Psychiatry Exposed

[Faith No More]

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Yeah, sometimes it's a smart move to implement coercive measures against severely mentally ill people, so I'm not completely against it.

Mental health is a vastly more important issue than personal freedom in such circumstances. However, the unfortunate thing about it is that this principle has also opened the doors for mental institutes to cause undeserved suffering to many patients whose illnesses are not severe enough. They get mislabelled and overdiagnosed (refer to post # 56) and then have to spend weeks in a hospital without having anything seriously wrong with them. Then many of them start to experience disastrous side effects from the medications which leaves them in a worse state than before.

Besides, I don't think there is strong evidence that patients who are compelled to receive treatment always do better in the long run, nor that the antipsychotic drugs are always beneficial. Some people get better, some people get worse, and some people stay the same. There's no guarantee what's going to happen to them in the future.

And yes, there are people with mental illnesses who are unable to understand that they have an illness. But on the other hand, there are also people who have been convinced that they have a mental illness even though it is actually something pretty normal. So, whose judgements are you going to rely on? Who should you trust the most? Quite frankly, I'd rather go with my own judgements, not what someone else thinks about me after a 15-minutes meeting.

Regarding the need for oversight, I don't see any good way to do that in psychiatry because, as you acknowledged also, the diagnosing of mental illness is highly subjective. Most of the time there is no scientific measurement, blood test, X-ray evidence, nor anything like that in psychiatry to verify whether or not what you've been told about your mental health is true. It's simply whatever the psychiatrist says. If he says that you have a mental illness and that you need treatment, then that is it. How can anyone else put to rights pronouncements that are so subjective?

So, basically, the whole issue I think boils down to a matter of trust. But unfortunately, history has repeatedly demonstrated that very often the trust gets betrayed and abused. The ubiquitous "Doctors know what's best for you" paradigm is often used as a smokescreen for selling drugs and doing evil things to patients without their knowledge. Horrific atrocities, abuses, and human rights violations are still being committed in secret by the "saviors" of mental illness. One of the many examples is the use of covert medication:

The Noncompliant Patient in Psychiatry: The Case For and Against Covert/Surreptitious Medication

And that's just the tip of the iceberg, of course.

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Don't get me wrong. I completely understand that there are issues with the psychiatric community and that there have been terrible abuses of the authority involved. As terrible as that can be, I don't think it's fair to expose psychiatry without balancing it out by mentioning the good it has done (dammit, now I sound like a theist defending religion).

One thing to keep in mind is that a patient isn't obligated to see a doctor, unless they are institutionalized or a ward of the state. If you don't trust your doctor, find another one. Psychiatrists are like anything else in that you need to shop around and find the right one for you. You have to understand that a patient does have a lot of control over their treatment. Sadly, a lot of the abuse happens because of ignorance on the part of the patient. There is a vast amount of information at our fingertips, and one has to be vigilant when dealing with mental health. People need to understand that the human factor is even more in play with psychiatry than with a regular physician, and a patient has to take responsibility into his/her hands.

Another thing to remember is that psychiatry is in its infancy compared to other sciences. When you add on to that the fact that the brain is highly complex and assessing it can be highly subjective, you have plenty of room for abuse. It is the nature of the beast, but not a reason to abandon the entire endeavor.