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Updated 15.20pm
AS A NATION we have a long history of locking up our own people for the most spurious of reasons, whether it be the Magdalene Laundries, the industrial schools or psychiatric hospitals.
It is in our history, a stark and shameful fact about our country from which we cannot escape, and there are many former inmates still seeking compensation.
After every scandal that has emerged, the public asked one question: ‘How did we let this happen?’
What follows that question is a statement: ‘We will never let this happen again.’
The late journalist Mary Raftery stated in her 2011 documentary on the mental health system, Behind The Walls, that in the 1950s Ireland led the world in locking people up with impunity. There was an attitude against people who were ‘problematic’ and sadly, there still is.
There is no doubt that our mental health system today is far better than years gone by, that the move towards community care, the closing of the large-scale institutions dotted around the country is to be welcomed.
Today, people are still detained in psychiatric hospitals. Many of course need the supports and treatment a hospital can provide, but for others, a question mark hangs over their continued detention.
However progressive the Mental Health Act 2001 was for the time, there are a number of shortcomings – the status labelling of patients and the rights it affords them is one of them.
Under the act there are two types of patients – voluntary and involuntary. One of the fundamental flaws within the law is its definitions of these patients and the unequal rights between them.
You would be mistaken in thinking that a voluntary patient is someone that has walked into a hospital of their own accord seeking help. While some patients are admitted this way, it is not the full picture.
The definition of a voluntary patient under the act means “a person receiving care and treatment in an approved centre who is not the subject of an admission order or a renewal order”. While an involuntary patient is defined as a person who has been “involuntarily admitted to an approved centre pursuant to an application under… and detained there on the grounds that he or she is suffering from a mental disorder”.
Under the law, an involuntary patient who is admitted against their will has a right to appeal their detention – this right was afforded to involuntary patients following the pivotal Croke V Ireland case.
In the early 1980s the person at the centre of the Croke case was diagnosed with a mental illness and admitted to hospital, where he was detained for a number of years without review. His case was taken to the the European Court of Human Rights (ECHR) under Article 5 of the Convention on Human Rights, which requires a proper system of judicial review of detention on the basis of mental disorder. He won his case. Following this landmark judgement, admission and review procedures were included in the new Mental Health Act 2001, but this was not enacted until 2006.
Tribunals were set up whereby after a period of 21 days the patient has the right to have their case heard in front of a tribunal of psychiatrists and legal experts.
Unfortunately, this right was not extended to voluntary patients.
Why would voluntary patients need a review of their detention: surely they can just leave? This is not always the case. A voluntary patient under the act is simply a person who is in hospital who is not subject to an admission order. In their interim report the expert group who is currently undertaking a fairly extensive re-writing of the mental health act cited this as something that needs to be investigated.
Some voluntary patients that are in approved centres lack the capacity to consent to their admission or treatment – yet their status is “voluntary”, not because they consented to be admitted, but because they had not the capacity to object. The expert group described this group of voluntary patients as the “defacto detained” and this group are not provided with any rights under the act.
Ultimately, you can walk into a treatment centre, ask for assistance and you are deemed voluntary, but a person who is incapacitated, who does not have the ability to make a reasoned decision about their treatment or admission, can also be a voluntary patient – as in you only can become an involuntary patient when you indicate you want to leave and are refused – you are then re-classed as an involuntary patient – and your rights begin to kick in. However, if you are a long term voluntary patient within a unit, who has neither the capacity nor the ability to indicate you want to leave or question your treatment, you are not entitled to a review.
In 2011, Amnesty Ireland highlighted this, stating that the “description of such patients as ‘voluntary’ is misleading, in that it suggests the exercise of free choice by the individual concerned”. The EH v St Vincent’s Hospital and Others in 2008 showed just how this could happen. This case involved an involuntary patient who had an order to extend her detention rejected by a tribunal. This, in turn, changed her status into a voluntary patient, because she lacked capacity. When she attempted to leave, the hospital invoked section 23 of the act, which gives the power to prevent a voluntary patient from leaving. Then a new admission order was made and patient’s status returned to involuntary and was detained further on successive renewal orders.
The case was taken to the Supreme Court where it was argued that she never should have been given the status of a voluntary patient as she was lacking in capacity, but the appeal was dismissed. Amnesty Ireland said that the lack of data on the numbers of “so-called compliant incapacitated patients” within the Irish mental health services is cause for an audit of these figures.
So who are these voluntary patients? While the Mental Health Commission strictly audits the numbers of involuntary patients per year, there is no breakdown as to what percentage of the voluntary patients are incapacitated.
Speaking to TheJournal.ie, Colm O’Gorman of Amnesty International Ireland said while the legislation was progressive at the time, it needs to be overhauled. He said the definitions of voluntary and involuntary patients is “rather fluid and arbitrary” adding, there is no traceability when someone is detained as a voluntary patient. He said:
Under the act they can detained if they are a risk to themselves or others, but there is no mandatory treatability requirement. They are not saying that they are being detained because they are a risk to themselves or others AND we believe that there is a therapeutic procedure that that will deal with that risk or will address that health problem – they are just simply being detained.In what other walk of life or context can you imagine something like this happening. On the basis of a risk alone is grounds for detention without any treatment and then the treatment can be ongoing.
He added that the new capacity legislation, which was published last week, should be linked up with the review group of the Mental Health Act. Leading legal and medical experts have criticised that this is not the case. O’Gorman said that it was not cohesive to have the review group and the new capacity legislation working in isolation of each other, as the two will have to interplay in reality. However, the minister denies that this is the case. Watch here:
Christina Finn/YouTube
Last week, the publication of the Assisted Decision-Making (Capacity) Bill 2013 was announced, which if working in conjunction with the mental health laws could improve matters for vulnerable people, such as those detained in institutions. Minister for Justice Alan Shatter said: “I am pleased to announce a comprehensive reform of the long-outdated law on mental capacity, which will greatly assist vulnerable people with limited decision making capacity to better manage their personal, property and financial affairs.”
Speaking about the new bill, law lecturer at NUI Galway, Mary Keys said:
The review of the Mental Health Act is still taking place. If we want to ensure the outcome of that review and the new capacity bill is not fragmented we need to ensure that the human rights principals are the same in both. The capacity legislation should underpin the mental health law. Links between the two need to be forged in order to avoid the fragmentation we have seen so far. This debate is really important and it is vital that it is incorporating the same value system into the Mental Health Act.
She added that she was concerned that the new capacity bill may be taking a very narrow approach to mental health law stating that other jurisdictions, like the UK, have prevented people that are formally detained to come under the capacity legislation, something that Ireland should not strive towards, she said. Keys added:
Both laws need to be complimentary and not to be collisional.
But it is not just the incapacitated. Some voluntary service users describe their experience as ‘‘compliance under the veil of coercion”. They have gone into hospital of their own accord, however, when they have decided to leave, their consulting psychiatrist has disagreed. Acting under the law, if your consulting psychiatrist believes he is acting in his patient’s “best interests” and if he believes they could be at risk to themselves or others, then he has the right to change your status from a voluntary patient to an involuntary.
Louise Bayliss, one such service user, who later became an advocate, said:
I was not well and I knew I needed some time out, to deal with it. I was voluntary as far as I was concerned, however when I decided I wanted to go, it became a big issue. My psychiatrist wanted me to stay but I was adamant I wanted to go, it was not what I thought it would be.I was effectively told that I could either stay as a voluntary patient or be made to stay as an involuntary, but that really, it would “look better” if I stayed as a voluntary – I mean, where is the voluntary choice there? And it seems the more you protest, the more likely you are to seem “distressed”, but wouldn’t anyone get distressed if they were told they couldn’t leave? Of course they would.
Rory Doody who has experienced mental health difficulties in the past said he would agree that this is very common. He said:
You have perhaps come out of hospital, you have gone back home and in order to get reviewed you go back into the outpatient department of the hospital and you meet a psychiatrist.
Depending on your day, whether you had trouble getting parking, if you had an argument with your loved one, if your favourite team lost a match the night before and you may be stressed, that can appear as ‘symptomatic’ and I have seen and sat in out patients departments where I have been asked ‘would you like to come inside, we think it would be best if you came inside’. What that does is actually negate community care.
Another service user who wished to remain anonymous said:
I voluntarily signed myself in to a mental health facility because I was concerned about my general frame of mind. At the time, I was under the impression that if you voluntarily sign yourself in, you can then leave when you feel ready to. Sadly, this was not the case and I was not informed of this when I signed myself in.It was only after I had signed myself in that I was then told by some of the other inpatients that I could only leave when whoever my attending psychiatrist had decided I was ready to. If I had known that this was how it worked, I would not have signed myself in at all, and I would not have subsequently ended up spending the next two months of my life being surrounded by some very disturbing people who I remain emotionally scarred about to this day.
