Wednesday, April 29, 2020

Psychiatrists as doctors, psychiatric institutions as hospitals, N Unit and Voltaire

Voltaire said that anyone who makes you believe absurdities will make you commit atrocities. He also insisted that arguing any point requires first defining your terms.

A doctor is a person skilled or specializing in healing arts. (Miriam Webster says so, not just me.)

And a hospital (the entomology is closely related to hospice, hostel, hotel, host) is fundamentally a place of refuge, where a person can find help and hope, e.g., to recover from sickness or injury.

There are other definitions, but these are mine for the purposes of this argument.

Psychiatrists generally admit that they do not heal or cure anything. They do not specialize in healing arts, they rather specialize in certain arcane arts of control. This is a legitimate social function, by the way. People who are violent, destructive, or who directly inspire and precipitate violent reactions from others, need to be controlled. Unfortunately most of us think controlling other people in some circumstances is bad, so we often need to pretend we’re not doing that when we really are. Psychiatry, especially state psychiatry, is precisely this pretense.

Psychiatrists are thus fake doctors. Society encourages them to fake being doctors, but that’s somewhat beside the point. Although they have medical degrees, licenses, and most of the elaborate accoutrements of what people think medical science might be, they nevertheless specialize in controlling arts, not healing arts. Saying you are a doctor, indeed insisting that you must be recognized by society as a doctor above all else, while simultaneously protesting that you cannot cure the illnesses of your patients, is an absurdity.

Likewise, psychiatric institutions are fake hospitals. They obtain patients from the police, hold them against their will, and force treatments on them. They dehumanize and punish them, and go to great, ritualized bureaucratic lengths to deny them rights. This is directly contradictory to any purpose of refuge, recovery, help and hope. Calling these oppressive places hospitals is an absurdity.

On N Unit at Elgin Mental Health Center, a forensic “patient“ for whom I advocate is being continuously harassed and threatened by several staff, with negative reports in his chart intended to block his progress to a less restrictive environment. He has an upcoming court hearing on a petition for conditional release, and staff taunt him about how easily they can torpedo any favorable decision on that petition. He’s not a young man, so he’s at risk for COVID19 while he is kept at the facility. He’s clearly not psychotic, in fact his psychiatrist believes he never was mentally ill. However that psychiatrist now says he won’t testify to the whole truth in court.

Today when this patient told a nurse manager named Sherry that he might write a complaint to Equip For Equality about her disrespectful attitude, Sherry literally jumped at the chance to reply, “I’m really happy you told me that, because it’s a threat, and now I can write in your chart that you threatened me!”

But complaining, accurately or inaccurately, about mistreatment to Equip For Equality or the Office of the Inspector General is not a threat, it’s every patient’s statutory right! Such rights were explicitly written into the law to make forced “hospitalization” nominally constitutional. Without the formal recourse, patients would be brutalized more often than they are. There would be rampant sexual abuse. Sherry might become another staff abuser of patients; Extreme coercion of patients to take unwanted, unnecessary, and extremely harmful psychiatric drugs would be completely unbridled, and a thin vestige of informed consent would evaporate. So the actual threat today came from Nurse Manager Sherry, not the patient who had a clear right to formally complain.

Mental patients are generally thought to be less truthful and/or less accurate in their observational ability than mental health professionals, so patients’ complaints about staff are very rarely substantiated or even honestly investigated. (A former investigator for OIG told me it’s about two or three percent.) Sherry knows perfectly well that one patient’s complaint is no realistic threat to her job or her professional future. She also knows perfectly well how effective her retribution will be against that patient, when she falsely charts him for “threatening” her.

On N Unit today, the thing that really happened was this: a patient “threatened” to speak truth to power and a nurse manager threatened his freedom, his future, and his life. The way the system is set up, it’s what happens all the time.

We are committing atrocities after being led to believe absurdities.

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