Friday, April 10, 2020

Shout-out to Dr. Mo

At the risk of causing trouble for someone purely by association with any approval from me, I’d like to say that one state psychiatrist (!) is doing a competent and (hopefully) effective job of helping at least one patient, at least for the moment.

I don’t really know Dr. Mo as well as I know some others on the plantation at Elgin, but I was very impressed yesterday during a staffing for a patient (whom I also don’t know that well, as a matter of fact). Dr. Mo’s full name is Tahseen Mohammed, M.D.

The patient has a Thiem date about five years away, and obviously he’d prefer to get out of Elgin sooner than that. But he has decided that it would be a huge advantage if, whenever he is free, he’s also free of psychiatric drugs. It seems to me he’s been wrestling with this for a while. He’s gone back and forth between being willing or not, to tell his treatment team he’ll simply refuse medication. I’ve told him I would defend him against any forced meds petition, but he needs to make his own decision and ultimately he’ll have to bring his treatment team along on it.

I actually didn’t think this guy stood much chance of doing this. I’ve known many psychiatric slaves who dreamed about freedom from the drugs, but most have feared it would require a severe trade-off of physical freedom from the plantation. They’re all told, more or less plainly, that if they don’t take “their” meds they’ll never be released. It’s not true, there’s no scientific medical or legal justification for the idea, but nonetheless that’s the policy and the received wisdom, that’s the practical situation. It’s also the specific battle that I seem to be fighting most often in my long continuing war for abolition.

Dr. Mo told my client during the staffing yesterday that he had no problem with his wish to be medication free. This is easy to say, and it is frequently said by state psychiatrists (I’ll resist the temptation to name and shame the bad guys here) with much artful duplicity. But for whatever reason, I felt myself believing that Dr. Mo was being straight with this guy. Maybe I was distracted by the odd circumstances of a staffing during the pandemic: everybody talking through masks, hoods, sitting about twenty feet away from anybody else. Maybe it’s easier to deceive others when your face is covered.

But Dr. Mo had a very practical problem that, it seemed to me, he handled very well. He was up against a deadline to get this patient’s signed release to be voluntarily medicated, and the patient had decided not to sign the release.

The situation was handled with a competent explanation of why the patient should ween off the various drugs gradually, rather than stop cold turkey. Dr. Mo promised he would actually help with this. The dose of meds will be cut pretty much in half immediately, and then reduced more, each month thereafter. I even suggested that the weening could be more gradual and take longer. There’s hardly anything more useful and socially valuable that an involuntary “patient” in the Illinois plantation system can do with whatever time they must spend as a slave, than getting entirely and stably off psychiatric drugs. When someone who is successful at this eventually returns to the community, they can be much more productive and capable of making amends for whatever mistake put them in this horrible system, if they are not disabled.

The thing is, when somebody has been taking psych drugs for a long time, they may not even know what will happen when they stop. My client will have to behave himself, lest clinicians who will be watching him like a hawk may discern “symptoms of his mental illness returning”, and use that as an excuse to enforce the old orthodox idea that anyone diagnosed with a serious mental illness should agree and resign themselves to take drugs they hate forever. There is a great deal of literature now, about “discontinuation” or withdrawal syndromes during a psych drug taper which can mimic “returning symptoms” of mental illness. Probably the best source of information about this whole subject is The Withdrawal Project of Inner Compass Initiative, founded by one of my very few-and-far-between personal heros, Laura Delano.

I strongly encourage anyone who reads this post, if it rings true at all to you that maybe getting off the drugs and learning to think, feel and behave in ways that do not frighten people or cause so much trouble... is a better idea than agreeing to permanent disability as a “mental health consumer-for-life” ... you should become acquainted with Laura Delano and her organization!

Meanwhile, thank you for your work, Dr. Mo. Happy Easter to all who celebrate, and stay healthy.

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