She said she believed people should be fully informed of what it means to sign yourself in before they do so, stating “because I guarantee, if most people were to be fully informed, they would end up not signing themselves in at all.”
This is something the minister said she too is concerned about. Speaking in an interview with TheJournal.ie, she said incidences where people have their status changed from voluntary to involuntary “should be very rare”. She said she had asked the expert group to look at this issue stating:
There is clearly an issue between voluntary patients becoming involuntary and how does that happen… and if it is necessary then there needs a whole process put around it in order to ensure the person themselves know what the process involves and that you asking to leave, the suggestion then becoming that you are involuntary, that this triggers this process.
Dr Shari McDaid, policy officer for Mental Health Reform said, “Voluntary patients should have the right to leave. But there are cases where voluntary patients have been converted into involuntary and brought in under an admission order. Last year there was 567 of these cases where patients were regraded from voluntary to involuntary. What should happen in these cases is that they should be clearly told what is happening and all information should be presented to them.”
She said while the figures for involuntary patients looks relatively small in comparison to years gone by, with voluntary numbers on the rise, she said the figures might not reveal the full picture. She said:
There are about 15,000 admissions each year and about 2,000 of these are involuntary last year. In that sense, the figures look small, but but a quarter of involuntary admissions are actually voluntary patients who have been re-graded, so anyone going in needs to know that they can be regraded as involuntary.Also many patients, despite being kept in hospital, would prefer to remain under the status of voluntary because they think it’s viewed better, so that needs to be considered. Then there are the patients who don’t have the capacity to make the decisions, and they have no protections whatsoever, because they are under the status of voluntary.
Colm O’Gorman said that there is a real concern over incidences when a person might be coerced into remaining a voluntary patient.
“Someone who is coerced into staying in as a voluntary patient is not a voluntary patient. They are there because they are coerced into staying and/or they are threatened with involuntary detention because it is more onerous,” he said.
O’Gorman added: “Isn’t that incredibly stigmatising to someone who will find themselves detained. It suggests that if someone is being detained because they are experiencing a serious mental health difficulty that this is a black mark against that individual for the rest of their lives. There is the whole question of further stigmatising. It also speaks clearly to the fact that many voluntary patients may not be voluntary because they feel pressured or coerced into staying when actually they want to leave.”
The expert group’s interim report also flagged this issue, stating: “There have been suggestions that many (capacitated) voluntary patients are not truly voluntary as they have consented to admission or to treatment only because of the threat of detention.” They added that they would recommend that voluntary patients should be voluntary in all respects and that patients should be well informed of what it entails when you voluntarily sign in to a hospital.
Minister Lynch said there is extraordinary scrutiny of the status-regrading figures and the longer-duration detainment figures are audited.
However, Section 23 and 24 of the act provides the power to prevent a voluntary patient from leaving and allows for their detainment. The UN Committee Against Torture said in 2011 that there was a “lack of clarity” in the reclassification of patients’ status. Amnesty International Ireland state that they are concerned that this can make voluntary patients ‘involuntary’ in all but name.
They stated that while every time a patient is re-graded from voluntary to involuntary, the Mental Health Commission must be notified, there is no such notification requirement where the “holding power” of section 23 is invoked, but where section 24 – the right to detainment – is not invoked. They said that when section 23 of the act is invoked, the MHC should also be informed, so as to address any “inappropriate use of the power”.
When asked about the possible rolling over of section 23, where a person wants to leave can be held for up to 24 hours, then the patient could be coerced into staying as a voluntary patient and whether there was a possibility of this abuse taking place, Minister Lynch said:
I don’t think that anyone, no minister, anywhere, could ever absolutely swear that there are not abuses in the system.
Christina Finn/YouTube
The expert group has called for a review of section 23 and 24 of the act stating that “a voluntary patient that wants to leave should be able to do so”. Where the patient is deemed to be at risk, the recommended the short term detainment of the patient should be permitted for just 12 hours, rather than 24 hours.
Rory Doody said the Mental Health Act “legitimates inequality” adding that it legitimises discrimination, as it separates them and us. “It separates people from people,” he said adding that he believed too much power belongs to psychiatry.
When asked if the minister agreed with this statement, she said she had never met a consultant psychiatrist, in whatever area of medicine, who liked to have his judgement questioned, but said they were not being given power, but were being given responsibility. She also said that psychiatrists acting “god-like” and “arrogant” was a difficulty.
Christina Finn/YouTube
A review of the Act took place in 2007, but many of the recommendations have not been implemented.
Colm O’Gorman of Amnesty Ireland sounds a warning on the nation’s seeming inability to learn from the past:
We surely have to acknowledge that we have a huge legacy difficulty. History only becomes history when you have learned from it and moved on from the past. If we do not do that, then it most likely is still influencing our present.
If we come from a history of those difficulties then the legacy, that denial, that failure to understand the complexities involved in issues like how we should properly support those with mental health problems, that is likely to influence the approach we have today.
This article was written with the support of the Mary Raftery Journalism Fund. To find out more about the fund, please visit www.maryrafteryfund.ie or follow @maryrafteryfund on Twitter.
First published 6.45am
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i suffered from drug induced psychosis. i experienced what this article describes, in regard to voluntarily entering a hospital, requesting to leave some time afterwards, and being refused, having to go through the tribunal process etc. at the time i was not happy, but in hindsight it is obvious to see my best interests were certainly in the eyes of the doctors/nurses who refused me from exiting the hospital.
what i was particularly unhappy about was the mandatory medication, which i believe is routine for every single patient, regardless of diagnosis. i know there is a strong argument to make on the requirement of medication, but i believe its time more assessment is made on how many cases are associated with emotional issues/distress/trauma, i firmly believe the majority can and would be traced back to emotional problems. medication does not cater to address the root problem, it simply suppresses natural processes which the majority of doctors just do not know how to handle.
in short: more doctors should be trained in taking a more therapeutic approach as opposed to loading patients with tablets and sending them on their way, it doesn’t resolve underlying issues, it just fills the pockets of pharmaceutical companies who are solely profit driven with no concern for long term side effects of these drugs or the overall well being of an individual who is constricted to these drugs for life.
I know someone in exactly same situation, its like he is a non-person, his family had him sectioned and it looks like to me a never ending process. I just can’t see him getting any of his life back.
Noel, doctors can’t fix “underlying issues”, only the problems that arise from them. It’s a common myth but for things like obesity for example, they can treat the side issues but can’t force a patient to get exercise and stop eating. same with drugs/drink/smoking etc., and it’s amazing how many former patients try to lay it all on ‘big pharma’, who arent angels by any means, but the expectation that doctors can fix someone who problems are behavioral is unrealistic.
That’s the point patients are ultimately responsible for their recovery. In a paternalistic system where psychiatrists make all the decisions the patient is dis-empowered and infantilised. More patient involvement and responsibility is crucial for recovery. The current system just doesn’t encourage this. I think its easier to come to terms with bad decisions that are your own than imposed ‘solutions’. Patients will make mistakes because they are human but so are doctors and they too make mistakes.
Yes, absolutely Aubrey and that’s the difference between good care and bad care. Or maybe between good and bad doctors. It should be decided on a case by case basis and depend on how the person has dealt with their issues before that point. If they’ve come to think of their problems as caused by other people then it’s going to be harder to get that person to be responsible for their recovery, and treating them as disempowered might be appropriate.
I don’t think its ever appropriate to disempower someone.
that’s not the same as treating them as though they’ve thoroughly surrendered their own responsibility though is it? But in any case, it’s common practice to commit someone against their will, even though it’s horrible it’s understood to be for their own good. It might be a huge ethical issue but I’d hardly say it should never happen.
“I’ve never meet a psychiatrist who like his judgement questioned” well maybe if some of them “god like” psychiatricts actually spent time and listened to the patient and their circumstances rather than using a tick box process in hospitals we wouldn’t have such a big problem. After my partner died I took an overdose and yes it was stupid but 12hours later when I was still in A/E I realised how stupid I was in that moment of sheer distress at losing him. I was admitted voluntary but then was deemed involuntary even though I had made them aware of my regret. Of course when I was told I could not leave this upset me and also when they took my partners scarf off me without asking along with other belongings I was distraught. It was the one comfort I had in the unit after he died and they didn’t even have the common curtsy to tell me they had gone through my belonging or my status changing until I asked to leave. Seems lack of communication between nurses doctors consultants and patients is the big problem. Common sense has got lost in the system. Thankfully I had one nurse who listened and understood after everything went on and eventually I got home. I was lucky. Many weren’t
While I understand your position, you have to have realised that as a result of you attempting to commit suicide the unit to which you were admitted had to take all reasonable action to prevent you from attempting it again – that would’ve included taking the scarf from you.
I’m presuming you got it back?
