Category: authoritarianism

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Jolijn Santegoeds – Why forced psychiatric treatment must be prohibited

Why forced psychiatric treatment must be prohibited

Translation of Dutch article “Waarom gedwongen GGZ behandeling verboden moet worden”

Why forced psychiatric treatment must be prohibited
29 March 2016, by Jolijn Santegoeds, founder of Stichting Mind Rights[1], Co-chair of World Network of Users and Survivors of Psychiatry (WNUSP)[2], board member of European Network of (Ex-) Users and Survivors of Psychiatry (ENUSP)[3]

Click here to download the article:
Why forced psychiatric treatment must be prohibited_29 March 2016

 

For centuries there has been resistance against forced admission in institutions, confinement in isolation cells, tying persons up with fixation-straps, the forced administration of medication, forced electroshocks, and other forced psychiatric treatments.

Coercion is not care
Coercion is one of the most horrific things that people can do to each other, while good care is actually one of the best things that people can offer to each other. There is a fundamental difference between coercion and care.

Coercion works countereffective to wellbeing, and leads amongst others to despair, fear, anger and grief for the person concerned. During coercion the voice of the person is ignored, and their boundaries are not respected. Coercion does not lead to more safety, or recovery of mental health. On the contrary: By suffering, powerlessness, and a lack of support, the risks for increasing psychosocial problems and escalation increase. Coercion is the opposite of care.

Coercion means a lack of care
Forced psychiatric interventions are not a solution, but are a problem for mental health care. For a long time, the existence of forced treatments, which enables caregivers to turn their back to the crisissituation and leave the person behind without actual support, is undermining the real development of good care practices.

Good care is possible
Good care can prevent coercion. By a respectful attitude and good support, problems and escalation can be prevented successfully, which makes coercion obsolete[4]. Real care is possible.

Efforts are needed
Despite the fact that all stakeholders in Dutch mental health care want to ban coercion[5], the total number of the use of coercion (the number of  legal measures RM and IBS) is rising annually. There are however specific initiatives to reduce coercion at various locations, such as the development of HIC (High/Intensive Care psychiatry)[6], where they aim to prevent solitary confinement by enabling intensive support. On the other hand there is an enormous rise in outpatient coercion (conditional measures), as well as in incidents with “confused people”. It has been concluded a number of times, that the practices are “persistent”, and that the culture is “hard to change”.

Learning from history
Europe has a long history of xenophobia against persons with psychosocial problems. Ever since the 15th century there have been special prison-like “madhouses”, where persons were chained and locked up like beasts, and exorcisms were common. After the discoveries of Charles Darwin and the Renaissance (17th and 18th century), the medical sector started to arise, followed by the arrival of the first Dutch Lunacy-law in the 19thcentury, which arranged “admission and nursing of lunatics in mental hospitals”, with the goal to provide “more humane” care as compared to the madhouses. The young medical science comprised a diversity of perceptions, and in the 20th century a lot of experiments followed, such as hot and cold baths, lobotomy, electroshock and so on. The “special anthropology”[7] or racial-science and eugenics, focussed on the search for the perfect human being, and “racial hygiene” to “avoid deterioration of the race”, openly doubting the capacities of certain populations, which resulted in genocide which didn’t spare psychiatric patients (WOII).

After these dark pages in history, universal declarations of human rights were established, emphasizing the value of each human being, and gradually the community became more tolerant. However, psychiatry hardly changed and held on to the questionable and experimental foundation, with confinement, regulation regimes, and experimental treatment methods as the unchanged core of the treatment range. Currently, efforts are still made to force persons into behavioural changes with the argument that they are “incapable of will” themselves, and not able to express preferences. This is absolutely incorrect: Every person sends signals. The challenge is to deal with that in a good way. Real care notices the person behind the behaviour. Professional care is something totally different than primitive repression of symptoms.

It is time to draw a line. It is urgently needed to recognize that mental health care got on a wrong track by history. Harsh ‘correction’ of persons until they are found ‘good enough’ is not a righteous goal of mental health care. It should be about wellbeing. Coercion is a revealed mistake of mental health care. Innovation is needed.

Worldwide need for coercion-free care
All over the world forced treatment exists. Extremely atrocious images are known from poorer parts of the world, with chained people for example in Asia[8] and Africa[9], but also in our own country with Brandon[10] and Alex[11]. As long as the western world keeps claiming that coercion is the same as good care, these scenes will be harder to ban, especially since several countries have high expectation of the western approach. It is important to come up with good solutions in the world wide search for coercion-free care.

Call by the United Nations
Since 2006, the UN Convention on the Rights of Persons with Disabilities (CRPD)[12]exists, which illustrates that a worldwide change is needed towards persons with disabilities. Several UN mechanisms clarify that coercion in care is a violation of human rights[13], [14], [15], [16], also when it comes to the Netherlands[17], [18]. A change is needed.

What’s next?
This is an important question.
What do we want now? Are we finally going to make it really right?
Are we going to show ourselves from our best sides?

A real change of culture is needed. Mental health care needs to reinvent itself, and put an end to the confinement and the use of coercion. Good care is possible.

“Yes but it is not possible…”
Commonly heard reactions are “These are good ideals, but not realistic” or “There is no other way, because the system isn’t supportive” or “The community is totally not ready for this”. The implicit assumption that a culture change would be ”unrealistic”, indicates limited perspective, hope and ambition. The system is in our hands. We are the current generation. Change is possible. The world is changing constantly. Also mental health care can change[19], [20], as can the public opinion. We are not powerless or insensitive. Efforts are needed to make the world better and nicer together. We can do that.

Change can feel scary. Without positive history or good practices elsewhere it may be a bit harder to imagine that everything can be different, but this cannot be a reason to just give up immediately. We do not question ourselves whether stopping all hunger in the world is realistic before we start with that. Every person counts. Real care is possible and needs to be realized, also in acute and complex crisis situations. Practices of abuse need to stop instantly. This is the task that has been given to our generation. It is worth to unite all our efforts to make the historical shift from exclusion to inclusion.

Also the remark “Yes but coercion is needed, as long as there are no alternatives”  needs to be refuted here. Coercion is not care, but it is abuse, and there is no valid excuse for abuse. Coercion is never needed. Good care is needed.

Making human rights a reality
The UN Convention on the Rights of Persons with Disabilities (CRPD) gives a momentum for change. If everyone cooperates now, throughout all layers of the system, then the intended change gets an unprecedented impulse. The articles of the UN-Convention offer a guidance, which enables worldwide coherent action. The UN Convention offers vast opportunities to change the world.

Together we can ban forced psychiatric treatments. When there’s will, there’s a way. In history, confinement was put central, and by now we know better. So we have to do better too. A largely unexplored world is ahead of us.

Key points
It is not easy to change the mental health care system, and the confidence in mental health care doesn’t restore without efforts. Several things are necessary to change the situation sustainably:

-Realise good care
The old fashioned psychiatry is not founded on human rights, diversity and inclusion, but on xenophobia and exclusion. Science has focussed so far on homogenising the community, and attempts to change the people (a bodice and check box mentality). Modern mental health care should focus on enabling a heterogeneous and  diverse community, by creating the right conditions in the community and to enable self-determination, liberty and inclusion, so that everyone can be happy and live a fulfilling life in our community. A fundamental reform is needed in mental health care.

Wellbeing – or mental health – is a very personal intrinsic value, which cannot be produced by coercion. Recovery from psychosocial problems is not an isolated process of the person concerned, but is closely intertwined with the social context of the person, such as chances in life, social acceptance and inclusion. The range of care needs to be reviewed fully, and adapted to the requirements of today.

Deprivation of liberty needs to be stopped immediately. The organization of care of good quality is necessary and urgent, and cannot be postponed any longer. The previous guidelines under the law BOPZ of 1994 to use coercion “as little as possible” and “as short as possible” have failed obviously, and the numbers on the use of coercion (legal measures RM and IBS) continuously keep on rising annually, and have more than doubled in the past 10 years. This trend is unacceptable, and therefore something really needs to change now. A need for support cannot be a reason for deprivation of liberty. Good care is possible.

Without good care, the mess will only transfer. It is absolutely necessary to make all possible efforts right now to provide care of good quality, including good care in crisis situations.

– Legislation: prohibit coercion, arrange care
The legislation on forced psychiatric treatments needs to be changed. The goal of mental health care is not: Treating vulnerable persons in a rough way, but the goal is to provide good care, also in crisis situations. A transition is needed.

The lunacy law dates from 1841, from a time when the medical profession was absolutely in it’s infancy. The law BOPZ of 1994, and also the law proposal on Mandatory Mental Health Care (recent) have a similar structure of legal measures RM and IBS, and resp. confinement and forced treatment form the core. This system is not founded upon awareness of human rights, and it is not about care of good quality, and it has to change.

Forced treatment is abuse. Legislation needs to protect all citizens from abuse. When the government participates in the abuse against certain groups, this is torture[21], [22], which is absolutely prohibited. The laws on coercion, such as BOPZ and the law proposal on Mandatory Mental Health Care are therefore unacceptable.

Legislation is meant to offer a fair framework for the community. A prohibition of forced treatments is necessary because of human rights[23]. Additionally, certain legislation can speed up the provision of good care and organize innovation[24]. It is possible to create laws that are really useful to the community. Wouldn’t that be great?

– Compensation: Recognize the seriousness
For years and years, the government and countless caregivers have taken over the lives of psychiatric patients, and forcefully subjected them to “care”, such as horrible forced treatment, isolation cells, forced medication, restraint-belts, electroshocks, all motivated by so-called “good intentions”. The sincerity of those responsible can now prove itself by genuine recognition of the suffering that many had to endure. A compensation would be appropriate: When you break something you have to pay for it. We consider that very normal.

* Apologies are needed to recover the relation between (ex-) users and caregivers.
* Recognition of the trauma’s by coercion, and support in overcoming these if desired.
* Compensation to show that the change of attitude is genuine.

Now it’s time to show that the Netherlands is indeed a civilized country.

Take action
I would like to call on everyone to contribute to the change in culture. Let’s ensure together that human rights will be realized for every human being, and that old-fashioned psychiatry disappears, and that mental health care only comprises good care.

Please spread this message to raise awareness.

 

**

To reinforce the above plea, I have attached a description of my personal experiences with forced psychiatry, which can be found via this link:

“16 years old, depressed and tortured in psychiatry – A testimony on forced psychiatric interventions constituting torture and ill-treatment”

 

**

This publication is part of the ‘Absolute Prohibition Campaign’, see https://absoluteprohibition.wordpress.com

 

[1] Actiegroep Tekeer tegen de isoleer! / Stichting Mind Rights www.mindrights.nl

[2] WNUSP: World Network of Users and Survivors of Psychiatry www.wnusp.net

[3] ENUSP: European Network of (Ex-) Users and Survivors of Psychiatry www.enusp.org

[4] Report: Best practices rondom dwangreductie in de GGZ 2011

[5] Declaration on reduction of coercion:  Intentieverklaring GGZ: preventie van dwang in de GGZ 2011

[6] High Intensive Care HIC (HIC)

[7] Description of Racial-science e.a.: Winkler Prins Algemeene Encyclopaedie, vijfde druk, Elsevier, 1936

[8] Human Rights Watch “Living in hell – abuses against people with psychosocial disabilities in Indonesia”, 2016

[9] Robin Hammond, fotoserie “Condemned – Mental health in African countries in crisis”

[10] Brandon van Ingen, Jongen al 3 jaar vastgebonden in een zorginstelling

[11] Alex Oudman, Schokkende beelden uit isoleercel – Toen en nu

[12] UN Convention on the Rights of Persons with Disabilities (CRPD)

[13] CRPD General Comment no. 1 on CRPD article 12 Equal Recognition before the law

[14] CRPD Guidelines on CRPD article 14 Liberty and Security of Person

[15] Statement of 2 UN Special Rapporteurs “Dignity must prevail – an appeal to do away with non-consensual psychiatric treatments” World Mental Health Day, 10 October 2015

[16] A/HRC/22/53 Special Rapporteur on Torture, Juan E Mendez, Torture in health care settings (2013)

[17] Communication sent to the Kingdom of the Netherlands by the UN Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment and the UN Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health. AL Health (2002-7) G/SO 214 (53-24) NLD 2/2013, October 2013, https://spdb.ohchr.org/hrdb/24th/public_-_AL_Netherlands_08.10.13_(2.2013).pdf

[18] CAT/C/NLD/CO/5-6, CAT Concluding Observations on the Netherlands

[19] High Intensive Care HIC (HIC)

[20] Intensive Home Treatment (IHT)

[21] Torture, for full definitiion see article 1 CAT, Convention Against Torture.

[22] A/HRC/22/53 Special Rapporteur on Torture, Juan E Mendez, Torture in health care settings (2013)

[23] amongst others the right to liberty, freedom from torture / Civil and political rights and CRPD

[24] amongst others the right to health care and adequate standard of living / Social, economic and cultural rights and CRPD

 

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José Raúl Sabbagh Mancilla (México)

In this article the author, as a therapist, presents his unconditional support to the absolute prohibition of forced treatments. He states that these types of treatment without consent are counterproductive and unsustainable. He highlights the importance of the standards that the CRPD imposes and the need to prohibit methods that annul the legal capacity of people with psychosocial disabilities.  

 

Mi nombre es José Raúl Sabbagh Mancilla, practico el acompañamiento terapéutico en México desde el año 2010. En estos años de práctica he escuchado la situación de algunos sujetos que han recibido diagnósticos como esquizofrenia, paranoia y daño neurológico.

El objetivo de este escriño no es dar una respuesta acerca la naturaleza de las causas de estas formaciones psíquicas, más bien considero que la posición de un clínico que, desde un saber absoluto y científicamente incuestionable, determina el estado general de estos sujetos, que además decide acerca de su futuro y obtura toda validez de sus decisiones, dificulta más su restablecimiento y una inclusión respetuosa a la vida en la sociedad. Estas acciones son clínicamente insostenibles y tienden a tener como consecuencia un mayor deterioro del estado de la persona.

Es por eso que, de acuerdo con la Convención sobre los Derechos de las Personas con Discapacidad, apoyo incondicionalmente la campaña por la Prohibición Absoluta de los internamientos involuntarios y las intervenciones psiquiátricas forzadas. Es importante que, en el accidentado contexto global de defensa de los Derechos Humanos, dejemos de sostener prácticas que, disfrazadas de un tratamiento ineficaz, implican una mayor cosificación de personas que en su propio padecer se sienten ya sumamente cosificadas.

