NUTHOUSE!

It may seem politically incorrect to call a mental health facility a nuthouse. But as far as I have been able to tell, it doesn’t offend the nuts (the patients in institutions) or their lay keepers (nurses, security therapy aides, activity therapists) who deal with each other hour-by-hour every day on a full work schedule. This crowd has a jaded sense of humor and few pc considerations (except perhaps about race) among themselves. They recognize various political risks and opportunities which an epithet offers at any particular moment, but they are not personally offended by “nuthouse”.

This category of “lay keepers” excludes doctors (psychiatrists and psychologists). They feel their special indignation over an insult to their much-maligned professional specialty, but probably not because anyone they know is called a nut.

Dictionaries almost always label the term “nuthouse” as offensive slang, but rarely assign that designation to “nut” when it means a crazy person. This enables the inference that any offense is to institutional, not personal, dignity.

Where polite society is valued by the bulk of its participants, it is created and maintained with live communication and continuing attention by individuals to each other’s sensibilities, not with a standard code specifying good and bad words for all. Where manners become broadly standardized in great detail, crowd control and politics are the real point, not interpersonal relations.

So we can dispense with any problem in using the word nuthouse. It just doesn't offend or emotionally damage the real people directly involved in nuthouses.

If our attitude, which is reflected by our choice of words, offends “the neighbors” or members of general society, that's a different issue. We have a right to ask why they care, when in all likelihood they have little or no contact with the people, nor any participation in the day-to-day environment, of state institutions which confine psychotic killers and perverts.

People want security. They don’t have a clear picture of what threatens their lives and happiness. Certainly the crazy and violent Other does threaten them, and so does their own immanent Mistake. Fear of the Other and fear of Mistake become the nuthouse. Your gut says it must be there, your mind hates to look.

Abusing science

More from the Chicago Tribune's front page today, on parents of autistic kids "abusing science" to justify experimental treatments....

The traditional medical concept of ethics putting Do No Harm! above all is quickly employed against unorthodox treatments for autism, but it never even enters the equation against harmful psychiatric treatments.

In first-world countries, schizophrenia is a lifelong "disease" to be treated with drugs having side effects only marginally better than the problem (and that evaluation is only fair in a public health context -- it's apparently worse for many individuals who have to be coerced to take their meds). But what do you know! In undeveloped nations where schizophrenia is not treated with anti-psychotic medications, this "disease" is not so chronic -- people get over it in a year or two. This according to at least two separate published World Health Organization studies!

All of the most recent psychiatric textbooks, as well as the DSM, contain direct, explicit and subtly refined admissions ... that there is absolutely no proven, bio- neuro- chemico- physiological brain-based cause of schizophrenia. Science simply does not know what causes it. There's lots of activity and hope that continuing research will provide a breakthrough any day. This same activity and hope have existed for more than fifty years.

So why is it, that when some mental "patient" is told by a "doctor" with coercive, state power over him, that he must take a drug which will turn him into a diabetic even if he personally sees no benefit from it at all, that NOBODY cries, "Above all, do no harm"... ??

Experiments

I note in today's paper a front-page article, "Autism's risky experiments".  Parents are said to be endangering autistic kids by treating them with unscientific regimens.  The problem is effectively summed up by an analogy:  If a child has jumped off a pier, even though science hasn't conclusively proved that throwing a life preserver will save him from drowning there's still a clear duty to try; one must only be sure the life preserver is made of cork, not lead.

It's an excellent point.  Guess what?  Those who believe orthodox treatments for mental illness are cork may be lobbing leaden "life preservers" to fellow human beings in trouble.

I have an institutionalized client who was diagnosed as paranoid schizophrenic and found not guilty of murder by reason of insanity, twenty-some years ago.  Schizophrenia of course, is the ultimate mental illness, the model for current orthodoxy.  Because of his diagnosis and his crime, most forensic psychiatrists believe my client should take anti-psychotic medications for the rest of his life whether he's acting crazy or not.  He chooses not to do so, because the drugs have unacceptable side effects.  Completely off of all psychotropic meds for a period of many years now, he shows no symptoms of psychosis; he's in his early sixties and in excellent physical health, successfully taking college classes on line, interacting socially, etc.