Eventually after much fighting. I understand completely they have to do that but to just take it from me without even telling me is bad form. It’s not like I wasn’t compus mentus. I was aware of my actions and regretted them. Just because I was a psy patient doesn’t mean I shouldn’t have been told my belongings would be rumbled through and some taken without my knowledge
Sounds like the doctors and healthcare professionals were very diligent in doing their job to protect your safety and health.
In my experience, nurses make a big deal out of taking anything longer than it is wider out of patients’ possession. Erving Goffmann writes in his book “Asylums” that the routine confiscation of personal possessions has less to do with safety than with conditioning the patient to accept his new role. Another example is razors; these are also confiscated but normally all a patient needs is to ask at the desk and the razor is handed over. My own razors were confiscated, but I could ask for them back and was allowed into the shower with them on my own. I was once asked what I wanted a razor for, and replied it was to shave my legs. What was the point of that interaction? How did it make me feel?
This is a timely and welcome article. Before I found myself in the situation, I would never have seen myself signing myself into a psychiatric ward and assumed that that a “voluntary” patient could leave. On the day I was in too much distress to ask enough questions. That’s why it’s important that the general public be informed; so that they’re armed with the knowledge in case they ever need it.
Tara makes important points about how the lack of dignity and respect for psychiatric patients is iatrogenic and does nothing to further healing or recovery. Good to see you’re doing well now.
Hi Tara,
My father died in an accident in 1998. The only thing I kept of his was an old sheepskin coat that he used to wear all the time. I kept it in my wardrobe in my mums house where I grew up.
In 2005, when I split up with my ex, I decided to go home with my kids for a few days to get some headspace. By this stage my mother had a new boyfriend.
They came to meet me off the train and my heart nearly stopped when I saw that my mums new partner was wearing the coat that I had kept of my dads.
He refused to take it off and my mother acted as though I was crazy for being upset.
For the record, if he couldn’t afford a coat I mightn’t have minded but the pair of them are away on constant holidays.
Anyway, I know how sacred items that belonged to someone you loved can be,
:)
In truth , our state has just as bad a history as any extremist state.
Detaining our people, abusing our people, abusing our children.
Shamefully we hear them say . ” this must never happen again”. Yet they did nothing or were complicit in those terrible very acts of barbarism .
Its horrific, to go into a hospital voluntarily and then when you opt to leave to be told you can’t? Thats imprisonment it is not treatment. My heart goes out to people in that kind of difficulty. But what a mess of a system.
@Austin…. it has to be assumed that when a person voluntarily goes into hospital, seeking help, they are not in a fit state in the first place, or like in my situation may be struggling and just seeking assistance or support. the problem arises then, when an individual seeks to leave, the mental health act can be enforced upon them, which reverts your voluntary status, where you are fit and stable enough to make decisions for yourself, to an involuntary state, which means 2 psychiatrists assess you and decide, whether you are either a threat to yourself or anyone else, in which case can detain you until you appeal to be heard by a tribunal (independent external adjudicators).
what has to be taken into consideration is the risk that someone may self harm, or even worse commit suicide, upon leaving the hospital, the doctors or nurses who allowed that patient to leave, and decided they were fit to take care of themselves, would no doubt be held responsible for these consequences. its a tricky situation, with no easy solution. all i can say from personal experience is the nurses and staff who work in these type of environments are very well trained personnel, they genuinely have the safety and wellbeing of patients at heart.
i should STRESS my experience is with a private hospital, i have no experience with the public system, but i have not heard good things.
Having been to a number of Amnesty conferences on Capacity Law and Mental Health, I can try to summarize one or two points made by Law lecturer Phil Fennell. One would be that over legislation can lead to confusion and what is really needed is a mindset change in the system. The second point he made at the last conference was that family members should not be involved in “sectioning” people as it can screw up family relationships. Or at least that is what I gathered from his comments.
“Phil Fennell, Professor of Law at Cardiff University, looks at mental health legislation in Britain and elsewhere, and draws lessons for reform of Ireland’s Mental Health Act 2001. Phil was speaking at an Amnesty International Ireland conference on mental health law reform in March 2013″ ~ http://www.youtube.com/watch?v=rDvah16UtaU
Maybe there are some families where they are very close to their relatives and the person feels comfortable with having them involved. I for one do not want my family involved in my mental health care. Due to their involvement 5 years ago.
At the time, when I realised what my family were doing to me, something I knew instinctively. No words were needed. I desperately tried to contact a solicitor but because it was August most seemed on holidays. I was on the phone to a mental health advocate who I must have contacted through Citizen Information. I would have engaged with him. I was engaging with him. Instead an ambulance, 2 police, a swarm of Psychiatric nurses and ambulance staff arrived on my doorstep. A complete waste of valuable resources. I had not endangered my own life or those around me. I had been through a trauma. A brother of a friend of mine had taken his own life and I had absorbed their grief. I also was on “anti-depressant”/SSRI drugs which are known to trigger “mania”/”psychosis” in some people.
I was then locked away for what seemed like a year as a “voluntary” patient. In fact it was really only 2 to 3 weeks but seemed much longer due to the traumatic way in which I was admitted. For 5 years I have felt traumatized by the experience. I only feel like I am getting over it now but will never truly get over it.
I did try to leave once. I felt unsafe in the unit because of an incident that had happened. But I was told that if I did try to leave I could be detained involuntary. Psychiatry have taken the work VOLUNTARY and reinvented it for their own purposes. The Mental Health Commission had no record of my detention. The MHC include Psychiatrists inspecting Psychiatrists. Can I really have faith in such a process? When I did eventually complain about the trauma I was put through I was told to complain to the HSE. The HSE was the system that had caused me the trauma and that had detained me! The mind boggles!
Despite people thinking I did not know what was going on (in fact I was hyper aware of what was going on on some level) I had the “insight” to stay and wait for my transfer to a private hospital. I can see from the notes that I obtained under Freedom of Information what was going on and what people were writing about me. If I spoke to the staff it was written in the notes that I was “over familiar” with the staff. I have since told the Occupational therapist to inform the hospital to put signs up saying “Patients do not talk to staff”!
It was such a cold, uncaring, unsympathetic place to be. Surrounded by strangers. With very little empathy. Just their trolley of “potions and poisons”. Well that is what I wrote in my diary at the time and I wasn’t far off the mark. While some of the major tranquilizers I was put on do offer relief if used short term (eg Zyprexa) I now realise that I was chronically exposed to this drug long term and that this was completely unnecessary. Half the dosage would have worked for starters! So I was basically over medicated and over sedated with a drug that can have serious side effects.
I was NEVER told that “anti-depressants”/SSRIs can cause “mania”. This would have put the whole situation in a completely different light. It would have removed some of the stigma and confusion that I felt. If I knew one of the main causes! In a Yale study, approx 1 in 12 patients were found to have been admitted owing to antidepressant-associated mania or psychosis: http://www.ncbi.nlm.nih.gov/pubmed/11235925
For most of the past 5 years I have suffered from Post Traumatic Stress from my “detention” and from the trauma of reading my notes. There is one line in my notes written by my GP and I will find it hard to ever trust a doctor based on it. After been traumatised by that line I questioned the doctor about it and all she could say was “Sorry. I do not remember writing it”. GPs seem to have very little training in mental health with a few exceptions. They seem to carry with them most of the stigma and misconceptions of the general population. And try coming off the mind numbing drugs. You will get NO support. You will be called “non-compliant”. You will be told “these drugs are not made for a’la carte people like you”. But thanks to that last comment I stepped away from the flawed biomedical model nearly 2 years ago. And refuse to look back. I have only very occasionally had to resort to any prescribe psychoactive drugs. I now understand what works for me and what does not. I realise that physical/mental health is something that requires daily work and that there is no pill that cures life.
I could easily have become a statistic. Lying in bed half the day. Over sedated. Been led to believe I was “mentally ill”. But luckily I became “enlightened”. I linked up to others who had survived this trauma. I also linked up to honest doctors who are not afraid to tell the truth eg Prof Ivor Browne. Also Dr Terry Lynch. I follow the work of Prof David Healy, Dr Joanna Moncrieff, Dr Peter Breggin, Dr Pat Bracken, Dr Bob Johnson, Dr Colin Ross and the list goes on.
So when yesterday I see people with fake Twitter accounts saying that I am on a “mad rant”, that I am “paranoid” when I try to highlight the evidence about the drugs, that I am a conspiracy theorists etc this kind of backward thinking has very little effect on me. But I do feel that society as a whole has very little understanding of how Psychiatry operates. It is only when you find yourself at their mercy and when you see their POWER and CONTROL in action that you can truly comprehend. I also realise that people have been through far worse than I have. But if I was to pick one thing that needs changing and one thing that Psychiatry plays on that would be any dysfunction in families. The use that to gain more power. And that needs to change. The person needs to be involved in their health care. Instead people start gossiping behind the person’s back. But for some reason I get to see/hear what is happening. In physical written form. Going behind a person’s back just leads to mistrust. At a time when a vulnerable person needs to be able to trust and needs empathy. But I do feel that, as Rosenhan pointed out all those years ago, that Psychiatric units can be places where the unwanted in society are placed. Without people realising the true impact of such a decision.