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In Italy, we don’t have a law against torture, by Erveda Sansi

 

contro psicofarmaci_col_rid

Drawing by Vincenzo Iannuzzi

 In Italy, the situation in the psychiatric field, with almost no exception, has worsened from the period of questioning psychiatric institution, in the beginning of the sixties. Then, Italy has been at the forefront of the closure of mental hospitals. Not only Giorgio Antonucci, Franco Basaglia and many professionals, but also a good part of the common people, realized that psychiatric hospitals were not places of care. Civil society, then, was sensitive to the issue of smash-down asylum culture. Publications appeared, there was an open debate, workers and students organized themselves and entered in asylums to see the conditions in which their fellow citizens were locked up. They protested and denounced the deplorable conditions the internees were forced to live in.

However, since several years, we observe a re-institutionalisation process and, at the same time, in some Italian hospital’s psychiatric wards happened many deplorable facts, due to forced treatment, institutionalization and forced restraint. Some of these facts have become infamous after that committees and relatives have asked for justice, as in the case of the well liked teacher Francesco Mastrogiovanni, 58 years old, that was debated also on national television channels. Franco Mastrogiovanni, after a forced psychiatric treatment the 4th August 2009, (because of a road traffic offense: circulation, at night, on a street closed to traffic), has been heavily sedated, tied to the bed of Vallo della Lucania’s hospital psychiatric ward, and left to die after four days of abandonment. During the 80 hours hospitalization he was nourished only with saline solutions; he was tied hands and feet to the bed, in such a position that his respiratory functions where compromised, and he was sedated with high doses of psychiatric drugs, without supervision from the staff. At wrists and ankles there are 4 cm wide grazes. A hidden camera recorded everything; the video is of public domain. At the trial the responsible physicians were found guilty and sentenced to 3 and 4 years detention, that, with the mitigating clauses, they won’t have to serve. The 12 nurses were acquitted because “they obeyed an order”. The Committee truth and justice for Francesco Mastrogiovanni, asks for truth and justice. Watch also the film 87 ore (87 hours), gli ultimi giorni di Francesco Mastrogiovanni (Francesco Mastrogiovanni’s the last days) by Costanza Quadriglio.

 

In Italy some deaths due to forced hospitalization and/or prolonged or short-time use of mechanical and chemical restraint have been reported by the press, television and network (this mean that there are a lot of other such “incidents”, we don’t know):

27 October 2005: Riccardo Rasman dies during a coercive treatment by the policemen, for a hospitalization against his will, in a psychiatric ward in Trieste.

21 June 2006: Giseppe Casu, guilty of having wanted to pursue his peddler job in the village square, dies in a psychiatric ward in the hospital “Santissima Trinità” of Cagliari, as a consequence of a thromboembolism, after a forced hospitalization and having been heavily sedated. He was tied hands and feet to the bed, for 7 days and was sedated with high doses of psychiatric drugs against his will.

28 August 2006: A.S., the 17th of August 2006 is admitted to the psychiatric ward in Palermo, for medical investigations. A.S. died after 2 days coma, the 28th of August, probably for excessive doses of psychiatric drugs.

26 May 2007: Edmond Idehen a 38 years old Nigerian man, went voluntarily into the psychiatric ward of Bologna’s hospital “Istituto Psichiatrico Ottonello – Ospedale Maggiore Bologna”. As he tried to leave the hospital, because he did not feel cared, the doctors forced him to stay, with the help of policemen. Edmond Idehen died as a consequence of a hearth attack while nurses and policemen held him down. He was also strongly sedated with psychiatric drugs.

12 June 2006: Roberto Melino, 24 years old, dies for a hearth attack; he entered voluntarily the psychiatric ward of Empoli’s “San Giuseppe” hospital. As he tried to leave the hospital, he was forced to stay by the doctors, and obliged to take high doses of psychiatric drugs, in spite of his evident and serious breath difficulties.

15 June 2008: Giuseppe Uva, 43 years old, was brought inside a police station, because he was driving in state of high alcoholic level. There he was subjected to ill-treatments. After 3 hours he was forced to an obligatory hospitalization in the Varese’s “Circolo” hospital and was forced to take psychiatric drugs. He died because of the stress provoked by the mix of alcohol and psychiatric drugs.

30 August 2010: Lauretana La Coca, 32 years old, entered voluntarily in Termini Imerese’s “Salvatore Cimino” hospital. After 10 days of hospitalization her condition got worse, till she got into a comatose state and died.

Giuseppe D.: A man, more than 70 years old, was interned in Reggio Emilia’s psychiatric prison. His problem was that the neighbour’s daughter is a psychiatrist. His lawyer took a legal action to the European Court of human Rights, but until now there has been no answer, so the Pisa’s student group “Collettivo Antipsichiatrico Artaud”, together with “Telefono viola” from Milan, decided to release the documentation relating to this case in Internet, according with Giuseppe D.’s will, his lawyer, and his relatives.

2 April 2010: Eric Beamont, 37 years old, the 2 April 2010 was hospitalized in Lamezia. After 2 days he entered coma, so the doctors transferred him to the Catanzaro’s “Pugliese – Ciaccio” hospital, where he died. There is the suspect that the death of Eric was caused from a high dose of benzodiazepine. Diagnosis was: subarachnoid hemorrhage[1]

28 May 2015 Massimiliano Malzone died during a forced treatment.

11 July 2015 Amedeo Testarmata died during a forced treatment.

29 July 2015 Mauro Guerra died during a forced treatment.

5 August 2015 Andrea Soldi died during a forced treatment…

Unfortunately in this article we have not described isolated occurrences, but an emblematic situation of violation of human rights in the Italian psychiatric institutions.

These are just some of the “incidents” that came to the limelight, but many more of them are not known when they happen, because, for example, people who live in loneliness are involved, or people whose relatives have given their consent, or simply when people want to get rid of a person perceived as annoying. We The Mad Hatter Association, constantly of forced psychiatric treatments, during which treated people suffer heavy damages. Forced treatments are often made on request of relatives, when patients refuse to take any longer the psychiatric drugs, or when their behaviour is perceived as disturbing. A friend of us (I.M.) tried to escape, but he was chased and filled with drugs; shortly after he was found dead at the bottom of a ravine. He was 40 years old. Another friend (A.S.) was walking on a path between fields and was stopped by police, because he was known as a “mentally ill” person. Then they called the psychiatrist on duty and told him: “He was walking near the railway and could possibly have in mind to commit suicide”; so they locked him up. I know this person, who often walks in the fields, where, however, it’s easy to be located near the railway, because of the constitution of the territory. He had never the intention of committing suicide. Another acquaintance of us died, throwing himself under a train, terrified by the fact that his mother, according to the psychiatrist, would refer to forced psychiatric treatment for him. Another one (U.S.) has suffered of heavy harassment, after having reported his superior’s embezzlement, noticed during his duties as a municipal technician. He was subjected to forced psychiatric treatment, kidnapped by police in riot gear. While he was sleeping, his door was smashed down, and he was thrown on the ground face down and handcuffed. He says that at least they could have tried to open the door, which was not locked. Now he is terrified and he even fears the dark; he is forced to take psychiatric drugs.

We can not think of de-institutionalization before we have dismissed the rules that allow forced psychiatric treatment, that allow to hold a person against his will, without having committed any crime, without the right to an equitable process, based on the alleged dangerousness and only because this person was diagnosed with a mental illness.

The so called “Basaglia law” the law nr. 180 from 13.5.1978, then joined and actually regulated by Law 833/1978 articles 33, 34, 35, 64, establishes the “Accertamenti e Trattamenti sanitari volontari e obbligatori” (“Forced health verifications and treatments”). In 1978 the law nr. 180 imposed the asylums’ closure, and the elimination of dangerousness or/and public scandal as criterion for forced treatment. But in the most Italian province, asylums didn’t close. So it was necessary to make another law, (because these asylums were too expensive), the law n. 724 from 23.12.1994, art. 3 paragraph 5, which dispose that these asylums had to be closed within the 31.12.1996; again disregarded, differed until the end of 1999. In 1996 the asylum inmates in Italy were 11.516 in 62 public asylums and 4.752 in private asylums.

According to this art. 180 law, forced treatment and included forced hospitalization, are possible if there are the following conditions: 1) a person “suffering mental illness” requires urgent medical treatment; 2) refuse the treatment; 3) it’s not possible to take adequate measures outside the hospitals. Forced treatments has a maximum duration of seven days, but can be renewed if necessary and then extended if it persists for a reasoned clinical need (it’s not an exception that the duration is extended for months and years). For forced treatments and the consequently limitation of personal freedom, there must be a request signed by two physicians, an administrative validation from the Mayor is required, followed by the validation of a judicial review by the Tutelary Judge.

Legislation of forced psychiatric treatment provides ample scope for arbitrariness and it is in strong contrast to the human rights regulations, that aim at preserving even people with disabilities from inhuman and degrading treatments. For those who commit a crime, it is expected that the judicial authority, within certain specific procedural rules, sanctions or imposes restrictive measures. We constantly deal with innocent people in forced psychiatric treatment, who can no longer find a way out of the psychiatric institution.

“I have to confess”, said a psychiatrist, “to have a person completely in my power, made me feel a kind of sadistic shiver”.

In Italy the CRPD was ratified in 2009, but just at now we have not a law against torture, torture is not a crime, torture is not forbidden in Italy. So, those who torture does not violate the law. In the meantime a lot of intermediate psychiatric institutions (also called little asylums) were built. They are public or private and reimbursed from the State. A very great business is behind. Some other examples: Lazio Region President Polverini’s decree on Lazio hospital system: the number of beds in Psychiatric Institutions raise from 369 up to 629; more 70%. 50 beds for the public structure and 210 for the private structure trigger the chronicization circuit.

260 beds = 90.000 life days subtracted to the people at the cost of 10.000.000 €.

Didn’t the Basaglia Law foresee the closing up of madhouses?

  • Professor Antonucci, what is, to date, the status of implementation of the law 180?

– Apart from some single exceptional case, what proposed Franco Basaglia is not realized, but it continues a job that Basaglia obviously would not approve: authoritarian interventions, taking people by force and bring it in psychiatric clinics, which are the continuation of the asylum. The asylum was established by the authoritarian intervention: I take a person against his will, then I submit her to a series of forced interventions, which are the essence of the mental hospital”. (http://www.psicoterapia.it)

The deplorable situation of the six Forensic Psychiatric Hospitals recently became more visible, after surprise-inspections of a parliamentary committee. The videos of the visits, showed by the national television, and the press releases can be found on the web. A parliamentary report had already been made in June 2010, but the photographs show a situation that until now has not yet changed. People held for decades for minor offenses, whose penalty would have expired long time since, if not repeatedly and automatically renewed.

Here below we report some data extracted from the text of the parliamentary relation on the June 2010 inspection of the 6 Italian psychiatric prisons (forensic institutions) still active (Senator Ignazio Marino, physician ,was Chair of the Investigative Committee on the National Health Care System). After the 1978 “Basaglia law”, madhouses had to be closed, but the 6 psychiatric prisons mentioned above keep doing the same job. Senator Marino was also concerned about the increasing of electroshock (from 9 institutions allowed to give electroshock before 2008, now we have more than 90 psychiatric institutions who dispense ECT).

The regulations and logics that manage these psychiatric prisons (forensic institutions) (in Italian OPG-Ospedale Psichiatrico Giudiziario), are the same inherited by the fascist Rocco Code (1934). 40 % of the 1500 actual convicted should already have been released, for detention terms expired, but they see their penalty end terms deferred in order of their supposed social dangerousness.

Nine people each cell, dirty bathrooms and bed sheets; dirty nurses’ gowns as well. In Barcellona Pozzo di Gotto (Messina), 329 convicted are overcrowded in cells built in 1914. Dirt everywhere. One patient was found naked, tied up to his bed, with a haematoma on his head. Aversa, built in 1898. 320 people locked up six by cell, in inhuman conditions.

NAS (Antisofistication and health nucleus of Carabinieri (Police)) reported and denounced all this to the Public Prosecutor’s Office, but this office is often made by the same persons that sentence patients to life.

In the Secondigliano OPG, the psychiatric prison is interior to the jail. Here stays since 25 years a patient who was sentenced two years. Burns and black eyes are not reported on the clinical diary. Feet and hands go gangrenous.

In Montelupo Fiorentino OPG they are 170 in a very scruffy building. In Reggio Emilia OPG they are 274 where they should be 132. 3 showers serve 158 patients. One is tied up to his bed since 5 days for disciplinary reasons. 3 in 9 meters square. “The OPG (psychiatric prison) are one of the “silence zones”, explains Alberto, of the Pisa Antipsychiatric Collective dedicated to Antonin Artaud, “and they show the political use of psychiatry. The consume of psychiatric drugs is more and more pushed, the electroshock comes back “in fashion”, perhaps to “heal post partum depression”. And a law lies in ambush in order to bring the forced hospitalization terms from 7 to 30 days”. After the scandal came to light, on 17 January 2012 the Senate Judiciary Committee unanimously approved the definitive closure of the OPG by 31 March 2013. The closure was extended until March 31, 2015. After the closure of the facilities in 2015, according to Law Decree n. 211/2011, converted into Law no. 9/2012, have been replaced by residences for Execution of Security Measures (R.E.M.S.). We have to closedown the Forensic Psychiatric Hospitals, instead of changing the name of them. If we don’t shut dawn these places once and for all, we cannot talk about de-institutionalization. Close them not in order to transfer their users to other psychiatric institutions, but to give these people a life dignity.

A research (source: British Medical Journal) conducted in 6 European countries (Italy, Spain, England, Netherlands, Sweden, Germany), that have closed asylums in the 70s, saw that between 1990 and 2003 an increase in the number of beds in forensic psychiatric hospitals, in psychiatric wards, in so-called safe houses. Supported housing is seen as an alternatives to asylums, as a sign of de-institutionalization, but they are rather a form of institutionalization. Also forced treatments are increasing. It is not clear the reason why the number of beds in Forensic Psychiatric Hospital increased, since there is no correlation between crimes like homicides and de-institutionalized persons.

It would be important to spread the awareness that forced treatments, like the restraint is an anti-therapeutic act, that makes cures more difficult, rather than to facilitate them. Physical restraint is not exercised only in the field of psychiatry. The areas of operation where should be discussed the problem of legitimacy, usefulness and appropriateness of physical restraint, do not consist only in hospitals, but also in nursing homes for the elderly, therapeutic communities for drug addicts and nursing homes for people with disabilities related to congenital or early acquired disabilities. An improvement in psychiatric nursing practice, characterized by the renunciation of physical restraint, would be a strong signal in order to spot out the problem also in other operating environments, urging those who work in this field to act with similar treatment practices, rather than restrictive ones.

