February 25, 2006

Letters to the Editor, WSJ.

Category: Ethics,Politics,Psychiatry — @ 2:22 pm

About a month ago, I posted an interesting article from the Wall Street Journal on The rising tide of forced treatment.

Below are a range of letters published in the Wallstreet Journal in response to the article. I have not seen the originals but got them via a MindFreedom mailing list.

The collection of letters are the mosy crystalline window into the devastatingly complex issues concerning psychiatric care, human autonomy, law, and suffering that I have seen in a long, long time. Do check it out.

Wed. February22,2006


MindFreedom International sends out alerts as part of our “MindFreedom
Shield” to encourage and support people who are seeking an underground
railroad to shelter them from coerced psychiatric drugging. Such
underground railroads provide support and assistance in a manner that
is completely legal and essential for these individuals. But an
underground railroad itself isn’t a program of MindFreedom, as you

You described MindFreedom as an organization of “mentally ill people
that opposes coerced drug treatment.” While many members are people who
have experienced abuse in the mental health system, or “psychiatric
survivors” as we call ourselves, we don’t refer to our membership as
“mentally ill.” In fact, many have spent much of their lives
passionately defending themselves against such damaging, false and
unscientific labels.

While you quoted several proponents of forced drugging, you ought to
have quoted even one of the many organized groups of psychiatric
survivors. After all, we are the ones who end up on the sharp end of
the needle.

David Oaks
MindFreedom International
Eugene, Ore.

[other letters:]

For the Mentally Ill: Caring or Incarceration?

One of the great tragedies of modern psychiatry is the large number of
incarcerated individuals who are mentally ill or drug addicted (“A
Doctor’s Fight: More Forced Care for the Mentally Ill,” page one, Feb.
1). This is the inevitable consequence of our reluctance to use caring,
coercive approaches, such as assisted outpatient treatment. A person
suffering from paranoid schizophrenia with a history of multiple
hospitalizations for being dangerous and a reluctance to abide by
outpatient treatment is a perfect example of someone who would benefit
from these approaches. We must balance individual rights and freedom
with policies aimed at caring coercion. Our responsibility to each
other and our respect for personal rights lie at the center of our
social and moral choices as Americans.

The Treatment Advocacy Center is to be commended for its sustained
advocacy on behalf of the most vulnerable mentally ill patients who
lack the insight to seek and continue effective care and benefit from
assisted outpatient treatment.

Steven S. Sharfstein, M.D.
American Psychiatric Association
Arlington, Va.

While forced care is sometimes necessary when a person is a danger to
himself or others, the call to expand its usage underestimates the
risks of imposing a different standard of civil liberty onto people
with mental illness than is guaranteed to the rest of us.

E. Fuller Torrey’s movement is part of an attitude of paternalism from
which people with mental illness are working hard to break free.
Moreover, his database of anecdotes on violence is misleading since
most people with mental illness aren’t violent and are more often the
victims of crime, not the assailants. There is a long history of our
country taking away the rights of people with mental illness who are
penalized merely for being “scary” and “burdensome.” It is time to go
forward, not backward.

Anthony M. Zipple, Sc.D., M.B.A.
Chief Executive Officer
Thresholds Psychiatric
Rehabilitation Centers

My 41-year-old brother has suffered from serious mental illness since
he was 15. At times, his behavior has become sufficiently threatening
or dangerous to require involuntary hospitalization. Like many others
with this disease, he doesn’t believe that he is ill (a neurological
deficit known as anosognosia) and therefore refuses to voluntarily
comply with treatment or to take medication, even though it has proven
remarkably effective. As a result, my smart, funny and talented brother
has spent much of the past 25 years homeless, jobless and delusional. I
can safely say to the civil libertarians that this isn’t the life he
would have chosen for himself; it was chosen for him by his untreated

Before Kendra’s Law, there was nothing my family could do to force him
to obtain treatment. Although the law isn’t a panacea and the mental
health system is a disgrace, being forced to stay in treatment is the
only chance he has of resurrecting his life.

Shari L. Steinberg
New York

Dr. Torrey complains about “taking heat” for being “politically
incorrect,” but he’s not really paying any penalty for his position. A
real penalty, however, is being paid by those who are targeted by the
laws he pushes through. To force outpatient “treatment” on anyone who
has ever been on the wrong end of the mental health system because of
the actions of the criminals in Dr. Torrey’s database is as unfair as
it would be to force such treatment on all physicians because of the
actions of Dr. Mengele.

Kent Reedy
San Diego

Using the term “force” to describe state laws authorizing court-ordered
treatment overlooks the point about what these laws are intended to
accomplish. Most people with serious mental illnesses are able to make
informed decisions about treatment. In a minority of cases, mental
illness negatively affects insight and ability to recognize the need
for treatment. The greatest risk is to the individuals themselves.

A New York State Office of Mental Health report shows that the impact
of Kendra’s Law has been positive in reducing hospitalizations,
arrests, homelessness and other consequences from lack of treatment.
And most people treated under Kendra’s Law say it has helped them. When
narrowly crafted and sufficiently protective of civil liberties, laws
authorizing court-ordered outpatient treatment can be both humane and

Michael Fitzpatrick
Executive Director
National Alliance on Mental Illness
Arlington, Va.

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