Impact on career. Impact on family relationships. And impact on the person’s Quality of Life through unnecessary. long term drugging in a lot of cases. So glad to be FREE from this system but my life was changed forever. I went looking for help with panic attacks. I ended up in a far greater hell than any panic attack. But I have managed to crawl back from that hell. Just about. There has to be a better way.
And one other thing that needs changing. According to Dr Michael Corry RIP only 10% of Consultant Psychiatrists are trained in Psychotherapy. And believe me that shows! Some lack basic listening skills. They are too busy labeling and judging the person and deciding which concoction of drugs to put the person in distress on. Last year I spent 1 hour with 84 year old Consultant Psychiatrist Prof Ivor Browne. Wow! The difference was HUGE! Ivor is a trained Psychotherapist with a Masters from Harvard. He works in a very methodical way and in my case quickly got to the crux of my trauma and the traumas that mainstream Psychiatry had put me through. He was refreshingly honest. He had a 9 point plan in place for me. Ivor rocks. I met him 3.5 years to the day of been locked away. And ironically, when I arrived in Dublin the first person I bumped into was the mental health advocate that I had been on the phone to on that day that turned my life upside down. The mental health advocate who, if “the system” had used, could have turned a traumatic admission into a therapeutic process and a much faster RECOVERY time.
The state may think it is exceptable to lock productive members of society away but in the end it is society that suffers, in a system that can disable people. And medical journalist Robert Whitaker is well aware of this disabling process and he captures it excellently in his book “Anatomy of an Epidemic”. With the recent release of the DSM-5 by Psychiatry (their “bible”) where most human emotions and reactions can now be labelled as a “mental illness”. And once you have a label you can have a drug to match $$$ Ireland needs to wake up to this tragedy and learn from it. Otherwise we will become a nation of dependents with a large percentage of people on prescribed psychoactive drugs. Not forgetting the drugging of children with cocaine like substances ie Ritalin, Equasym. Children who are put on these drugs may show short term improvements but long term, by messing with the natural brain chemistry, they are put at risk of more serious mental health issues. Including “Bipolar”. I do not want to see any child ending up on the road I went on. There has to be a better way. Starting with diet. There is a better. way. I do not start the day with a pill. I start it with Yoga. I exercise. I get out on the bike. I feel ALIVE. I can feel the symptoms fade away gradually. The damage of the SSRI etc I am still a work in progress but getting there. I believe in the WRAP principles of RECOVERY ~ Education, self-advocacy, HOPE, SUPPORT and last but not least personal responsibility. Taking responsibility for my own health. Being forever vigilant and self-aware. And getting back to being a productive member of society. Something that can be taken away by the current approach to mental health.
fortunately there is a growing number of people in Ireland like Ivor Browne, Mary Maddock and Terry Lynch who incorporate a more wholesome approach to recovering from mental health hiccups. they should be voices for the masses.
Ann u have learned a lot but ,nobody sought u out for treatment ,u must have been unwell .That does not go away overnight ,but now u have chosen to blame the treatment for all your problems,which is terribly unfair to people who do need treatment(medication)as giving them the notion that they are being poisoned by what actually helps is terribly wrong .People never had so much responsibility and control over their own mental health ,and u go whatever road works best for u ,but don’t put people off getting help by saying the cure is worse than the disease .
Exactly! “The cure can be worse than the disease”.
If someone feels they benefit from the drug they are on and it is improving their Quality of Life in the true sense of the word, then who are I to judge.
I am talking about my own experience with prescribed psychoactive drugs. And also that I was not informed of the dangers of long term exposure to Olanzapine/Zyprexa. Which can lead to weight gain, diabetes and shrinkage of the brain. People have a right to informed consent and choice. It is only through my research in the last 18 months of so that I can see the bigger picture.
I unfortunately allowed my GP to refer me to a Psychiatrist for help with panic attacks. In an attempt to get access to Cognitive Behaviour Therapy. I NEVER asked to be locked away like a criminal, even though I had committed no crime. They sought me out, as you can see from my other post. And once they had access to my VHI details (something I should never have given them but it did allow me to have my own room) they must have rubbed their hands together in glee as they milked €20,000 from VHI ! Interestingly when I eventually got my transfer to the private hospital I do not feel traumatised by that experience. They only kept me for a week. I was allowed in the garden, to the church and even to Heuston station if I wanted! While the drugging regime was the same, I got treated with basic dignity. There has to be a better way of “helping” people in distress and there is! But the current system revolves around a billion dollar Big Pharma industry $$$ In this corrupt Capitalist world.
[Never stop or change medication without talking to a good doctor, due to the dangers of withdrawal]
“family members should not be involved in “sectioning” people as it can screw up family relationships”
what if the person is wrecking the house and assaulting family members?
Families should be advised that if they love the person more than they care about what that person thinks of them while they are sick, then they need to get involved. Too many people don’t get help for family members because it might ‘upset’ him or her. This isn’t the 50s when you can get your wife locked up for cooking your dinner wrong.
I have seen first hand where a famiky member was basically signed over to a mental institution . Without reading the fine print it basically meant the state was taking full responsibility while treatment was given and the parents lost all there rights.
When the patient was allowed out sometimes the patient said to the parents I am going to kill myself if you send me back. The parents said ok you can stay at home.
Next day there was an ambulance and 6 squad cars with garda in riot gear waiting to enter the house to get the patient.
The patient was only 14 and never hurt anyone. This is typical of our fuc**** up system.
Exactly. Parents and family can go looking for help from Psychiatry without realising the dangers and the POWER and CONTROL that Psychiatry have to drug people into oblivion without addressing the underlying cause of the problem.
“Teen girl in care of HSE to continue anti-psychotic medication despite her mother’s objection” ~ http://www.irishtimes.com/news/crime-and-law/teen-girl-in-care-of-hse-to-continue-anti-psychotic-medication-despite-her-mother-s-objection-1.1370237 These drugs can cause damage, especially to a young brain. As highlighted by Dr Bob Johnson (from Isle of Wight) in this article. But mainstream Psychiatrists don’t care.
If they could be sued for the potential damage they could cause would they be half as quick to chronically expose a person to such mind altering drugs? It is when you sit in a room full of people who are Psychiatric survivors that you can sometimes visibly see the damage that has been done. And also akathisia is a major possible side effect. A person can be left restless and unable to sit still after long term exposure to a drug. I just have to look across the road at my neighbour and can see someone who is on these drugs long term up early and pacing. One of many possble side effects. Also tardive dyskinesia.
Robert Whitaker – Global Psychiatric Epidemic – October 23, 2012 (speaking in Denmark). You can see some people who have been damaged by the drugs from 1 hr 10 mins in you can hear a woman speak who has been chronically exposed to the drugs: https://www.youtube.com/watch?v=VgS79hz1saI
“For so long the voice of those who have been treated have been ignored” ~ Robert Whitaker. In a lot of cases it goes back to basic listening skills and asking the right questions!
@itiswhatitis315 ~ Exactly. Parents and family can go looking for help from Psychiatry without realising the dangers and the POWER and CONTROL that Psychiatry have to drug people into oblivion without addressing the underlying cause of the problem.
“Teen girl in care of HSE to continue anti-psychotic medication despite her mother’s objection” ~ http://www.irishtimes.com/news/crime-and-law/teen-girl-in-care-of-hse-to-continue-anti-psychotic-medication-despite-her-mother-s-objection-1.1370237 These drugs can cause damage, especially to a young brain. As highlighted by Dr Bob Johnson (from Isle of Wight) in this article. But mainstream Psychiatrists don’t care.
If they could be sued for the potential damage they could cause would they be half as quick to chronically expose a person to such mind altering drugs? It is when you sit in a room full of people who are Psychiatric survivors that you can sometimes visibly see the damage that has been done. And also akathisia is a major possible side effect. A person can be left restless and unable to sit still after long term exposure to a drug. I just have to look across the road at my neighbour and can see someone who is on these drugs long term up early and pacing. One of many possble side effects. Also tardive dyskinesia.
Robert Whitaker – Global Psychiatric Epidemic – October 23, 2012 (speaking in Denmark). You can see some people who have been damaged by the drugs from 1 hr 10 mins in you can hear a woman speak who has been chronically exposed to the drugs: https://www.youtube.com/watch?v=VgS79hz1saI
“For so long the voice of those who have been treated have been ignored” ~ Robert Whitaker. In a lot of cases it goes back to basic listening skills and asking the right questions!
