As mentioned a few weeks ago, I ordered a newly-published book on detention and involuntary treatment by a Canadian science journalist and author, Ron Wipond. The subtitle is: "The rise in pychiatric detentions, forced treatment, and abusive guardianships." Wipond is a capable writer who has done an enormous amount of work tracking reports and figures, and interviewing former detainees, as well as psychiatrists, nurses, administrators, lawyers and lots of other people who have a finger in this very unsavoury pie. He writes clearly and the book moves at a fairly fast pace. I had a specific goal in reading it, which I'll mention at the end, but the striking impression it gives is of the endless chaos and disorganisation of American psychiatry. Except on one point: it is a very efficient money-maker for its many components.
The book is divided in five parts, copiously illustrated with actual case material, but each one suffers from the same problems: large areas of essential information are either not collected or are kept secret by various means. In Part I, "The expansive reach of psychiatric power," he describes how the ever-widening reach of the American diagnostic system, now known as DSM-5, is creating new mental "illnesses" that then require treatment. There is now a large and powerful bureaucracy making a living from psychiatry, including lots of psychologists and social workers, which builds its own momentum. This is actively aided by the ultimate psychiatric argument, "lack of insight." As somebody who has railed against this elastic and undefined "judgement" for decades, I was a bit disappointed but to deal with its endless ramifications would require another book so I pressed on.
Part II looks at "Core drivers of civil commitment," really devolves into money. How much money is spent on mental health, and how much do all the different operators make? There is no doubt that private psychiatry and its associated hospitals profit very handsomely from being able to detain people. After dissecting figures, he concludes that the involuntary psychiatric industry creams off about $19billion a year in bed costs alone. By comparison, in the US, which has the world's largest prison population, the private prison industry gets only about $3.9billion a year from its guests.
Part III, "Mass funnels into psychiatric incarceration," is important. How do people take their first steps on the career path of a mental patient? Schools, and now kindergartens, are a major factor in producing lifelong mental patients, but add to that family disputes, especially where money is involved, children in care being overdosed with psychiatric drugs, unruly teenagers from broken families, you know it all. Adding to that is the private psychiatric industry which profits massively from being able to declare people "in need," or "at risk," knowing that anything the patients say or do can be turned against them, and that tribunals always side with the hospitals anyway. Chapter 13 is entitled "An assembly line of fraud," outlines some of the rackets by which private hospitals, insurers and psychiatrists working together can turn a minor family upset into a more or less endless source of money.
Moving on, Part IV looks at "Institutional management, profiteering and political repression." Anybody who speaks out about wrong-doing or corruption is at serious risk of being labelled crazy, locked up and drugged, and that is the end of the matter. There are only pipelines into the system, but there are none that lead out. This is across the board: private industry, government, military, schools, universities, even big hospitals (which are just businesses to the people who run them). The playbook is the same: Declare the person mentally disturbed and nobody will ever listen to them again. In particular, he points to the horrific matter of being pregnant and upset in a Republican state. Many of these states now have laws saying that the rights of the foetus override those of the mother, regardless. So an unborn child can have a court-appointed lawyer to protect its interests whereas the mother can't. Later, if the mother wants to see her medical file, she can't, as it contains material relating to the child (whether born alive or not) and she can't access the file of another person.
And so to Part V, which is where I hoped to find the material I was looking for, on the crucial question of whether there is any evidence to say that detention and involuntary treatment are beneficial. What we want is clear-cut evidence from properly conducted trials to show that the benefits of depriving a person of all human rights is better than doing nothing. Except there is always the other option of providing treatment on a voluntary basis, although that's very hard work so it has no appeal compared with filling in a few forms, mumbling something to a tribunal and walking out with what you want. Of course, as we all know, there has never been such a trial. There are naturalistic studies, such as Loren Mosher's Soteria House, or Open Dialogue, from Finland, but they can't compete with the ceaseless blast of propaganda from the mainstream psychiatric industry.
Finally, he points out how the social media industry is in bed with the surveillance state so that everything a child or teenager writes, regardless of intent, can result in police and mental health staff banging on the door. And if the parents insist there is nothing wrong with the child, well, they'll just get an order saying they're neglectful. Don't think it isn't happening, because it is.
So the book should be essential reading for everybody connected with the mental health industry, every police officer, lawyer and judge, school teachers - and politicians. If you've worked in a mental health unit, or been a guest, there will be nothing new for you. But it is important to know that the problem of institutionalised abuse of the mentally-troubled is deep-seated, it has powerful supporters and it isn't going to go away if we do nothing. Fortunately, the UN Convention on the Rights of People with Disability has taken a strong stand against detention and involuntary treatment, that it should be phased out entirely. However, unless there is pressure from below, all the interests just mentioned will work behind the scenes to make sure it is never implemented, and they can go on making money without let or hindrance.
Wipond, R (2023). Your Consent is Not Required. The rise in pychiatric detentions, forced treatment, and abusive guardianships. Dallas, Tx: BenBella Books.
STOP PRESS: Shock horror revelation. A report in Psychiatric Times (March 14th 2023) of a study on ketamine usage in the US shows that 55% of people who were prescribed the drug for different diagnoses took too much:
The 2023 Future of Mental Health: Ketamine Therapy Report ... uncovered that at-home treatment options increase the risk of patients’ irresponsibly abusing the drug, becoming dependent, or being funneled in and out of treatment. Younger generations, especially Millennials and Gen Z, reported misusing or abusing ketamine when trying it at home...
Unbelievable. Who could possibly have expected this? The researchers gave a highly-addictive drug to mentally-disturbed people to treat themselves at home, and they actually got themselves addicted to it? You can't trust the younger generations, they're just so irresponsible. By the way, can I sell you a course of ketamine, two sprays up your conk for $790?
Plus by APN: 2023 Future of mental health: ketamine therapy report. Accessed March 21st, 2023.
Scary