ENUSP -Forced psychiatric interventions constitute a violation of rights and disable care

Human rights context

Since 2006, the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) calls for a paradigm shift to break away from paternalistic laws and paternalistic attitudes towards persons with disabilities, and shift to respectful support of decision-making based on the person’s own will and preferences. The implicit call of the UN CRPD to put an end to forced psychiatric treatments has been made explicit by several publications of the CRPD Committee, and especially by the Guidelines to Article 14. The Guidelines make clear that the detention of persons with psychosocial disabilities under domestic legislation on the grounds of their actual or perceived impairment and supposed dangerousness to themselves and/or to others “is discriminatory in nature and amounts to arbitrary deprivation of liberty.”[1]

 

Nevertheless, two UN treaty bodies currently are in conflict with the standards set by the UN CRPD: the Human Rights Committee[2] and the Subcommittee on Prevention of Torture (SPT) in their document “Rights of persons institutionalized and medically treated without informed consent”. Yet the Human Rights Committee admits that forced measures are harmful: “The Committee emphasizes the harm inherent in any deprivation of liberty and also the particular harms that may result in situations of involuntary hospitalization.” [3] The Human Rights Committee even recommends States parties “to revise outdated laws and practices” and says that “States parties should make available adequate community-based or alternative social-care services for persons with psychosocial disabilities, in order to provide less restrictive alternatives to confinement.” However, despite this, the Human Rights Committee acknowledges the possibility of forced measures, provided they are applied “as a measure of last resort and for the shortest appropriate period of time, and must be accompanied by adequate procedural and substantive safeguards established by law.”[4]

Also the SPT allows forced commitment and forced treatment, but they go even further by saying that abolition would violate the “right to health” and the “right to be free from torture and other ill-treatment”. For instance, the SPT states “…placement in a psychiatric facility may be necessary to protect the detainee from discrimination, abuse and health risks stemming from illness”[5], “The measure [treatment without consent] must be a last resort to avoid irreparable damage to the life, integrity or health of the person concerned…”[6]. In addition, the SPT acknowledges restraints as a legitimate measure: “Restraints, physical or pharmacological … should be considered only as measures of last resort for safety reasons”[7], and further allows for “medical isolation”[8].

It is interesting to note that before the publication of these two documents mentioned above, the thematic report “Torture in Health Care Settings” by the UN Special Rapporteur on Torture and other cruel, inhuman or degrading treatment or punishment (A/HRC/22/53), urged an absolute ban on forced psychiatric interventions, in order to ensure that persons with psychosocial, intellectual and other disabilities be free from torture and ill-treatment. However his voice apparently was not heard, as well as other voices documenting numerous violations of human rights in psychiatric institutions. One of them is the report of FRA issued in 2012, which reveals the trauma and fear that people experience, and states that “the extremely substandard conditions, absence of health care and persistent abuse have resulted in deaths of residents in institutional care.”[9]

 

Therefore, it can be seen that the arguments in favour of the administration of forced measures are based on false grounds, because as has been proven by numerous sources, including CPT reports and the sources mentioned above, psychiatric institutions in no case can be considered a safe haven from discrimination, abuse, torture and ill treatment. With regard to medical considerations and care we put forward the following:

 

Forced psychiatric interventions are not care.

Care is supposed to result in improved well-being and recovery. Well-being – or mental health – is a very personal, intrinsic value, which cannot be produced by force. Caring for one another is one of the best things that people can offer to each other. On the contrary, forced psychiatric interventions are very traumatizing, and result in suffering and more psychosocial problems. It makes the situation worse, and is amongst the worst things that people can do to each other. There is a huge difference between forced interventions and care. They are the total opposite of each other.

 

Forced psychiatric interventions disable care.

Forced psychiatric interventions are counter-productive to mental health and care, and represent a “breach of contact”. This can be seen on the one hand, for example, with nurses who stop trying to communicate or provide support, and resort to forced interventions. It can also be seen on the other hand, in the feelings of misunderstanding and trauma of the person subjected to forced interventions, which disable meaningful contact. It is obvious that good contact and communication are necessary for good mental health care. The end of communication, as is induced by forced psychiatric interventions, is a very harmful practice, which makes meaningful contact, and therefore mental health care in itself, impossible.

 

Forced psychiatric interventions do not result in safety.

Due to suffering, increased psychosocial problems, and a lack of any support for recovery caused by forced psychiatric interventions, the risks of escalation increase, and can even result in an endless circle of struggle and escalation, as our experiences show. The common argument given “to protect from harm or injury to self or others”, is not based on factual evidence supporting this statement. Forced psychiatric interventions do not result in more safety, but lead to more crises, and subsequently to greater risk of escalation.

 

Forced psychiatric interventions indicate a deficiency in mental health care.

Forced psychiatric interventions are more of a mechanism for (attempted) social control embedded within an underdeveloped and structurally neglected (and politically abused) system of mental health care that is built on the horrible remnants of the past, rather than on skills to support mental health and well-being. Underdevelopment and insufficient funding of the mental health care system is in place because of the extremely low political priority given to mental health care, consequently explaining the extremely low level of funding. It is impossible to deliver quality care without proper funding and attention to quality standards. However, due to historical stigma, mental health care remains unpopular with society, i.e. voters, and therefore politicians. In case of dire shortage of funding, the best possible solution for the system is to keep things calm, by delivering lots of harmful and in many cases unwanted medication to isolated people and calling it medical care. However, real mental health care is possible when efforts are made and sufficient funding is provided.

 

A world of options between “last resort” and “no care”

Many persons, including many States, cannot see beyond a very narrow “black and white” approach regarding psychosocial crisis situations, with only two options: either forced treatments (torture), or doing nothing (neglect). This simply isn’t the full picture. Between these two extremities, there is a largely undiscovered world of options for real support and real mental health care in psychosocial crisis-situations, with aspects such as: non-violent de-escalation, prevention of crisis in the earliest stage possible, focussing on contact and openness instead of repression, building trust and providing real support in acute crisis-situations. (Ex-) users and survivors who have experienced this are the best positioned to be involved in this shift of paradigm.

 

Real development of mental health care is urgently needed.

Unfortunately for decades, the real development of good care practices has been undermined by the existence of forced treatments, which has enabled caregivers to turn their back to the crisis situation, and leave the person behind without actual care, repressed and stripped of their dignity. This should stop. Forced psychiatric interventions constitute a very serious human rights violation. They can never be called care and cannot be considered a safety and anti-discrimination measure, because they lead to exactly the opposite.

 

We believe in the creative potential of humanity and the possibility to solve complicated problems when appropriate efforts are made. But in order to allocate the appropriate resources and generate enough creative efforts, appropriate motivation is needed. The UN CRPD standards give us and should give policymakers such motivation to realize and state publicly that the status quo in psychiatry is totally unacceptable and must be changed to a humane system of real care.

 

The discrepancies in the recommendations referred to above, even among different entities of the same organization (United Nations) must be eliminated and the provisions of the CRPD must prevail.

 

This is a challenge, but by thinking and acting together, it is possible to make this a reality.

 

We must keep in mind just one thing as a basis for this objective:

 

 

Forced psychiatric interventions constitute torture and ill-treatment and

must be banned!

 

 

 

 

 

 

 

[1] CRPD Committee’s Guidelines on article 14 Liberty and security of person, III, para.6 (September 2015)

[2] General Comment No.35, para.19 (30 October 2014)

[3] Ibid.

[4] Ibid.

[5] SPT, Rights of persons institutionalized and medically treated without informed consent, para.8

[6] Id. para.15

[7] Id. para. 9

[8] Id. para.10

[9] European Fundamental Rights Agency: Involuntary placement and involuntary treatment of persons with mental health problems, 2012. Available at: http://fra.europa.eu/sites/default/files/involuntary-placement-and-involuntary-treatment-of-persons-with-mental-health-problems_en.pdf

Fiona Walsh – Convention on the Rights of Persons with Disabilities (CRPD): Civil Liberties, Equality and Upholding Human Rights

The 100th Anniversary of the 1916 Rising (Easter Rebellion) is currently being marked in Dublin City and Ireland. The Rising was launched by a small number of Irish Republicans at Easter time 1916 aiming to terminate British rule in Ireland and establish an independent Irish Republic. One of the principles of the Proclamation guaranteed:

‘religious and civil liberty, equal rights and equal opportunities to all its citizens’

In the context of those presenting in emotional distress today in Ireland in 2016 however there is still no guarantee that civil liberties will be respected and the reality of equal rights/opportunities for those perceived to be suffering from ‘mental disorders’ is not on the horizon just yet.   Diagnoses are based on subjective interpretation of ‘symptoms’ by Irish psychiatrists and other professionals who typically see individuals in terms of perceived deficits, brain disorders and inherited genetic defects. There are some more enlightened professionals who think in terms of ‘support’ and supporting decision making for those in distress as opposed to those who however compassionate and well meaning think in terms of ‘control’ ‘risk’ and substitute decision making. Many survivors of psychiatric abuse dread the paternalistic ‘best interests’ approach which typically has been used to deprive them of their basic human rights and to define what has contributed to their distress and what might support them to come through it.

 

Typically individuals in Ireland present in a voluntary capacity via their General Practitioner (GP), out of hours service or to the Accident & Emergency Unit of their local public hospital or to one of the private facilities. I am not aware of any psychiatric unit that does not use coercive practices of some sort.   Most who present in a voluntary capacity on the first occasion are not made aware on entering the facility they can be detained and forcibly treated, albeit on the 2nd opinion of another psychiatrist, which usually validates the first opinion. If you do not agree to Diagnosis and Treatment, then you may well be subjected to detention and forced drugging, seclusion, restraint, ECT etc. Under international human rights law this is could be regarded as Torture. The first thing that typically goes is the individuals clothes, access to fresh air etc, access to phonecalls/visitors , even your children until it is established that you will essentially play ball. Mothers can as I did receive threats such as ‘you know we have the option to contact child protection services’. True informed consent for any ‘Treatment’ including around serious side effects of medication must be sought yet typically is not and usually information not provided automatically either way so that the individual can make or be supported to make an informed decision. For those that know how the system operates and disagree with the medical model fear permeates and is increasingly stopping individuals in distress from reaching out to get the support they desperately crave in a given crisis. Reports of individuals taking their own life rather than submitting to coercion are sadly not uncommon and increasing in frequency in Ireland. Members of our Traveller Community have an increased incidence of suicide seven times higher than the rest of the population and fear often prevents travellers seeking professional support.

 

Ministers Frances Fitzgerald and Aodhan O Riordain published a ‘Road Map for Ratification of UN Convention on the Rights of Persons with Disabilities’ on 21st October 2015.   Introducing Capacity Legislation features on this road map. Accordingly on 30/12/2015 our President Michael D Higgins signed the Assisted Decision Making (Capacity) Bill 2013. Rather than respecting the principles of CRPD though our Departments of Justice and Health and Government bizarrely based the legislation around ‘Mental Capacity’ providing for a ‘Functional Capacity Test’. Prof Brendan Kelly, a prominent Irish Psychiatrist has had huge influence and uses the CRPD to even defend administering Electroshock against the expressed wishes of an individual (family/loved ones have no rights either in respect of those with involuntary status).  Minister Kathleen Lynch refused to listen to the voice of Civil Society Capacity Coalition, chaired by Eilionoir Flynn, Deputy Director, Centre for Disability Law & Policy NUI Galway and essentially deprived Irish Citizens of the Right to have Legal Capacity respected in law. In addition the legislation denies the right to make a legally binding Advance Healthcare Directive in the context of emotional health, even in respect of ECT. Although the word ‘unwilling’ was recently removed from our Mental Health Act 2001 , the word ‘unable’ still remains, essentially allowing forced detention and drugging to continue unabated. As a survivor of Psychiatry (my experience is relatively mild in many respects) I sat in the Public Gallery of our Houses of Parliament (Dail and Seanad) saddened by the refusal of our Minister and Government to uphold the principles contained in CRPD and respect Human Rights, despite being challenged by brillant Human Rights advocates including Jillian Van Turnhout and Katherine Zappone in our Seanad and Padraig Mac Lochlainn along with other elected representatives in our Dail Chamber. At a recent NGO Forum on Human Rights in Dublin Castle , ‘United Nations Council, ten years on’ (which UN Rapporteur Ms Catalina Devandas Aguilar was invited to speak and attended) Layla de Cogan Chin, Dept of Justice left attendees in no doubt with the Dept line that the Irish Government will essentially pick and choose what rights will be respected and that CRPD will be ratified with reservations/declarations.

