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Abolition Is Not Reform, Abolition is Emancipation

There are those who like to call the mental health system “broken”. There are usually two reasons for doing so. One is that a person would like to see more money pumped into the mental health system. The other is that they are encountering people they don’t want to encounter, and they feel that if the system worked, the sight of these people would not be disturbing them so.

I don’t call the mental health system “broken”. The mental health system is actually a “mental illness” system and, if anything, it “works” altogether too well. We’ve got a saying, “Children should be seen and not heard.” This saying leads up to a further, but unexpressed, saying, “Adult children should neither be seen nor heard.” What do we do with our adult children? There’s the loony bin. You figure it out.

If “mental illness”, as the late Thomas Szasz claimed, is a metaphor. “Mental health” is a metaphor as well. Bodies get physical diseases. Minds just get fuzzy, half-baked ideas, and illogical thoughts. The pursuit of folly though is not a disease any more than the pursuit of wisdom is a cure. We are free to chose either pursuit, or neither, as we wish. Of course, despite the fact that no disease has been found to explain aberrant behaviors, that doesn’t prevent people from speculating about “disease” as a cause.

If you’re going to call the mental health system “broken”, the first question one has to ask is what is the purpose of the mental health system. For example, is the mental health system there to “heal sick” people, to “fix broken brains”? If so, it has always done an absolutely lousy job not “healing” and not “fixing” them. I submit that the real purpose of the mental health system is to keep people with psychiatric labels out of other people’s hair. This, the system, considering the shots it has taken due to scandals arising from institutionalization, does sufficiently enough.

What is a mental hospital? Is it a place for “healing sick” people, or is it a place for punishing people who behave “badly”? While the nurses station found on most psych wards suggests the former, the locked doors found in nearly all of them says it is the latter. All you have to do is to consult the dictionary to get the idea that something is awry here. A mental hospital is a peculiar hospital, to say the least, but it is a particular prison. The distinction between the two depends upon whether you think it does a better job “healing the sick”, or punishing the misbehaving.

I echo Dr. Szasz in calling for the abolition of forced mental health treatment. The system, as meat grinder, as a destroyer of men and women, isn’t broken in the slightest. It does it’s job of breaking spirits, of swallowing up bodies, and of spitting out bones exquisitely well. I think, if they really and truly cared about their clients, more mental health professionals would be taking the same position. This destroying of people, by going straight at their potentials, and watching them fizzle, is a thing that should not be tolerated. Difference should be expected and encouraged, not suppressed.

This accent on perceiving a “broken” system is a call for reform, and this reform usually means one of two things. Either people think it is too hard to get people treatment, or people think the treatment they receive too harsh. I am against reform as reform is always piece-meal, and there’s no end to it. Reform always, and of necessity, leads to further reform. I support the abolition of forced mental health treatment. Prejudice and discrimination, so-called “stigma”, comes of force. End forced mental health treatment, and you will also be ending so many things that are wrong with the mental health system today. There is no reason, no good reason anyway, in my opinion, for persevering in the present farce of pretending otherwise.

22 Responses

  1. Abolition is not going to happen and diverting our resources and energy to it is a waste of both. It’s a shame that we can’t get realistic and practical and see what we can actually accomplish together. Sadly, given their hostility, I’m starting to question the motives of certain leaders of the abolitionist movement. Do they actually want to improve people’s lives or do they just crave the fame and glory that they will never achieve?

    I contribute in many, many ways to support the mentally ill but I will not swallow this libertarian diatribe that everybody, no matter what level of distress that they suffer, can look after themselves. I was harmed terribly by the psychiatric machine yet I still think there’s a place for some kind of crisis intervention, though vastly better scrutinized and with far more legal safeguards than we have at present.

    Some people’s idea of reform is just ranting and raving about how they were wronged. The rage is both understandable and justifiable but it will accomplish nothing.

    • If people had taken the same attitude to chattel slavery in 19th century America that you are taking to forced psychiatry, the slave trade would still be flourishing today. I think we are diverting our resources and energy by going after the surface manifestations of “stigma” rather than going after the real source of “stigma”, and that source is forced treatment.

      I am not saying that anyone who wants mental health treatment shouldn’t be able to have that treatment. I’m just saying that some people don’t want mental health treatment, and that they are perfectly within their rights in wanting to refuse it. The right to treatment, without the right to refuse treatment, is a wrong that should be corrected. To take away a person’s freedom, and their security of person, by harming that person with drugs, for instance, in such a fashion, is to deny them of their basic human rights.

      Say what you will. I am not going espouse locking up more and more people in the name of protecting members of the general public from other members of the general public because some over educated nincompoop would project a theoretical sickness onto some of them. To my way of thinking, doing so would be an example of hatred and intolerance. Hatred and intolerance are not projects I am interested in encouraging, let alone promoting, in the slightest.

