very resentful. I think because of the anger that it will generate, there will be some tragedies that happen because of forced treatment, and not just in spite of it. It doesn’t give the mentally ill person a chance to come out of denial through their own thought processes. Also, preempting deterioration with forced medication without it having already happened assumes that the medical model of psychiatry is applicable in all cases. There may be a few individuals who are ready to discontinue medications who should not be forced to take medication based on the assumption that they will get worse.  

Laura’s law is at a polarity opposite that of the independence and self empowerment of a person with mental illness. This is like the abortion debate. While the consensus is that abortion is a bad thing, not all people agree that it should be outlawed. Similarly, while I believe medication will help numerous mentally ill persons, and while I advocate taking medication in my column, I do not believe that the law should universally force it on people.  

When you take choice away from the consumer, you deprive them of the opportunity to outgrow noncompliance, or else to be done with medication, if able. And while I believe that Laura’s law seems, at first glance, to be written with some conscientiousness, it is too intrusive on those consumers who would like to live with some amount of independence.  

I take medication but I personally don’t want a law to force me to do that. When I take medication, it is symbolic of my personal empowerment because I have the wisdom to know that I need it. A law that forces me to take medication takes away from that empowerment. I believe mentally ill persons, when in acute psychosis, acute mania or acute depression, may need to be forced to take medication temporarily. However, at some point in recovery, you ought to give a person a chance to figure it out for themselves, once their reasoning is intact. Otherwise, you’re ending up with someone who isn’t given a chance to become a “whole” person.  

Hope for someone with a major mental illness includes the idea that we will not be institutionalized for the rest of our lives. I believe that the wellness checks that would be a part of Laura’s Law, as well as the flexible criteria for determining whether or not someone is “deteriorating” allow the potential for extreme abuses in the name of enforcing this law. Too much power is being put in the hands of those who would enforce this law.  

Laura’s Law will create a population that is imprisoned while existing geographically “out in society.” It allows for any person diagnosed with mental illness to be subject to indefinite control.  

While theoretically, if someone has been out of the hospital for a period of four years they are not subject to enforcement, a social worker need only order someone back into the hospital before the four years have elapsed. This allows for a person to become permanently restricted.  

The purpose of this law seems to be that of protecting mainstream, affluent society against the nuisance, inconvenience, or perceived threat of persons with mental illness who are trying to coexist. The stipulation that Laura’s Law would not take money away from voluntary programs does not hold water. All that is needed is for a county to adopt this law and then make a cut to voluntary programs the following year. Politicians are sneaky.  

One of the main goals of this column is to help mentally ill person realize that they may need to get treatment. If Laura’s Law is enacted in all counties, there would be no point to writing this column. If the only choice given to consumers is “left cheek or right cheek” then you have taken away the basic dignity of a lot of people. And these are people who cherish what little dignity they may have left.