 

Increasingly Irish survivors are looking to United Nations and the International Human Rights arena to expose the inability/indifference of the Irish Government and Psychiatry Profession to respectively legislate and usher in reform so that those who seek support can do so free of fear and terror of coercion. For some layer by layer of their human dignity is stripped away and they have to recover from the Diagnosis and ‘Treatment’ in addition to what brought them in contact with services in the first place.   In my own case presenting in a voluntary capacity agreeing to take all prescribed medication, still resulted in an attempt by treating Psychiatrist in 2011 to attempt sectioning on the basis of a second opinion of her choice not mine. My apparent ‘crime’ was that I did not agree with given diagnosis or that medication would be of therapeutic benefit.  A dear friend of mine, fellow human rights defender and member of Recovery Experts by Experience (REE) , at 77 years of age has to live daily with the fear of having ECT forced upon her despite having a power of attorney and Advance Directive made. Why should any Psychiatrist have the power to totally disregard her expressed wishes and disrespect her right to Legal Capacity should she ever become distressed in the future? Why should any human being live with the daily fear of having forced ECT again? As a member of Recovery Experts by Experience (REE) we made a submission to UN ICCPR in 2014. Tallaght Trialogue advocacy also submitted two reports under UN ICESCR in addition to contributing to joint parallel report from Civil Society, coordinated by Noeline Blackwell on behalf of FLAC. As a member of Tallaght Trialogue Advocacy I presented in person in June 2015 to UN ICESCR Committee in Geneva (speaking notes link below).

 

The UN CRPD reflects that each Human being has a right to be treated equally (Article 5) and have their will and preferences respected, that their legal capacity (Article 12) is inherent and above all that their human dignity must be respected. My hope is that the standards in the Convention that prohibit forced detention (Article 14) and treatment will propel Irish elected representatives to seek, resource and fund alternative approaches to coercion such as Open Dialogue, Hearing Voices Approach (see http://hearingvoicesnetworkireland.ie/ ) , Crisis Houses, Peer Support & Advocacy … Survivors of Psychiatry deserve to have their voices heard not silenced as is the case in Ireland where tick a box engagement is typical and ‘Experts speak to Experts’ time and time again without the voice of lived experience.

 

Thank you Tina Minkowitz and fellow advocates at CHRUSP, Eilionoir Flynn & past and present Colleagues, CDLP NUI Galway , Fiona Morrissey Lawyer & Researcher and to all who contributed to the CRPD and advocate to have the standards enshrined upheld. It is time the incoming Irish Government embraced the principles of Civil Liberties and Equality in the 1916 Proclamation and ratified the CRPD (signed 30th March 2007) and Optional Protocol without declarations/reservations. Why not embrace the opportunity without further delay to respect Legal Capacity (Article 12) and the will and preferences of individuals and treat every citizen equally regardless of physical disability, psycho-social disability or a perceived disability? A Democracy that silences the voice of Civil Society is not what the signatories of the 1916 Proclamation aspired to, nor is it appropriate for the survivors of psychiatric abuse past and present in 2016. It is time for Irish Legislators to be challenged by those charged nationally to uphold human rights to step up to the plate and respect and ratify the CRPD and Optional Protocol. Accordingly I unreservedly support the Campaign to Support CRPD Absolute Prohibition of Commitment and Forced Treatment.

 

Signed: Fiona Walsh, Human Rights Defender & Survivor of Irish Psychiatric Abuse

Dated: 28th March 2016

Member:

  1. Recovery Experts by Experience (REE)
  2. Tallaght Trialogue Advocacy (on facebook & twitter @TallaTrialogue)

 

Speaking notes ICESCR Review Ireland June 2015 , Fiona Walsh, Tallaght Trialogue Advocacy (pages 19/20 FLAC newsletter)

http://www.flac.ie/publications/flac-news-25-2-aprjun-2015/

http://hearingvoicesnetworkireland.ie/

 

Irish Examiner Newspaper Article 20/01/2016

http://www.irishexaminer.com/viewpoints/yourview/electroconvulsive-therapy-is-still-given-to-patients-who-dont-want-it-377065.html

 

Dr. Fiona Morrissey, Lawyer & Mental Health Researcher: Article in Irish Examiner dated 21/11/2015 and link to her research regarding Advance Directives

http://www.irishexaminer.com/viewpoints/analysis/assisted-decision-making-bill-why-changes-are-needed-to-current-laws-366167.html

 

Article in Irish Independent 15/11/2015

http://www.independent.ie/irish-news/health/mentally-ill-still-forced-to-endure-shock-treatment-34201655.html

Eilionoir Flynn CDLP NUI Galway – Blog Posts on www.humanrights.ie

http://humanrights.ie/author/eilionoirflynn/

Prof Brendan Kelly, Psychiatrist, letter to editor 22/11/2015

http://www.independent.ie/opinion/letters/dont-deny-them-this-treatment-34223005.html

Roadmap to ratification of CRPD issued by Irish Dept of Justice

http://www.justice.ie/en/JELR/Roadmap%20to%20Ratification%20of%20CRPD.pdf/Files/Roadmap%20to%20Ratification%20of%20CRPD.pdf

Olga Runciman – ‘A true story filled with lies’

I wrote this piece from a place of anger and outrage and it was never intended for anyone’s eyes or ears and is therefore completely raw.

A series of circumstances resulted in Michael Rassum reading it and he said I can put music to this. The result is our spoken word ‘A true Story Filled with Lies’

Why did I write it? Because this person whom I call Peter (not her real name) died of her psychiatric drugs and despite it being a clear cut case her family and I watched how psychiatry closed around itself, protecting itself and they got away with it. For years her family have sought justice just like so many others. They never got it.

Her death was the reason that we were a group who joined together and created the organization ‘Death in Psychiatry’ an organization for those who have lost a loved one to psychiatry and to stop others suffering the same fate. Dorrit Cato Christensen who has also contributed to this campaign lost her daughter and she is also one of the founding members of the organization and is today the chair.

Psychiatry has been unable to prove that it is dealing with a biogenetic illness and, likewise, its drug treatments fall dismally short of what is considered good evidence based medicine. On the contrary the evidence especially long term, point at an increased risk of chronicity, brain damage, early death – up to 25 years shorter and, as in ‘Peter’s’ case, sudden death due to drug induced arrhythmia of the heart.

To force treat people with drugs that carry with it a risk of brain damage, death and little evidence of any long, term benefits what so ever, is an unspeakable act of institutional violence.

This piece is a true story the only thing that is changed is the name and gender. It is in three sections. “Death”, “Big Pharma, the Unholy Alliance” and finally the funeral called the “Winds of Change”.

I am today a psychiatric survivor, but this could have been me.
Or you or one of your loved ones…

Please support CRPD Absolute Prohibition of Commitment and Forced Treatment.

 

Robert Whitaker: Medical Science Argues Against Forced Treatment Too

The argument that is usually made against involuntary commitment and forced treatment is that these actions, under the authority of a state, violate a person’s basic civil rights. They deprive a person of liberty and personal autonomy, and do so in the absence of a criminal charge. The United Nations Convention on the Rights of Persons With Disabilities upholds that position by prohibiting discrimination in relation to these rights. That is a morally powerful argument, and it should stand at the center of any protest against forced treatment.

However, there is another argument, one of adjunctive value, that can be made against involuntary commitment and forced treatment. Medical science argues against forced treatment too.

The “state,” in order to justify involuntary commitment and forced treatment, will argue that such coercion is necessary to provide “medical treatment” to individuals who, because of their impaired state of mind, won’t give their consent to such treatment. The implication is that if the “psychotic” individual were of sound mind, he or she would want this treatment, and thus the state is serving as a helpful guardian. But this “medical” argument falls apart upon close examination.

First, there is evidence that psychiatric hospitalization itself—whether voluntary or involuntary– leads to an increased risk of suicide. In a 2014 study, researchers at the University of Copenhagen looked at the psychiatric care received by 2,429 individuals in the year before they committed suicide, and after matching this group of completed suicides to a control group of 50,323 people in the general population, and after making adjustments for risk factors, they concluded that the risk of dying from suicide rose as people received increasing levels of psychiatric care. Taking psychiatric medications was associated with a six-fold increased likelihood that people would kill themselves; contact with a psychiatric outpatient clinic with an eight-fold increase; visiting a psychiatric emergency room with a 28-fold increase; and admission to a psychiatric hospital a 44-fold increase.[1]

In an editorial that accompanied the article, which was published in the Journal of Social Psychiatry and Psychiatric Epidemiology, the writers—all experts in suicide research—observed that these were robust findings. The Danish study, they wrote, “demonstrated a statistically strong and dose-dependent relationship between the extent of psychiatric treatment and the probability of suicide. This relationship is stepwise, with significant increases in suicide risk occurring with increasing levels of psychiatric treatment.” This link was so strong, they concluded, that “it would seem sensible, for example, all things being equal, to regard a non-depressed person undergoing psychiatric review in the emergency department as at far greater risk [of suicide] than a person with depression, who has only ever been treated in the community.”

These researchers concluded that it is “entirely plausible that the stigma and trauma inherent in (particularly involuntary) psychiatric treatment might, in already vulnerable individuals, contribute to some suicides. We believe that it is likely that a proportion of people who suicide during or after an admission to hospital do so because of factors inherent in that hospitalization.”[2]

Second, from a medical point of view, the “therapeutic relationship” between “patient” and “doctor” is understood to be an important factor to a “good outcome,” and forced treatment regularly leads to a breakdown in that relationship. The personal accounts of people who have been forcibly treated regularly compare it to torture, rape, and so forth. Moreover, these accounts cannot be dismissed as the writings of people who are “impaired” in their thinking, either at the time or later; such personal accounts often reveal an extraordinary level of detail and clarity.

Third, forced treatment regularly involves injections of an antipsychotic, and such initial treatment is regularly a precursor to long-term treatment with such drugs (and often in a coercive manner). However, there is now substantial evidence that such drug treatment over the long term does harm. For instance:

  • There is evidence that the drugs shrink brain volumes, with this shrinkage associated with an increase in negative symptoms, functional impairment, and cognitive decline.[3]
  • The drugs induce tardive dyskinesia in a significant percentage of patients, which reflects permanent damage having been done to the basal ganglia.
  • Martin Harrow, in his longitudinal study of psychotic patients, found that medicated patients fared worse over the long-term on every domain of functioning. The medicated patients were eight times less likely to be in recovery at the end of 15 years than those off the medication.[4]

This is simply a quick review of the medical case that can be made against forced treatment. But even this cursory review tells of treatment that increases the risk of suicide, can prove devastating to the “therapeutic relationship,” and may set a person onto a long-term course of medication use that has been found to be associated with a variety of harms and poor outcomes. As such, the argument that involuntary commitment and forced treatment are in the best “medical” interest of the “impaired” person falls apart when viewed through this scientific lens, and once it does, involuntary commitment and forced treatment can be clearly seen for what they are.

They are not a means for providing necessary “medical help” to an individual. They are an assertion of state authority and power over an individual, and that assertion of authority violates the person’s fundamental civil rights. Any societal discussion of involuntary commitment and forced treatment needs to focus on that issue, and not be distracted by the “medically helpful” claim.

 

[1] C. Hjorthøj, Risk of suicide according to level of psychiatric treatment—a nationwide nested case control study. Soc Psychiatry Psychiatr Epidemiol (2014) 49: 1357-65.

[2] M. Large. Disturbing findings about the risk of suicide and psychiatric hospitals. Soc Psychiatry Psychiatry Epidemiol (2014) 49:1353-55.