Referring to the psychiatric drugs there are rules of the Convention on Human Rights, which require user’s fully informed consent, before administering, even if he’s disabled. Most psychiatric drugs are prescribed for a long time, sometimes for life, without informing the user on their effects, and without any help in the resolution of his real and existential problems. Psychiatric drugs can cause neurological diseases, that sometimes become irreversible. Akathisia, dyskinesia, are very unpleasant effects and can throw a person in despair. Often the user is encouraged to continue taking the drugs even when he asks to withdraw them, and it is almost impossible to find professionals who help and give directions for withdrawal. Peter Breggin, a psychiatrist, working with institutions as WHO (World Health Organisation) and FDA (Food and Drug Administration), wrote hundreds of pages on the harmful effects of psychiatric drugs. Peter Lehmann, who tested the effects of drugs on himself during his hospitalization in a psychiatric clinic, has published and continues to publish the results of his research for which he uses pharmaceutical and medical literature. The effect of psychiatric drugs is known, but the billion-dollar business behind it is too big to lose it. Peter Lehmann is the first survivor of psychiatry to be awarded with the honorary degree, conferred him by the clinical psychology faculty of the Aristotele’s University of Thessaloniki, for his work as researcher and activist in the field of mental health.

A person who starts to take drugs, in most cases will be induced to take them for life, because they create addiction problems. The psychiatric user develops a very strong dependence toward the psychiatric service too. For the psychiatrists, lack of compliance is in fact intended in it self an aggravation of the disease. Then the conditioning that takes place, goes in the direction of dependence from psychiatric services, of becoming “childish” and “chronic patient”.

Although in almost all European countries asylums and psychiatric hospitals have been eliminated or substantially reduced, this does not mean that in the new post-asylum structures, asylum-dispositifs have been eliminated. People are, with few exceptions, completely sedated by psychiatric drugs, even though apparently there are implemented programs such as art therapy. The intake of psychiatric drugs is induced also in order to make the user unconscious.

Erwin Redig, a German psychiatric survivor, says: “There are people putting us under pressure to force us to take them (psychiatric drugs). If we do not take them, our changes embarrass them. If this is our case, we must make clear to ourselves that we are swallowing drugs for other people’s welfare, because they find us unpleasant if we do not”.

“The dispositif of discomfort-complex, that operates in a small residence, acts more broadly in the society”. Neuroleptic drugs affect thinking, block the flow of thoughts, and make people flatten. I relate the words of a healthcare professional: “As soon as psychiatric drugs are given to people, they literally get extinguished. To what extend is it fair to cancel the person?” Although in the European countries, the asylum psychiatry and the psychiatric hospitalization of users have given way to communities, the psychiatric institution culture has not changed. The patterns of asylum residentiality are still active. But most of all it is still alive an asylum mentality, therefore it is important for everyone to be aware how much everybody’s mentality is crucial in creating or not creating devices that belong to psychiatric institutions; operating devices that constitute a widespread operating module. “Residential Intermediate Structures”, foreseen in Italy by the 1983 law, should have had the provisional nature as their specificity; therefore they should not constitute either a definite admission or a final place for forced hospitalization; they should have been  transitional housing, that could break prejudice and exclusion logics. In March 1999, by a special decree, to the Italian Regions was imposed the definitive closure of the asylums, under threat of strong economic sanctions, because despite the birth, on paper, of the new “local services”, mental hospitals were still crowded with patients.

Named by the derogatory title of “asylum residuals”, for these people that nobody wanted, residential structures accounted for an illusion of freedom; they founded themselves to be again in a mental institution. “Many patients”, writes one of them in an autobiography, “have never been so well in terms of comfort, but nevertheless they are in a state of fearful desolation”.

An induced need of security, the defence from a potentially dangerous mind sick person that at any time, during an outbreak, could commit heinous actions against others or against himself; shortly, on the basis of this need and of this false scientific fundamentals, we build the myth of the need of post-asylums psychiatric institutions. If we don’t get reed of the psychiatric prejudice, the “mental health” institution remains. There are many alternatives pursued by individuals, associations or institutions, but they are deliberately ignored. The responsibility for solving the problems of institutionalization, is not up only to psychiatrists or to mental health professionals, but to the whole civil society. Everybody contributes to the asylum mentality. Users as well, who have internalized the psychiatric diagnosis and can no longer live without it.

Mary Nettle, chairman of Enusp until 2010, expects an increasing involvement of users and survivors of psychiatry in researches about psychiatry; while they often are excluded or not paid on the pretext that they are not professionals.

Although many examples exist that  prove that you can accompany a person in troubles out of his problems, through dialogue and support in the resolution of the objective and material difficulties, and helping him to get awareness of his own rights, these experiments and their positive results continue to be deliberately ignored.

 

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I will never forget, by Irit Shimrat

a work in progress

I will never forget, though I wish I could, what psychiatric brutality feels like. Being taken to hospital by the cops, by brute force, in handcuffs, though my only crime was confusion.

Being stripped naked in front of male orderlies. Being shackled to a gurney on the psych emergency ward. Being painfully jabbed in the ass by a nurse wielding a needle filled with a drug that had immediate, nightmarish effects. Being ignored by chatting nurses as I whispered, then said, then screamed that I had to go to the bathroom. Being left to lie in my own shit for hours as they discussed boyfriends and hair styles.

Being wheeled to a concrete cell, furnished only with a mattress on the floor and a metal toilet and tiny sink, an observation window in the metal door, and a camera in the corner of the ceiling. Being left there for days, under the glaring fluorescent light, with someone coming in three times a day to leave a sad, bland meal in a plastic tray on the floor. Performing for the camera and writing on the walls with my shit as the drugs that were supposed to knock me out made me crazier and crazier.

Finally being released onto the ward, but being slammed back into solitary confinement every time I “acted out.” Slowly and painfully learning to conform, so as to earn such “privileges” as being allowed to wear real pajamas, then my own clothes; being allowed out for a cigarette; being allowed to make a phone call. Being mocked and brutalized by burned-out nurses.

Finally being allowed visitors, only to have them stare at me in horror and pity, as I shuffle like a zombie, much too drugged to make conversation. Eventually learning the magic words that got me out: “I understand that I’m sick and need to take these drugs for the rest of my life.” Drugs that had already resulted in dry mouth; flaking skin; extreme constipation; painful muscle spasms; inability to sit, stand or lie still – not to mention their effects on my mind: the terror, the agony, my absolute failure to be able to hang onto my self. The certainty – my only certainty – that I had died and gone to hell. That I was being punished for crimes I couldn’t remember. That I would never be able to live in the world again.

I was wrong in that certainty, but it’s been a hard road back, and I’ve had to travel it many times. Always, when I’m back out in the world, I find myself suffering from the effects of institutionalization, terrified of the loneliness, of having to take care of myself, of not being able to make it outside the bin. I’ve had to suffer the withdrawal symptoms from whatever they were forcing me to take, which I stop taking as soon as I get out. I’ve had to punish myself, hit myself, scream at myself for having been such an idiot as to get locked up again. I’ve had to go through weeks or months of wanting to kill myself to make sure this never happened to me again. I’ve had to slowly rebuild my life. And I’ve had to live with the permanent effects, physical and emotional, of being poisoned with psychiatric drugs and traumatized by institutional cruelty.

My life has been a sheltered one, on the whole. I was born and raised in a comfortable middle-class family, with lots of parental love and support and no violence or neglect. I have never been raped or beaten or hungry. Nevertheless, I got bored as a teenager, took lots of drugs, and ended up going crazy, several times, over the years. But being crazy wasn’t, of itself, a bad thing. If I had been allowed to go through it – if I had been treated with kindness and compassion, and encouraged to explore my thoughts and visions and make sense of them – it could have been the wonderful experience that it always started out as. It could have enriched me.

The only really bad thing that has ever happened to me is psychiatry. It has damaged my body and mind, destroyed my self-esteem, and forced me to re-invent myself, again and again, every time it tore me apart.

 

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Pink Belette: La psiquiatrie en France/ Psychiatry in France

La psychiatrie en France, zone de non-droit (par Pink Belette)

Une patiente française sous contrainte fait son « audit » dans le cadre de la campagne pour soutenir l’Abolition totale des soins et de l’hospitalisation sans consentement en application de la CDPH de l’ONU

http://depsychiatriser.blogspot.no/2016/03/la-psychiatrie-en-france-zone-de-non.html

 

Pourquoi je suis contre les « soins sous contrainte » :

On pourrait croire que, au pays de la liberté, on a encore droit à son intégrité morale et physique.

Rien n’est plus faux. Par experience, impossible pour quiconque d’échapper à un soin sous contrainte (SPDT, « soin à la demande d’un tiers » ou « péril imminent »).

Il suffit que : une personne la demande (que ce soit la famille, un voisin…), qu’on soit « pas bien », déstabilisé, agité, « instable », en colère, dépressif, sur la défensive, « en opposition », « délirant », amaigri, boulimique, fumeur de shit, drogué…

Il suffit aussi qu’on refuse l’hospitalisation ou un traitement pour que les médecins se relaient pour demander un soin sous contrainte. Une fois hospitalisé, « on » vous fait comprendre que vous perdez vos droits à la personne, l’argument étant : « maintenant on est responsable de vous pour TOUT »… Par contre, vis-à-vis de vous, « on » n’est responsable de rien…

 

Depuis la loi Bachelot du 5 Juillet 2011, en particulier si on a le malheur de contester le diagnostic ou le traitement, c’est alors après la sortie d’hospitalisation qu’on ne peut plus se débarrasser de la contrainte, et c’est là que c’est le plus pervers : injections forcées, consultations obligatoires avec un praticien hospitalier non choisi (à la rigueur, on a le choix entre deux médecins).

Le pire : si on refuse de se rendre au centre médico-psychologique du secteur assigné, la police vient gentiment vous cueillir chez vous pour vous hospitaliser en soins obligatoires à un degré encore plus coercitif (SPDRE, « sur la demande de l’Etat ») et sur un temps plus long et sans contact autorisé avec l’extérieur (!) jusqu’à ce qu’il aient réussi à réduire votre volonté à néant. Ainsi, il arrive que les personnes concernées doivent abandonner leur logement pour « vivre » en psychiatrie (parfois pendant des dizaines d’années, voir le cas de Dimitri Fargette)…

 

Je suis témoin : en France, il y a réellement du souci à se faire…

  1. Il n’y a aucune alternative à la psychiatrie institutionnelle (lobbying des psychiatres ET de l’industrie pharmaceutique contre d’autres formes de thérapies) ;
  2. Aucune littérature ou culture antipsychiatrique (des « survivants », il n’y en a pas…)
  3. L’Ordre des Medecins Psychiatres qui suspend : tout psychiatre « en décalage » avec le système consensuel (d’après le Dr. O.G, psychiatre libéral et ex-chef de clinique) ;
  4. L’Ordre des Medecins Psychiatres qui suspend : un psychiatre responsable de la mort d’une patiente… seulement pour 2 semaines (voir l’affaire Florence Edaine)
  5. La « Mafia des tutelles » : tout patient faisant des séjours répétés est automatiquement placé sous curatelle ou tutelle (sans consentement, c’est renforcé)…
  6. Des mères se voient enlever leurs enfants immédiatement après la pose d’un diagnostic de maladie mentale ; jamais de scandale médiatique…
  7. On fait comprendre aux femmes en âge de procréer qu’il faut surtout adopter la contraception, en sous-entendant qu’on leur enlèverait leur enfant de toute façon. Ce qu’on ne leur dit pas, c’est que tous les neuroleptiques passent la barrière placentaire, c’est pourquoi j’ai entendu parler d’autant de cas d’avortements spontanés chez les femmes sous traitement. Dixit une infirmière, on donne de l’Haldol aux femmes enceintes, ce qui « prouverait » soi-disant « le peu de nocivité de l’Haldol » (!). Jamais d’étude là-dessus ni de scandale médiatique…
  8. Des services fermés qui regorgent de dépressifs qui ne sont pas en « péril imminent » et qui se sentent surtout mal de recevoir par exemple 4(!) antidépresseurs à la fois…
  9. Une cellule d’isolement toujours occupée (appelée « chambre de soins intensifs »!), ce qui participe du « folklore »…
  10. « Abonné une fois, abonné toujours » : les traitements qu’on ne peut plus JAMAIS arrêter ;
  11. Aucune étude à long-terme sur les effets des psychotropes…
  12. Aucun recours en cas d’abus psychiatriques (système interne de « médiation » caduc : mal vous en prend d’écrire une lettre au directeur de l’établissement…)

 

Pourquoi je suis contre ce nouveau système de « Juge des Libertés et Détentions » (relatif à la loi du 27 septembre 2013) :

On vous fait croire que c’est une voie de recours. Rien n’est plus faux, à part en cas de vice de forme (ce qui n’arrive quasiment jamais, puisque les psychiatres ont intérêt à ce que la procédure se passe en bonne et dûe forme). Au contraire, c’est un enfermement de plus…

  1. Le juge n’est pas psychiatre, il se garderait bien de remettre en question le jugement des médecins sur le fond. Par contre, on lui a expliqué que tout patient qui conteste le traitement est en « opposition », ce qui constitue déjà une preuve de « déni de maladie ».
  2. Les médecins y trouvent donc une voie bien pratique pour se décharger de leurs responsabilités, puisque « c’est le juge qui décide ». Et alors on voit défiler les patients dans le bureau du juge, accompagnés d’un soignant : « on vous amène Mme X »…
  3. On vous octroie un avocat commis d’office une semaine avant, mais qu’on ne peut pas contacter avant. Le jour de l’audience, c’est 15 minutes pour faire connaissance et se préparer, et ceci « dans les cases »…
  4. Ce qui est très alarmant, c’est qu’on ne trouve pas d’avocat en libéral, à part peut-être à Paris, et seulement pour un recours aux assises.
  5. Le juge prétexte qu’il ne peut lever le soin sous contrainte si c’est à la demande du directeur de l’établissement. Or, toutes les demandes de mise en soins sous contrainte passent par l’approbation du directeur. Tout le monde se donne bonne conscience, donc ;
  6. Une fois l’audience terminée (10 minutes), où l’on se voit déstabilisé, accusé et mis en doute, le juge « ordonne » le maintien en hospitalisation complète et de la mesure de contrainte, ce qui confère force de loi aux médecins (et donc une impunité totale) et SURTOUT donne encore plus de poids à la mesure.
  7. Inutile de préciser que si on était encore crédible avant, on ne l’est plus du tout et c’est définitif. Si on refuse de signer la feuille ou de comparaître, c’est pire, et on s’attire les foudres des médecins et du personnel soignant, qui vous mettent la pression, vous humilient et vous maltraitent. On ne peut pas non plus refuser que l’audience ait lieu.
  8. Le juge sait pertinemment qu’il s’agit d’une volonté potitique de faire taire les « récalcitrants » par voie chimique et coercitive. Il y adhère donc pleinement.