Can you remove this double post. Thanks. It did not stick the first time and then I reposted it.
another member of the antipsychiatry movement Aine? the problem lies in expecting your doctor to fix all the “underlying issues”, which only the patient can do, and part of the problem stems from the way the system is set up to make the patient feel powerless. In reality, the patient is the one who heals themselves and if they can’t/won’t do that, the underlying issues remain, and the patient ends up blaming their doctors. This happens a lot …
The patients I know that are most critical are those who have recovered fully. These are not people that sit around feeling sorry for themselves and looking to blame someone. Theses are people who have been able to put enough distance between them and their experience to judge it in a calm and reasoned manner. I find your comment patronising.
that would be the opposite of my experience, which is what it is whether you find it patronising or not.
Here say all round then.
If you like. So, you’re saying that people you know who have been helped through their illnesses are now highly critical of how they were treated, even though their treatment was entirely successful? Forgive my scepticism but are they critical of certain parts of their treatment, or the whole process?
If treatment fails you blame the patient but when a patient recovers you want the doctors to take the credit. Many people here have described how they recovered despite their ‘treatment’ but you have your mind made up. People have left hospitals, changed treatment and ignored appointments and got on with their lives. They will never engage with the services again because they have found a better way. That is clearly not the doctors success but they’ll try and take it anyway. Be as skeptical as you want.
Well I am asking you – are you saying that that’s the norm, or are you acknowledging that the vast majority of people get well with medication and then move on? In other words, you say most people who you know who are critical of their care, are fully healthy, but are you also suggesting that that is the majority experience?
There are terrible doctors, and patients often have no improvement with one while the next can help them immensely.
If this was written in the 60 ies I would understand ,but what a load of nonsense .People are not detained unless it’s absolutely necessary,and ,their are multi deciplinary team meetings every week re.patients ,and their families ,nurses ,social workers ,psychiatrists ,and anyone else with an interest can attend ,so everything is agreed as a group ,in a group meeting .Its all documented ,every detail is followed up on and ,nobody is kept longer than necessary .In fact due to the closure of units ,it is very difficult to get a bed in an acute unit these days .Amnesty Ireland are obviously looking to keep themselves busy and just need to look through the notes of any patient to see the detail that’s being noted everyday .Maybe if they concentrated more on the pressure staff are under due to cut backs in staff and cuts to mental health service,they would b using their time more productively
“Amnesty Ireland are obviously looking to keep themselves busy” ~ I wish that was the case. Unfortunately at the last conference it was announced that Amnesty may be pulling back on their work in mental health. That may be music to your ears but as a Psychiatric survivor I would rather see them continue their good work and their excellent conferences. Well done Colm O’Gorman et al for speaking up for the vulnerable in society.
EIlish, your attitude is typical of the problem in mental health. Your experience is not important, I know best, I don’t want to engage with the person, I have a pill for that. If everything was wonderful and people where happy to be held against their will and forcibly ‘treated’ this would not be news. Listen with an open mind.
There is a travesty regarding children and teenagers who need inpatient psychiatric treatment who are in fostercare or residential care on foot of a care order. Psychiatric services do not accept the court-granted status of parental authority (to consent to treatment) accorded to HSE social workers. MH services Go to the High Court to request that the child be admitted as an involuntary admission, EVEN when there is NO objection by anyone to the child being voluntarily admitted. However, if the child were physically sick or injured, social work consent would be acceptable in other medical domains.
Not only is this policy/practice (in respect of children on a care order) a contempt of court, it further stigmatises (a) children in care on foot of a care order, and (b) the 20% of people who have MH issues.
Involuntary MH patient status will be on those children’s medical records for life, even though they never objected to being admitted in the first place.
Ironically, a person can stand In Loco Parentis for the child’s treatment, this is acceptable to MH services, even though MH services won’t recognise the validity of consent accorded to the child’s social work team.
Furthermore, foster parents who have been granted increased autonomy by a judge in the District Court for signing for their foster-child’s medical and passport may face the same outcome of their foster-child being admitted only on an involuntary basis.
A case for Amnesty, surely?
Another article distorting reality, with a. slew of comments from people who have an agenda to push and nothing but ignorance to support it.
It is remarkably difficult to get yourself admitted to a psychiatric ward – as doctors we have a very high threshold for admitting people, certainly relative to the medical or surgical patients we see.
If you are given a bed in an acute unit, it is because several professionals are convinced there’s no other option, that you are not well, and that you aren’t safe anywhere else.
When we discharge someone from hospital, we are taking responsibility for their health – whether they came in with a sore belly or acute psychosis. Signing a piece of paper to say the person is well enough to leave the ward is a big deal, and puts our careers on the line every day.
If you have been admitted with a condition that distorts your ability to make decisions, it is especially important that we be sure you are well before allowing you to leave – whatever the condition is.
Imagine the headlines if we started discharging all the manic patients, or all the little old ladies with delirium after a UTI, or all the drunk trauma patients who insist they’re well enough to leave. Disaster guaranteed.
What agenda do you think people have? You clearly have your own bias being part of the system and worrying about your career. Why do you think its OK to skew statistics by presenting people as voluntary when in fact they are far from voluntary. Do you not think that voluntary patients should be free to leave and seek alternate treatment if they see fit? Only psychiatrists are allowed to treat people without consent which means we must have some accountability for their actions.
@significantrisk Ahh! The arrogance of doctors who do not listen to the patient. It was that arrogance that helped me come off drugs nearly 2 years ago. The prescribed variety. When I was told “These drugs are not made for a’la carte people like you”. After been called “non-compliant” (at a time when I was taking the potions and poisons).
“People who have an agenda to push and nothing but ignorance to support it”. Below the belt but obviously you feel the need to stoop so low.
I suppose you would believe that people who have been sexually abused who speak out about the abuse have an agenda to push too? Not forgetting that some people who experience mental distress and go on to become victims of Psychiatry may have initially been victims of child sexual abuse. You seem to have the empathy of an amoeba. Possibly something to work at if you want to be a good doctor. Or do doctors learn where to find the off switch in medical school?
Thank God for good doctors who understand mental health issues. http://www.truthtrustconsent.com/ Otherwise I would have given up all faith in ye long ago when it comes to trauma and distress. I can never see myself discussing mental health issues with a mainstream doctor again. Now that I can truly see what ye are like.
In the words of a great actor Jack Nicholson, if you have been indoctrinated in medical school in a certain way that revolves around the biomedical model, then realising that this is a flawed model that does not work for a lot of people may be a lot to take on board ~ https://www.youtube.com/watch?v=MMzd40i8TfA
@significantrisk And the mind boggles at the name (will refrain from speculating on what you actually could be!) if you are a doctor as you claim, hoping that our paths never cross in the real world as you seem to get a kick out of emotionally abusing people and putting them down.
My faith in the medical profession when it comes to mental health was at a low ebb, due to emotional abuse in the past. It has now reached rock bottom. I would actually classify your approach to people who have been victims of Psychiatric abuse as cyber bulling. And would like for the journalists on TheJournal.ie to take note of that.
PS I would also question the amount of training you received in mental health as it is obvious that you do not specialize in the area? Assuming again that you are a doctor. And thinking that you probably are.
And finally, I have a strong inkling of who it was that came in under the name WanderArch! If it is two separate doctors then that is even more concerning!
I do feel that I am dealing with a doctor there too, based on past experience. But possibly the same person.
Aine, I’m not a doctor of any kind, nor have I claimed to be, but your comments concern me.
You tar every doctor with one brush, I’m presuming you’ve been to every doctor in the country? All 10,000 of them? Yes?
The OH is in the area, I can assure you that what you outline here is either what “used” to happen, or is fictitious. Doctors cannot admit under this act unless there is a real and substantive risk to the patient, and even then, the most an NCHD can do is hold you for 12hrs, until a psychiatric consultant can assess you for admission. After that, you have to be either admitted or discharged. Doctors don’t go around picking random people off the street and admitting them forever, they’re not allowed.
When a patient is admitted involuntarily, it takes an exceptional amount of work, between obtaining medical clearances, ensuring the patient is not under the influence of alcohol or other substances when being admitted, ensuring that you have constant supervision from admission to discharge.
I’ve read your comments, and yes, maybe once upon a time they might have been real, now – not so much. Your generalisation that doctors think they’re gods – inaccurate. They’re legally responsible for their actions – that means they have to cover themselves by ensuring patients are safe. If you feel you’ve been hard done by – clearly you do – contact the IMC.