[3] J. Radua, “Multimodal meta-analysis of structural and functional changes in first 
episode psychosis and the effects of antipsychotic medications,” Neuroscience and Biobehavioral Review 36 (2012): 2325–33.

[4] M. Harrow. “Factors involved in outcome and recovery in schizophrenia patients not on antipsychotics medications.” J Nerv Ment Dis (2007) 195: 407-414.

 

 

José Raúl Sabbagh Mancilla (México)

In this article the author, as a therapist, presents his unconditional support to the absolute prohibition of forced treatments. He states that these types of treatment without consent are counterproductive and unsustainable. He highlights the importance of the standards that the CRPD imposes and the need to prohibit methods that annul the legal capacity of people with psychosocial disabilities.  

 

Mi nombre es José Raúl Sabbagh Mancilla, practico el acompañamiento terapéutico en México desde el año 2010. En estos años de práctica he escuchado la situación de algunos sujetos que han recibido diagnósticos como esquizofrenia, paranoia y daño neurológico.

El objetivo de este escriño no es dar una respuesta acerca la naturaleza de las causas de estas formaciones psíquicas, más bien considero que la posición de un clínico que, desde un saber absoluto y científicamente incuestionable, determina el estado general de estos sujetos, que además decide acerca de su futuro y obtura toda validez de sus decisiones, dificulta más su restablecimiento y una inclusión respetuosa a la vida en la sociedad. Estas acciones son clínicamente insostenibles y tienden a tener como consecuencia un mayor deterioro del estado de la persona.

Es por eso que, de acuerdo con la Convención sobre los Derechos de las Personas con Discapacidad, apoyo incondicionalmente la campaña por la Prohibición Absoluta de los internamientos involuntarios y las intervenciones psiquiátricas forzadas. Es importante que, en el accidentado contexto global de defensa de los Derechos Humanos, dejemos de sostener prácticas que, disfrazadas de un tratamiento ineficaz, implican una mayor cosificación de personas que en su propio padecer se sienten ya sumamente cosificadas.

In Italy, we don’t have a law against torture, by Erveda Sansi

 

contro psicofarmaci_col_rid

Drawing by Vincenzo Iannuzzi

 In Italy, the situation in the psychiatric field, with almost no exception, has worsened from the period of questioning psychiatric institution, in the beginning of the sixties. Then, Italy has been at the forefront of the closure of mental hospitals. Not only Giorgio Antonucci, Franco Basaglia and many professionals, but also a good part of the common people, realized that psychiatric hospitals were not places of care. Civil society, then, was sensitive to the issue of smash-down asylum culture. Publications appeared, there was an open debate, workers and students organized themselves and entered in asylums to see the conditions in which their fellow citizens were locked up. They protested and denounced the deplorable conditions the internees were forced to live in.

However, since several years, we observe a re-institutionalisation process and, at the same time, in some Italian hospital’s psychiatric wards happened many deplorable facts, due to forced treatment, institutionalization and forced restraint. Some of these facts have become infamous after that committees and relatives have asked for justice, as in the case of the well liked teacher Francesco Mastrogiovanni, 58 years old, that was debated also on national television channels. Franco Mastrogiovanni, after a forced psychiatric treatment the 4th August 2009, (because of a road traffic offense: circulation, at night, on a street closed to traffic), has been heavily sedated, tied to the bed of Vallo della Lucania’s hospital psychiatric ward, and left to die after four days of abandonment. During the 80 hours hospitalization he was nourished only with saline solutions; he was tied hands and feet to the bed, in such a position that his respiratory functions where compromised, and he was sedated with high doses of psychiatric drugs, without supervision from the staff. At wrists and ankles there are 4 cm wide grazes. A hidden camera recorded everything; the video is of public domain. At the trial the responsible physicians were found guilty and sentenced to 3 and 4 years detention, that, with the mitigating clauses, they won’t have to serve. The 12 nurses were acquitted because “they obeyed an order”. The Committee truth and justice for Francesco Mastrogiovanni, asks for truth and justice. Watch also the film 87 ore (87 hours), gli ultimi giorni di Francesco Mastrogiovanni (Francesco Mastrogiovanni’s the last days) by Costanza Quadriglio.

 

In Italy some deaths due to forced hospitalization and/or prolonged or short-time use of mechanical and chemical restraint have been reported by the press, television and network (this mean that there are a lot of other such “incidents”, we don’t know):

27 October 2005: Riccardo Rasman dies during a coercive treatment by the policemen, for a hospitalization against his will, in a psychiatric ward in Trieste.

21 June 2006: Giseppe Casu, guilty of having wanted to pursue his peddler job in the village square, dies in a psychiatric ward in the hospital “Santissima Trinità” of Cagliari, as a consequence of a thromboembolism, after a forced hospitalization and having been heavily sedated. He was tied hands and feet to the bed, for 7 days and was sedated with high doses of psychiatric drugs against his will.

28 August 2006: A.S., the 17th of August 2006 is admitted to the psychiatric ward in Palermo, for medical investigations. A.S. died after 2 days coma, the 28th of August, probably for excessive doses of psychiatric drugs.

26 May 2007: Edmond Idehen a 38 years old Nigerian man, went voluntarily into the psychiatric ward of Bologna’s hospital “Istituto Psichiatrico Ottonello – Ospedale Maggiore Bologna”. As he tried to leave the hospital, because he did not feel cared, the doctors forced him to stay, with the help of policemen. Edmond Idehen died as a consequence of a hearth attack while nurses and policemen held him down. He was also strongly sedated with psychiatric drugs.

12 June 2006: Roberto Melino, 24 years old, dies for a hearth attack; he entered voluntarily the psychiatric ward of Empoli’s “San Giuseppe” hospital. As he tried to leave the hospital, he was forced to stay by the doctors, and obliged to take high doses of psychiatric drugs, in spite of his evident and serious breath difficulties.

15 June 2008: Giuseppe Uva, 43 years old, was brought inside a police station, because he was driving in state of high alcoholic level. There he was subjected to ill-treatments. After 3 hours he was forced to an obligatory hospitalization in the Varese’s “Circolo” hospital and was forced to take psychiatric drugs. He died because of the stress provoked by the mix of alcohol and psychiatric drugs.

30 August 2010: Lauretana La Coca, 32 years old, entered voluntarily in Termini Imerese’s “Salvatore Cimino” hospital. After 10 days of hospitalization her condition got worse, till she got into a comatose state and died.

Giuseppe D.: A man, more than 70 years old, was interned in Reggio Emilia’s psychiatric prison. His problem was that the neighbour’s daughter is a psychiatrist. His lawyer took a legal action to the European Court of human Rights, but until now there has been no answer, so the Pisa’s student group “Collettivo Antipsichiatrico Artaud”, together with “Telefono viola” from Milan, decided to release the documentation relating to this case in Internet, according with Giuseppe D.’s will, his lawyer, and his relatives.

2 April 2010: Eric Beamont, 37 years old, the 2 April 2010 was hospitalized in Lamezia. After 2 days he entered coma, so the doctors transferred him to the Catanzaro’s “Pugliese – Ciaccio” hospital, where he died. There is the suspect that the death of Eric was caused from a high dose of benzodiazepine. Diagnosis was: subarachnoid hemorrhage[1]

28 May 2015 Massimiliano Malzone died during a forced treatment.

11 July 2015 Amedeo Testarmata died during a forced treatment.

29 July 2015 Mauro Guerra died during a forced treatment.

5 August 2015 Andrea Soldi died during a forced treatment…

Unfortunately in this article we have not described isolated occurrences, but an emblematic situation of violation of human rights in the Italian psychiatric institutions.

These are just some of the “incidents” that came to the limelight, but many more of them are not known when they happen, because, for example, people who live in loneliness are involved, or people whose relatives have given their consent, or simply when people want to get rid of a person perceived as annoying. We The Mad Hatter Association, constantly of forced psychiatric treatments, during which treated people suffer heavy damages. Forced treatments are often made on request of relatives, when patients refuse to take any longer the psychiatric drugs, or when their behaviour is perceived as disturbing. A friend of us (I.M.) tried to escape, but he was chased and filled with drugs; shortly after he was found dead at the bottom of a ravine. He was 40 years old. Another friend (A.S.) was walking on a path between fields and was stopped by police, because he was known as a “mentally ill” person. Then they called the psychiatrist on duty and told him: “He was walking near the railway and could possibly have in mind to commit suicide”; so they locked him up. I know this person, who often walks in the fields, where, however, it’s easy to be located near the railway, because of the constitution of the territory. He had never the intention of committing suicide. Another acquaintance of us died, throwing himself under a train, terrified by the fact that his mother, according to the psychiatrist, would refer to forced psychiatric treatment for him. Another one (U.S.) has suffered of heavy harassment, after having reported his superior’s embezzlement, noticed during his duties as a municipal technician. He was subjected to forced psychiatric treatment, kidnapped by police in riot gear. While he was sleeping, his door was smashed down, and he was thrown on the ground face down and handcuffed. He says that at least they could have tried to open the door, which was not locked. Now he is terrified and he even fears the dark; he is forced to take psychiatric drugs.

We can not think of de-institutionalization before we have dismissed the rules that allow forced psychiatric treatment, that allow to hold a person against his will, without having committed any crime, without the right to an equitable process, based on the alleged dangerousness and only because this person was diagnosed with a mental illness.

The so called “Basaglia law” the law nr. 180 from 13.5.1978, then joined and actually regulated by Law 833/1978 articles 33, 34, 35, 64, establishes the “Accertamenti e Trattamenti sanitari volontari e obbligatori” (“Forced health verifications and treatments”). In 1978 the law nr. 180 imposed the asylums’ closure, and the elimination of dangerousness or/and public scandal as criterion for forced treatment. But in the most Italian province, asylums didn’t close. So it was necessary to make another law, (because these asylums were too expensive), the law n. 724 from 23.12.1994, art. 3 paragraph 5, which dispose that these asylums had to be closed within the 31.12.1996; again disregarded, differed until the end of 1999. In 1996 the asylum inmates in Italy were 11.516 in 62 public asylums and 4.752 in private asylums.

According to this art. 180 law, forced treatment and included forced hospitalization, are possible if there are the following conditions: 1) a person “suffering mental illness” requires urgent medical treatment; 2) refuse the treatment; 3) it’s not possible to take adequate measures outside the hospitals. Forced treatments has a maximum duration of seven days, but can be renewed if necessary and then extended if it persists for a reasoned clinical need (it’s not an exception that the duration is extended for months and years). For forced treatments and the consequently limitation of personal freedom, there must be a request signed by two physicians, an administrative validation from the Mayor is required, followed by the validation of a judicial review by the Tutelary Judge.

Legislation of forced psychiatric treatment provides ample scope for arbitrariness and it is in strong contrast to the human rights regulations, that aim at preserving even people with disabilities from inhuman and degrading treatments. For those who commit a crime, it is expected that the judicial authority, within certain specific procedural rules, sanctions or imposes restrictive measures. We constantly deal with innocent people in forced psychiatric treatment, who can no longer find a way out of the psychiatric institution.

“I have to confess”, said a psychiatrist, “to have a person completely in my power, made me feel a kind of sadistic shiver”.

In Italy the CRPD was ratified in 2009, but just at now we have not a law against torture, torture is not a crime, torture is not forbidden in Italy. So, those who torture does not violate the law. In the meantime a lot of intermediate psychiatric institutions (also called little asylums) were built. They are public or private and reimbursed from the State. A very great business is behind. Some other examples: Lazio Region President Polverini’s decree on Lazio hospital system: the number of beds in Psychiatric Institutions raise from 369 up to 629; more 70%. 50 beds for the public structure and 210 for the private structure trigger the chronicization circuit.

260 beds = 90.000 life days subtracted to the people at the cost of 10.000.000 €.

Didn’t the Basaglia Law foresee the closing up of madhouses?

  • Professor Antonucci, what is, to date, the status of implementation of the law 180?