A very respectable forensic psychiatrist recently testified in court to the effect that, until such time as this man agreed to take antipsychotic meds, he should be allowed no privileges whatsoever in the institution.  This testimony was based on purported "science", which the court was quickly happy to buy without serious question.

But the orthodoxy that schizophrenia is a known brain disease effectively treated with medication is no better than the so-called "risky experiments" which parents are allegedly perpetrating on their autistic children.  It's probably much worse.

There was a time when almost all learned authorities had great "scientific" evidence of the harmful effects of witchcraft and the value of the Inquisition's "treatments" for it.  Actually, this historical orthodoxy was followed and accepted for hundreds of years -- much longer than the idea that mental illness is brain disease.

A perjury complaint was filed against the psychiatrist who testified against my client.  He changed his tune 180 degrees, saying medication was not an issue in the case.  The complaint which apparently adjusted his reality so severely can be viewed at: http://docs.google.com/View?id=dgzw8ztk_0g42tw5d3

Despicable coercion

State psychiatry has the purpose of restraining and disabling individuals who behave badly. It does not have a purpose of helping people who are sick. Individuals are coerced to take drugs which disable them neurologically. One of the methods of coercion lies in filing petitions for involuntary (court-ordered) "treatment" when anyone exercises their right to refuse medication. Most often, these petitions are not viable in the face of any competent legal defense. They are filed anyway, in the hope that the individual will not be defended competently, and will simply knuckle under and agree to take medication "voluntarily".

Following is a letter sent to a treatment team yesterday, after just such a cynical, fraudulent, coercive and illegal petition was dismissed the moment I arrived to enter my appearance in court for the defense. I'm removing the names to stay out of trouble, but I might add them back in some time later. State psychiatry needs to be resisted and challenged at every opportunity.

__________________________________________________________

November 20, 2009

Ms. X (Social Worker)
Dr. Y (Psychiatrist)
Elgin Mental Health Center
750 S. State St.
Elgin, IL 60123

Re: Patient Z abuse

Dear Ms. X and Dr. Y:

I appeared as legal counsel for your patient Z today in Mental Health Court. I have told Z that I will be his advocate with the treatment team and EMHC, if he needs or wants me to, in the future.

I'd like to make as strong a point as I can, very early in any such relationship, that I consider the recent petition for involuntary administration of psychotropic medication (court docket #xxx) to have been in bad faith, a violation of the Mental Health Code, and perhaps a criminal act.

Reportedly you, Dr. Y, stated that someone else required you to file this petition. But as you must know, statutory requirements were unmet. For one easy example among several, on page 4 the petition required you to state specific reasons why, and the manner in which, benefits of the treatment you intended to force on patient Z would outweigh the harm. Your only statement was, "The benefits outweigh the risks."

This was a transparent tautology of course, certainly not medicine, perhaps not even psychiatry. It now becomes evidence of an illegal act. The Mental Health Code prohibits threats of involuntary treatment merely to coerce a patient to accept treatment "voluntarily". The law also explicitly defines known falsehoods in any petition as criminal.

No matter who ordered this petition filed (I certainly have several suspects), the signature which appears at the bottom still says Dr. Y, M.D. And frankly, Ms. X does not go unnoticed as case manager. I'm sure there are EMHC or DHS administrators for whom it may seem very easy and convenient, to just order blanks filled in on a computerized involuntary petition whenever a recipient of services refuses meds. But your patients know the difference between a mean threat and honest help; and I will not fail to investigate and expose the kind of abuse that I see here. If treatment team members are the only visible targets, they will be regarded as perpetrators, I promise you.

Unless patient Z actually behaves in some manner which could justify his being held down by half a dozen guards while you force a needle into his body and inject powerful drugs to alter his mind and personality and dehumanize him, I strongly suggest that you never file a petition like this again.

Actually, I suggest that you apologize to him, officially and in writing, for the petition which was dismissed so instantly today. (You need not apologize to me for my time, because you have created valuable evidence in exchange for that.)

Very truly yours,


S. Randolph Kretchmar

cc: Patient Z
Dr. Q, M.D.
DHS Counsel
Citizens Commission on Human Rights International