We have only to look to history to find common ground (Common Ground, hey!) in the struggle to insist on informed consent, informed shared decision making, and an end to coercive and forced mediacal and psychiatric "treatment". The current struggle to perserve or, sadlyyes, even reinvent, civil and human rights IS the civil rights struggle of our times. Some think that rights for GLBTQqIi folks is where this struggle lies, but it goes much deeper than even this. In fact historically the two are tied together, if not joined at the hip.

In my 16th year, that would have been 1965, I was incarcarated for several months in "seclusion" in a Boston area "shock joint". This was so that MH professionals could convince my mother that I 'needed' electroconvulsive 'therapy' (or shock treatments) in order to 'cure' my purported 'illness' of homosexuality. My point is that trends in diagnosing what constitutes 'mental illness' are often politically motivated, as Dr. Deegan has so cogently pointed out to us previously.

After 1972 the law of the land changed to mandate informed consent when Jean Heller, an American Press reporter, broke the story of the so-called Tuskeegee Syphillis Study, in the Washington Post. The United States Health Service Sponsored 'experiment' took 616 poor rural men who were seeking treatment, and lied to them from 1932 to 1972, apparently believing that their 'right' to know superceded any right the men might have made claim to. This was far from being kept a 'secret', but Ms. Heller's article raised the ethical questions which needed to be asked and then turned the country around.

'Medicalized' encrochment on our freedoms is nothing new. Even today court ordered, and/or psychiatrically and guardianship coerced abortion and "sterilizations" are ordered for those of us with MH diagnoses, as in the 'bad old days.' Apparently we need constant vigilance and struggle to work against these. You can bet that most of this stuff happens to 'minority' and minority status (i.e. women).

The unfortunate reality is that there are still people behind research, policy, and practice decisions that hold the following philosophical assumptions:

1. Pill medications are the most important treatment interventions for what is collectively labeled as mental illnesses.
2. The reason most people do not take pill medicines is that they lack “insight” into their mental illness.
3. The “right” medications that people need are what are prescribed by the prescriber who does possess “insight.”
4. If people are not closely monitored in their use of psychiatric medications, they will not take them or not take them “correctly”

What this ignores is the complex decision making process people go through when deciding whether or not to use pill medication as part of their recovery. It does not take into account how past and present experiences with pill medications, treatment interventions, and interactions with treatment professionals affect decision making. It limits the value placed on other life choices that people must weigh into their decision to take medications.

While I don’t have all the references at hand, there is a growing body of evidence that people want to be involved in their decisions regarding medications, have valid uncertainties in taking medications they wish to discuss, and have the capacity to engage in discussion about the use of medications. Even so, there is a considerable lack of research on the decision making process regarding medications compared to the literature base on compliance vs. non-compliance.

Many people do decide to take pill medicine and do so because they see a value in the medications that fits within their overall life context. This decision is made easier when they are presented with accurate information (including the benefits, harms, and reasonable expectations of what the medication can do), professionals who are willing to understand and discuss their personal values and life goals in the decision making process, being presented with multiple options on how to achieve stated life goals or overcoming difficulties they are presently experiencing, and support for carrying out the decisions they make.

Unfortunately, many people also take medication because of fear associated with possibly losing services or supports, being subjected to forced hospitalization, or being reported to those who have the authority to make life more difficult. This doesn't seem like a good approach to improving the therapuetic alliance or effective shared decision making.

The goal should be to help people be more active in engaging in decisions around their overall health and wellness, not reinforce the position of the person as passive recipient of medications. Beyond all the obvious ethical violations, the thought of a “pill police” conjures for me, I am concerned about the message this reinforces about the capabilities of people to engage in making important life decisions that will affect them profoundly. It shows we still have considerable work to do in changing perceptions and behaviors of people who influence research, policy and practice decisions.

Rick Goscha

I am not surprised that they are spending money for research into new technologies meant to control us. Add them to the recent attempt at forced abortion and sterilization of a woman with a diagnosis of mental illness is Massachusetts just this week, not 50 years ago as one might think - and you will see that our entire history as a group of people has been through and through about control - and making money off of us.

As "mental illnesses" have been medicalized, we have decreased in status, not become normalized, like people with substance abuse issues. This is because the psychiatrists along with the pharmaceutical industry will do whatever they must to maintain their profit margins by pushing drugs that are extremely addictive and hard to withdraw from on people for whom therapy is more appropriate, especially with the increasing knowledge of the long term health risks and early deaths of people taking psychiatric drugs.

I find this truly horrifying and very Orwellian. I won't repeat the cogent points made by many commenters above - inlcuding Drake, Naomi, Rick and Rachel... but this development is yet another encroachment on individual liberty and the right to truly informed consent. We should be very afraid.

This concerns me, if a person is deemed not to have capacity, then they can already be forced to have treatment. What happens once they have regained capacity? Can they choose to stop this?... I find this very scary!

Hi, What a wonderful blog to have discovered through the Mother Bear Community Action Network.

We need to be doing research about recovery, and building places of respite for people and caregivers. We need access to real rehabilitation, such as with community healing residential treatment centers.

Finding more ways to control people diagnosed with schizophrenia is ridiculous (because they are plenty of ways already in place with court ordered forced injections and such) --and more control is not at all in the best interest of the people and/or patients diagnosed.

This technology is scary. America's mental healthcare system hasn't changed all that much since it began, but hopefully there is hope.

Hopefully more people will start standing up for human rights and more organizations like Common Ground and the Mother Bear Community will begin to show up across the nation.