– Apart from some single exceptional case, what proposed Franco Basaglia is not realized, but it continues a job that Basaglia obviously would not approve: authoritarian interventions, taking people by force and bring it in psychiatric clinics, which are the continuation of the asylum. The asylum was established by the authoritarian intervention: I take a person against his will, then I submit her to a series of forced interventions, which are the essence of the mental hospital”. (http://www.psicoterapia.it)

The deplorable situation of the six Forensic Psychiatric Hospitals recently became more visible, after surprise-inspections of a parliamentary committee. The videos of the visits, showed by the national television, and the press releases can be found on the web. A parliamentary report had already been made in June 2010, but the photographs show a situation that until now has not yet changed. People held for decades for minor offenses, whose penalty would have expired long time since, if not repeatedly and automatically renewed.

Here below we report some data extracted from the text of the parliamentary relation on the June 2010 inspection of the 6 Italian psychiatric prisons (forensic institutions) still active (Senator Ignazio Marino, physician ,was Chair of the Investigative Committee on the National Health Care System). After the 1978 “Basaglia law”, madhouses had to be closed, but the 6 psychiatric prisons mentioned above keep doing the same job. Senator Marino was also concerned about the increasing of electroshock (from 9 institutions allowed to give electroshock before 2008, now we have more than 90 psychiatric institutions who dispense ECT).

The regulations and logics that manage these psychiatric prisons (forensic institutions) (in Italian OPG-Ospedale Psichiatrico Giudiziario), are the same inherited by the fascist Rocco Code (1934). 40 % of the 1500 actual convicted should already have been released, for detention terms expired, but they see their penalty end terms deferred in order of their supposed social dangerousness.

Nine people each cell, dirty bathrooms and bed sheets; dirty nurses’ gowns as well. In Barcellona Pozzo di Gotto (Messina), 329 convicted are overcrowded in cells built in 1914. Dirt everywhere. One patient was found naked, tied up to his bed, with a haematoma on his head. Aversa, built in 1898. 320 people locked up six by cell, in inhuman conditions.

NAS (Antisofistication and health nucleus of Carabinieri (Police)) reported and denounced all this to the Public Prosecutor’s Office, but this office is often made by the same persons that sentence patients to life.

In the Secondigliano OPG, the psychiatric prison is interior to the jail. Here stays since 25 years a patient who was sentenced two years. Burns and black eyes are not reported on the clinical diary. Feet and hands go gangrenous.

In Montelupo Fiorentino OPG they are 170 in a very scruffy building. In Reggio Emilia OPG they are 274 where they should be 132. 3 showers serve 158 patients. One is tied up to his bed since 5 days for disciplinary reasons. 3 in 9 meters square. “The OPG (psychiatric prison) are one of the “silence zones”, explains Alberto, of the Pisa Antipsychiatric Collective dedicated to Antonin Artaud, “and they show the political use of psychiatry. The consume of psychiatric drugs is more and more pushed, the electroshock comes back “in fashion”, perhaps to “heal post partum depression”. And a law lies in ambush in order to bring the forced hospitalization terms from 7 to 30 days”. After the scandal came to light, on 17 January 2012 the Senate Judiciary Committee unanimously approved the definitive closure of the OPG by 31 March 2013. The closure was extended until March 31, 2015. After the closure of the facilities in 2015, according to Law Decree n. 211/2011, converted into Law no. 9/2012, have been replaced by residences for Execution of Security Measures (R.E.M.S.). We have to closedown the Forensic Psychiatric Hospitals, instead of changing the name of them. If we don’t shut dawn these places once and for all, we cannot talk about de-institutionalization. Close them not in order to transfer their users to other psychiatric institutions, but to give these people a life dignity.

A research (source: British Medical Journal) conducted in 6 European countries (Italy, Spain, England, Netherlands, Sweden, Germany), that have closed asylums in the 70s, saw that between 1990 and 2003 an increase in the number of beds in forensic psychiatric hospitals, in psychiatric wards, in so-called safe houses. Supported housing is seen as an alternatives to asylums, as a sign of de-institutionalization, but they are rather a form of institutionalization. Also forced treatments are increasing. It is not clear the reason why the number of beds in Forensic Psychiatric Hospital increased, since there is no correlation between crimes like homicides and de-institutionalized persons.

It would be important to spread the awareness that forced treatments, like the restraint is an anti-therapeutic act, that makes cures more difficult, rather than to facilitate them. Physical restraint is not exercised only in the field of psychiatry. The areas of operation where should be discussed the problem of legitimacy, usefulness and appropriateness of physical restraint, do not consist only in hospitals, but also in nursing homes for the elderly, therapeutic communities for drug addicts and nursing homes for people with disabilities related to congenital or early acquired disabilities. An improvement in psychiatric nursing practice, characterized by the renunciation of physical restraint, would be a strong signal in order to spot out the problem also in other operating environments, urging those who work in this field to act with similar treatment practices, rather than restrictive ones.

Referring to the psychiatric drugs there are rules of the Convention on Human Rights, which require user’s fully informed consent, before administering, even if he’s disabled. Most psychiatric drugs are prescribed for a long time, sometimes for life, without informing the user on their effects, and without any help in the resolution of his real and existential problems. Psychiatric drugs can cause neurological diseases, that sometimes become irreversible. Akathisia, dyskinesia, are very unpleasant effects and can throw a person in despair. Often the user is encouraged to continue taking the drugs even when he asks to withdraw them, and it is almost impossible to find professionals who help and give directions for withdrawal. Peter Breggin, a psychiatrist, working with institutions as WHO (World Health Organisation) and FDA (Food and Drug Administration), wrote hundreds of pages on the harmful effects of psychiatric drugs. Peter Lehmann, who tested the effects of drugs on himself during his hospitalization in a psychiatric clinic, has published and continues to publish the results of his research for which he uses pharmaceutical and medical literature. The effect of psychiatric drugs is known, but the billion-dollar business behind it is too big to lose it. Peter Lehmann is the first survivor of psychiatry to be awarded with the honorary degree, conferred him by the clinical psychology faculty of the Aristotele’s University of Thessaloniki, for his work as researcher and activist in the field of mental health.

A person who starts to take drugs, in most cases will be induced to take them for life, because they create addiction problems. The psychiatric user develops a very strong dependence toward the psychiatric service too. For the psychiatrists, lack of compliance is in fact intended in it self an aggravation of the disease. Then the conditioning that takes place, goes in the direction of dependence from psychiatric services, of becoming “childish” and “chronic patient”.

Although in almost all European countries asylums and psychiatric hospitals have been eliminated or substantially reduced, this does not mean that in the new post-asylum structures, asylum-dispositifs have been eliminated. People are, with few exceptions, completely sedated by psychiatric drugs, even though apparently there are implemented programs such as art therapy. The intake of psychiatric drugs is induced also in order to make the user unconscious.

Erwin Redig, a German psychiatric survivor, says: “There are people putting us under pressure to force us to take them (psychiatric drugs). If we do not take them, our changes embarrass them. If this is our case, we must make clear to ourselves that we are swallowing drugs for other people’s welfare, because they find us unpleasant if we do not”.

“The dispositif of discomfort-complex, that operates in a small residence, acts more broadly in the society”. Neuroleptic drugs affect thinking, block the flow of thoughts, and make people flatten. I relate the words of a healthcare professional: “As soon as psychiatric drugs are given to people, they literally get extinguished. To what extend is it fair to cancel the person?” Although in the European countries, the asylum psychiatry and the psychiatric hospitalization of users have given way to communities, the psychiatric institution culture has not changed. The patterns of asylum residentiality are still active. But most of all it is still alive an asylum mentality, therefore it is important for everyone to be aware how much everybody’s mentality is crucial in creating or not creating devices that belong to psychiatric institutions; operating devices that constitute a widespread operating module. “Residential Intermediate Structures”, foreseen in Italy by the 1983 law, should have had the provisional nature as their specificity; therefore they should not constitute either a definite admission or a final place for forced hospitalization; they should have been  transitional housing, that could break prejudice and exclusion logics. In March 1999, by a special decree, to the Italian Regions was imposed the definitive closure of the asylums, under threat of strong economic sanctions, because despite the birth, on paper, of the new “local services”, mental hospitals were still crowded with patients.

Named by the derogatory title of “asylum residuals”, for these people that nobody wanted, residential structures accounted for an illusion of freedom; they founded themselves to be again in a mental institution. “Many patients”, writes one of them in an autobiography, “have never been so well in terms of comfort, but nevertheless they are in a state of fearful desolation”.

An induced need of security, the defence from a potentially dangerous mind sick person that at any time, during an outbreak, could commit heinous actions against others or against himself; shortly, on the basis of this need and of this false scientific fundamentals, we build the myth of the need of post-asylums psychiatric institutions. If we don’t get reed of the psychiatric prejudice, the “mental health” institution remains. There are many alternatives pursued by individuals, associations or institutions, but they are deliberately ignored. The responsibility for solving the problems of institutionalization, is not up only to psychiatrists or to mental health professionals, but to the whole civil society. Everybody contributes to the asylum mentality. Users as well, who have internalized the psychiatric diagnosis and can no longer live without it.

Mary Nettle, chairman of Enusp until 2010, expects an increasing involvement of users and survivors of psychiatry in researches about psychiatry; while they often are excluded or not paid on the pretext that they are not professionals.

Although many examples exist that  prove that you can accompany a person in troubles out of his problems, through dialogue and support in the resolution of the objective and material difficulties, and helping him to get awareness of his own rights, these experiments and their positive results continue to be deliberately ignored.

 

I will never forget, by Irit Shimrat

a work in progress

I will never forget, though I wish I could, what psychiatric brutality feels like. Being taken to hospital by the cops, by brute force, in handcuffs, though my only crime was confusion.

Being stripped naked in front of male orderlies. Being shackled to a gurney on the psych emergency ward. Being painfully jabbed in the ass by a nurse wielding a needle filled with a drug that had immediate, nightmarish effects. Being ignored by chatting nurses as I whispered, then said, then screamed that I had to go to the bathroom. Being left to lie in my own shit for hours as they discussed boyfriends and hair styles.

Being wheeled to a concrete cell, furnished only with a mattress on the floor and a metal toilet and tiny sink, an observation window in the metal door, and a camera in the corner of the ceiling. Being left there for days, under the glaring fluorescent light, with someone coming in three times a day to leave a sad, bland meal in a plastic tray on the floor. Performing for the camera and writing on the walls with my shit as the drugs that were supposed to knock me out made me crazier and crazier.

Finally being released onto the ward, but being slammed back into solitary confinement every time I “acted out.” Slowly and painfully learning to conform, so as to earn such “privileges” as being allowed to wear real pajamas, then my own clothes; being allowed out for a cigarette; being allowed to make a phone call. Being mocked and brutalized by burned-out nurses.

Finally being allowed visitors, only to have them stare at me in horror and pity, as I shuffle like a zombie, much too drugged to make conversation. Eventually learning the magic words that got me out: “I understand that I’m sick and need to take these drugs for the rest of my life.” Drugs that had already resulted in dry mouth; flaking skin; extreme constipation; painful muscle spasms; inability to sit, stand or lie still – not to mention their effects on my mind: the terror, the agony, my absolute failure to be able to hang onto my self. The certainty – my only certainty – that I had died and gone to hell. That I was being punished for crimes I couldn’t remember. That I would never be able to live in the world again.

I was wrong in that certainty, but it’s been a hard road back, and I’ve had to travel it many times. Always, when I’m back out in the world, I find myself suffering from the effects of institutionalization, terrified of the loneliness, of having to take care of myself, of not being able to make it outside the bin. I’ve had to suffer the withdrawal symptoms from whatever they were forcing me to take, which I stop taking as soon as I get out. I’ve had to punish myself, hit myself, scream at myself for having been such an idiot as to get locked up again. I’ve had to go through weeks or months of wanting to kill myself to make sure this never happened to me again. I’ve had to slowly rebuild my life. And I’ve had to live with the permanent effects, physical and emotional, of being poisoned with psychiatric drugs and traumatized by institutional cruelty.

