Psychiatry is an ancient phenomenon with an invasive and brutal history. In the past, the mentally ill were strapped to their beds and doctors performed lobotomies and electroconvulsive therapy in the hope to improve a patient’s mental state. As asylums closed in the 1970s and 1980s, old brutal practices and the use of coercion in psychiatry were abandoned. Therefore, psychiatry is now thought to be a benign medical practice to help the mentally ill.
Though at some point in history the focus shifted towards care rather than custody, an editorial, published earlier this year in the British Medical Journal (BMJ), revealed disturbing trends in coercive practices in today’s mental health system.
While there will always be situations where intervention and coercion are inevitable to protect the life of the patient or their relatives, they are often unnecessary. Nonetheless, these ancient practices are once again becoming routine in our modern mental health care system.
Today, an increasing number of mental health professionals see coercion as an essential tool, giving rise to new types of secure mental health facilities that replicate some of the inhumane and unethical practices of old asylums.
People are required to take super-powerful psychiatric drugs against their will while being unable to leave locked wards. According to the report’s findings, more than half of the admissions to psychiatric hospitals in England are now involuntary.
Although society has the right to be protected, using the health care system to detain people for punishment rather than treatment is unethical and criminal. Mental health institutions have too much power and the concerns of patients or their relatives are often ignored.
In many cases, a mentally ill person is seen as a danger to society. Britain’s current Mental Health Act has allowed thousands of unnecessary detentions and failed to deal with discrimination against ethnic minority patients. Though there is little evidence that community treatment orders offer any benefit, they form an integral part of the mental health services.
And what’s worse, our prisons are also increasingly being used to manage and contain mentally ill people. In the United States, there are now over three times more mentally ill people in jails than in hospitals. Of these people, 16 percent have a serious mental illness and should receive proper treatment instead of being locked away.
The recent shift in psychiatry, which prioritizes risk management over individual health and social needs, has given institutions too much power. All too often the patients are left out of the decision-making and psychiatric health care providers are reluctant to share information. They feel they know what’s best for their patients.
Coercion is once again being used to gain physical, legal, chemical, psychological, and financial control. Patients are increasingly losing their freedom. Psychiatric coercive measures are a cruel, inhuman, and degrading treatment that goes against our human rights. According to the International Association Against Psychiatric Assault, psychiatric coercion fulfills all the criteria of the definition of torture as taken from the Anti-Torture Convention of the United Nations.
Though collaborative and person-centered care leading to recovery should be the primary focus of mental health services, people are increasingly being drugged and locked up in psychiatric institutions. They are diagnosed against their will and forcibly subjected to physical intervention with damaging psychiatric drugs and electroshocks.
Given these inhumane and damaging practices, patients who might benefit from psychiatric care are likely to delay or avoid treatment out of fear of losing their freedom and compromising their basic rights. Instead of helping these people, we have taken a step back by imprisoning and torturing them. Are we going back to the time of lunatic asylums that functioned as poorhouses and jails for the mentally unstable?