One suggestion I've always offered to people who wish to understand what state psychiatric institutions are really like is that the patients and the doctors have much more in common than any lay person would ever expect. It's an old joke of course, but in truth, they're almost indistinguishable from each other. I realize this seems unlikely as a serious proposition, and I can't completely explain it, but it is my own subjective experience.
The other day one of my clients, a man who attempted to kill his family some years ago (I'll call him Pedro) gave me new insight about this.
It was election day, a holiday for all clinical and administrative personnel at Elgin Mental Health Center. Pedro mused that it was a very different atmosphere when the the only staff around were the security guys. He liked it, it was a simpler community, somehow more straightforward. He commented, "When the clinical and administrative staff are gone, you don't feel so much like you're being continuously watched and evaluated. It's subtle, but quite a relief!"
Our conversation eventually came around to a fascinating parallel: When Pedro attempted to kill his family, he recalls really believing that he was trying to help them avoid a terrible spiritual fate. He was deluded, perhaps consciously self-deluded. The result of his action clearly was violent harm.
When psychiatrists and other mental health clinicians coerce and drug their patients and keep them locked up, they believe they are trying to help them. They are deluded of course, perhaps self-deluded. The result of their actions is violent dehumanization and long-term social harm.
What do you know, maybe that's why these two nominally opposing classes, forensic psychiatrists and forensic mental patients, seem so much alike! They're both immersed in delusion obfuscating the difference between help and harm.
When a psychiatrist at Elgin tells a patient he must take anti-psychotic drugs because of his mental illness, and the judge will never release him if he's not medicated, that appears to me to simply be a lie, or (charitably) a mistake caused by incompetence.
Anti-psychotic drugs turn guys into diabetics and zombies, dramatically reducing their life expectancy, etc., for no long-term benefit. This is the conclusion of scientific medicine, it's acknowledged from the very top of the mental health food chain, i.e., by NIMH. The judge who decides on anyone's release from Elgin Mental Health Center defers to the "clinical experts" and doesn't care or much notice what diagnosis or treatment they consider appropriate, so then those experts can be blamed for any bad result, like recidivism or future violence.
When Pedro concludes that the thing he must do from loving concern is kill his family, because otherwise they will all surely be taken by the Devil, that likewise appears to me to simply be a lie, or (charitably) a mistake caused by incompetence.
Attacking human beings with a knife causes violent harm, the blood is visible. There is probably no evidence in the whole history of philosophy and theology that murdering a body will save the soul inhabiting it. The moral codes of every civilization without exception have prohibited this crime. No judge who decides on anyone's release from Elgin Mental Health Center ignores the common-sense implications of an act of violence, or entirely escapes suspicion of complicity, when they say a guilty criminal may be "treated" instead of punished.
The psych and the crazy guy are brothers in delusion. The judges are our own elected enablers. And all our jokes about it are dark indeed, because help and harm cannot be the same no matter what the people in state nuthouses say.