My life has been a sheltered one, on the whole. I was born and raised in a comfortable middle-class family, with lots of parental love and support and no violence or neglect. I have never been raped or beaten or hungry. Nevertheless, I got bored as a teenager, took lots of drugs, and ended up going crazy, several times, over the years. But being crazy wasn’t, of itself, a bad thing. If I had been allowed to go through it – if I had been treated with kindness and compassion, and encouraged to explore my thoughts and visions and make sense of them – it could have been the wonderful experience that it always started out as. It could have enriched me.

The only really bad thing that has ever happened to me is psychiatry. It has damaged my body and mind, destroyed my self-esteem, and forced me to re-invent myself, again and again, every time it tore me apart.

 

Pink Belette: La psiquiatrie en France/ Psychiatry in France

La psychiatrie en France, zone de non-droit (par Pink Belette)

Une patiente française sous contrainte fait son « audit » dans le cadre de la campagne pour soutenir l’Abolition totale des soins et de l’hospitalisation sans consentement en application de la CDPH de l’ONU

http://depsychiatriser.blogspot.no/2016/03/la-psychiatrie-en-france-zone-de-non.html

 

Pourquoi je suis contre les « soins sous contrainte » :

On pourrait croire que, au pays de la liberté, on a encore droit à son intégrité morale et physique.

Rien n’est plus faux. Par experience, impossible pour quiconque d’échapper à un soin sous contrainte (SPDT, « soin à la demande d’un tiers » ou « péril imminent »).

Il suffit que : une personne la demande (que ce soit la famille, un voisin…), qu’on soit « pas bien », déstabilisé, agité, « instable », en colère, dépressif, sur la défensive, « en opposition », « délirant », amaigri, boulimique, fumeur de shit, drogué…

Il suffit aussi qu’on refuse l’hospitalisation ou un traitement pour que les médecins se relaient pour demander un soin sous contrainte. Une fois hospitalisé, « on » vous fait comprendre que vous perdez vos droits à la personne, l’argument étant : « maintenant on est responsable de vous pour TOUT »… Par contre, vis-à-vis de vous, « on » n’est responsable de rien…

 

Depuis la loi Bachelot du 5 Juillet 2011, en particulier si on a le malheur de contester le diagnostic ou le traitement, c’est alors après la sortie d’hospitalisation qu’on ne peut plus se débarrasser de la contrainte, et c’est là que c’est le plus pervers : injections forcées, consultations obligatoires avec un praticien hospitalier non choisi (à la rigueur, on a le choix entre deux médecins).

Le pire : si on refuse de se rendre au centre médico-psychologique du secteur assigné, la police vient gentiment vous cueillir chez vous pour vous hospitaliser en soins obligatoires à un degré encore plus coercitif (SPDRE, « sur la demande de l’Etat ») et sur un temps plus long et sans contact autorisé avec l’extérieur (!) jusqu’à ce qu’il aient réussi à réduire votre volonté à néant. Ainsi, il arrive que les personnes concernées doivent abandonner leur logement pour « vivre » en psychiatrie (parfois pendant des dizaines d’années, voir le cas de Dimitri Fargette)…

 

Je suis témoin : en France, il y a réellement du souci à se faire…

  1. Il n’y a aucune alternative à la psychiatrie institutionnelle (lobbying des psychiatres ET de l’industrie pharmaceutique contre d’autres formes de thérapies) ;
  2. Aucune littérature ou culture antipsychiatrique (des « survivants », il n’y en a pas…)
  3. L’Ordre des Medecins Psychiatres qui suspend : tout psychiatre « en décalage » avec le système consensuel (d’après le Dr. O.G, psychiatre libéral et ex-chef de clinique) ;
  4. L’Ordre des Medecins Psychiatres qui suspend : un psychiatre responsable de la mort d’une patiente… seulement pour 2 semaines (voir l’affaire Florence Edaine)
  5. La « Mafia des tutelles » : tout patient faisant des séjours répétés est automatiquement placé sous curatelle ou tutelle (sans consentement, c’est renforcé)…
  6. Des mères se voient enlever leurs enfants immédiatement après la pose d’un diagnostic de maladie mentale ; jamais de scandale médiatique…
  7. On fait comprendre aux femmes en âge de procréer qu’il faut surtout adopter la contraception, en sous-entendant qu’on leur enlèverait leur enfant de toute façon. Ce qu’on ne leur dit pas, c’est que tous les neuroleptiques passent la barrière placentaire, c’est pourquoi j’ai entendu parler d’autant de cas d’avortements spontanés chez les femmes sous traitement. Dixit une infirmière, on donne de l’Haldol aux femmes enceintes, ce qui « prouverait » soi-disant « le peu de nocivité de l’Haldol » (!). Jamais d’étude là-dessus ni de scandale médiatique…
  8. Des services fermés qui regorgent de dépressifs qui ne sont pas en « péril imminent » et qui se sentent surtout mal de recevoir par exemple 4(!) antidépresseurs à la fois…
  9. Une cellule d’isolement toujours occupée (appelée « chambre de soins intensifs »!), ce qui participe du « folklore »…
  10. « Abonné une fois, abonné toujours » : les traitements qu’on ne peut plus JAMAIS arrêter ;
  11. Aucune étude à long-terme sur les effets des psychotropes…
  12. Aucun recours en cas d’abus psychiatriques (système interne de « médiation » caduc : mal vous en prend d’écrire une lettre au directeur de l’établissement…)

 

Pourquoi je suis contre ce nouveau système de « Juge des Libertés et Détentions » (relatif à la loi du 27 septembre 2013) :

On vous fait croire que c’est une voie de recours. Rien n’est plus faux, à part en cas de vice de forme (ce qui n’arrive quasiment jamais, puisque les psychiatres ont intérêt à ce que la procédure se passe en bonne et dûe forme). Au contraire, c’est un enfermement de plus…

  1. Le juge n’est pas psychiatre, il se garderait bien de remettre en question le jugement des médecins sur le fond. Par contre, on lui a expliqué que tout patient qui conteste le traitement est en « opposition », ce qui constitue déjà une preuve de « déni de maladie ».
  2. Les médecins y trouvent donc une voie bien pratique pour se décharger de leurs responsabilités, puisque « c’est le juge qui décide ». Et alors on voit défiler les patients dans le bureau du juge, accompagnés d’un soignant : « on vous amène Mme X »…
  3. On vous octroie un avocat commis d’office une semaine avant, mais qu’on ne peut pas contacter avant. Le jour de l’audience, c’est 15 minutes pour faire connaissance et se préparer, et ceci « dans les cases »…
  4. Ce qui est très alarmant, c’est qu’on ne trouve pas d’avocat en libéral, à part peut-être à Paris, et seulement pour un recours aux assises.
  5. Le juge prétexte qu’il ne peut lever le soin sous contrainte si c’est à la demande du directeur de l’établissement. Or, toutes les demandes de mise en soins sous contrainte passent par l’approbation du directeur. Tout le monde se donne bonne conscience, donc ;
  6. Une fois l’audience terminée (10 minutes), où l’on se voit déstabilisé, accusé et mis en doute, le juge « ordonne » le maintien en hospitalisation complète et de la mesure de contrainte, ce qui confère force de loi aux médecins (et donc une impunité totale) et SURTOUT donne encore plus de poids à la mesure.
  7. Inutile de préciser que si on était encore crédible avant, on ne l’est plus du tout et c’est définitif. Si on refuse de signer la feuille ou de comparaître, c’est pire, et on s’attire les foudres des médecins et du personnel soignant, qui vous mettent la pression, vous humilient et vous maltraitent. On ne peut pas non plus refuser que l’audience ait lieu.
  8. Le juge sait pertinemment qu’il s’agit d’une volonté potitique de faire taire les « récalcitrants » par voie chimique et coercitive. Il y adhère donc pleinement.

 

Pourquoi je suis contre les traitements forcés :

J’insiste sur le fait que les psychiatres hospitaliers ont les pleins pouvoirs sur le choix et le dosage des traitements, il ne s’agit JAMAIS d’un consentement éclairé. La « balance bénéfice-risque » est toujours de leur côté, même en cas de surdosage, même si la personne prend déjà 17 médicaments et pèse 200kg (ce qui est le cas d’une amie à qui on a donné Zyprexa ET Xeroquel suite à quoi elle a fait un accident vasculaire cérébral). Ils ne sont jamais responsables des effets secondaires non plus et vous orientent « gentiment » vers votre généraliste…

De plus, c’est toujours les médecins qui « décident » à votre place si vous allez bien ou non, et ce, même s’ils ne vous connaissent pas ou vous on vu seulement 5 minutes…

L’effet pervers de la chose, c’est que c’est tellement insupportable d’être enfermé et camisolé chimiquement qu’au bout d’un mois, on fait semblant d’aller mieux, on renie ses opinions et on arrête de se plaindre des effets secondaires pour pouvoir sortir, sous peine de se voir diagnostiquer en plus des « troubles du comportement » et un « déni de la maladie»…

 

J’AI ETE TORTUREE : au Zyprexa (surdosage), au Solian, au Tercian, au Risperdal (8 mg pour un poids de 50 kg), à l’Haldol (90 gouttes par jour) et « shootée » au Valium (40mg!)…

Le médecin et le personnel infirmier refusaient de prendre en compte : les troubles de l’élocution, tremblements, convulsions, dyskinésies, impatiences insupportables, angoisses mortelles, envie de mourir et tortures psychiques (« enfer » mental) qui ont apparu immédiatement et ont même empiré avec le temps. Je me suis battue en vain en plaidant que les neuroleptiques anesthésient la conscience, font perdre la mémoire, rendent docile et influençable, rendent dépressif et encore plus anxieux, affectent les capacités intellectuelles et détruisent l’âme.

J’ai également été mise plusieurs fois en isolement avec violences de la part du personnel ET des employés de la sécurité, alors que je n’ai JAMAIS été agressive. J’ai été mise sous contention, j’ai été déshabillée de force, j’ai été déshydratée, humiliée, bafouée, maltraitée…

Aujourd’hui, même si j’ai droit à un traitement moins inhumain, l’Abilify en injectable (après une 4ème tentative de suicide), je reste « accro » au Valium, traumatisée et toujours en alerte, dans l’angoisse de manquer à mes « obligations » ou de faire mauvaise impression, sans parler de l’absence totale de perspectives, de motivation et de joie dans ma vie, sans parler de ma vie affective qui est une misère (mort spirituelle, isolation, dépression, anxiété…).

Ma carrière artistique, qui avait débuté avec succès, a été définitivement brisée pendant mes meilleures années (la trentaine) et je suis aujourd’hui dans l’incapacité de créer alors qu’avant je foisonnais d’idées et me donnais les moyens pour les mettre en œuvre. Il est également trop tard et trop compliqué pour moi maintenant pour devenir mère.

Je vis dans la précarité à la charge de l’Etat.

 

Pourquoi j’ai toujours été opposée à leurs « diagnostics » pathologisants :

Je suis une personne ayant vécu les pires traumatismes dans la petite enfance (viols et abus, harcèlement), dont la plupart des souvenirs sont remontés plus de trente ans après, ce qui a grandement affecté mon équilibre psychique. J’ai malheureusement dû constater que, d’après les psychiatres (pour autant qu’ils m’aient crue…), il n’y aurait aucune relation de cause à effet entre ce que j’ai subi et mes troubles (!), ce qui est tellement énorme et risible qu’on aurait plutôt envie d’en pleurer…

J’ai pu constater, à l’instar de la Dre Muriel Salmona, seule psychiatre en France à ma connaissance qui aborde la souffrance psychique sous l’angle du trauma, qu’en France, aucune prise en charge spécifique n’est prévue ou proposée, et après 8 ans de psychiatrie, aucun médecin à ce jour ne m’a diagnostiqué un syndrôme de stress post-traumatique avec dissociation, ce qui pourtant devrait être le cas après des viols dans la grande majorité des cas selon la Dre muriel Salmona ( Association Mémoire Traumatique et Victimologie ). Je n’ai quasiment jamais pu faire de travail thérapeutique avec un psychiatre.