” I am still more frightened by the fearless power in the eyes of my fellow psychiatrists than by the powerless fear in the eyes of their patients.” R.D.Laing
” Many people continue to think of the psychiatrist as the wise, warm and caring person who will help them tackle their problems. But the modern psychiatrist may have no interest in ‘talking therapy’. His or her entire training is more likely devoted to ‘medical diagnoses’ and ‘physical treatment’. He or she may look at you with all the empathy and understanding of a pathologist staring through a microscope at germs and then offer you a drug.” Dr Peter Breggin
” We are still mad about the mad. We still don’t understand them and that lack of understanding makes us mean and arrogant, and makes us mislead ourselves and so we hurt them” David Cohen
“One patient who was so treated was David Oaks, who today is editor of Mind Freedom, an activist news letter for ex-patients. In 1975 he suffered a psychotic break while an undergraduate at Harvard University.” I was told I would have to be on drugs for the rest of my life, that it was like insulin for diabetes. I was held down and I tried to reject the drugging, put in solitary confinement and forcefully injected. It galvanized me to fight back against this oppression. This forced drugging is a horrible violation of the core American values of freedom.” Robert Whitaker
Truer measures of the human being are those in the eyes of another who is kind who sees him an loves him; and those of his own hopes an dreams. Psychiatry has not understood this moral imperative. It has become a tragic and cruel mismeasure of man.” Dr Lars Martensson
” If the misery of the poor be caused not by the laws of nature, but by our institutions great is our sin.” Charles Darwin
” Clear away the debris, take a closer look- and psychiatry today is built on sand. Pity really – the most intriguing, glorious, delightful entity in the entire cosmos – reduced by doctors to a poor imitation of a pocket calculator, which they then gum up with drugs.” Dr Bob Johnson
” We are also survivors of one of the meanest systems of oppression ever developed and its victims and its critics. We are the ones to tell the truth that mental illness is an illusion, intellectually and scientifically, but also a system of social control of unprecedented thoroughness and persuasiveness. It is our role to expose this illusion and to free us all – for we are the constrained, oppressed. limited by this phantom of mental illness. We stand with reason against error and superstition, with imagination against conformity and oppression. What good luck to be part of such a good struggle for freedom and human rights.” Kate Millet
An interesting article, however, the content seems to gloss over the fundamental perspective that someone is seriously mentally ill and can be a danger to themselves and others needing to be in hospital to undertake proper treatment. Having seen this first hand I notice that authorities take such measures extremely seriously and those in such institutions are seriously ill. There are similar precedents in other disease area eg infectious diseases such as TB where a person must be institutionalised on occasion either voluntary or involuntarily to protect themselves and our community. These situations represent a conflict of liberty versus disease where often the patient does not recognise their poor health as part of that illness. Simply put sometimes being institutionalised may be the best option for a safe and effective treatment and this does not seem to be part of the context of this discussion.
If a person is to be held against their will without redress surely we should be honest about it. If a patient is voluntary they should be able to leave when they wish otherwise they are involuntary and society should be able to see how wide spread the practice of incarceration is. Honest and openess what exactly is your problem with that?
You might like to have a look at this video to understand that when TB is described as a contagious illness it is very different to psuedo diseases which are wrongfully diagnosed as so called’ mental illnesses’.
http://www.youtube.com/watch?v=Qj7GmeSAxXo
So should a patient be allowed leave if the doctor feels that they are at risk of committing suicide or that they pose a risk to the lives of others, even if they are voluntary?
@Nigel If you were a true risk to the lives of others would you be classified as “voluntary”? I don’t think so!
People who are in mental distress are usually no more violent than the rest of the population, unless alcohol or drugs are involved. The one time I saw a person with mental health difficulties been a threat to someone else was when he was in withdrawal from a drug called Largactil. He had been admitted to a general hospital after collapsing and they had taken him off the drug cold turkey. People who are in withdrawal from drugs can be volatile. But doctors/hospitals seem oblivious to the risk. Luckily I saw what was happening and was able to go rescue the victim and kept him for 5 nights. The person who became violent has all the hallmarks of akathisia (restlessness and pacing/cannot sit still ~ damage caused by long term exposure to drugs). Alcohol would also be a factor.
Prescribed psychoactive drugs can increase the risk of suicide, violence and even homicide in some people. I know this from studying the work of Prof David Healy (Wales) and Dr Peter Breggin (New York).
Adverse Reactions to Psychiatric Drugs: Yolande Lucire (forensic Psychiatrist) ~ See 10 mins in ~ https://www.youtube.com/watch?v=IEoSs6Yo0DA
According to Dr Lucire, Psychiatric patients are no more violent that the general population.
What can make people violent is the psychoactive drugs that they are on. I had previously heard this comment about violence from Dr George Szmuckler at an Amnesty conference in Dublin.
This also applies in the prison service ~ I have started to study and look into the work of Dr Bob Johnson who worked in Parkhurst prison (Isle of Wight).
Cutting jail benzo use reduces violence ~ http://www.irishexaminer.com/ireland/cutting-jail-benzo-use-reduces-violence-215716.html
Extract ~ Harry Kennedy, head of the Central Mental Hospital, said that since they stopped prescribing the medication in their prison clinics, the suicide rates there had fallen.
He said in the CMH, the most violent patients in the State are now managed without BZDs, a group name for tranquilizers commonly known as benzos.
Prof Kennedy’s statement comes as the Department of Health continues to draft laws to impose additional controls on BZDs and hypnotics known as Z-drugs.
The measures are being brought in to deal with both legal over-prescribing of the drugs by GPs and psychiatrists, and the massive illicit sale of the drugs, fuelled by a booming online trade.
That’s not true. Even people who are a danger to themselves or others are entitled to be voluntary patients in hospital the problem arises when they want to leave and the professionals feel that they are still a risk to themselves or others. So I ask again should these people be entitled to leave hospital?
Considering the concept “voluntary” does not actually exist in the current system, based on the true meaning of the word and due to the way the system is set up, I assume everything is assessed on a case by case basis.
Only if you have found yourself locked away in such a facility, even if you have not endangered your own life or others or pose no threat to others, can you truly comprehend what Psychiatry is about and the POWER and CONTROL they have. As someone put it recently, they even have more power than High Court judges in some cases, due to the weight that society puts on the knowledge of doctors. Granted for all I know you may actually work in the industry.
I watched as my basic human rights got stripped away, as my career slipped away from me (despite all my hard work and the fact that I had gone back to college and graduated 3 years earlier with all the time, hard work and expense that that entailed). I got turned into a prescription drug addict as basic information was held back from me eg a) SSRIs can cause “mania” b) stopping drugs cold turkey would have resulted in my 2nd admission, shortly after the first (the dangers of that were not properly explained to me and on my readmission the word WITHDRAWAL was never mentioned. 3.5 years later when I told Prof Ivor Browne about what I thought was a “breakdown” the pieces started to fit into place. He said “Sur you were probably in withdrawal”. And suddenly things started to make sense. Withholding basic information like that, when a person is in distress, makes the situation a whole lot worse!
“The Act: The Mental Health Act 2001, setting out the circumstances in which a person may be admitted to, detained and treated in a hospital against their will, is not human rights compliant and must be urgently updated and amended” ~
http://www.amnesty.ie/our-work/review-mental-health-act-2001-against-human-rights-standards
Considering the concept “voluntary” does not actually exist in the current system, based on the true meaning of the word and due to the way the system is set up, I assume everything is assessed on a case by case basis.
Only if you have found yourself locked away in such a facility, even if you have not endangered your own life or others or pose no threat to others, can you truly comprehend what Psychiatry is about and the POWER and CONTROL they have. As someone put it recently, they even have more power than High Court judges in some cases, due to the weight that society puts on the knowledge of doctors.
I watched as my basic human rights got stripped away, as my career slipped away from me (despite all my hard work and the fact that I had gone back to college and graduated 3 years earlier with all the time, hard work and expense that that entailed). I got turned into a prescription drug addict as basic information was held back from me eg a) SSRIs can cause “mania” b) stopping drugs cold turkey would have resulted in my 2nd admission, shortly after the first (the dangers of that were not properly explained to me and on my readmission the word WITHDRAWAL was never mentioned. 3.5 years later when I told Prof Ivor Browne about what I thought was a “breakdown” the pieces started to fit into place. He said “Sur you were probably in withdrawal”. And suddenly things started to make sense. Withholding basic information like that, when a person is in distress, makes the situation a whole lot worse!
“The Act: The Mental Health Act 2001, setting out the circumstances in which a person may be admitted to, detained and treated in a hospital against their will, is not human rights compliant and must be urgently updated and amended” ~
http://www.amnesty.ie/our-work/review-mental-health-act-2001-against-human-rights-standards
Thank you for all your open and honest posts Aine – the situation you experienced must have been horrific for you and you have described it with great clarity.
This is an incredibly complex issue and society needs to take note of the personal experiences of people on all sides of the debate.
The counter-argument may also be valid in many cases however, that if a mental health specialist genuinely feels that the patient is not thinking coherently at the time and presents as a serious risk of suicide (or potential harm to others) if they are released, then there is a strong argument for detaining them until this period has passed, even if against their will.
Its a bit of a cliche, but suicidal thoughts may be temporary whereas suicide itself is permanent.
Families generally know when a family member is ‘not him/herself’ and needs help, and they usually act in the individual’s best interests in seeking that help (however I wouldn’t doubt that occasionally families have their own hidden motives for getting people admitted against their will).