 

Pourquoi je suis contre les traitements forcés :

J’insiste sur le fait que les psychiatres hospitaliers ont les pleins pouvoirs sur le choix et le dosage des traitements, il ne s’agit JAMAIS d’un consentement éclairé. La « balance bénéfice-risque » est toujours de leur côté, même en cas de surdosage, même si la personne prend déjà 17 médicaments et pèse 200kg (ce qui est le cas d’une amie à qui on a donné Zyprexa ET Xeroquel suite à quoi elle a fait un accident vasculaire cérébral). Ils ne sont jamais responsables des effets secondaires non plus et vous orientent « gentiment » vers votre généraliste…

De plus, c’est toujours les médecins qui « décident » à votre place si vous allez bien ou non, et ce, même s’ils ne vous connaissent pas ou vous on vu seulement 5 minutes…

L’effet pervers de la chose, c’est que c’est tellement insupportable d’être enfermé et camisolé chimiquement qu’au bout d’un mois, on fait semblant d’aller mieux, on renie ses opinions et on arrête de se plaindre des effets secondaires pour pouvoir sortir, sous peine de se voir diagnostiquer en plus des « troubles du comportement » et un « déni de la maladie»…

 

J’AI ETE TORTUREE : au Zyprexa (surdosage), au Solian, au Tercian, au Risperdal (8 mg pour un poids de 50 kg), à l’Haldol (90 gouttes par jour) et « shootée » au Valium (40mg!)…

Le médecin et le personnel infirmier refusaient de prendre en compte : les troubles de l’élocution, tremblements, convulsions, dyskinésies, impatiences insupportables, angoisses mortelles, envie de mourir et tortures psychiques (« enfer » mental) qui ont apparu immédiatement et ont même empiré avec le temps. Je me suis battue en vain en plaidant que les neuroleptiques anesthésient la conscience, font perdre la mémoire, rendent docile et influençable, rendent dépressif et encore plus anxieux, affectent les capacités intellectuelles et détruisent l’âme.

J’ai également été mise plusieurs fois en isolement avec violences de la part du personnel ET des employés de la sécurité, alors que je n’ai JAMAIS été agressive. J’ai été mise sous contention, j’ai été déshabillée de force, j’ai été déshydratée, humiliée, bafouée, maltraitée…

Aujourd’hui, même si j’ai droit à un traitement moins inhumain, l’Abilify en injectable (après une 4ème tentative de suicide), je reste « accro » au Valium, traumatisée et toujours en alerte, dans l’angoisse de manquer à mes « obligations » ou de faire mauvaise impression, sans parler de l’absence totale de perspectives, de motivation et de joie dans ma vie, sans parler de ma vie affective qui est une misère (mort spirituelle, isolation, dépression, anxiété…).

Ma carrière artistique, qui avait débuté avec succès, a été définitivement brisée pendant mes meilleures années (la trentaine) et je suis aujourd’hui dans l’incapacité de créer alors qu’avant je foisonnais d’idées et me donnais les moyens pour les mettre en œuvre. Il est également trop tard et trop compliqué pour moi maintenant pour devenir mère.

Je vis dans la précarité à la charge de l’Etat.

 

Pourquoi j’ai toujours été opposée à leurs « diagnostics » pathologisants :

Je suis une personne ayant vécu les pires traumatismes dans la petite enfance (viols et abus, harcèlement), dont la plupart des souvenirs sont remontés plus de trente ans après, ce qui a grandement affecté mon équilibre psychique. J’ai malheureusement dû constater que, d’après les psychiatres (pour autant qu’ils m’aient crue…), il n’y aurait aucune relation de cause à effet entre ce que j’ai subi et mes troubles (!), ce qui est tellement énorme et risible qu’on aurait plutôt envie d’en pleurer…

J’ai pu constater, à l’instar de la Dre Muriel Salmona, seule psychiatre en France à ma connaissance qui aborde la souffrance psychique sous l’angle du trauma, qu’en France, aucune prise en charge spécifique n’est prévue ou proposée, et après 8 ans de psychiatrie, aucun médecin à ce jour ne m’a diagnostiqué un syndrôme de stress post-traumatique avec dissociation, ce qui pourtant devrait être le cas après des viols dans la grande majorité des cas selon la Dre muriel Salmona ( Association Mémoire Traumatique et Victimologie ). Je n’ai quasiment jamais pu faire de travail thérapeutique avec un psychiatre.

Quant à leur diagnostic de schizophrénie, il n’a jamais été étayé, expliqué ou argumenté, et mon dossier a été établi sur des « observations » des médecins et de simples « impressions » du personnel soignant… J’ai constaté également que parler de spiritualité conduisait immanquablement à un diagnostic de « délire mystique », donc, selon eux, de schizophrénie.

J’en conclus que l’enfermement et leurs mauvais soins n’ont fait qu’en rajouter à mes traumatismes, je ne crois pas un seul instant que leurs maladies imaginaires résultent d’un déséquilibre chimique dans mon cerveau ou d’une quelconque « maladie » biologique, je sais que les effets des neuroleptiques sont catastrophiques à long-terme et je suis totalement en accord avec de nombreux anti-psychiatres à l’international, dont le Dr. Peter Breggin, Joanna Moncrieff, David Healy, Robert Whitaker, Thomas Szazs, Peter Goetzsche et autres… (cf. le site madinamerica.com).

 

CONFORMEMENT À LA CONVENTION DES NATIONS UNIES SUR LES DROITS DES PERSONNES HANDICAPÉES, ARTICLES 12, 14 ET 15, TEL QU’INTERPRÉTÉ DANS L’OBSERVATION GÉNÉRALE NO. 1 ET LES LIGNES DIRECTRICES SUR L’ARTICLE 14, ET AUX PRINCIPES DE BASE ET LIGNES DIRECTRICES PUBLIEES PAR LE GROUPE DE TRAVAIL SUR LA DETENTION ARBITRAIRE DE L’ONU, PRINCIPE 20 ET LIGNE DIRECTRICE 20, JE PLAIDE POUR L’ABOLITION TOTALE DE LA PSYCHIATRIE COERCITIVE ET DES TRAITEMENTS FORCES.

JE REVENDIQUE TOUS MES DROITS A LA PERSONNE EN TANT QUE FEMME MAJEURE PROTEGEE, PERSONNE HANDICAPEE, EN PARTICULIER LE DROIT INALIENABLE DE DISPOSER PLEINEMENT DE MON CORPS ET DE MON ESPRIT SANS CHIMIE IATROGENE, DE MA LIBERTE INCONDITIONNELLE.

JE CONSIDERE LA PSYCHIATRIE INSTITUTIONNELLE ET SES PRATIQUES COERCITIVES COMME UN CRIME CONTRE L’HUMANITE, UNE ATTEINTE A LA DIGNITE ET A LA LIBERTE DE PENSEE 

Pink Belette, Mars 2016

 

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Psychiatry in France, NO-RIGHTS-ZONE (By Pink Belette)

A french patient under forced commitment makes her « audit assignment » as part of the campaign to support CRPD absolute prohibition of commitment and forced treatment

 

Why I am against commitment and forced treatment :

One could believe that, in the land of liberty, one is still entitled to his or her physical and moral integrity.

Experience proves it wrong. It is impossible for anyone to escape forced commitment (so-called « care on demand of a third party » or « imminent danger »).

It’s already a done deal if : one person asks for it (family, neighbour…), one is « not well », unsettled, agitated, « not stable », gets angry, is depressed, on the defensive, « in opposition », exuberant, emaciated, bulimic, shit smoker, drugged…

It is sufficient if one refuses hospitalization or a treatment for the doctors to relieve each other in order to enforce commitment. Once hospitalized, it is been made perfectly clear that one looses his or her personal rights, only argument is : « now we are responsible of you for EVERYTHING »… Thus, towards the « patient », nobody is responsible of anything…

 

Since the « Bachelot law » of July 5th 2011, particularly if one has something to object, be it diagnose or treatment, it is then after being out of hospital that one cannot get rid of commitment, which is most perverse : forced injections, mandatory appointments with an non-chosen clinical psychiatrist (or, best case, with a choice between two doctors).

And, worst of all : if one refuses to go to the assigned medical center of one’s district, the police comes to pick one up at home and rehospitalization is mandatory with an increased commitment that is even more coercive (« on demand of the State »), on a longer lapse of time and with no authorization to communicate with the outside (!) until they succeed to break one’s will and reduce one to nothingness… It so happens that people loose their home and « live » in psychiatry (sometimes for decades, see Dimitri Fargette’s case)…

 

I witness : in France, there is really matter to worry about… 

  1. There is no alternative to institutional psychiatry (lobbying of psychiatrists AND pharmaceutical industry against other forms of therapies) ;
  2. No antipsychiatric litterature nor culture (no « survivors »…)
  3. The « College of Psychiatrists » who suspends : every psychiatrist « not aligned » with this consensual system (according to Dr. O.G, liberal psychiatrist and former head of clinic);
  4. The « College of psychiatrists » suspending : a psychiatrist responsible for the death of a patient… only for two weeks (see the case of young patient Florence Edaine)
  5. The « Guardianship mafia » : every patient who is repeatedly hospitalized is automatically placed under guardianship under a certain degree (without consent, it is being reinforced…)
  6. Single mothers get their children robbed and placed immediately after a diagnosis of mental illness is established, never one scandal about this…
  7. Women in age to bear a child are being strongly recommended a contraception, with a wink that their child would be taken away from them anyway. What they are not being told is that all neuroleptics pass the placenta barrier, that’s why i have heard of so many miscarriages from women under treatment. A quote from a nurse : « pregnant women are given Haldol, which proves it’s little nocivity » (!). Never one study about that nor mediatic scandal.
  8. Closed wards full of depressive people who are not in « immediate danger » and are feeling bad mainly because they are being given for example 4 (!) antidepressants at a time…
  9. An always occupied isolation chamber (so-called « intensive care chamber »!), which participates to the « folklore »…
  10. « Once subscriber, always subscriber » : treatments one can NEVER withdraw from ;
  11. No long-term study on psychotropic medication… (All so-called studies are biased)
  12. No recourse in case of even flagrant psychiatric abuse (internal system of « mediation » obsolete : it’s a very bad idea to write a letter to the director of the institution…)

 

Why I am against this new system of « Judge of Liberties and Detentions » (related to the law of september 27th 2013) :

They are making believe it is a recourse. I was proved wrong, except for instance on a technicality (which almost never happens, because it’s in the psychiatrists’ interest that the procedure goes well and in due form). On the contrary, it’s in the sense of more legal coercion…

  1. The judge is no psychiatrist, he would never ever put into question the judgment of the physicians concerning the core. Thus, he has been briefed about the « fact » that any patient who opposes treatment is « in opposition », which establishes already a proof of « illness denial » (and as a proof of illness itself).
  2. Therein it has been found a very practical way for doctors to be discharged of their responsibilities, as « it’s the judge who decides ». And now, bunches of patients are being spotted filing up before the judges’ office, escorted by a nurse : « we bring you Ms. X »…
  3. Patients get a mandated advocate one week before the audience, but who cannot be contacted in advance. At audience day, it’s 15 minutes to meet and prepare, and, of course, in a « formated » way.
  4. Very alarming is the fact that no liberal advocate is to be found for psychiatric abuse pleas, except maybe in Paris, and mostly for a recourse before the Court of Assize.
  5. The judge pretends he cannot lift the forced commitment because it’s asked for by the hospital director. Yet, all demands for forced commitment have to be validated by the director. Hence everyone gives him- or herself a good conscience there ;
  6. Once the audience done (10 minutes), where one gets destabilized, accused and doubted of, the judge « orders » the maintaining of the person in complete hospitalization and of the measure, which confers force of law on the doctors (hence, total impunity).
  7. Not to mention the fact that if one still had credibility before, it’s no longer the case and irreversible. If one refuses to sign the convocation or to attend the audience, it’s worse, and one is being bullied by staff members and doctors alike, who put one under pressure, humiliates one… One also cannot refuse the audience being held despite of one’s absence.
  8. The judge knows pretty well that it’s a political will to make silent the « opponents » of the system, chemically and coercively. He therefore fully concurs with it.

 

Why I am against forced treatment :

I insist on the fact that hospital psychiatrists are almighty regarding the choice and dosage of treatments, it’s never about an « informed consent ». The « benefit- risk balance » is always on their side, even in case of overdosage, even if the person already takes 17 meds and weighs 400 pounds (which is the case of a friend to whom was administered Zyprexa AND Seroquel after which she had a cerebral attack with impairment). They are also never responsible for side effects and, in case of complaint, derefer to one’s generalist physician…

Thus, it is always them who « decide » on one’s behalf if one is well or not and this, even if they don’t know the person or have seen him or her only five minutes…

Perverse effect of the thing : it’s so unbearable being locked up and silenced chemically, that, after a month, one pretends to feel better, disavow his or her opinions and stops complaining about side effects in order to get out, knowing that otherwise one will be diagnosed behavioural troubles and « illness deny »…

 

I WAS TORTURED : with Zyprexa (overdosis), Amisulpride, Cyamemazine, Risperdal (8 mg for a weight of 100 pounds), Haldol (90 drops a day) and « shooted » with Valium (40mg!)…

The doctors and staff refused to take into account : speaking troubles, heavy trembling, convulsions, dyskinesia, unbearable akathisia, heavy existential fear, wish to be dead and psychical tortures (mental « hell ») which appeared immediately and even worsened as time went by. I fought in vain, pleading that neuroleptics anesthetize consciousness, occasion memory loss, make one docile and influentiable, make depressive and even more anxious, impair one cognitively and destroy the soul.

I was also put into solitary confinement several times with violences from the staff AND security agents, despite the fact I have NEVER been even agressive. I was put under contention, was violently undressed, dehydrated, humiliated, spoliated, mistreated…

Today, even if I get a « less inhumane » treatment – Abilify retard injection – (after a 4th suicide attempt), I remain addicted to Valium, traumatized and always on alert, fearing to miss my « obligations » or to make bad impression, without mentioning total absence of perspectives, motivation or joy in life, without mentioning my affective life that is a misery (spiritual death, isolation, depression, anxiety…).