Quant à leur diagnostic de schizophrénie, il n’a jamais été étayé, expliqué ou argumenté, et mon dossier a été établi sur des « observations » des médecins et de simples « impressions » du personnel soignant… J’ai constaté également que parler de spiritualité conduisait immanquablement à un diagnostic de « délire mystique », donc, selon eux, de schizophrénie.

J’en conclus que l’enfermement et leurs mauvais soins n’ont fait qu’en rajouter à mes traumatismes, je ne crois pas un seul instant que leurs maladies imaginaires résultent d’un déséquilibre chimique dans mon cerveau ou d’une quelconque « maladie » biologique, je sais que les effets des neuroleptiques sont catastrophiques à long-terme et je suis totalement en accord avec de nombreux anti-psychiatres à l’international, dont le Dr. Peter Breggin, Joanna Moncrieff, David Healy, Robert Whitaker, Thomas Szazs, Peter Goetzsche et autres… (cf. le site madinamerica.com).

 

CONFORMEMENT À LA CONVENTION DES NATIONS UNIES SUR LES DROITS DES PERSONNES HANDICAPÉES, ARTICLES 12, 14 ET 15, TEL QU’INTERPRÉTÉ DANS L’OBSERVATION GÉNÉRALE NO. 1 ET LES LIGNES DIRECTRICES SUR L’ARTICLE 14, ET AUX PRINCIPES DE BASE ET LIGNES DIRECTRICES PUBLIEES PAR LE GROUPE DE TRAVAIL SUR LA DETENTION ARBITRAIRE DE L’ONU, PRINCIPE 20 ET LIGNE DIRECTRICE 20, JE PLAIDE POUR L’ABOLITION TOTALE DE LA PSYCHIATRIE COERCITIVE ET DES TRAITEMENTS FORCES.

JE REVENDIQUE TOUS MES DROITS A LA PERSONNE EN TANT QUE FEMME MAJEURE PROTEGEE, PERSONNE HANDICAPEE, EN PARTICULIER LE DROIT INALIENABLE DE DISPOSER PLEINEMENT DE MON CORPS ET DE MON ESPRIT SANS CHIMIE IATROGENE, DE MA LIBERTE INCONDITIONNELLE.

JE CONSIDERE LA PSYCHIATRIE INSTITUTIONNELLE ET SES PRATIQUES COERCITIVES COMME UN CRIME CONTRE L’HUMANITE, UNE ATTEINTE A LA DIGNITE ET A LA LIBERTE DE PENSEE 

Pink Belette, Mars 2016

 

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Psychiatry in France, NO-RIGHTS-ZONE (By Pink Belette)

A french patient under forced commitment makes her « audit assignment » as part of the campaign to support CRPD absolute prohibition of commitment and forced treatment

 

Why I am against commitment and forced treatment :

One could believe that, in the land of liberty, one is still entitled to his or her physical and moral integrity.

Experience proves it wrong. It is impossible for anyone to escape forced commitment (so-called « care on demand of a third party » or « imminent danger »).

It’s already a done deal if : one person asks for it (family, neighbour…), one is « not well », unsettled, agitated, « not stable », gets angry, is depressed, on the defensive, « in opposition », exuberant, emaciated, bulimic, shit smoker, drugged…

It is sufficient if one refuses hospitalization or a treatment for the doctors to relieve each other in order to enforce commitment. Once hospitalized, it is been made perfectly clear that one looses his or her personal rights, only argument is : « now we are responsible of you for EVERYTHING »… Thus, towards the « patient », nobody is responsible of anything…

 

Since the « Bachelot law » of July 5th 2011, particularly if one has something to object, be it diagnose or treatment, it is then after being out of hospital that one cannot get rid of commitment, which is most perverse : forced injections, mandatory appointments with an non-chosen clinical psychiatrist (or, best case, with a choice between two doctors).

And, worst of all : if one refuses to go to the assigned medical center of one’s district, the police comes to pick one up at home and rehospitalization is mandatory with an increased commitment that is even more coercive (« on demand of the State »), on a longer lapse of time and with no authorization to communicate with the outside (!) until they succeed to break one’s will and reduce one to nothingness… It so happens that people loose their home and « live » in psychiatry (sometimes for decades, see Dimitri Fargette’s case)…

 

I witness : in France, there is really matter to worry about… 

  1. There is no alternative to institutional psychiatry (lobbying of psychiatrists AND pharmaceutical industry against other forms of therapies) ;
  2. No antipsychiatric litterature nor culture (no « survivors »…)
  3. The « College of Psychiatrists » who suspends : every psychiatrist « not aligned » with this consensual system (according to Dr. O.G, liberal psychiatrist and former head of clinic);
  4. The « College of psychiatrists » suspending : a psychiatrist responsible for the death of a patient… only for two weeks (see the case of young patient Florence Edaine)
  5. The « Guardianship mafia » : every patient who is repeatedly hospitalized is automatically placed under guardianship under a certain degree (without consent, it is being reinforced…)
  6. Single mothers get their children robbed and placed immediately after a diagnosis of mental illness is established, never one scandal about this…
  7. Women in age to bear a child are being strongly recommended a contraception, with a wink that their child would be taken away from them anyway. What they are not being told is that all neuroleptics pass the placenta barrier, that’s why i have heard of so many miscarriages from women under treatment. A quote from a nurse : « pregnant women are given Haldol, which proves it’s little nocivity » (!). Never one study about that nor mediatic scandal.
  8. Closed wards full of depressive people who are not in « immediate danger » and are feeling bad mainly because they are being given for example 4 (!) antidepressants at a time…
  9. An always occupied isolation chamber (so-called « intensive care chamber »!), which participates to the « folklore »…
  10. « Once subscriber, always subscriber » : treatments one can NEVER withdraw from ;
  11. No long-term study on psychotropic medication… (All so-called studies are biased)
  12. No recourse in case of even flagrant psychiatric abuse (internal system of « mediation » obsolete : it’s a very bad idea to write a letter to the director of the institution…)

 

Why I am against this new system of « Judge of Liberties and Detentions » (related to the law of september 27th 2013) :

They are making believe it is a recourse. I was proved wrong, except for instance on a technicality (which almost never happens, because it’s in the psychiatrists’ interest that the procedure goes well and in due form). On the contrary, it’s in the sense of more legal coercion…

  1. The judge is no psychiatrist, he would never ever put into question the judgment of the physicians concerning the core. Thus, he has been briefed about the « fact » that any patient who opposes treatment is « in opposition », which establishes already a proof of « illness denial » (and as a proof of illness itself).
  2. Therein it has been found a very practical way for doctors to be discharged of their responsibilities, as « it’s the judge who decides ». And now, bunches of patients are being spotted filing up before the judges’ office, escorted by a nurse : « we bring you Ms. X »…
  3. Patients get a mandated advocate one week before the audience, but who cannot be contacted in advance. At audience day, it’s 15 minutes to meet and prepare, and, of course, in a « formated » way.
  4. Very alarming is the fact that no liberal advocate is to be found for psychiatric abuse pleas, except maybe in Paris, and mostly for a recourse before the Court of Assize.
  5. The judge pretends he cannot lift the forced commitment because it’s asked for by the hospital director. Yet, all demands for forced commitment have to be validated by the director. Hence everyone gives him- or herself a good conscience there ;
  6. Once the audience done (10 minutes), where one gets destabilized, accused and doubted of, the judge « orders » the maintaining of the person in complete hospitalization and of the measure, which confers force of law on the doctors (hence, total impunity).
  7. Not to mention the fact that if one still had credibility before, it’s no longer the case and irreversible. If one refuses to sign the convocation or to attend the audience, it’s worse, and one is being bullied by staff members and doctors alike, who put one under pressure, humiliates one… One also cannot refuse the audience being held despite of one’s absence.
  8. The judge knows pretty well that it’s a political will to make silent the « opponents » of the system, chemically and coercively. He therefore fully concurs with it.

 

Why I am against forced treatment :

I insist on the fact that hospital psychiatrists are almighty regarding the choice and dosage of treatments, it’s never about an « informed consent ». The « benefit- risk balance » is always on their side, even in case of overdosage, even if the person already takes 17 meds and weighs 400 pounds (which is the case of a friend to whom was administered Zyprexa AND Seroquel after which she had a cerebral attack with impairment). They are also never responsible for side effects and, in case of complaint, derefer to one’s generalist physician…

Thus, it is always them who « decide » on one’s behalf if one is well or not and this, even if they don’t know the person or have seen him or her only five minutes…

Perverse effect of the thing : it’s so unbearable being locked up and silenced chemically, that, after a month, one pretends to feel better, disavow his or her opinions and stops complaining about side effects in order to get out, knowing that otherwise one will be diagnosed behavioural troubles and « illness deny »…

 

I WAS TORTURED : with Zyprexa (overdosis), Amisulpride, Cyamemazine, Risperdal (8 mg for a weight of 100 pounds), Haldol (90 drops a day) and « shooted » with Valium (40mg!)…

The doctors and staff refused to take into account : speaking troubles, heavy trembling, convulsions, dyskinesia, unbearable akathisia, heavy existential fear, wish to be dead and psychical tortures (mental « hell ») which appeared immediately and even worsened as time went by. I fought in vain, pleading that neuroleptics anesthetize consciousness, occasion memory loss, make one docile and influentiable, make depressive and even more anxious, impair one cognitively and destroy the soul.

I was also put into solitary confinement several times with violences from the staff AND security agents, despite the fact I have NEVER been even agressive. I was put under contention, was violently undressed, dehydrated, humiliated, spoliated, mistreated…

Today, even if I get a « less inhumane » treatment – Abilify retard injection – (after a 4th suicide attempt), I remain addicted to Valium, traumatized and always on alert, fearing to miss my « obligations » or to make bad impression, without mentioning total absence of perspectives, motivation or joy in life, without mentioning my affective life that is a misery (spiritual death, isolation, depression, anxiety…).

My artistic career, which finally started with success has been definitively broken during my best years (in my 30′) and today I am totally unable to create despite the fact that before, I had thousands of ideas and was giving a great deal to put them into meaningful use. It is also too late and too complicated for me now to become a mother.

I live in precarity at the charge of the State.

 

Why I was always opposed to their pathologizing « diagnoses » :

I’m a person who endured the worst traumas in early childhood (rape and abuse, mobbing…), while most memories came up again more than 30 years afterwards, which greatly affected my emotional balance. I had unfortunately to experience that, according to psychiatrists (if they even believed me), there would be no cause-to-effect relationship between what I had to bear and my troubles (!), which I find so enormous and stupid that one would rather cry…

I had to notice, alike Dr. Muriel Salmona – only psychiatrist in France knowingly approaching psychical suffering under the perspective of trauma – that in France, no specific caretaking is being proposed nor planned, and after 8 years of psychiatry, not one physician has diagnosed me a post-traumatic stress disorder with dissociation which, according to Dr. Muriel Salmona (« Association Mémoire Traumatique et Victimologie ») is the case after rape and abuse.

I could almost never do a therapeutic work with a psychiatrist.

Regarding their diagnosis of schizophrenia, it has never been illustrated, explained or argumented, and my medical records have been established on mere « observations » from the doctors and sheer « impressions » from the staff…

I also came to the conclusion that to actually speak about spirituality would eventually always end in them diagnosing a « mystical delirium » and, as such, schizophrenia.

My conclusion is that their imprisoning and bad treatments have done none but to aggravate my traumas and personal issues, I don’t believe a second that their imaginary « diseases » result in a chemical imbalance in my brain or an unknown « biological » illness, I know that neuroleptics and affiliated meds are catastrophic in the long-term (causing brain damage) and I totally agree with numerous anti-psychiatrists internationally, such as the Drs. Peter Breggin, Joanna Moncrieff, David Healy, Robert Whitaker, Thomas Szazs, Peter Goetzsche and others… (see on madinamerica.com).

