The recent death of Ribgoberto Alpizar in the Miami airport has gotten me thinking about improving psychiatric care for the severely ill. I'm not a psychiatrist, but a longtime 'consumer' so I think I can speak to this with some authority. We HAVE to find ways to make involuntary care more compassionate, or many patients will continue to avoid care until they face a possible tragedy.
I would humbly suggest making stable psych patients a part of the process in determining who needs involuntary care. It takes one to know one, and the decision is often made now by a judge with no medical training who never meets the patient.
Also, as some communities are now installing 'civilian review boards' to oversee the police, I would love to see a similar thing with psych patients. We should have a right to a say in allegations of abuse in hospitals, laws affecting our daily lives, funding of agencies, and procedures of police Crisis Intervention Teams. Of course an ironclad rule would be that members must be stable while serving in such a capacity.
As things currently stand, many of us are painfully aware that we have virtually no voice in our treatment, or laws passed on our 'behalf.' This only fuels suspicion of the medical and legal establishment, and rightly so.
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There is an intrinsic problem with patient input to their own conditions of care. The conditions must be determined by what is best for the patient under the comprehension of current medical knowledge limited by the personal rights of the patient. If the patient is considered incompetent to participate in this consideration by law and by medicine, the patient is thereby at the total mercy of the system for his/her own benefit and for the benefit of society in general. I do not know how it can be managed to give a patient under such conditions a voice in treatment procedures. A recent article in the New York Times indicated that many doctors are insensitive to the desires and rights of patients who are considered mentally normal. This doctor attitude must be magnified many times when considering a mentally limited patient. I do not know how to get out of this bind.
Sand, you make a good point. I think a major problem is that hospital and MH staff in general can determine whatever they WANT as to a patient's competency. If a case ever goes to a review by a third party, their 'professional' judgement gets 90% of the weight in any decision made. That's one of the major things that needs to change, and it'll take decades
An interesting thought - borne out of good intent.I have a radical suggestion.Firstly let me show my hand - I'm a professional hypnotherapist and as such work with many clients who are considered 'mental' with a wide range of conditions like severe depression – and I cure them. The first stage is always what we call hypnoanalysis - that is using a light hypnotic trance to establish the root causes of the problem. My experience of some traditional medical doctors and psychiatrists is that they pre-prescribe conditions - if someone is depressed then give them some anti-depressant pills. Doctors simply don't have the time or skills to do the all-important analysis - we do.So why not establish a panel of hypnotherapists skilled in hypnoanalysis. We can assess, advise and usually treat. The problem is that the medical profession is only slowly accepting hypnotherapy as a viable treatment.