My artistic career, which finally started with success has been definitively broken during my best years (in my 30′) and today I am totally unable to create despite the fact that before, I had thousands of ideas and was giving a great deal to put them into meaningful use. It is also too late and too complicated for me now to become a mother.

I live in precarity at the charge of the State.

 

Why I was always opposed to their pathologizing « diagnoses » :

I’m a person who endured the worst traumas in early childhood (rape and abuse, mobbing…), while most memories came up again more than 30 years afterwards, which greatly affected my emotional balance. I had unfortunately to experience that, according to psychiatrists (if they even believed me), there would be no cause-to-effect relationship between what I had to bear and my troubles (!), which I find so enormous and stupid that one would rather cry…

I had to notice, alike Dr. Muriel Salmona – only psychiatrist in France knowingly approaching psychical suffering under the perspective of trauma – that in France, no specific caretaking is being proposed nor planned, and after 8 years of psychiatry, not one physician has diagnosed me a post-traumatic stress disorder with dissociation which, according to Dr. Muriel Salmona (« Association Mémoire Traumatique et Victimologie ») is the case after rape and abuse.

I could almost never do a therapeutic work with a psychiatrist.

Regarding their diagnosis of schizophrenia, it has never been illustrated, explained or argumented, and my medical records have been established on mere « observations » from the doctors and sheer « impressions » from the staff…

I also came to the conclusion that to actually speak about spirituality would eventually always end in them diagnosing a « mystical delirium » and, as such, schizophrenia.

My conclusion is that their imprisoning and bad treatments have done none but to aggravate my traumas and personal issues, I don’t believe a second that their imaginary « diseases » result in a chemical imbalance in my brain or an unknown « biological » illness, I know that neuroleptics and affiliated meds are catastrophic in the long-term (causing brain damage) and I totally agree with numerous anti-psychiatrists internationally, such as the Drs. Peter Breggin, Joanna Moncrieff, David Healy, Robert Whitaker, Thomas Szazs, Peter Goetzsche and others… (see on madinamerica.com).

 

IN ACCORDANCE WITH THE UNITED NATIONS CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES, ARTICLES 12, 14 AND 15, AS INTERPRETED IN GENERAL COMMENT NO. 1 AND THE GUIDELINES ON ARTICLE 14, AND WITH THE BASIC PRINCIPLES AND GUIDELINES OF THE UN WORKING GROUP ON ARBITRARY DETENTION PUBLISHED IN 2015, PRINCIPLE 20 AND GUIDELINE 20, I SPEAK IN FAVOUR OF ABSOLUTE PROHIBITION OF COERCIVE PSYCHIATRY AND FORCED TREATMENT.

I RECLAIM ALL MY RIGHTS TO PERSONHOOD AS A DISABLED ADULT WOMAN UNDER PROTECTION, IN PARTICULAR THE INALIENABLE RIGHT TO DISPOSE ENTIRELY OF MY BODY, MIND AND SOUL WITHOUT IATROGENIC CHEMICALS AND MY UNCONDITIONAL LIBERTY.

I CONSIDER INSTITUTIONAL PSYCHIATRY AND ITS COERCIVE PRACTICES A CRIME AGAINST HUMANITY, A SEVERE HARM TO DIGNITY AND TO FREEDOM OF THINKING.

 

Pink Belette, March 2016

 

 

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Eveline Zenith – Freedom From Religion

Freedom From Religion: Campaign to Support CRPD

http://muddledtranslation.blogspot.no

Freedom of Religion, Freedom from Religion: A Psychotherapy Survivor’s Account of Unravelling the Colossal Irony

By Eveline Zenith

Our freedom to believe and practice as we choose is correlated with the core values of liberty and autonomy. The Canadian Charter of Rights and Freedoms protects our rights by stating that everyone has freedom of conscience and religion; also, religious belief cannot be preferred to non-belief. In the United States, freedom of religion is constitutionally protected in the First Amendment, and is associated with the separation between church and state.

Freudian psychoanalysis is a religious ideology that has absolutely no relevance in my life. I can only say that now I have researched it in depth, and this has been no simple task. Finding information about this clandestine methodology required: hours of detective work; a small fortune of books; under-cover attendance at a psychoanalytic seminar; six months of email correspondence with a psychoanalyst; intensive abuse recovery; jumping through every possible hoop in the system… and it remains today irredeemable. I did all this in order to regain sanity after therapy; my mind became so scrambled I had to abruptly discharge myself from the transaction. I am staggeringly aware of how lucky I am.

I had a nervous breakdown and began constantly re-living the bizarre statements my analyst had said to me. They were all vague and stated in a slow hypnotic tone, by a man who had been presenting as a “blank slate”. I had absolutely no familiarity or understanding of him: his intentions, beliefs, or personality. With sheer terror I would wake at 3am… trembling, eyes watering, remembering his intense staring, cutting words, sadistic glee, and condescending manner. There were other times when I felt bonded with him, that he cared, that he was a spiritual guide. The cognitive dissonance alone was torture enough to drive me insane!

Once I went “no contact” all my illusions disintegrated; I became appallingly aware of the prospect that he had deliberately abused me. He has the power, the education, and the techniques at his disposal to really screw me just for kicks. The research I have done on emotional abuse is a succinct match to the so-called techniques; I was vulnerable and had no idea what I was consenting to. He would simply shift the goalposts whenever I grew wise; he’d divert to blaming my hyper-vigilance and trust issues.

I never imagined I would have to defend my human dignity to an institution that is supposed to protect me, or that they would dismiss my testimony and actually try to silence me. The greatest, deepest betrayal was that it was an endeavour to heal from childhood abuse. That therapist held the keys to my most defenseless wounds and senselessly battered them. There is still no accountability on behalf of the profession: either this is considered permissible, or this practitioner needs to be corrected.

I have learned that Freudian psychoanalysis – perhaps psychotherapy on the whole – holds the absolute belief that the pathological relationship will inevitably re-enact. What this means is that if you were abused before, you will re-experience it in therapy and be re-traumatized. I have not yet found anyone in the field who will explain in plain language how this works; it makes no rational sense. This is an accessibility issue. Not only is it illogical, it is downright heinous without mandatory informed consent. Currently, the authorities assume on good faith that the practitioner will inform the client. If you have any knowledge of the world of predators, abuse, and exploitation, you will know this is a loophole for corruption. Also, if you don’t understand this is the process, you will only experience your therapist as your abuser and hopefully get out of it like I did!

There is no therapeutic value in having your spiritual guide manifest as your worst nightmare unless there is a therapeutic alliance; this can only be forged through informed consent every step of the way. Sex, boxing, and psychotherapy are similar: if one person isn’t participating it’s a crime. Psychoanalysis believes practitioners can subject us to treatment because they feel we need it; they have a plan for us, but they don’t reveal it. There are plenty of ethics seminars where theories are discussed about what’s good or bad for clients, but no actual observance of human rights is mandated. The entire “treatment” goes on in complete privacy, with biased accounts of clients’ “transferences” scratched on notepads for billing purposes. I never consented to any transference; I assumed everything was in the here and now. All of this religious interpretation was done behind my back so there was no way I could refute it, question it, challenge it, or even benefit from it. I have searched far and wide in a vast wilderness of possibilities, finally concluding that my practitioner is delusional, sadistic-aggressive, lacks empathy, and has no substantive reasoning for any of it besides money and control. This conclusion is the reason I am alive and well today.

The imperative reason I advocate for the absolute prohibition of coercive treatments is because this harm is done to the previously harmed, vulnerable, and voiceless members of our society. These are people who have had cruel, devastating, and heinous things done to us; large parts of our bodies and souls have been murdered. Even with all the agency I possess, I can’t get through to anyone on the other side of the door. The lack of education and total absence of conversation about abuse in the mental health profession is criminal negligence, considering that is the number one reason people use these services. Although the Code of Ethics for Psychiatry explicitly states informed consent, I am told by the authorities I consented simply by being there.

In terms of CRPD principles, although many sections address aspects of this problem I focus on sections 14 through 16:

Article 14: Liberty and security of the person 

  1. States Parties shall ensure that persons with disabilities, on an equal basis with others:

(a) Enjoy the right to liberty and security of person;

(b) Are not deprived of their liberty unlawfully or arbitrarily, and that any deprivation of liberty is in conformity with the law, and that the existence of a disability shall in no case justify a deprivation of liberty.

  1. States Parties shall ensure that if persons with disabilities are deprived of their liberty through any process, they are, on an equal basis with others, entitled to guarantees in accordance with international human rights law and shall be treated in compliance with the objectives and principles of this Convention, including by provision of reasonable accommodation.

Article 15: Freedom from torture or cruel, inhuman or degrading treatment or punishment 

  1. No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his or her free consent to medical or scientific experimentation.
  2. States Parties shall take all effective legislative, administrative, judicial or other measures to prevent persons with disabilities, on an equal basis with others, from being subjected to torture or cruel, inhuman or degrading treatment or punishment.

Article 16: Freedom from exploitation, violence and abuse 

  1. States Parties shall take all appropriate legislative, administrative, social, educational and other measures to protect persons with disabilities, both within and outside the home, from all forms of exploitation, violence and abuse, including their gender-based aspects.
  2. States Parties shall also take all appropriate measures to prevent all forms of exploitation, violence and abuse by ensuring, inter alia, appropriate forms of gender- and age-sensitive assistance and support for persons with disabilities and their families and caregivers, including through the provision of information and education on how to avoid, recognize and report instances of exploitation, violence and abuse. States Parties shall ensure that protection services are age-, gender- and disability-sensitive.
  3. In order to prevent the occurrence of all forms of exploitation, violence and abuse, States Parties shall ensure that all facilities and programmes designed to serve persons with disabilities are effectively monitored by independent authorities.
  4. States Parties shall take all appropriate measures to promote the physical, cognitive and psychological recovery, rehabilitation and social reintegration of persons with disabilities who become victims of any form of exploitation, violence or abuse, including through the provision of protection services. Such recovery and reintegration shall take place in an environment that fosters the health, welfare, self-respect, dignity and autonomy of the person and takes into account gender- and age-specific needs. 
  5. States Parties shall put in place effective legislation and policies, including women- and child-focused legislation and policies, to ensure that instances of exploitation, violence and abuse against persons with disabilities are identified, investigated and, where appropriate, prosecuted. 

Unravel edit

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12 trucs que croient les psychiatres/12 things psychiatrists believe… by Pink Belette

12 trucs que croient les psychiatres et qui vont vous énerver

http://depsychiatriser.blogspot.no/2016/03/12-trucs-que-croient-les-psychiatres-et_24.html

Par Pink Belette

1: Sur la souffrance : si vous souffrez autant, c’est disproportionné, donc pathologique. C’est donc votre cerveau qui déconne. Inutile de chercher d’ou vient la souffrance, c’est congénital, vous n’y pouvez rien.

2: Si vous êtes schizo, maniaco, etc… , c’est à vie. Mais bon, une maladie mentale, c’est comme un diabète, ça se traite mais ne se guérit pas. (Citation d’une infirmière : « la psychiatrie n’a pas pour vocation de guérir »)

3: Tout médicament a des effets secondaires, c’est normal, donc.

4: Vous voulez dire que c’est le vécu de la personne qui l’a rendu malade ? « Oh, vous savez, c’est comme l’histoire de la poule et de l’oeuf, on ne peut pas savoir qui était là avant » (cit.!)

5: Si vos parents toxiques persistent à s’inviter dans la loge du psychiatre, sachez que : les parents ont toujours raison et sont évidemment toujours bienveillants à l’égard de leur enfant. Ils déforment tous vos propos, faits et gestes ? C’est vous qui n’êtes pas dans la réalité et c’est vous qui les faites beaucoup souffrir avec votre maladie, soyez-en conscients

6: Plus la dose prescrite est forte, plus vous allez vous remettre rapidement, on pourra toujours baisser après, pour un « traitement au long cours »…

7: Vous parlez de votre âme comme si elle existait et avait la plus grande importance, c’est forcément un délire mystique de votre cerveau malade

8: Vous demandez des preuves scientifiques, le Vidal, des explications, bref vous êtes en opposition et il faut vous remettre à votre place de malade qui est censé écouter et obéir au médecin.

9: Règle absolue : Il ne faut jamais dire à un psychiatre « vous n’avez pas le droit » (bien sûr, les psychiatres ont tous les droits même s’ils n’ont pas d’arguments).

10 : Vous trouvez que l’ambiance dans le service est totalitaire et osez émettre des critiques : c’est donc que vous avez un grave trouble du comportement.

11 : « Ah non, les neuroleptiques n’affectent pas les capacité intellectuelles »…

Mais non, ils ne rendent pas malheureux, dépressif, angoissé, c’est votre maladie et il faut donc revoir votre traitement à la hausse ou changer pour une molécule plus lourde qui va vous anesthésier la conscience, vous verrez, vous n’aurez même plus conscience d’être dans la merde…

12 : « Vous êtes en soins sous contrainte, donc c’est nous qui sommes responsables de vous, vous perdez vos droits, etc »…

Le patient : « et vous, vis-à-vis de moi, vous êtes redevable de quoi ? »

« Je vous triple la dose, vous avez de graves troubles du comportement » (cit. d’une psychiatre lors d’un premier entretien)

****

12 Things Psychiatrists believe which will piss you off

By Pink Belette (France)

1: On suffering : if you suffer so much, it is not proportionate, as a matter of fact it is pathological. As a matter of fact, it’s your brain that is on the blink. No need to search from where the suffering comes, it’s congenital, you just cannot help.

2: If you are schizophrenic, bipolar, etc…, it’s for your whole fucking life. But, a mental disease, you know, it’s like diabetes, it can be treated but not healed (quote from a nurse : « psychiatry’s vocation is not to heal »)

3: Every medication has side effects. It is normal, as a matter of fact.

4: What say you ? That it is one’s bad life experiences that make one sick ? « Oh, you know, it’s like the story of the chicken and the egg, you’ll never know which one was first » (quote…)

5: If your toxic parents persist inviting themselves into the office of the psychiatrist, please be aware that : parents are always right and are of course always benevolent towards their son, daughter… They distort all your sayings, facts and actions ? It’s you who are not into reality and it’s you who make them suffer so much with your disease, be strongly aware of that fact.