 

IN ACCORDANCE WITH THE UNITED NATIONS CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES, ARTICLES 12, 14 AND 15, AS INTERPRETED IN GENERAL COMMENT NO. 1 AND THE GUIDELINES ON ARTICLE 14, AND WITH THE BASIC PRINCIPLES AND GUIDELINES OF THE UN WORKING GROUP ON ARBITRARY DETENTION PUBLISHED IN 2015, PRINCIPLE 20 AND GUIDELINE 20, I SPEAK IN FAVOUR OF ABSOLUTE PROHIBITION OF COERCIVE PSYCHIATRY AND FORCED TREATMENT.

I RECLAIM ALL MY RIGHTS TO PERSONHOOD AS A DISABLED ADULT WOMAN UNDER PROTECTION, IN PARTICULAR THE INALIENABLE RIGHT TO DISPOSE ENTIRELY OF MY BODY, MIND AND SOUL WITHOUT IATROGENIC CHEMICALS AND MY UNCONDITIONAL LIBERTY.

I CONSIDER INSTITUTIONAL PSYCHIATRY AND ITS COERCIVE PRACTICES A CRIME AGAINST HUMANITY, A SEVERE HARM TO DIGNITY AND TO FREEDOM OF THINKING.

 

Pink Belette, March 2016

 

 

Christian Discher – The forgotten and the “Hell in Ueckermünde”

The forgotten and the “Hell in Ueckermünde” [Die Hölle von Ueckermünde] Has anything changed in German Psychiatry’s since the wall came down?

http://inklusionspolitik.de/en/the-forgotten-and-the-hell-in-ueckermunde-die-holle-von-ueckermunde-has-anything-changed-in-german-psychiatrys-since-the-wall-came-down/

by Christian Discher

In Germany, politicians and social research institutes campaign under the claim that we live in a society, in which all people are to be included: older people and people in need of care; disabled people; women; homo- and transsexual people, as well as transgender people; children; the sick; men; and immigrants. Universities receive millions of euros in funding, so that they can begin and maintain research projects focused issues facing “inclusion“. However, due to the mighty cleave between theory and reality, results in research rarely become established practical behaviors or values. Still, a closer look at the concept of inclusion makes it clear: Germany has a long way to go before it can be considered an inclusive society. In the debate over discrimination and exclusion (Inklusion/Exklusion: Stichweh 1997), the public receives hardly any information about the fate of those who, due to a particular psychological disturbance, are forced to live in psychiatric wards. Mainstream media does occasionally report on particular offences, when an acutely ill person is institutionalized. Nonetheless, the difference between mentally ill criminals and mentally ill people is not highlighted. (legal foundation) Meanwhile, depression and eating disorders are widely recognized. Such is as well the case with schizophrenia only with the difference, that the schizophrenic, after being released from treatment, is rarely able to find a place in our society. The latter are those who make us anxious on the subway with their loud announcements the stalking methods of secret government services or CSI. Others beg and attempt to convert their audience. An honest question: who, when confronted with such people in the bus or on the street, doesn’t feel anxious?(Discher: 2015) That the diagnosis of schizophrenia or psychosis – now known to be rooted in a diseased metabolic system – leads to paranoid thoughts and socially inacceptable behaviors, […] Clarification is not provided by mainstream media. Yet, in the case of many diagnosed schizophrenics, this diagnosis is ungrounded. As C. was seventeen years old, he was treated in the intensive care unit at the psychiatric and psychotherapeutic clinic in Ueckermünde. Stettiner Haff (August 2014) Bild 1 In 1993, when the ARD compromisingly distributed the report, Die Hölle von Ueckermünde Hell in Ueckermünde [by Ernst Klee]  the media reacted aggressively. (Moussavian) The inhumane involuntary commitment in the psychiatric wards that took place in this period of the GDR called for worldwide shock and chagrin. What was more horrifying? The argumentation of interviewed personnel or the forcible commitment of human beings? Or was it the terrified men, who had not seen light for years and were showcased to the public without prior consent? Investigative journalism at whose cost? In 2014, on the 25th anniversary of the fall of the Berlin wall, people celebrated their newly won freedom. But what had become of those, who experienced Ueckermünde, and how is it with those, who are being treated their today? Ueckermünde, a small city at Stettiner Haff touts its “inclusivity” projects. On the website of a regional politician (Dahlemann: 2013), to following goal is heralded: “The beginning of an inclusive region [at the Stettiner Haff” “Many were already there in Bürgersaal. Whether Kulturspeicher or Kleeblattchule Anklam, politicians like Patrik Dahlemann, or regular people – they were all there in order to drive the project forward. Hopefully, it will then become concrete, so that many ideas like that of market for leisure activities, carpooling center, consulting center, among others, will be able to be better implemented and ‘inclusion on the backwater‘ will be brought to life.” The mission is expressed honestly, in words that include everyone. Nevertheless, the number people who retire early in Germany on account of psychological illness is increasing dramatically. In opposition to other German states, the number of mental illnesses in Mecklenburg-Vorpommern increased 102% between 1997 and 2011. The number of in-patients being treated grows at a steady rate. In plans for the further development of an integrative aid services for psychologically ill persons in Mecklenburg-Vorpommern, attempts are made to react to structural problems. There are even discussions about interdisciplinary collaborations. During this negative development, the role and responsibilities of those who are active in systematic psychiatric clinics is not questioned. But how do those people fare, who are placed in House 12, a clinic on the edge of Ueckermünde? On a sign at the Ravenstein St. exit, the way to the center for forensic psychiatry as well as to Kita Morgenstern is described.

Wegweiser zur Klinik für Forensische Psychiatrie und Psychotherapie

Further information leads the visitor to the AMEOS hospital complex. The clinic for psychiatry, psychotherapy, and psychosomatic treatment, which is located at 23 Ravensteinstraße, is not mentioned. Before the interested person can find a proper description of the way to the clinic, he or she must first conduct fairly extensive internet research. On its modern web page, the hospital appeals to its 130 year old tradition and gives a detailed presentation of its guiding principles. With 87 in-patient beds, 6 wards, an ambulance, as well as five different treatment options in the day-clinic, the hospital offers enough space for a large number of patients. Modern methods of diagnosis and responsible doctors rounds out the presentation. Since the end of the Second World War, the institution had been reformed. (Cf. Seiffert: 2010).

“Normal psychologically ill” patients as well as the mentally retarded were brought into either red brick buildings or an old socialist construction. Signs that are for orientation say “open and closed integration“ guide you to the buildings. What do the terms integration and inclusion have in common? Across from House 40 is a landing. It is a concrete construction from the socialist era –desperately in need of cleaning – that, in 1997 and for some years thereafter, was still being used in 1997 as an open ward. Today, it is used as dormitory space for disabled people; children play soccer, unconcerned and joyful. The kindergarten Morgenstern is walled in, surrounded by dilapidated shanties that are used as storage spaces. Barbed wire walls tower behind the kindergarten. A sports field, monitored by countless video cameras. Not too far away, at 15 Ravensteinstraße, is the hospital for forensic psychiatry and psychotherapy. With its impressive architecture and reedy ponds, it could easily be mistaken for a vacation spot, if one overlooks the security cameras. Is the latter really a proper place for the rest and recovery of children, patients, and disabled persons, a proper place for the new form of “inclusion” in Ueckermünde? Are the patients and residents given a modern place for sports activities? No. In 1997, at the age of 17 years, C. was checked into House 12, the ward for acute psychiatric illnesses in Ueckermünde. He was just about to complete his Abitur , a high-school examination in Germany, as he suddenly faced a personal identity crisis. Homosexuality, a young love affair, and exclusion in his social environment; problems with his parents. Inner changes and experiences, common among adolescents. In order to help himself come through these developments, he turned to god, began to pray regularly and trust his inner voice. Through conversations with helpful friends, C. searched for a way out of this life-crisis. It was to no avail. His way was impeded by too many of the difficulties and realities of growing-up. He then sought support from a female pastor. He sat across from her, crying, and listened to the advice he would eventually follow: he should check himself into the clinic in his home city. That time, he wasn’t offered alternatives. That he had lost a massive amount of weight in the weeks before he checked in to the clinic played no part in any of the conversations. As he came to the hospital, C. had no idea that he was in the psychiatry ward. It was a bad time. He wanted to display himself honestly, to stand by his homosexuality. He undressed and waited in the corridor of the ward. He realized quickly, however, that this was no way to solve his problem. He calmed himself down but still could not understand that the doors of the ward were locked. He was not used to being shut in, and he felt completely closed in. No one questioned him about his problems; no one noticed the life crisis. At the entrance to the lavatory, he suffered a hemorrhage, that would eventually lead to his downfall. The cleaning of the lavatory and his body cost time. As he made his way back to his room, nurses and doctors were waiting in the corridor. Insecure in front of the crowd, he pushed one to the side, excusing himself with the words, “You made me anxious.” No one knew about his problems and painful stomach illness. His behavior led to his institutionalization at the acute psychiatric ward in Ueckermünde. Discher (2015).

Extract of an Interview with C. “As soon as I got there, someone gave me medication, and I was fixed in 24 hours. The assistant to the doctor assured me, “Don´t worry, you won´t remember the time here”. “I wasn’t addressed to as “Mr.”, but as “Ms.” … After my first day in the acute ward I couldn’t speak anymore. Walking and moving around were as good as impossible. I would need two years until I could say a normal sentence again, and I would need more than five before I could return to my life. But that had nothing to do with the diagnosis I received: I had to recover from the treatment itself. I don’t think I need to tell you that this didn’t get any better after my release from Ueckermünde. I got to know a bunch of people. Many of them are dead; they killed themselves. I wanted to do it, too, yet somehow I knew, that I would make it. “Today I’m married. Despite all of the written attestations of my “below average intelligence”, “boundless hubris – particularly concerning life plans”, and my “immaturity and naïveté”, I  passed my Abitur and later I finished my studies at university. Now I have a job with responsibility and I have both feed on the ground. Out of all of my relations, only my closest friends know about my experience at Ueckermünde … and how I can’t help but remember my stay, every day, every word of it. Everything.” “I have yet to meet someone, who, after their stay in House 12, managed to get their life back together. Either they’ve got a pension, or they aren’t around anymore.”

How should the “normal person” understand the abnormal if no clear distinction is made between forensic psychiatry and the common clinic for psychiatry, psychotherapy, and psychosomatic? Who would have believed C. after his stay in House 12? Who would have even checked if the measures, which stripped him of his freedom, were justified?Judges aren’t doctors. When making decisions, they rely on the testament of medical experts. What goes on behind closed doors is typically controlled by the state and not subject to criticism. General standards make sure that there is consistency and verifiability. Tied up, untied, time to get up.

The lost identities and life goals are lost to the place, that was meant to heal them. I have spoken with countless individuals. Only after long and detailed searches in the internet can one become acquainted with the terrifying life histories which are inseparable from modern forms of psychiatric treatment. Bernd Seiffert from NRW. Thomas Juritz, Olaf L., Mario Hagemeister from Rostock. They are no longer among us. Ueckermünde and the fates of people with psychiatric illnesses are harldy mentioned in publically broadcast legal. After the therapeutically accompanying in Ueckermünde, one is thrown back into life, into the self-help and support groups, into assistant living, or—under the cloak of “inclusion”—into a sheltered workshop? Although people hear about the events in these hospitals, they never really learn about them. Only when they are affected can they afford a look into the inside workings of the red brick buildings. There is no way back. They have been permanently away from life.

These types of clinics create illnesses, psychosis, a metabolic illness of the brain, is not single-handedly responsible for the inability of patients to reenter their lives. If family members with psychosis feel themselves overwhelmed and rely on the advice of professionals, the story of C. will become commonplace. Today, everyone feels a personal connection to talk about depression. Depression has arrived in our society. Do people outside really know what it means to be taken over by deep sadness, avolition, or an urge to suicide? Or is “depressive” merely used as a popular word, because our society is too unreflective?  In this context, clinics are not discussed as much. Nowadays, who would be excited to go to a psychiatrist and get a prescription? These types of forcibly commitment and methods of treatment for younger and older people in Ueckermünde relegate the psychiatry’s to the shadows, that pay effort for a reorientation in medical and health care. Professions with leap of faith: the entire staff, composed of doctors, psychologists, social workers and consultants, that is, those whose level of trustworthiness is much greater than that of the psychologically ill. There is no chance of a collapse. Not only is that red brick building part of the complete system of our society, but the people that work there and go about their business as servants of the everyday, keep it alive. Outer facades and inner building structures are easily renovated. People and their way of thinking are not. Perhaps it is time for the 130 year old tradition of the psychological clinic to reveal its inner workings to the eye of the public.