      While depriving more and more people of their basic liberties may be a very effective way of dealing with them. I will leave that matter to you and yours. If favoring freedom and responsibility is ranting and raving, well then, I’m more than content to rant and rave, however ineffectual it would appear to be to you and yours for me to do so.

      • Chattel slavery was a very different and much more evil scenario than forced psychiatry. Indeed, it is offensive to compare the two. There is *never* any justification for slavery; there are, however, in rare and extraordinary circumstances, various justifications for mental health intervention.

        If there were no mental health laws, then a police officer coming across a suicidal woman standing on a bridge railing would be breaking the law if he were to grab her. Is that the kind of libertarian utopia you envision? Without mental health legislation, all that would happen would be that medical professionals and police officers would simply disregard the law and no court in the land would ever award damages. Thus, we would forfeit the meagre protections we have at present.

        Wouldn’t it make more sense to improve the framework we have now? For instance, to provide immediate and free legal advocacy to anybody facing involuntary hospitalization? To demand that the concept of true (as in informed and uncoerced) consent be enshrined in law? To divert our resources into providing Soteria Houses and other community-based, voluntary treatment with a view to making conventional psychiatry obsolete?

        These are real, achievable goals as opposed to abolition which is a non-starter. Contrary to your implication, I certainly do not espouse locking more and more people up. In fact, I am dedicated to getting more and more people free. If you have ever had first-hand experience with a suicidal or psychotic person, you might decide that intervention is neither hatred nor intolerance.

        It’s not worth arguing about anyway because abolition will never, ever happen, nor should it.

      • Actually chattel psychiatry isn’t so very different from forced psychiatry. When people can disregard the Bill of Rights of the US Constitution in their Mistreatment of other human beings, you’ve got the same situation. A slave, the personal property of another person, was accounted 3/5th of a human being. Now tell me people who have been through the mental health treatment ringer have the same citizenship rights as everybody else, and I will call you for the liar you actually are.

        I’m not pitching suicide prohibition. That’s your thing. People have a right to take their own life whether it is acknowledged or not. Who’s to stop them from doing so. Anyone who wants to do themselves in, can do themselves in. If the problem we have in attempted suicide is with people who really don’t want to do themselves in, okay, I’d give them the opportunity to make up their minds rather than assuming I knew what was best (or valuable) for them…in particular. I’m working under the assumption that people kill themselves because they are sad, or unfortunate, or frustrated though, rather than “sick”. The presumption of “sickness” creates all sorts of lack of due process human rights violation issues in the mental health system.

        I’m not against systemic or framework improvements. The problem with providing legal advocacy is, given the lack of due process involved, we’re dealing with kangaroo courts anyway as is. It takes more than telling a person, “You’re screwed”, to fix the system. The law is bad, and it should be scrapped. I agree about diverting funding. Diverting funds from costly ineffective programs to inexpensive effective programs makes all sorts of sense. Doing so could be perceived as a prevention measure, too.

        I’m not going to propose any halfway measures that involve fracturing the value of this or that human being into less than a human being. You can do that to your hearts content. I prefer to acknowledge the difference between a hospital and a prison, and not to confuse the difference between the two. Miriam-Webster is a real help with this matter. A federal penitentiary is a prison. A general hospital is a hospital except, maybe, for the psych-unit if it has one. A mental hospital is a psychiatric prison. When treatment is freely chosen, fine and dandy, but when wards are locked, and people are not allowed to come and go as they please, you don’t have a hospital, you have a psychiatric plantation house.

        If it is a point not worth arguing for you, then, by all means, please, stop arguing. I don’t care what you do myself. I am not going to support violating people’s Constitutionally given rights. I am not going to support violating those Constitutionally given rights even if the person whose rights are being violated has a psychiatric history. Adult child, for me, is an oxymoron, but perhaps it means something else to you.

      • Verbose and redundant. Extremists, especially those who can neither read nor formulate an argument, set us back further and further.

      • Extremist is a person who abducts, imprisons, tortures, and poisons another person, and then calls that abduction, imprisonment, torture, and poisoning acceptable medical practice. Believe me, I am not that kind of extremist. Mental health law enables the state to do what it would be criminal for a private citizen to do to another person. Get rid of mental health law, and assault is assault again, even if the person doing the assailing is an employee of the federal or state government.

      • Um, no. An extremist is a person who takes an extreme position and generally disregards any valid, opposing point of view. You are the epitome of an extremist. You’re just furthering Fuller Torrey’s cause.

      • I wouldn’t support non-consensual psychiatry any more than I’d support non-consensual sex, but if you want to make an argument in favor of non-consensual sex, I’d love to hear it.