A full and open debate about the current state of mental health services in Ireland is needed, in which all parties with an interest can discuss treatments and experiences in the system, with an acceptance and respect for the genuinely held views from all perspectives.
Thanks Noel! We all know the old saying ‘ you can bring a horse to the water but you can’t make him drink’. People in distress need support and encouragement. We all can get lost from time to time. We are all capable of acting in good and bad ways for ourselves and others. We need to be allowed to be free to make mistakes and hopefully learn from them. We will never have perfect people and a perfect society. Maybe we are the most oppressive when we try to make others do things we think are good. Maybe the conspiracy of goodwill is the most oppressive. Maybe this is why mental health acts and coercive psychiatry fail so miserably. They add more suffering and anguish to already struggling people.
“Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive.” C.S. Lewis
“The salvation of the world lies in the hands of the creatively maladjusted.” M.L.King
http://www.mindfreedom.org
http://www.mindfreedomireland.com
Empathy and compassion instead of force and oppression! Which would you like better?
https://www.facebook.com/photo.php?fbid=10151389215197060&set=pb.571852059.-2207520000.1374573969.&type=3&theater
Great article. Nice to see the psychiatric cartel challenged and questioned. They and big money making pharma have destroyed many lives including friends of mine. Seriously how can time locked up in a room with people with much bigger issues than yours and administered pills cure sadness at the death of a family member or partner??
So, I’m not seeing what the motivation might be for a doctor or hospital to ‘detain’ someone against their will unless there was some concern about how they might behave outside their care?
Maybe if a doctor could legally relinquish care of a person and send them on their way with no responsibility for that person, it would be less of a minefield, but there would be uproar if someone were released and then harmed themselves or others.
Tim – there is never a convincing argument put forward by the people pushing an anti-medicine agenda as to WHY we would go around doing nasty mean things to people.
They merely sit there ranting that we are part of some evil conspiracy, or other such gibberish.
I’ve been told (seriously) that doctors like to keep people sick so they can make money out of them. Since I don’t know a single doctor who has to drum up business to stay afloat (and I know lots) I am highly sceptical of this explanation.
@significantrisk did it ever occur to you that people who you claim are on an “anti-medicine agenda” may have tried the “mediicine agenda” for some time. In my own case 6 years. And finally realised it was getting them no where fast. Only if you have experienced been turned into a prescription drug addict can you truly understand.
Remembering the day that I went to the pharmacist and asked for one of 2 items on my prescription. The woman working there said she was going to call my doctor to tell him and basically report me. I was the one that had gone to the doctor asking for the prescription. Legalised drug pushers or what? I used to be a bit green on the subject but no more!
Tim – indeed, if any sort of drumming could change the workload we have, doctors would be aiming for fewer patients.
Aine, I’ve read your comments today and yesterday, and quite frankly, they worry me and do so greatly. But that is not my problem, although I did have to read your drivel, and that was tormenting.
As for your anti-medicine agenda (which you do, quite clearly have, as is evidenced by your various rantings on anything to do with mental health here), I do wish you’d post something short, crisp and sweet, with referenced papers (no personal websites or YouTube videos, actual PubMed or BMJ papers). I’m guessing though you can’t.
You know what they call alternative medicine that works? Medicine. With good reason.
@WanderArch. No one held a gun to your head and asked you to read my comments. So I can’t reference properly or so you claim? At least one of my referenced article is a Yale study and “PubMed” ~ http://www.ncbi.nlm.nih.gov/pubmed/11235925
Who decided that youtube is banned on here? I am not in the middle of a PhD thesis or a Masters for that matter. If I do use a youtube video you can be fairly sure it links in to a reputable person eg Prof David Healy in Wales who is a reputable Psychiatrist and not afraid to speak the truth. Or Irving Kirsch who is a Harvard professor.
“I’m guessing though you can’t”. Thanks for the put down. Hardly rocket Science to go off and find stuff from the BMJ. But the question is who could be funding such research or have ghost written an article eg the gibberish that people like Prof Charles Nemeroff comes out with who is on millions from Big Pharma. I once heard him say in video footage that God invented a certain part of the brain specifically for SSRIs. I for one, as someone who has been damaged by an SSRI, do not believe that!
Come back to me when you have been put on drugs long term that are known to be damaging eg the drug Olanzapine/Zyprexa. Drugs that cause significant weight gain and can cause diabetes. A drug that can cause “significant reduction in brain volume that affects both gray and white matter” if chronically exposed to it: Studies funded by the maker themselves! And something that I became aware of via reputable doctors (Joanna Moncrieff and Peter Breggin). http://www.nature.com/npp/journal/v30/n9/full/1300710a.html
Only when you have been lying around sedated and confused for nearly 3 years can you truly understand the damage that doctors/Psychiatrists can inflict in the name of “medicine”. What happened to “first do no harm”?
oddly, I’ve also been to the pharmacist to pick up some heavy painkillers and had the pharmacist call the prescribing doctor to check – it’s common where narcotics are concerned, particularly ones with street value like mine. I don’t think there is sinister intent there. Since they’re not on any kind of commission, it’s hard to see why they’d want to push drugs on you if you didn’t need them.
Like the drugs “that are known to be damaging eg the drug Olanzapine/Zyprexa. Drugs that cause significant weight gain and can cause diabetes” as you mentioned. Are you saying those drugs are meant to cause diabetes, or that they are side effects? Because, yes, drugs have side effects that the doctor is supposed to tell you about, but even if they don’t you can look up the internet yourself and find out.
Needless to say I moved pharmacist!
As for my lack of knowledge about Zyprexa at the time I was put on it, hindsight is a great thing. When you are drugged up with these powerful tranquilizing psychotropic drugs, getting out of bed can be an effort! Never mind doing research on the drug about lawsuits etc I trusted that doctors/Psychiatrists would not put me on a drug that can be so damaging if used long term! I have learned my lesson the hard way. While these drugs can offer short term relief in times of crisis, I never needed them 24/7/365.
I’d honestly day that if I struggled to fit through the door, due to the weight gain that drugs like Zyprexa can cause, that the “doctors” would be more concerned that I was being “compliant” that any possible serious side effect that can affect Quality of Life and general self-esteem! I was once even told not to read the literature that comes with the drug.
@WanderArch Are you from the medical profession? You asked for material from the British Medical Journal. Then that is what I will give you! http://www.bmj.com/content/346/bmj.f3256/rr/648024
DSM-5: a fatal diagnosis?
academic psychiatry, research ethics and the pharmaceutical industry.
In his article on DSM-5, discussing conflicts of interest, Jonathan Gornall refers to the case of Emory University Professor Charles Nemeroff, who concealed huge payments made covertly to him by GlaxoSmith Kline, makers of the anti-depressant paroxetine, whilst lead investigator on a National Institutes of Health study of that very drug. Nemeroff was obliged to resign from Emory but was then appointed chair of psychiatry at the University of Miami. The Miami Herald reported this week (30 May) that Senator Charles Grassley, chair of US Senate Committee on Finance, had written to the National Institutes of Health to ask why they had recently granted Nemeroff $400,000 per year for 5 years when he remains under federal investigation.
None of this appears to concern the Institute of Psychiatry, King’s College London, a research establishment with an international profile. The Institute has invited Professor Nemeroff to give the inaugural Annual Lecture of its new Centre for Affective Disorders on 17 June, describing him as “one of the world’s leading experts in the neurobiology of depression”.
The Nemeroff case tells us something about how the psychiatric establishment and the biomedicine-driven research world work, and about their relationship with the pharmaceutical industry that has a vested interest in the biologisation of human experience- indeed in the disease- mongering Jonathan Gornall reprises. Nemeroff’s appointment to another chair of psychiatry as if nothing had happened and when the case against him was not closed, his receipt of substantial new grants, and the Institute of Psychiatry in London continuing to laud him as “one of the world’s leading experts”, all show how psychiatric academe sails blithely on as if such revelations beg no broader questions about its associations and supposed scientific independence, about research ethics, and specifically how conflicts of interest must inevitably contaminate the integrity of the research data informing publications in the scientific literature.
It is worth adding that in fact no clinically meaningful “neurobiology of depression” has been discovered- and perhaps never will be, given that “depression” is merely a syndromal category, subsuming a very heterogeneous range of patients and circumstances,and whose widely differing understandings of their distress point rather more often to social space than to the space between their ears.
Competing interests: None declared
I would also classify this comment as a form of cyber bullying.
To which comment are you referring to? If its mine, well it is not cyber bullying. It’s stating a fact – your comments are tormenting to read – they are incredibly long, with much of the information repeated, even duplicated comments. I’m sorry if that offends you, but I just find your comments completely overwhelming and incredibly difficult to keep up with.