We are searching for the way toward “inclusion”, that is, toward a society that is open and inclusive for everyone. Meanwhile, this word— “inclusion”—is a lovingly used in-word that sparks the interest of the public and propels politicians in their campaigns, but ultimately forgets the people who are left because no one is lobbying for them. “Inclusion” is a perfectly valid term in scholarship. It is wonderfully suited for raising millions of euros for research projects, the results of which are often not applicable in practice. Those who teach the concept of “inclusion” rarely think it out to its end or represent it practically. Those who actually campaign for “inclusion”, as they happily fulfill their contracts and are kept satisfied by their acting and remain in silence. (Discher 2015)

Bibliography

Thanks B. for your  support.

Adresse Kita Morgenstern: Christophorus Tagesstätte Kita Morgenstern, in: http://www.kita-portal mv.de/de/tageseinrichtungen/kitas_in_m_v/kitas_in_m_v_kita_profil&kitaid=66 (27.01.15).

AMEOS Klinikum: Klinik für Psychiatrie und Psychotherapie Ueckermünde: Ravensteinstraße 23, in: http://www.ameos.eu/1638.html (27.01.2015).

AMEOS Klinikum für Forensische Psychiatrie und Psychotherapie Ueckermünde. Ravensteinstraße 15a. Ueckermünde 17373. Deutschland. in: http://www.ameos.eu/forensik-uede.html(27.01.2015). Auszug aus dem Bericht Sicherheit und Gesundheit. Schwerpunkt psychische Erkrankungen, in: http://www.baua.de/de/Informationen-fuer-die-Praxis/Statistiken/Schwerpunkt/Psyche.html (10.01.2015)

Antwort der Bundesregierung auf die Kleine Anfrage der Abgeordneten Dr. Martina Bunge, Dr. Ilja Seifert, Diana Golze, weiterer Abgeordneter und der Fraktion DIE LINKE. – Drucksache 17/10576 – Zwangsbehandlungen in Deutschland, in: http://dipbt.bundestag.de/dip21/btd/17/107/1710712.pdf

Autor unbekannt: Tod in Rostock, in: http://www.todinrostock.de.(27.01.15).

Bundesanstalt für Arbeitsschutz und Arbeitsmedizin: Auszug aus dem Bericht Sicherheit und Gesundheit. Schwerpunkt psychische Erkrankungen, in: http://www.baua.de/de/Informationen-fuer-die-Praxis/Statistiken/Schwerpunkt/Psyche.html (10.01.2015)

Dahlemann, Patrick. 2013: Startschuss für eine inklusive Region am Haff: http://patrick-dahlemann.de/nk-startschuss-fur-eine-inklusive-region-am-haff/(10.01.2015). Die Hölle von Ueckermünde, in: https://www.youtube.com/watch?v=odtM4k9H4k4&spfreload=10.

Discher, Christian. 2015: Die Übriggebliebenen (in Vorbereitung).

Klee, Ernst, in: http://www.fischerverlage.de/autor/Ernst_Klee/2830 (27.01.15).

Mecklenburg Vorpommern. Ministerium für Arbeit, Gleichstellung und Soziales Plan zur Weiterentwicklung eines integrativen Hilfesystems für psychisch Kranke Menschen in Mecklenburg-Vorpommern, in , http://www.regierung-mv.de/cms2/Regierungsportal_prod/Regierungsportal/de/sm/_Service/Publikationen/index.jsp?publikid=4665

Moussavian, Sima: Die Hölle von Ueckermünde- Inhalt.in: http://www.helpster.de/die-hoelle-von-ueckermuende-inhalt_207544 (27.01.2015).

Netzwerk für Inklusion am Stettiner Haff, in: http://www.inkaha.de/index.php/component/content/category/33-website(10.01.2015).

Neurologen und Psychiater im Netz: Psychosen. Krankheitsbild. Herausgegeben von Berufsverbänden und Fachgesellschaften für Psychiatrie, Kinder- und Jugendpsychiatrie, Psychotherapie, Psychosomatik, Nervenheilkunde und Neurologie aus Deutschland, Österreich und der Schweiz, in: http://www.neurologen-und-psychiater-im-netz.org/psychiatrie-psychosomatik-psychotherapie/stoerungen-erkrankungen/psychosen/krankheitsbild/(27.01.15).

Seiffert, Bernd. Sein Trauerblog, in: http://psychiatriekritikerberndseiffert.blogspot.de. (27.01.15).

Seiffert, Bernd.2010: Das Verbrechen der Psychiatrie. Eine Zusammenfassung von Bernd Seiffert, in: http://www.meinungsverbrechen.de/wp-content/uploads/2011/03/Die-Verbrechen-der-Psychiatrie_02_2010.pdf (27.01.15).

Stichweh, Rudolf.1995). Inklusion/Exklusion, Differenzierung und Weltgesellschaft. Anmerkung des Autors: „Erweiterte Fassung eines Aufsatzes, der zunächst in Soziale Systeme 3, 1997, 123-136, erschienen ist. Der Abschnitt V ist neu hinzugefügt“, in: http://www.fiw.unibonn.de/demokratieforschung/personen/stichweh/pdfs/17_36stichweh_6.pdf (27.01.2015).

The Mad Hatter – presents a conversation with Dr. Giorgio Antonucci

Il Cappellaio Matto – The Mad Hatter – presents a conversation with Dr. Giorgio Antonucci

Italian group of users and survivors Il Cappellaio Matto is happy to share an extended interview with Giorgio Antonucci, physician, psychoanalyst, and director of two mental hospital wards for many years.
He fought to prevent and abolish forced psychiatric treatment, to the liberation of people from Italian mental hospitals from the early 60s onwards and above all to demonstrate that a psychiatric diagnosis is in reality a psychiatric judgment, supported by a social prejudice.
The first of eight instalments of the interview can be seen here:
It is available with English language subtitles thanks to the efforts of Il Capellaio Matto.
That’s the first publication in a foreign language , except a book in Danish: Svend Bach, a literature professor at the Aarhus University, dedicated him: Antipsykiatri eller ikke-psykiatri.
Giorgio Antonucci began his job as a physician in Florence (Italy), trying to solve the problems of people who risked to end up in psychiatry. He began to engage himself in psychiatric problems, trying to avoid hospitalizations, internments and any kind of coercive methods. In 1968 he worked in Cividale del Friuli (with Edelweiss Cotti), a public hospital ward, the first Italian alternative  to  mental hospitals. In 1969 he worked at the psychiatric hospital of Gorizia, directed by Franco Basaglia; he criticised the fact that in this hospital electroshock was taken away only for men, and continued to exist for women. (It is to taken in account, that Basaglia was away most of the time, for conferences and so on, then he died at 56 in 1980). Antonucci said that of course Basaglia was the first who took under question the mental hospital and that he rightly said that it was (is) a matter of class. But Basaglia did not go all the way down to say that the mental hospital is a prejudge in itself, not only a building, and he spent his time with conferences all over the world and writing books, articles etc. Antonucci indeed was working every day with the patients, to give them back their freedom.
From 1970 to 1972 Antonucci directed the “Mental Hygiene Centre” of Castelnuovo nei Monti in the province of Reggio Emilia. From 1973 to 1996 he worked as head physician in two mental hospitals of Bologna, Osservanza and Luigi Lolli, dismantling some psychiatric wards and setting up new residential opportunities for former inmates, giving them complete freedom of every personal choice. A successful example unique in Italy and probably in the world. From a political and religious point of view he is an anarchist, libertarian and atheist.
“Forced treatments are violations of their rights and harmful to them, to their thoughts and their lives, therefore I started dealing with psychiatry”, he says.
In this short conversation with the actor and activist Saverio Tommassi, Antonucci discusses the difference between genuine systems of healing and psychiatry as a way of social control, “a moralistic judgement and the claim to control the behaviour of those who don’t respect social conventions”. He explains the genesis of his own opposition to all forms of psychiatric incarceration, restraint and forced drugging: as a young doctor, he witnessed the lock-up in asylums of women considered “difficult”, who had once been prostitutes, and been labelled as mad by Catholic authorities. He soon grasped that 90% of the occupants of institutions were the “socially undesirable” – homeless, disaffected housewives, unemployed, etc: “Inside the mental hospitals, it wasn’t mad people who were locked up – as it’s usually believed – but unlucky people who happened to find themselves in hard situations”.
“I think that often, in addition to the hazard of psychiatric opinion, the most dangerous thing is when a person resigns to his own conviction of being sick” .
Dr. Antonucci has never made a forced treatment or forced hospitalization, and has never prescribed psychiatric drugs, because, he said “as a doctor I did the Hippocratic swear to never harm a person”.
Later, Antonucci describes the “calate”, mass expeditions of Italian citizens to state psychiatric wards to see exactly how inmates were treated: “It was a cause of great disgrace to the doctors because people, including children, were found tied up to chairs or to beds and locked up inside little rooms. And so for the first time, an entire population made up of peasants, local authorities, workers, county mayors, even a parliamentary deputy all brought into question the asylums as an institution”.
Giorgio Antonucci’s language is always very simply, without difficult words because he says that his words have to reach all people.
Dr. Giorgio Antonucci believes in the value of human life and he thinks that communication, not enforced incarceration and inhumane physical treatments, can help a person in difficulty – if the person wants to be helped. In the institution of Osservanza (Observance) in Imola, Italy, Dr. Antonucci treated dozens of so-called schizophrenic women, most of whom had been continuously strapped to their beds or kept in straitjackets and lobotomized with psychiatric drugs. All usual psychiatric treatments were abandoned, also psychiatric drugs, unless a person wanted to continue to take them. Dr. Antonucci released the women from their confinement, spending many, many hours each day talking with them, in order to establish a communication. He listened to stories of years of desperation and institutional suffering.
He ensured that patients were treated with respect and without the use of psychiatric drugs. In fact, under his guidance, the ward was transformed from the supposed most violent in a self-managed ward. After a few months, his “dangerous” patients were free, walking quietly in the garden and in the city streets. Most of them were discharged from the hospital and could go back to their families, but if someone wanted, could stay there, and was given two keys: one for the front door and the other for his own room. Afterwards, many of them had been taught how to work and care for themselves for the first time in their lives.
Dr. Antonucci’s major results also came at a much lower cost. Such programs constituted a permanent testimony of the existence of both genuine answers and hope for the seriously troubled.
Dacia Maraini, one of the most famous Italian writers, in an interview with Giorgio Antonucci wonders why, given the good results obtained, the same isn’t done in other wards: “First of all because it is very tiring – answers Antonucci with his quiet voice, – it took me five years of very hard work to restore confidence to these women; five years of conversations, even at night, of relationship face to face. This is not a technique, but a different way of conceiving human relationships.
“What is this new method which concerns the so-called mentally ill”? asks the writer. “For me it means that the mentally ill does not exist and psychiatry must be completely eliminated. Doctors should only treat body diseases. Historically in Europe psychiatry was born in a period in which society was organized in a stricter way, and it needed large displacements of manpower. During these deportations, under hard and hostile conditions, many people remained disturbed, confused, no longer produced goods and so there was the need to set them aside. Rosa Luxemburg said: “With the accumulation of capital and the movement of people, the ghettos of the proletariat widened”.
In the 17th century when the absolute monarchy (the State) takes form in France, the asylums were called “hospice places for poor people who annoy the community”.
Psychiatry came next, as an ideological cover. In Bleuler’s psychiatric treaty, the inventor of the term schizophrenia, it’s written that schizophrenics are those who suffer from depression, who stand still or obsessively run around the courtyard. But what else could they do so as inmates? Finally Bleuler concludes unintentionally comically: “They are so strange that sometimes they look like us”.