      • There is no argument for non-consensual sex and once again you demonstrate your poor analogy skills. When it comes to comparing rape and MH intervention (which is as odious a comparison as that to slavery), the crucial distinction is that in rare and extraordinary circumstances (such as with the bridge jumper) intervention is ethically justified. Get rid of MH laws and all that will happen is that police and doctors will simply disregard the law and no court will ever hold them liable. Thus what you propose will destroy the meagre protections we have at present. Want to actually make change? Then provide options for alternatives. Tighten treatment standards. Work on redefining the concept of consent. Make legal advocacy automatic. Start a database re: patient experience. So much to do yet you choose to waste your time on this futile endeavour. Do you have any idea how much you diminish our prospects?

      • We agree to disagree then, which is more of an option than we’d get from forced psychiatry or forced sex. Police and doctors, not only disregard the law, they’ve got illegal, or unconstitutional, laws to enforce their will. I really don’t see how I could ever approve of unwanted mental health treatment being forced on a person any more than I could approve of unwanted sex being forced on a person. Informed consent is often not informed, and sometimes, you don’t even have consent at all. When it comes to trafficking in human beings, I wouldn’t let psychiatry off the hook. Maybe you would. Okay, that’s you. That’s not me.

      • No, as I said, there is much room for improvement. I believe I already suggested redefining the concept of consent. That’s an example of a realistic, achievable goal, as opposed to what you’re futilely and incoherently shrieking for.

      • “Redefining”? Pulleeze! The bard’s English can only take so much abuse. It means what it means. “Redefine” consent to mean non-consent, and you’ve just thrashed our ability to communicate. George Orwell had a word for such “redefining” in his dystopic novel 1984. He called it Newspeak.

      • Once again, you have failed to understand. Redefining consent in this context would mean limiting that term to specify “informed and uncoerced.” That would address the large grey area where people are technically consenting but only under threat of force. One of many problems with the status quo is it’s impossible to count how many are being coerced. That’s why I support immediate and free legal advocacy for every patient. Until then, you can still inform yourself and present your case to the doctor(s) in an intelligent, rational way. If you reasonably believe you’re being quietly coerced, then it’s a good idea to ask to have the assessment recorded. If not, then ask why not? There’s lots we can do to educate ourselves and others and make practical, positive changes. Please consider devoting your energy to that. I guarantee your efforts as evidenced by your blog will bring you nothing but a diminished reputation.

  2. Great post Frank.

  3. Here’s just one example of an achievable goal. We could push to have the required 2nd doctor’s assessment be blinded, i.e. no previous info as to status or diagnosis. That’s the kind of reasonable change the courts will entertain. Here’s another: we could petition to have the standards for in and out patient commitment equalized.

    • Don’t see it. Nor would the 2nd doctor. We’ve got a grab bag of diagnostic labels, arrived at by committee vote, and you think agreement would mean anything? I think it might mean another shovelful of dirt. I’m just saying diagnostic labeling is not science. You’ve got psychiatrists calling it art. Again, not science. Some people are out to replace most inpatient commitment with outpatient commitment and, in a sense, inpatient commitment is the big threat for people undergoing outpatient commitment. Doing so, replacing one with the other, would in effect equalize the standards as you put it. Of course, you’ve still got forensic cases and non-compliant outpatients to close the gap. Either way, forensic has always crossed a line between written law and convention. I’d be careful, if I were you, not to paint myself into a corner. I would imagine that good is preferable to any evil, however lesser.

      • I think you misunderstand the purpose of a blinded assessment. It would make an enormous improvement to our commitment rate.

      • You also misunderstand the implications of standardizing criteria between in/out patient treatment. There’s enormous room here for consumer activism to reduce coercion.

      • Please explain how it’s good to decline to intervene in a suicide in progress. Please explain how it’s good to leave a psychotic person rolling around on the floor screaming that her hands on fire. Please explain how it’s good to let a teenage girl starve herself to death. Please explain how it’s good to give a gun to someone suffering from paranoia.

        It’s all very well to call for abolition but it’s harder to suggest alternatives.

        Like it or not, some have been helped enormously. Yes, others have been harmed (I’m one of them) so let’s make improvements. Extremism doesn’t get results. Advocating effective policy changes does. Please consider changing course as your ship is sinking.

      • I’m not in the habit of pathologizing people, and I”m not going to get into that habit now. If a person breaks the law, that person will have to face the consequences of breaking the law. Possessing a pet “mental illness” monster is no excuse. Nobody’s “mental illness” made them do it any more than demons, the devil, rock and roll, or Barbee did.

        It’s not our commitment rate. I’m not forcing treatment on anybody. Nor am I giving tacit approval to the practice.

        Alternatives exist, and I’m not one to discourage them.

        I’m not in a sinking ship. I have no problem taking the moral high ground on this matter. It’s certainly more defensible than the moral low ground.

    • I’m not out to ignore, rationalize, encourage, support, promote or advance psychiatry between nonconsenting adults in any way whatsoever. Instead I oppose all psychiatry between nonconsenting adults. Consensual psychiatry is fine, and up to the individual; nonconsensual psychiatry is assault, and it is just plain wrong.

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