So what do u recommend Aubrey that people are let out to harm themselves or others. People sometimes do know they need help then resist or resent getting it .it such a grey area ,and they are only advised to stay if likely (decided by a consultant ) that they are a danger to b out .the first person to b attacked if they do go out and kill themselves is the consultant .would u take a chance?
I suggest you listen to people and treat them with respect. That you understand your limitations. One of the biggest problem for patients is they have little control of their own care. I’m sure you’re aware that one reason to keep a patient against their wishes is simply to be unhappy with your treatment. Can you not see that as a catch twenty two situation. Also the same hospital which holds you will throw you out when your health insurance finishes covering you. This is about power not risk management and your comments are alarmist and create further sigma. How many of the thousands of inpatient mental health patients are truly a risk to themselves and others, very few.
You lost me when you said ” the same hospital will throw you out when your health insurance runs out”
If the public knew the truth maybe then people would receive the help they needed. We deserve to know the truth so we can have peace of mind, body and spirit.
“The public is often surprised to hear of research that tells of people diagnosed with a psychotic disorder who are doing well without medication, and there is a reason for that. Such information has been kept from the public (and to a large degree, out of psychiatric textbooks.) When Martin Harrow published his findings that schizophrenia patients who had stopped taking antipsychotic medication had much higher recovery rates over the long term than those who stayed on antipsychotics, the American Psychiatric Association didn’t publicize his results and neither did the NIMH. As a result, no newspaper reported on this startling outcome, even though we can be sure that if the results had been the reverse, the APA, the NIMH, and the manufacturers of antipsychotics would have trumpeted this finding to the media.”
http://www.madinamerica.com/2013/07/my-reply-to-pete-earley-do-i-have-blood-on-my-hands/
“The definition of a voluntary patient under the act means “a person receiving care and treatment in an approved centre who is not the subject of an admission order or a renewal order
This means that anyone who does not feel they are not in loving, understanding hands( CARE) is not a voluntary patient. Anyone who is forced to receive a drug they find will harm them.
Hi all, just a quick comment from Mental Health Reform.
We are quoted in the above article, having spoken to the writer of the article, Christina Finn. We welcome the chance to add to the discussion about the rights of voluntary and involuntary patients, but I wanted to clarify one point in relation to the quote from Dr. Shari McDaid of Mental Health Reform:
The point we wished to make was not that a quarter of voluntary patients are regraded to involuntary – rather it was that about a quarter of involuntary admissions are actually voluntary patients who have been regraded.
I hope that clarifies the confusion in terms of the statistics given. Lara Kelly, Communications Officer, Mental Health Reform.
High Court orders suspension of psychiatrist over sex-with-patients allegations
A major error I have noticed in this article is in relations to the stats they use. They state that last year 567 patients were changed from voluntary to involuntary. In the next sentence they state that out of 15000 admissions last year 2000 of these were involuntary admissions. They then say that 20% of the rest have had their status changed from voluntary to involuntary. 15000 minus 2000 is 13000. 20% of 13000 is about 2600. So is 2600 or 567 patients that had their status changed?
567 according to MHC ~ “Detention of a Voluntary Patient (2012) Section 24 of the Mental Health Act 2001 outlines the procedures relating to a decision to re-grade a voluntary patient to involuntary status. In such admissions the admission order is made on a statutory form, Form 13 Certificate & Admission Order to Detain a Voluntary Patient (Adult), signed by two consultant psychiatrists. There were 567 such admissions notified to the Commission in 2012″ ~
You can see the annual report for 2012 from the MHC on this page and download it. http://www.mhcirl.ie/ (top of page)
When I asked the MHC for information on my case under FoI they had no record of me as a “voluntary” patient. I have a vague memory of being in contact with them while detained and I do believe someone from the MHC came to the hospital when I was there. But no one asked to see me. I may have been sleeping. But I do feel a nurse emphasized that the MHC had been around after they had left! A) It was 5 years ago B) They had me drugged up.
I can see another statistic in here. 174 deaths in 2012. And it is called an “asylum” or at least in the old days it was. With those type of statistics is it really a place offering protection and safety? ~
Deaths in Approved Centres
Approved Centres are required to notify the Commission of the death of any resident of an approved centre in accordance with Article 14(4) of the Mental Health Act 2001 (Approved Centres) Regulations 2006 and Section 2.2 of the Code of Practice. In 2012, 45 approved centres notified the Commission of 174 deaths. Based on the information reported to us, 10.9% of notifications (19) related to sudden, unexplained deaths.
A death is categorised as a ‘sudden, unexplained death’ by the Mental Health Commission on review of the circumstances surrounding the death, indicated by the service, on the death notification form. Where the circumstances suggest a likely suicide, missing patients, violence or any circumstance where negligence or malpractice may have been a factor the death is categorised as a sudden, unexplained death.
Hi all, just a quick comment from Mental Health Reform.
We are quoted in the above article, having spoken to the writer of the article, Christina Finn. We welcome the chance to add to the discussion about the rights of voluntary and involuntary patients, but I wanted to clarify one point in relation to the quote from Dr. Shari McDaid of Mental Health Reform:
The point we wished to make was not that a quarter of voluntary patients are regraded to involuntary – rather it was that about a quarter of involuntary admissions are actually voluntary patients who have been regraded.
I hope that clarifies the confusion in terms of the statistics given. Lara Kelly, Communications Officer, Mental Health Reform.
@Nigel ~ I did contact Mental Health Reform yesterday so that they could clarify this anomaly that you pointed out. As well as going on the page of the Mental Health Commission. This is their post below which I have reposted up here ~
“Hi all, just a quick comment from Mental Health Reform.
We are quoted in the above article, having spoken to the writer of the article, Christina Finn. We welcome the chance to add to the discussion about the rights of voluntary and involuntary patients, but I wanted to clarify one point in relation to the quote from Dr. Shari McDaid of Mental Health Reform:
The point we wished to make was not that a quarter of voluntary patients are regraded to involuntary – rather it was that about a quarter of involuntary admissions are actually voluntary patients who have been regraded.
I hope that clarifies the confusion in terms of the statistics given. Lara Kelly, Communications Officer, Mental Health Reform”
Oops! Repost. Apologies. I saw the comment in another place in the comments section and didn’t realise it was here too.
My fault for posting it twice, apologies for the confusion! Lara, Mental Health Reform.
Hi robin, thanks for clarifying that issue for me.
Dear Christina I have attempted to summarize the main thrust of this research for a mental heajth newsletter in order to make it more accessible to service users, I hope you find this 550 word account accurate to your findings.
Grey areas become black holes at the Hotel California
Investigative journalist Christina Finn was awarded the funding from the Mary Rafery trust last year which produced three articles on in-patient psychiatric care. Her findings are worthy of attention as they point to loop holes of potential abuse by authorities in our hospital system.
Based on this research, I attempt to summarize her main contentions, not including issues surrounding consent in patients receiving ECT. Hospital admissions procedure cannot be dealt with here either. Therefore, I will be looking at inpatient status – article `Defacto Detained : How Voluntary Patients Can`t Leave.
All of the following statements have been derived from the Irish news website thejournal.ie where the full findings can be found, including a forum which allows readers to respond and give their opinion.
Since around 8 years ago, I understand that involuntary psychiatric inpatients or those bearing a temporary certified label after their name on the books, should be entitled, according to a relatively new Mental Health Act, to a review board or tribunal that could allow for their earlier release from the hospital setting.
So-called `voluntary`patients are not accorded the same right.
She observes that in this way, a patient might easily get stuck inside, subject to the whims of their psychiatrist, as to when they will be deemed `ready`to be let go, according to what many patients have described as very arbitrary yardsticks of wellness, Or just plain nonsense `measures`presented to patients as a ladder towards a discharge date.
This patient can often find themselves in the dark for many lost weeks and weekends without any meaningful contact with their consultant and most importantly, no recourse to action. In other words, they have no access to any kind of review.
One respondant who voluntarily admitted himself to hospital having the presence of mind to admit that there was something just not right with him which was enduring. Entering this setting of his own free will, he was confident of finding some help that he clearly needed.
Patients on the ward immediately began to tip him off how it was going to be, warning him how he was now interned and no possibility of getting out. He found himself in a black hole losing months of lifetime,
He reports a very disturbing experience of no treatment to speak of and says he truly believed he was voluntary when he signed himself in and would most certainly not have done so had he known the true situation.
Christina has also uncovered an insidious practice common enough in the hospital setting. That is, patients who have their status changed while inside the hospital from voluntary to involuntary and back.
One patient reports being menaced by their doctor that they will have to submit to temporary certified status , but that the patient shouldn`t want this as it would look bad, representing a grave mark against them . An embarrassment to their families and could potentially devastate their careers.
If you examine this, it means that the psychiatrist is stigmatising the patient and using it as a weapon to keep them hanging on and hanging around. These, (most patients), the journalist has called the Defacto Detained.
But legally, wouldn`t they be better off if they had been sectioned ?
At least then, they could plead their case.
have your say