6: The more the prescribed dose is strong, the more you will recover rapidly, it will be still time later to decrease afterwards, for a « long-term treatment »…

7: You do talk about your soul as if it actually exists and has the greatest importance, it’s inevitably a mystical delirium of your sick brain.

8: You ask for scientific proofs, the drug reference manual, explanations, short said : you are « in opposition » and you need to be reput on your true category which is the insane, expected to listen and obey the doctor.

9: Compulsory rule number X : thou shall never, ever say to a psychiatrist « you have no right to do this » (of course, psychiatrists have the whole rights on you, even if they don’t have arguments)

10 : You feel the ambiance in the ward is totalitarian and dare criticize : hence it is you have a grave behavioral disorder.

11 : « Ohhhh, no, no, no, neuroleptics do not impair cognition »…

Oh, noooo, they don’t make you unhappy, depressed, anxious ; it’s – your – disease – and – your – treatment – must – be – increased ; or : it must be changed for a stronger molecule which will anesthetize your consciousness, you’ll see, you won’t even be aware being in a shitty situation…

12 : « You – are – under – forced – commitment, hence we are responsible of you, hence you loose your rights, etc »…

Patient : « and, regarding me, what are you beholden to ? »

« I triple your dose, you have a grave behavioral disorder » (quote from a psychiatrist in first interview)

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Aporte de Lucila López, Usuaria y sobreviviente de la psiquiatría en Argentina

CAMPAÑA DE APOYO A LA CDPD COMPROMISO CON LA PROHIBICIÓN ABSOLUTA DE LA PRIVACIÓN DE LA LIBERTAD Y EL TRATAMIENTO FORZADO DE LAS PERSONAS CON DISCAPACIDAD PSICOSOCIAL

 

Señores del Comité sobre los Derechos de las Personas con Discapacidad:

Solicito tengan a bien dar la merecida atención a todas las voces que elevamos los actores socio-políticos que pedimos la prohibición absoluta de la privación de la libertad por motivos de discapacidad psicosocial.

Lucila López

Usuaria y sobreviviente de la psiquiatría en Argentina.

(también se puede leer en https://sodisperu.org/2016/03/22/aporte-a-la-campana-prohibicionabsoluta-por-lucila-lopez-usuaria-y-sobreviviente-de-la-psiquiatria-en-argentina/)

CAMPAÑA DE APOYO A LA CDPD ART. 14 LL-MARZO14 2016 (doc)

Intentaré exponer los motivos sobre la importancia de obtener el apoyo necesario para que la Campaign to Support CRPD Absolute Prohibition of Commitment and Forced Treatment  – Campaña de apoyo CDPD COMPROMISO CON LA ABSOLUTA PROHIBICIÓN DE LA INTERNACIÓN Y EL TRATAMIENTO FORZADO iniciada por la Dra. Tina Mikowitz resulte como positivo fortalecimiento al momento de las Observaciones Generales a favor del irrestricto cumplimiento del artículo 14 inc. y todos los artículos vinculantes.

Artículo 14

Libertad y seguridad de la persona

  1. Los Estados Partes asegurarán que las personas con discapacidad, en igualdad de condiciones con las demás:

a) Disfruten del derecho a la libertad y seguridad de la persona;

b) No se vean privadas de su libertad ilegal o arbitrariamente y que cualquier privación de libertad sea de conformidad con la ley, y que la existencia de una discapacidad no justifique en ningún caso una privación de la libertad.

2. Los Estados Partes asegurarán que las personas con discapacidad que se vean privadas de su libertad en razón de un proceso tengan, en igualdad de condiciones con las demás, derecho a garantías de conformidad con el derecho internacional de los derechos humanos y a ser tratadas de conformidad con los objetivos y principios de la presente Convención, incluida la realización de ajustes razonables.

“El Comité sobre los Derechos de las Personas con Discapacidad reafirma que la libertad y la seguridad de la persona es uno de los derechos más preciosos a que tiene derecho. En particular, para las personas con discapacidad, y en especial las personas con discapacidad intelectual y discapacidad psicosocial tienen derecho a la libertad en conformidad con el artículo 14 de la Convención. En él se especifica el alcance del derecho a la libertad y a la seguridad de la persona en relación con las personas con discapacidad, prohíbe toda discriminación basada en la discapacidad. De este modo, el artículo 14 se relaciona directamente con el propósito de la Convención, que es garantizar el disfrute pleno e igual de todos los derechos humanos y las libertades fundamentales a todas las personas con discapacidad y promover el respeto de su dignidad inherente.”[i]

__________________

Nada se puede pensar por fuera de un contexto. El tema propuesto es un tema ineludible en términos de un pensamiento con eje en los Derechos Humanos.

Escribir en Argentina sobre la necesidad de garantizar la prohibición absoluta de privar de la libertad a las personas con discapacidad en nombre de tratamientos impuestos, forzados, en contra de la propia voluntad, es escribir en un contexto en el que el respeto a los DD.HH. es ostensiblemente violado provocando actualmente una seria preocupación para el CIDH, específicamente por una presa política. En relación al tema, es significativo que Estela de Carlotto[ii] haya preguntado -¿Cómo se puede decir que está muy bien una mujer presa? Y calificó esa afirmación de la más alta autoridad del país como “una barrabasada”. El texto completo es el siguiente:

“La barrabasada[iii]que dijeron es que la habían visitado en la cárcel y que estaba muy bien. Fue violento. ¿Cómo se puede decir que está muy bien una mujer presa?

Me permito hacer un parangón y preguntar:   ¿Cómo se puede decir que está bien una persona privada de la libertad (presa) por su discapacidad?

Estoy a favor de la prohibición absoluta de la privación de la libertad involuntaria y tratamientos forzados de las personas con discapacidad psicosocial y el compromiso para con todos comienza en el ejercicio para mi propia vida de ese derecho y el Art. 14 de la CDPD me autoriza a exigir el cumplimiento de la norma jurídica.

Mis argumentos son en nombre propio a partir de mis experiencias y la observación de la experiencia de otros, articulando mi condición de usuaria y sobreviviente de la psiquiatría, mi visión como profesional dedicada a la prevención en Salud Mental y Derechos Humanos y como familiar, en tanto soy madre de un hombre que siendo niño y hasta entrada su adultez, necesitó de la protección de sus derechos incluido el derecho a la salud y el derecho a la salud mental.

Estuve privada de la libertad y en contra de mi voluntad por última vez entre el 5 de julio de 2014 y el 12 de enero de 2015. La cuarta vez en mi vida y la más extensa en tiempo.

Esa misma barrabasada “que me encontraban muy bien” la escuché de familiares y amigo/as y me mantuve en un total mutismo.

Desde el año 2011, la crisis anterior con internación contraria a mi voluntad, comencé a guardar mutismo absoluto delante de los que apoyaron esa medida y están dispuestos a apoyarla de nuevo.

¿Por qué guardar mutismo?

Por lo intolerable que resulta la alianza entre los profesionales de la salud mental y familiares y/o amigos:

  • Ignoran la CDPD.
  • No tienen en cuenta el respeto a la persona como un igual.
  • Prevalezcan sobre mi cuerpo y sobre mi psiquismo[iv] decisiones ajenas violatorias de todos
  • Los siguientes derechos enumerados en la CDPD (Ley 26.378) que es parte del cuerpo jurídico de la Constitución Nacional de Argentina.

Artículo 5º

Igualdad y no discriminación

Artículo 12

Igual reconocimiento como persona ante la ley[v]       

Artículo 14

Libertad y seguridad de la persona

Artículo 15

Protección contra la tortura y otros tratos o penas crueles, inhumanos o degradantes

Artículo 17

Protección de la integridad personal

Artículo 18

Libertad de desplazamiento y nacionalidad

Artículo 19

Derecho a vivir de forma independiente y a ser incluido en la comunidad

Artículo 22

Respeto de la privacidad

Artículo 23

Respeto del hogar y de la familia

1.C) Las personas con discapacidad, incluidos los niños y las niñas, mantengan su fertilidad, en igualdad de condiciones con las demás.

Artículo 24

Educación

Artículo 25

Salud

Artículo 27

Trabajo y empleo

Artículo 28

Nivel de vida adecuado y protección social

Enumerados todos los derechos vinculantes que se violan a partir de la falta de respeto al art. 14, argumentaré los motivos por los que pido la PROHIBICIÓN ABSOLUTA DE LA PRIVACIÓN DE LA LIBERTAD INVOLUNTARIA.

En Argentina, exigir la prohibición absoluta de la libertad involuntaria por motivos de discapacidad psicosocial encuentra un horizonte de futuro posible con la prohibición establecida por la LNSM –Ley 26.657 – de la creación de nuevos manicomios públicos y privados en todo el territorio de la Nación y el cierre definitivo de todos para el año 2020.

La privación forzada de la libertad, -o internación involuntaria- o no por motivos de discapacidad psicosocial es claramente una acción discriminatoria, de acuerdo a la legislación argentina y el marco jurídico internacional:

“La discriminación es el acto de agrupar a los seres humanos según algún criterio que lleva a una forma de relacionarse socialmente. Concretamente, suele ser usado para hacer diferenciaciones que atentan contra la igualdad, ya que implica un posicionamiento jerarquizado entre grupos sociales 1, es decir, cuando se erige un grupo con más legitimidad o poder que el resto.

En el año 1988, se sancionó la Ley Nº 23.592 sobre Actos Discriminatorios que en su Artículo 1º reconoce como discriminación cualquier impedimento o restricción del pleno ejercicio “sobre bases igualitarias de los derechos y garantías fundamentales reconocidos en la Constitución Nacional […] por motivos tales como raza, religión, nacionalidad, ideología, opinión política o gremial, sexo, posición económica, condición social o caracteres físicos”. Asimismo, el documento titulado “Hacia un Plan Nacional contra la Discriminación”, aprobado por Decreto Nº 1086/2005.Instituto Nacional contra la Discriminación, la Xenofobia y el Racismo. (INADI ¿Qué es la discriminación?).-

 

La privación de la libertad involuntaria a partir de la  CDPD se constituye en un acto de violación de DD.HH.y el Estado se debe responsabilizar de ello[vi] pues  aún cuando en Argentina ha ratificado la CDPD y le ha dado status constitucional:

La Ley Nacional de Salud Mental Ley 26.657- que es considerada una Ley de Salud Mental modelo por todos los avances dirigidos hacia el nuevo paradigma social y del respeto de los DD.HH. de las personas con discapacidad, incurre en la violación del artículo 14 considerando que:

La LNSM En el Capítulo VII, Art. 20) contempla de la internación involuntaria: “Ley 26.657 ARTICULO 20. — La internación involuntaria de una persona debe concebirse como recurso terapéutico excepcional en caso de que no sean posibles los abordajes ambulatorios, y sólo podrá realizarse cuando a criterio del equipo de salud mediare situación de riesgo cierto e inminente para sí o para terceros. Para que proceda la internación involuntaria, además de los requisitos comunes a toda internación, debe hacerse constar… “

Acá encontramos un argumento a favor de la internación involuntaria contraria a la letra de la CDPD y su art. 14.-

La idea que prevalece en este artículo de la LNSM es la del paradigma del MMH., encuentra gran receptividad tanto en los profesionales de la salud como así también de familiares. Desde la implementación de la LNSM no se cumple con el art. 14 de la CDPD pero tampoco se cumple con lo que estipula la LNSM en el Art. 20, pues la concepción de recurso terapéutico excepcional se convierte en letra muerta de la ley y es una mera formulación administrativa o de buenas intenciones si se pueden llamar así a los argumentos esgrimidos para privar de la libertad en forma involuntaria.

Este acto discriminatorio y violatorio de DD.HH. goza de un consenso intelectual que supone el encierro de las PcD como “un corte, una instancia de reordenamiento subjetivo”.

El “corte subjetivo” se produce en la PcD en el momento que se denomina crisis y no necesita de ser privada de la libertad. Se puede “volver a la vida plena” en la vida plena de poder padecer un “corte” de “conexión con la realidad” si se brindan todos los apoyos y ajustes necesarios para tornar viable la vida en la comunidad.

No podemos ser discriminados por ser personas con discapacidad psicosocial y considerar terapéutico el encierro y el aislamiento que es una práctica iatrogénica al igual que la medicación forzada.

Vuelvo sobre la necesidad de contextuar el texto.

En Argentina hay una gran resistencia de parte de los profesionales de la salud mental a mencionar el tema discapacidad ligado al tema de las problemáticas de la salud mental.

En este presente inmediato, hablar de Derechos Humanos en Argentina articulados con la Salud Mental o con cualquier otro aspecto de la vida de las personas en general es un tema que pone en cierto peligro a quien se anima a denunciar.

Mi opinión al respecto después de muchos años de indagar el tema es que los profesionales de la salud mental junto a una gran parte de la población no aceptan que las PcD psicosocial somos personas con el reconocimiento de la dignidad y el valor inherentes y de los derechos iguales e inalienables de todos los miembros de la familia humana.

No aceptan la condición de sujeto de derecho en igualdad de condiciones que invoca la CDPD y esto es especialmente notorio al observar que en Argentina, la LNSM Nro. 26.657, es despreciada e incumplida por la corporación médico-psiquiátrica quienes consideran que debe ser derogada porque entre algunos de sus acertados artículos se promueve la interdisciplinariedad, el cierre de la totalidad de los manicomios públicos y privados en todo el territorio nacional y también promueve las internaciones en hospitales generales (considerando el respeto a quien desee ser internado de forma voluntaria).-

El primer obstáculo para hacer notar que el art. 20 de la LNSM 26.657 viola el Art. 14 de la CDPD es que los profesionales de la salud y de la salud mental, los trabajadores sociales y un amplio espectro de la justicia y una enorme masa de la población en general no están dispuestos a respetar los DD.HH. de las PcD psicosocial y que las lógicas manicomiales prevalecen en el imaginario social sobre los avances y cambios que en la materia se vienen discutiendo a nivel mundial.

La mayoría de las internaciones que se realizan son involuntarias y en general no se cumplen los pasos que la LNSM dispone para estos casos. Una ingeniería perversa de mecanismos burocráticos actúa evitando que la información llegue a la justicia en tiempo y forma, haciendo permanecer a una persona hasta por cuatro meses internada sin haber ejercido ni el consentimiento informando sobre el tratamiento que le administran arbitrariamente ni tuvo acceso a un abogado defensor como lo estipula la LNSM.

