This is a study that was published in the Lancet, a leading medical journal. I’m sharing the results as I already know that coercive psychiatric “care” not only doesn’t work, but it also causes graves harm routinely in many different ways. Below the excerpt from the study is more commentary and then links to additional information about forced treatment.
Compulsory supervision outside hospital has been developed internationally for the treatment of mentally ill people following widespread deinstitutionalisation but its efficacy has not yet been proven. Community treatment orders (CTOs) for psychiatric patients became available in England and Wales in 2008. We tested whether CTOs reduce admissions compared with use of Section 17 leave when patients in both groups receive equivalent levels of clinical contact but different lengths of compulsory supervision….
Conclusion:
In well coordinated mental health services the imposition of compulsory supervision does not reduce the rate of readmission of psychotic patients. We found no support in terms of any reduction in overall hospital admission to justify the significant curtailment of patients’ personal liberty. (read the full report about the study from the Lancet)
Beneath this post is a listing of other articles on this blog that deal with involuntary treatment.
Richard Bentall has a piece in the Guardian from a couple of months ago questioning the routine use of coercion in psychiatric treatment. He points out most significantly that most people who are labeled with psychiatric diagnosis have trauma and abuse histories. Further coercion from the system are additional traumas perpetrated against already vulnerable people.
I’ve added a collection of posts from Beyond Meds on the topic of force at the end of the post. I will add this post to the navigation menu at the top of the page for those who want to explore the topic of force and coercion in psychiatric care. It will be updated as appropriate and remain there as a resource.
Many mental health professionals, especially psychiatrists, see coercion as an essential tool, so it is important to understand why it should be avoided if at all possible. Respect for autonomy – the right to make choices – is, for good reason, a widely recognised principle in medical ethics. Aside from the fact that autonomy is regarded as a virtue in its own right, its denial is usually distressing. Indeed, a compulsory admission to hospital is often experienced as traumatic, sometimes leading to the same kind of post-trauma symptoms experienced by victims of assault or life-threatening events. Of course, many psychiatric patients have previously experienced physical and sexual abuse, bullying and other kinds of victimisation – that is often why they develop psychiatric problems in the first place – so coercion by services adds to a burden of adversity that is already too great to bear. It also damages relationships between patients and services, often leading to greater reluctance to seek psychiatric help during future crises.
Defenders of coercion typically argue that it is a necessary evil, because patients do not know what is in their best interests. This argument, of course, assumes that patients are irrational in rejecting psychiatric care, that psychiatric treatments such as antipsychotic medication are always beneficial, and that patients compelled to receive treatment do better in the long-run.
If you’re not aware of just how brutal and coercive psychiatry can be, it’s well worth understanding. Some of it is so extreme it’s hard for those uninitiated to conceive of but, sadly, it’s very common. The bottom line is psychiatry, in general, at best, is subtly coercive. Drugs are generally presented as necessary rather than one, often far less than ideal, possibility for treatment. This means one is made to believe through somewhat more subtle coercion that they have no choice but to take drugs with very dangerous adverse effects that include disabling physical illness and very early death.
● That’s crazy: powerful documentary on the coercive nature of psychiatry — If you’re not aware of just how brutal and coercive psychiatry can be, you should really watch this. This may seem extreme to those who’ve not seen it happening but it’s very common and the bottom line is psychiatry, in general, at best, is subtly coercive. Drugs are generally presented as necessary rather than one, often far less than ideal, possibility for treatment. This means one is made to believe through what amounts to subtle coercion that they have no choice but to take drugs with very dangerous side effects.
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