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Thursday, December 14, 2017

Involuntary Treatment: Unethical but Not Always Illegal

The ease with which people can be forced into treatment has been a financial goldmine for private "rehabs"

The ease with which people can be forced into treatment has been a financial goldmine for treatment centers, private mental hospitals, and lawyers specializing in helping families have their children committed.

Addiction Recovery Legal Services, a well respected law firm in Florida, assists “families to obtain and enforce confidential, court ordered drug and alcohol intervention, assessment, stabilization, and treatment before an individual suffers the significant and dangerous affects of substance abuse and addiction.” Yes, court ordered treatment before you suffer any significant effects.

“A hearing is set before the court after a Petition for Involuntary Assessment and Stabilization is filed,” explains Addiction Recovery Legal Services. “That petition is basically saying, `Judge, I want you to have this person assessed and stabilized.' Following this hearing the individual is held for up to 5 days for medical stabilization and assessment. Also, a recommendation is made to the court”

A Petition for Treatment must be filed with the court, and a second hearing held for the court to review the assessment and recommendation. Based upon that recommendation, the judge can then order a 60-day treatment period, with a possible 90-day extension if needed.

If “the addict” exits treatment in violation of the judge's order, the family's lawyer goes back to the court and demands that “the addict” answer why they didn't comply with treatment.

“If the addict refuses,” states the attorneys at Addiction Legal Recovery Services, “we have them held in civil contempt of court for not following the treatment order and ordered to return to treatment or be incarcerated. This why the Marchman Act works - it carries real consequences.” The consequence of not complying with involuntary treatment is involuntary incarceration.

You will notice that the person is designated as “the addict” despite the person never having been diagnosed with the actual medical condition of addiction which can only be diagnosed by a medical professional, preferably an addiction medicine specialist.

On the basis of nothing more than assumption at least, or medical diagnosis without a license at worst, the court is going to compel treatment for a condition that may or may not exist -- no one knows because there was never a medical diagnosis prior to forced treatment.

Doesn't the person being forced into treatment have rights? Well, yes and no. People accused of crimes who cannot afford an attorney are supposedly provided a public defender. Some cities, such as Lynwood, Washington, only require the court appointed attorney to be on premises for people who plead guilty. If you plead not guilty, your court appointed attorney isn't even there.

“Families walk in there thinking they're trying to get someone help, and suddenly their loved one has an attorney who's trying to get the case dismissed,” acknowledges a law firm specializing in involuntary treatment. “We're going to get the person into treatment, and if they leave, we're going to get them back."

This “preemptive” approach to enforced treatment for financial gain was previously proven successful in the expansion of schizophrenia treatment, primarily involuntarily, to those who had no need of anti-psychosis medications. As documented by Richard Gosden and Sharon Beder, authors of “'Pharmaceutical Industry Agenda Setting in Mental Health Policies,” published in Ethical Human Sciences and Services (1991), the market for drugs treating schizophrenia was limited to prescription medications treating people who suffered from psychosis.

The way to expand the market was to promote the concept of a “pre-psychotic” phase of schizophrenia which requires preventative treatment before the person manifested any signs of psychosis. “To further expand the market they also decided to wage campaigns to weaken civil liberties protections,” noted the researchers, “and thereby increase the number of people who could be treated involuntarily.”

Those companies wishing to expand the market for their drugs launched an integrated multiphase campaign. One aspect was funding selected psychiatric researchers to promote the doubtful belief that schizophrenia must be detected and treated in a pre-psychotic stage to avoid brain deterioration. (Gosden, 2001, pp. 224-247). Another key element was a public relations strategy funded by drug company Eli Lilly. Represented as an “anti-stigma” campaign, it advocates for the elimination of prejudice against schizophrenics as long as “they are taking their medication.”

Adding another dimension to the market expansion strategy were “scare tactic” news stories containing wild hyperbole about the life threatening danger of untreated schizophrenics. The public was now getting messages such as this one from the Treatment Advocacy Center: "Violent episodes by individuals with untreated schizophrenia and bipolar disorder have risen dramatically, now accounting for an estimated 1,000 homicides annually in the United States"

The intention of these combined efforts was to weaken civil liberties protections in mental health laws in order to increase the number of people eligible for involuntary treatment. Associating violence with schizophrenia is irresponsible, and portraying it as something that must be prevented in advance is simply a blatant falsehood. In truth, there are number one factor predicting violence in some with schizophrenia is an established previous history of violence.

The bottom line was the bottom line, and the advocates of involuntary treatment were well organized and well funded. The Treatment Advocacy Center, dedicated to associating schizophrenia with violence, and calling for the urgent need of forced treatment, said that people must be compelled to have treatment “before individuals become a danger to themselves or others, particularly for individuals who lack awareness of their illness-a common side-effect of these devastating disorders.”

What “hinders treatment,” in their view, are federal and state laws protecting patients' rights, and basic civil liberties. This well-coordinated campaign to expand the market for treatment and drug sales is ongoing and remarkably successful. The Wall Street Journal, following the progress of this campaign, described the market for schizophrenia drugs as a "fast-growing, $5 billion-a-year market" in which Eli Lilly’s Zyprexa has already gained a $2.35 billion share and is "on course to surpass $2.5 billion this year". (Hensley and Burton, 2001).

It doesn't require extensive research to recognize this same approach working with excellent financial rewards, and corresponding human damage, in the realm of alcohol and drug treatment.

Perhaps we should have court ordered treatment for water skiers, horseback riders, and amateur boxers, all of whom have more deaths and injuries per year than non alcoholic drug users.

This entire issue raises all manner of ethical problems, in addition to legal ones, and is especially troubling for mental health professionals who know the difference between emergency involuntary admission for the obviously mentally deranged, and the coerced admission of perfectly sane people into treatment centers because someone doesn't approve of their drinking or drug use.



About the Writer

Burl Barer is a writer for BrooWaha. For more information, visit the writer's website.
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1 comments on Involuntary Treatment: Unethical but Not Always Illegal

Log In To Vote   Score: 1
By Uttam Gill on November 26, 2011 at 11:46 pm

Its very thought provoking article...You are absolutely right though we have different laws here but I agree with you that there is an unholy nexus using the existing frame of system to churn billions of dollars...the coercive and invasive doctrines of conventional belief to deal with treatment for depression, schizophrenia or drug addictions needs a radical change...Lets hope it happens

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