Es de mi particular interés las internaciones involuntarias de niños/as-adolescentes y jóvenes por motivos vinculados al consumo problemático de sustancias psicotrópicas en instituciones aberrantes con la anuencia de sus familias y también, en el otro extremo del arco, a las personas mayores y la naturalización de su institucionalización en lugares llamados geriátricos, residencias u hogares que también, con un proceder perverso, ocultan las problemáticas de discapacidad mental más propias de la ancianidad, del deterioro cognitivo que puede aparecer con el avance de la edad y otras formas de discapacidad mental que no son atendidas en su particular singularidad y sí son privadas de la libertad casi siempre sin su propio consentimiento.

Entonces sufren internaciones involuntarias y así se violan los DD.HH. de:

Niñas, niños, adolescentes mujeres y hombres, jóvenes, adulta/os y ancianas/os declarados o no personas con discapacidad mental por razones vinculadas a problemáticas de la salud mental.

En todos estos casos prevalece el concepto discriminatorio que no tenemos igual reconocimiento como persona ante la ley.

Partiendo de esta premisa comenzaré a exponer de qué manera la internación, la privación de la libertad involuntaria es una verdadera violación de DD.HH. que comete el Estado atropellando derechos y aumentando la discapacidad y propiciando el empobrecimiento de las personas afectadas en sus intereses económicos, sociales y culturales.

La internación involuntaria es iatrogénica:

  • en lugar de un resultado positivo para la salud, la privación de la libertad junto a tratamientos con drogas psiquiátricas forzados generan enfermedades, atenta contra la salud psíquica y física de la persona y la despoja del ejercicio de un sinfín de derechos aún cuando no se haya restringido su capacidad jurídica y esto también en internaciones –involuntarias o no- a corto plazo.

La realidad de una gran mayoría es que su capacidad jurídica está restringida.

En Argentina actualmente hay más de 20.000 personas privadas de la libertad en manicomios públicos y privados, según datos poco fidedignos, en su mayoría hombres entre 20 y 40 años que en su mayoría llevan un promedio de 15 a 20 años de privación de la libertad. De esa mayoría un número elevado entró en el circuito de las internaciones por consumo problemático de sustancias psicotrópicas siendo el alcohol la que encabeza el listado de ellas, que no es una droga ilegal.

Es muy llamativo que los datos oficiales oculten las cifras que puedan informar la cantidad de niñas y mujeres privadas de la libertad de manera involuntaria que hay en el país y me animo a decir que debe ser significativamente superior a la cantidad de hombres privados de la libertad.

En todos o en casi todos esos casos, ya sea en el ámbito público como en el privado la violación al art. 14 de la CDPD conlleva la violación de todos los otros artículos de la CDPD enumerados anteriormente.

La libertad y la seguridad de la persona son avasalladas y entonces su integridad en el más amplio concepto de la palabra también.

Hay una gran parte de la población privada de la libertad por motivos de discapacidad psicosocial que desconocen su verdadera identidad. Están desprovistas de documentos de identidad. No tienen contacto con familiares desde hace años y han sido separados de su comunidad.

Muchos, con estudios iniciados, han perdido el derecho a continuarlos, otros directamente no acceden porque comienzan el derrotero de las internaciones psiquiátricas durante la infancia. Conocí en el manicomio a un hombre mayor de cincuenta años que estaba internado desde los cinco años, desde su primera infancia… y allí murió.

Las instituciones psiquiátricas tienden a incurrir en una doble violación al Derecho a la Salud, en tanto:

  1. La privación de la libertad involuntaria o no, es iatrogénica.
  2. La PcD psicosocial internada en instituciones psiquiátricas suele carecer de verdadera atención médica en otros aspectos que su salud requiera: la aparición de síntomas de un quebrantamiento de la salud física suele ser ignorado, “interpretado” como síntoma o manipulación de la PcD desde el discurso médico-psiquiátrico y también, se le niega el acceso a profesionales de otras especialidades. Ejemplo: la asistencia de un otorrinolaringólogo… “porque es incómodo el traslado a un servicio especializado” y la persona debe aceptar y tolerar no ser atendida. Esta triste realidad trae aparejado resultados muy graves: muertes por enfermedades tratables tanto en la población femenina como en la masculina. También se les niega el acceso a los tratamientos indicados por médicos especialistas en el caso que tengan acceso a una consulta.

Todo esto está reñido con el principio básico del ser en igualdad de condiciones.

La vida privada de la libertad “no es vida”.

La privación de la libertad acompañada por el tratamiento forzada con drogas psiquiátricas provoca una especie de muerte psíquica.

Los acontecimientos de la vida cotidiana bajo los efectos de la medicación psiquiátrica –forzada o no, dentro y fuera de la internación- se perciben como si se mirara a través de un vidrio esmerilado, la voz de los otros llega a uno con un efecto retardado, y nuestros pensamientos también resultan lentos bajo los efectos de las drogas psiquiátricas. El contacto con el otro, con el afuera, está “mediado” por una cortina invisible que ralentiza los movimientos por el cuerpo rigidizado y los sentidos aletargados.

Así, el otro, cualquiera que sea, nos percibe “raros” “distintos” y los médicos aseveran que es el “devenir propio de la enfermedad diagnosticada” negando de cuajo que ese estado es el efecto de la privación de la libertad y del tratamiento químico forzado.

Con la privación de la libertad involuntaria, suele aparecer un estado de apatía profundo, un gran desinterés por todo… en mi experiencia esta apatía y el desinterés –incluso de hablar y permanecer en un mutismo absoluto- lo produce la imposibilidad de comprender que para el círculo de personas de mi afecto, esa situación fuera considerada buena, que dijeran que me “encontraban mejor”… si realmente esa es la mirada que tienen mis afectos cercanos, sean familiares o amigos, debo decir que no tienen registro alguno de las vivencias ciertas de humillación y maltrato que se viven en una internación.

Hay personas que estando internadas involuntariamente, hacen abandono de su aspecto físico y de su higiene. También eso es leído como un aspecto de “su enfermedad”… no se lee como un efecto iatrogénico de la privación de la libertad.

Los cambios a los que el cuerpo se ve sometido, desde el notorio aumento de peso con la pérdida de las formas propias del cuerpo y además, la falta de agilidad que provoca la medicación que rigidiza los músculos y el estado de “desconexión” que las mismas producen – y se aumenta notablemente con la privación de la libertad-, son otros aspectos que la persona padece, que pueden resultar motivo de vergüenza o mayor disminución de la estima.

La persona privada de la libertad, en un manicomio, tiene que poder evaluar estrategias de supervivencia y muchas veces, las elecciones son “el mal menor” y no lo que corresponde ni es justo ni a lo que se tiene derecho aún cuando se sea plenamente consciente de que se tiene derecho.

Cabe aclarar que una gran mayoría de la población internada desconoce todos sus derechos y además, cree que no los tiene. En las PcD psicosocial institucionalizadas durante muchos años en forma permanente o intermitente, se notan conductas propias de las personas sometidas a gran sometimiento y la faceta que muestran con claridad es la idea de “no tener derechos”

Así es muy poco probable que ellos luchen por una forma de vida independiente, el derecho a ser incluid en la comunidad en igualdad de condiciones porque se perciben así mismos como “personas enfermas”

Es común escuchar a adolescentes afectados a tratamientos -involuntarios o no- por consumo excesivo de drogas psicotrópicas, y en especial alcohol, decir “no tengo derecho a nada porque he consumido drogas” y ese discurso es avalado por los responsables de su rehabilitación y tratamiento y en cierta medida y en muchas oportunidades también ese concepto es sostenido por familiares, se suma a esto que los profesionales de la salud mental encuentran dificultades para aceptar que los problemas derivados del consumo excesivo de drogas legales o ilegales es un tema que debe ser abordado dentro del ámbito de la salud… y son enviados a lugares de encierro con un régimen propio y diría “sin ley” donde prevalece la ley del más fuerte que suele ser en general “un adicto recuperado” que impone tratos degradantes.

Así, son salvajemente humillados y denigrados, abusados sexualmente y de otras formas niñas/niños y adolescentes sometidos a trabajo solamente comparables a la tortura y la esclavitud en el marco de internaciones forzadas o no.

En relación a esta problemática de la salud mental el entramado es de una gran complejidad y la violación de DD.HH. es indescriptible.

Nadie que está privado de la libertad tiene la posibilidad de decidir un lugar de residencia por fuera del manicomio que le ha tocado en desgracia y en virtud de su status social o el de su familia…

La mayor cantidad de personas privadas de la libertad de modo involuntario lo son por problemas sociales y al mismo tiempo:

La mayor parte de las problemáticas llamadas “enfermedades mentales” provienen de problemas sociales no atendidos debidamente por el Estado y afectan de manera altamente significativa a la población de menos recursos.

Poblaciones importantes en las que, de generación en generación, han transcurrido sus vidas en situaciones de extrema pobreza sin conocimiento de los Derechos Humanos que los asisten si tienen la desgracia de “caer en el manicomio, no tienen salida”. Se patologiza la pobreza!!! Hay un perverso discurso que “dice que la persona no ha sido capaz de tener ingresos adecuados para su sustento y/o el de su familia y garantizar vivienda, educación y salud”.

Esa supuesta enfermedad de una persona: ¿cómo se llama cuándo el sistema de salud mental con la privación de la libertad –involuntaria o no- des-ancla a la persona de su vida, de sus bienes, de sus ingresos económicos, de su universidad o de su escuela de estudios primarios y así, la deja en un vacío de derechos y sobre eso la re-diagnostica?

No hay mayor factor discapacitante que la pobreza, el hambre, la falta de techo y de educación. Y eso puede ser un punto de partida o de llegada para una persona con discapacidad social.

También muchas personas que caen abruptamente en la pobreza como consecuencia de las crisis económicas que se conocen como “respuestas al humor de los mercados”, es decir: las crisis económicas resultado de propuestas políticas neoliberales y del salvaje capitalismo, arrojan a la “locura” y al intento de suicidio –cuando no a la muerte misma- a muchas personas que mantuvieron durante gran parte de su vida un status de vida acorde a los derechos propios de una persona trabajadora con derecho al trabajo, la salud y la vivienda como derechos básicos inalienables y esas personas, recalan en los manicomios con un diagnóstico de enfermos psiquiátricos pero en sus Historias Clínicas no constan las condiciones de existencia al momento de la internación ni sus antecedentes culturales, laborales, familiares y sociales, ni nada, absolutamente nada de su vida antes de haber sido calificado como enfermo/a psiquiátrico/a.

Con horror observo que la familia reproduce el sistema de pensamiento manicomial.

La misma familia termina violando el derecho al hogar y la familia.

Poco a poco se aleja hasta dejar en el abandono a la persona.

Se la priva de la familia, de los hijos y de los nietos.

La familia se aleja porque es estigmatizada y además no recibe psico-educación alguna para albergar al familiar que sufre y contribuir a su inserción en la comunidad. Todo lo contrario, siempre se acentúa el hecho que la persona está enferma, que su enfermedad es incurable y que con el tiempo estará cada vez peor.

Eso es verdad cuando a una persona la privan de la libertad, en forma involuntaria o no, porque todo lo que le va pasando no es consecuencia de su padecimiento espiritual, emocional o psíquico… es consecuencia del asilamiento tras los muros agudizado por la “droga- dependencia- inducida” y por la soledad impuesta, que llega a sus grados de tortura más elevado en las celdas de aislamiento o con la sujeción mecánica en los casos que la persona presente algún tipo de excitación motriz que bien pudo ser ocasionada por un ”medicamento” o por falta de una caricia… por un miedo extremo o por una profunda angustia que nadie parece dispuesto a aliviar con un acompañar en un cuerpo a cuerpo hasta que el terror disminuya.

¿Dónde están escritas las bases del encierro involuntario como forma de cura?

En la decisión de privar de la libertad a una persona con discapacidad psicosocial de manera forzada hay un pensamiento, hay una lógica “a priori” que dispone que esa persona “no tiene cura en su enfermedad” y es una persona gravosa para la comunidad a la que se atribuyen todo tipos de males para sí mismo y o para terceros y que merecen la condena del encierro. Esto subyace en el pensamiento de quienes ejercen autoridad sobre la PcD psicosocial y le restringen la vida y la sumen en una vida en su mínima expresión, carente de sueños y anhelos, de amor y de libertad.

En Argentina los manicomios en su mayoría cuentan con “dispositivos de inserción laboral” a los cuales las personas privadas de la libertad son “invitados” a participar. Esa invitación y la aceptación o no, lleva a aumentar la cantidad de etiquetas que una persona puede ir sumando en el encierro de acuerdo a lo que se llama la falta o no de “adherencia al tratamiento”. Si la persona acepta trabajar en un emprendimiento de inserción laboral intra-hospitalario, recibirá un peculio[vii]… una míseros centavos por su trabajo y si no acepta, se le calificará como a una persona “institucionalizada que no tiene voluntad ni interés en el trabajo” y con pocas posibilidades de su inserción en la comunidad.

Las personas que estando internadas nos preocupamos por nuestra situación laboral somos desmotivadas y se nos promueve un pensamiento basado en la imposibilidad de continuar con tareas “normales” y el “beneficio” de acceder a “pensiones por discapacidad”.

Sostener delante de un psiquiatra la firme decisión de continuar trabajando en el mercado de trabajo como un ciudadano más, es descalificado en sus palabras, se es tratado como una persona que niega su “incapacidad” y lo usual es que el médico psiquiatra desconozca absolutamente todo lo referido a esa persona: sus estudios, su historia laboral y su estándar de vida si se trata de un manicomio púbico y en uno privado, si la persona en situación de encierro tiene un estar en el mundo alivianado de preocupaciones económicas porque posee dinero suficiente… no es menos descalificado… solo que esa persona puede llegar a tener más posibilidades de una vida autónoma si es que los familiares no lo inhabilitan restringiendo su capacidad jurídica para hacer ellos, usufructo de los bienes económicos de la persona con discapacidad.

Ninguna persona que tenga como único sustento en Argentina una pensión por discapacidad puede acceder a una canasta básica de alimentos, ni a la vivienda ni a la salud, no puede tener una vida independiente y autónoma ni puede vivir con libertad en la comunidad porque sus ingresos económicos, que son considerados “un beneficio” social, no le permiten tener ninguna autonomía económica.

No existe un nivel de vida adecuado ni protección social verdadera.

Vuelvo sobre el rechazo en Argentina de parte de los profesionales de la salud por la noción de discapacidad de la “persona con padecimiento mental” en cualquiera de sus manifestaciones.

La discapacidad es una concepción que pone en cuestión a la tan preciada, tanto como despreciada “enfermedad mental” corriendo el eje de la enfermedad individual al eje de las barreras sociales que obstaculizan la libertad individual, lo que se da en llamar el cambio de paradigma.

