A woman named Luanne killed her baby several years ago. She was found not guilty by reason of insanity and remanded to the custody of the Illinois Department of Human Services at Elgin Mental Health Center for "treatment". In fairly short order Luanne was "diagnosed" with bipolar disorder and told to take all the latest psychiatric drugs....
The only problem was, Luanne had begun to wonder whether those same drugs had been the cause of her insanity to begin with, whether her baby was in fact dead because she had suffered from an iatrogenic psychosis. After all, SSRI's have that black box warning now, that says their use may be associated with homicidal ideation and other darkly dangerous, crazy behavior. That sounded a little too coincidental to Luanne, so she started doing some research.
The research took awhile, because at Elgin they get pretty restrictive with library privileges. They can't easily afford to let "patients" access information that might be inconvenient to the institutional machinery of coercion. (It's a bit like some classic totalitarianism, perhaps the Soviet Union, where psychiatry was so avidly practiced.)
Eventually however, Luanne decided to wean herself off psychotropic medication. She tried to get her doctor to help, but he refused, so she did it herself, successfully. By the time she told the "treatment" team that she wasn't taking meds and would refuse to take them in the future, she had retained me as legal counsel to protect her rights.
It's not difficult to make sure a client isn't forced to continue taking psych drugs, that's a cut-and-dried strategy for me. On the other hand, getting them released (especially when they were charged with murder) is a much tougher row to hoe. That takes serious work by the client.
I usually try to explain it this way...
"You killed somebody. The judge decided that you can be fixed instead of just punished, so you're not in prison, you're in this so-called hospital. The judge more or less trusts these clinicians, your treatment team and the administration here at Elgin, to know how you can best be fixed, and whether or not you have been fixed, and when it might be safe to let you return to society.
"Now society really hates finding bodies that are not supposed to be dead but are, especially bodies of children. So the judge sort of stuck his neck out by not sending you to prison forever. He will need strong reassurance that it's right to let you out of Elgin Mental Health Center any time soon. He'll probably need all relevant opinions on that matter to be unanimous. Your psychiatrist is in a similar position, assuming he's well intended. Nobody wants to be wrong about whether another dead body might turn up because of you.
"So you have to convince a fair number of people that you are mentally healthy, that you'll never hurt anyone, and that you totally understand what happened and why, with regard to the crime you were charged with. I expect this will be a rather long and difficult task, although I think you can do it and I'll try to help. It is entirely a task in communication, agreement and empathy."
This is what I told Luanne, a year or so ago. She's been working on it but, as anyone would perhaps be tempted to do, she occasionally wishes there were some kind of more convenient shortcut. I have worried that her theory about iatrogenic psychosis would distract her from what she really needs to accomplish.
Today I was trying to explain this for the umpteenth time. Luanne alternately tried to explain to me what it had been like to believe (insanely) that she needed to kill her baby, that somehow it was the right thing to do. She had gotten into this before in a handful of conversations. But for some reason, today she got into it much more deeply. I found myself listening to specific, grisly details: whether it's better to cut a baby's trachea or carotid artery, which hurts more or takes longer to result in unconsciousness, what a surprise the amount of blood was, what Luanne was thinking, how she counted to herself as she drew the knife across her poor baby's neck, how sad she was, how she suddenly wondered too late if it was a mistake....
I shut up and just steeled myself to listen. It took five or ten minutes. Luanne was in tears, sobbing. Then it occurred to me, I'm this woman's lawyer, not her therapist or confessor. (Maybe it was a selfish protest: Why do I have to subject myself to this horror?)
I said, "Can I ask you something, Luanne? In the year and a half that you've been here at Elgin, have you ever been able to tell anyone what you've just told me, in the last ten minutes?"
I was honestly heartbroken and surprised by her immediate response: "No! Because they don't let me, they don't want to listen, they just call me a murderer and insist that I take more drugs like the ones that caused this to happen in the first place."
On the way home, I cried in the car. How can it be so difficult to help a person? What are these people doing, what am I paying for with my taxes? I didn't even ask Luanne to talk about her crime, but she sure wanted to! How can it be possible, that no one at Elgin ever managed to get her through this, in a year and a half? Why do they choose to fight against her? Why can't anybody listen to her?
The only answer I can think of is, this is psychiatry. They declare mental diseases and enforce prescriptions. They just don't know anything about, or deal with, people.