More about Mental Health

The typical response to comments such as my previous is that the mentally ill suffer a lot and we must do something to help them. Well, sure. But how does locking them up help? Either mental illness is a disease or it isn’t. If it isn’t a disease then unwelcome behaviour* should be dealt with through the courts not physicians and our current system is abhorrent. But if it is a disease then involuntary commitment is twice as bad because having a disease is not a reason for someone to be deprived of liberty. We don’t lock you up because you have polio.

And what’s more diagnosis of mental illness is imprecise at best. Co-morbidity is the rule and not the exception. For any given patient diagnosed with schizophrenia (the classic psychiatric condition and the one for which patients are most often committed involuntarily), one-third of psychiatrists would come to a different diagnosis. So not only is the basis for incarceration improper, but the evidence for that (unsound) basis is unreliable.

The solution is a very simple one – that all treatment should be voluntary. This is the principle that underlies all medicine, and there is no reason that mental health should be an exception.

* Some mentally ill people can be violent, for example. But we already have laws against assault, etc.

Slicing up eyeballs (Ah ha ha ho!)

“No Freeman shall be taken or imprisoned, or be disseised of his Freehold, or Liberties, or free Customs, or be outlawed, or exiled, or any other wise destroyed; nor will We not pass upon him, nor condemn him, but by lawful judgment of his Peers, or by the Law of the Land. We will to no man sell, to no man delay, to no man deny, either Justice or Right.”

This is not just the 800-year-old fundament of our constitution, but it is the principle of every free society. It is the basis of the rule of law, and individual liberty.

Imagine a country where you could be imprisoned against your will, indefinitely and without recourse, without even an accusation of having broken any law. And that this decision to imprison you is taken not by a judge and jury, but is instead an administrative decision by a government functionary. And that while imprisoned you will be forced to undergo medical procedures against your will, including – but not limited to – taking anti-psychotic drugs and undergoing ECT.

The image that springs to most people’s minds is some totalitarian state – Stalinist Russia, perhaps. And indeed, this is exactly what was done to many dissidents in the USSR. But actually, the exact same thing happens in modern Britain – and indeed, the USA, France, Germany etc. And the victims are people labelled (correctly or not) as “mentally ill”.

Some mentally ill people are violent and commit crimes. They indeed should be incarcerated for whatever crimes they may have committed. But these are not the ones whose behaviour I wish to discuss. Rather, those individuals who have broken no law, but some doctor judges to be a risk of “harm to themselves or others” – the standard for “involuntary admission.” I.e. locking someone up against their will.

The standard is wholly arbitrary and unjust, and applied to no other section of the community. Take, for instance, a man whose wife leaves him for another lover. The man is known to be very angry about the situation, and the local police think he might well intend to kill his wife and her new beau. Can the police lock him up as a “risk”? No. They need (1) evidence that (2) he has actually committed some crime. Without that the man is free to proceed on his merry way.

Now suppose that the man actually acts on his intentions, and gets into a fight with his rival. Well, practically speaking he’ll probably only get a caution or at most community service, but if he is sent to prison it will only be by decision of a magistrate or jury, and then only for a fixed period of time. Whether or not the man continues to harbour ill-will towards his wife and her lover is quite irrelevant to how long he will spend incarcerated.

Now suppose instead that the man turns his rage inwards, and becomes depressed. The local GP thinks he might well intend to commit suicide. Well that’s all we need! Lock him up! And keep him locked up until he changes his mind! Forever, if need be! And unlike a regular prisoner, he’s got no rights to refuse medical treatment now!

The whole thing is absolutely monstrous. And that’s without even getting into the extent to which mental illness is really a disease, which I will deal with another time.

If someone says that they are Jesus, shouldn’t the answer be: “Congratulations!”