Los aún hoy promotores de las lógicas manicomiales encuentran en la concepción de la discapacidad una herramienta que otorga derecho a quienes ellos le quieren negar -ya no los derechos- si no la vida misma condenándoles al encierro y al estado de ser muertos vivientes, verdaderos zombis que deambulan entre los muros sin más pregunta que si la inmunda comida llegó a la mesa o no… si alguien se acordó de su existencia y llegó de visita o no…

A las mujeres privadas de la libertad se les puede llegar a producir la esterilidad quirúrgica…de modo involuntario… como se las puede prostituir… o abusar sexualmente de ellas y provocarle embarazos no deseados y hasta obligarlas a abortos o someterlas al robo de sus hijos…

Ingresar al manicomio es ingresar a la mismísima anomia[viii]: no se tuvo vida, la vida comienza y termina en los muros del manicomio.

La falta de ley a la que la palabra anomia refiere es lo que hace del manicomio un territorio que es tierra de nadie… y feudo de unos cuántos a la vez… en ese feudo la crueldad es ejercida con menos sutileza a medida que el ejecutor se aleja de la jerarquía del psiquiatra… y llega al personal de limpieza…

La degradación del concepto de ser humano y ser humano en igualdad de condiciones se traduce en el concepto de enfermo mental que es legislado por una concepción que se rige por un supuesto científico que designa la normalidad de las personas…

¿Quién puede decir yo soy normal, usted es normal y usted no sin sonrojarse?

Solamente alguien enceguecido de soberbia, solamente un ser que tanto teme a la locura, es capaz de pensar que es posible encerrarla tras los muros sin cometer violación de DD.HH.

La anomia en este caso es el estado provocado por un conjunto de personas que han degradado del juramento hipocrático y de otras que ejercen la violación de Derechos Humanos.

Para los que imponen esa legislación –paradójicamente carente de ley- para los que degradan con sus conceptos la condición humana al extremo de la privación involuntaria de la libertad, de tratamientos forzados, de humillaciones, torturas y tratos degradantes… para ellos la concepción de la diversidad funcional no existe y sin embargo, los involucra en tanto seres humanos- lo peor que les puede pasar es probar su propia medicina.

Puedo escribir miles de palabras más para tratar de transmitir la tortura que significa ser privada de la libertad – forma involuntaria o no- y de las graves consecuencias en mi salud y la observada en la salud de otros, como yo, obligados a la ingesta de drogas psiquiátricas en contra de nuestra voluntad.

Sin embargo, los profesionales de la salud mental con compendios de siglas alfanuméricas que definen conductas como los son los DSM y el CIE viven tan pagados de sus saberes y tan pagados por la industria farmacéutica y por los circuitos económicos que se destinan al sistema de salud,

  • son incapaces de recapacitar sobre sus prácticas, sobre su negación del paradigma de la discapacidad y ni pensar que puedan asomar su inteligencia al mundo de la diversidad funcional,
  • ni pueden comprender un mundo en evolución a velocidades nunca vividas en direcciones impensables hace menos de un cuarto de siglo, que desborda de nuevas problemáticas sociales donde todo parece desquiciado[ix] y estallado -y no necesariamente enfermo- sino nuevo y desconocido.

Como nuevo y desconocido hasta hace poco en Argentina es que nosotros, las PcD psicosocial, tenemos derechos y somos sujetos de derechos, pedimos trato en pie de igualdad y nos negamos a la internación involuntaria y al tratamiento forzado.

Hay una palabra en psicología muy interesante: constructo.

No voy a definir con exactitud el término, voy a explicar que constructo viene a designar esos aspectos que se saben que existen pero son difíciles de probar, de definir o controvertidos al momento de querer hacerlos “objetivables”.

Son constructos la inteligencia, la personalidad y la creatividad.

Me pregunto en qué lugar del cerebro está el recuerdo del olor dulce de mi abuela paterna… y de la voz de mi madre… dónde se guardan las canciones de cuna con las que he mecido el sueño de mis niños… dónde en el cerebro está el registro del primer diente, de la primera risa, de la primera travesura de mis hijos…en qué célula está el clima que rodeaba la escena que recuerdo de mi padre lustrando mis zapatos para ir a la escuela… dónde viven en mí los cuentos de hadas y brujas, el encanto del otoño teñido con el recuerdo del primer beso… donde se localizan los recuerdos de los compañeros desaparecidos, cómo perduran sus voces a pesar de los años… dónde se almacena todo lo aprendido y dónde permanece lo desaprendido, donde se produce y se reproduce la capacidad de amar cuando se ha sido vejada… cómo y donde están objetivados en mi cerebro lo que me permite pensar en colores para pintar, danzar, reír y llorar… olvidar y recordar…

Me pregunto de qué otra manera se puede privar de la libertad en forma involuntaria si no es a la fuerza y si no es desconociendo los derechos que nos atañen.

Esa fuerza tan bien descrita por Antonin Artaud en su CARTA A LOS DIRECTORES DE LOS ASILOS DE LOS LOCOS. “……………………………………………………….No nos sorprende ver hasta qué punto ustedes están por debajo de una tarea para la que sólo hay muy pocos predestinados. Pero nos rebelamos contra el derecho concedido a ciertos hombres – incapacitados o no – de dar por terminadas sus investigaciones en el campo del espíritu con un veredicto de encarcelamiento perpetuo……………………………………………………………………………………………………………………………………………………………….. ¡Y qué encarcelamiento! Se sabe – nunca se sabrá lo suficiente – que los asilos, lejos de ser “asilos”, son cárceles horrendas donde los recluidos proveen mano de obra gratuita y cómoda, y donde la brutalidad es norma. Y ustedes toleran todo esto. El hospicio de alienados, bajo el amparo de la ciencia y de la justicia, es comparable a los cuarteles, a las cárceles, a los penales…………………………………………………………………………………………………………………………………………………………………………….Esperamos que mañana por la mañana, a la hora de la visita médica, recuerden esto, cuando traten de conversar sin léxico con esos hombres sobre los cuales – reconózcanlo – sólo tienen la superioridad que da la fuerza.[x]

Lucila López

Usuaria y Sobreviviente de la Psiquiatría                                                                                           Psicóloga Social                                                                                                                                                                                            Psicodramatista                                                                                                                                       Analista Institucional                                                                                                                             Agente Comunitaria en Prevención de adicciones.

Miembro de WNUSP

Miembro de INWWD 

 

C.A.B.A

ARGENTINA

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Escrito por Lucila López en apoyo a la CAMPAÑA POR LA PROHIBICIÓN ABSOLUTA DE LA PRIVACIÓN DE LA LIBERTAD Y EL TRATAMIENTO FORZADO DE LAS PERSONAS CON DISCAPACIDAD PSICOSOCIAL, POR EL CUMPLIMIENTO IRRESTRICTO DEL ART. 14.- Buenos Aires, Argentina, Marzo 14, 2016

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[i] Committee on the Rights of Persons with Disabilities /Guidelines on article 14 of the Convention on the Rights of Persons with DisabilitiesThe right to liberty and security of persons with disabilities/

Adopted during the Committee’s 14th session, held in September 2015

[ii] Estela de Carlotto, Presidenta a Abuelas de Plaza de Mayo uno de los organismos más importantes de Derechos Humanos de la Argentina.

[iii] *) Barrabasada: 2. Hecho equivocado que origina un gran destrozo o perjuicio. (evil thing) RAE

[iv] Y la de todos los privados de la libertad por motivos de discapacidad psicosocial.

[v] Ley NSM viola el art. 12 al decir: “Se presume la capacidad jurídica”… En la CDPD el art. 12 especifica “igual reconocimiento ante la ley”…

 

[vi] Se hace indispensable el resarcimiento económico.

[vii] *) Para el libre ejercicio del artículo 19, el respeto absoluto del art. 27 – Trabajo y empleo es una condición inalienable y elemental.

Me voy a detener a explicar en el significado de peculio porque es gravísimo que haya muchas PcD psicosocial y con otras discapacidades también, que trabajen con carácter obligatorio y sean pagadas con un peculio porque eso es rayano a un sistema de esclavitud.  El Derecho al Trabajo y al Empleo se viola de manera flagrante y es una vergüenza.

Peculio.- Significado – etimología- definiciones. Del lat. peculium.

  1. m. Dinero y bienes propios de una persona.
  2. m. Hacienda o caudal que el padre o señor permitía al hijo o siervo para su uso y comercio.

La palabra peculio proviene en su etimología del latín “peculium” que a su vez deriva de “pecus” que significa ganado, ya que esa era la medida que se aplicaba para valorar los bienes, cuando no existía la moneda. Los peculios eran porciones pequeñas de bie

nes, que se separaban en el antiguo Derecho Romano, del patrimonio familiar, que pertenecía en su integridad y en propiedad al pater, jefe de la unidad político religiosa en qué consistía la familia, y varón de mayor edad dentro de ella. Destina una pequeña porción a hijo y esclavos. También relacionado con el ámbito carcelario.

Hasta hace pocos días el peculio era de $150.- mensuales, equivalentes a  u$s 0,34 diarios.

Actualmente el peculio es $300.- mensuales equivalente a u$s 20,34 = u$s 0,68 diarios.

Los talleres protegidos para personas con discapacidad están naturalizados y solamente en la Provincia de Buenos Aires, hay 4.500 personas con discapacidad que trabajan en más 173 talleres protegidos.  En la Ciudad Autónoma de Buenos Aires un importante taller protegido, las personas con discapacidad psicosocial  hacen  los muebles para la administración pública y hospitales de la ciudad.

El actual valor del peculio en la Provincia de Buenos Aires fue anunciado hace pocos días por el Ministro de Desarrollos Social quien dijo: “van a recibir 300 pesos por mes como parte del peculio, en lugar de los 150 que cobran actualmente, que van a servir no solo para ayudar a ellos sino también a sus familias”. Asimismo informó que los operarios recibirán una tarjeta para la compra de productos alimenticios por un monto de 100 pesos mensuales. (equivalente a u$s 0,21 diarios ¡para alimentos! ¿Y consideran que deben ayudar a la familia!

Al día 14 de enero de 2016 se les adeudaba el pago desde septiembre de 2015.

[viii] Anomia: del gr. ἀνομία anomía.1. f. Ausencia de ley. 2. f. Psicol. y Sociol. Conjunto de situaciones que derivan de la carencia de normas sociales o de su degradación RAE

[ix] Desquiciar

  1. tr. Desencajar o sacar de quicio algo. Desquiciar una puerta, una ventana.U. t. c. prnl. U. t. en sent. fig.
  2. tr. Descomponer algo quitándole la firmeza con que se mantenía. U. t. c. prnl.
  3. tr. Trastornar, descomponer o exasperar a alguien. U. t. c. prnl.
  4. tr. p. us. Hacer perder a alguien la privanza, o la amistad o valimiento con otrapersona. RAE

[x] http://lalibertaddeotrodecir.blogspot.com.ar/2016/03/carta-los-directores-de-los-asilos-de.html

 

 

 

 

 

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Madness/Follia, by Roberta Gelsomino

http://www.ilcappellaiomatto.org/2016/03/roberta-gelsomino-contributo-alla.html

Contributo alla Campagna per la proibizione assoluta del TSO

Madness (translated by Cristina Paideri)

Enraged, my father skims through
the same lost papers,
I fancy  him still cursing
a letter that more powerfully shouts.
Dear Commission
this time it’s my turn to talk.
Prestigious people behind a desk,
You are going to judge me and my life in a few minutes;
No one knows about it and you strangers pretend to know.
Like a head of cattle hastily marked and branded in the ass,
it isn’t my own good that you certainly care.
You  refer  to papers and signatures in abundance
as if I wasn’t here talking to you in this room.
You pretend that for those who help me
I must be stupid, crazy and silent
“We pay and that’s her gratitude !”
So I think the moment has come to talk.
If  only  you had the tact,  according to the Hippocratic oath,
you would propose other solutions to my needs,
even stronger, and not blackmail.
I was just hoping to be believed, what an idiot!
Into the paternal exhausting humiliation
I fear to burn myself, to fall, to hurt
what could you know of my condition!
You don’t want to help me, to waste your time ,
“Is she the only one in this condition? Poor parents!”
I believe in  things such as madness and horror.

Follia

Sfuriato mio padre scartabella
i soliti smarriti documenti
immagino mentre ancor bestemmia
una lettera che più potente grida.
Gentile Commissione
questa volta parlerò io a mio nome
Voi Illustri dietro una scrivania
in pochi minuti a valutar me e la vita mia;
Nessun ne sa e voi mai visti vi eleggete a sapere
come capo di bestiame confermata e marchiata nel sedere
in tutta fretta
non è certo il mio bene a cui voi tutti date retta.
Vi rifate a carte e firme in abbondanza
come se io non esistessi a parlarvi qui
in questa stanza.
Fate intendere che per qualcuno che mi aiuta
io debba stare scema, pazza e muta
“Noi paghiamo e questo il suo ringraziamento”
dunque per dirvi mi sembra un buon momento.
Se a valutar, se voi davvero aveste tatto
cioè coerenza con l’Ippocrate patto
proporreste altre soluzioni al mio bisogno
persino più forte, e non un ricatto.
Speravo solo di essere creduta, che idiota!
alla paterna sfiancante umiliazione
ho timore di scottarmi di cadere di ferire
che ne puoi sapere di questa condizione!
Aiuto voi non ne volete dare, perdere tempo a fare,
“V’è la sola messa così? Poveri genitori!”
Credo in cose così follia ed orrori.

poesia e disegno di Roberta Gelsomino

edizionieventualmente.it

 

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“All for the Best of the Patient” – Dorrit Cato Christensen

http://www.madinamerica.com/2016/03/all-for-the-best-of-the-patient/

Personal Story March 18, 2016

 

I am sharing my story in support of the CRPD campaign: Absolute Prohibition of Involuntary Commitment and Forced Treatment. This campaign is of utmost importance. Treatment and commitment carried out by force is torture, and must be abolished immediately. For psychiatric ‘help’ to happen by force is a paradox and makes absolutely no sense. It can destroy people’s personality and self-confidence. It can lead, in the long run, to physical and psychological disability – and unfortunately, as I know only too well, it can also result in sudden death.

I have been in very close contact with the Danish psychiatric treatment system. My dear daughter Luise got caught in this ‘helping system’ by mistake, but she didn’t make it out alive. I’m sad to say I later discovered that the way Luise was treated was more the rule than the exception. After writing a book about Luise and the psychiatric system, Dear Luise: A story of power and powerlessness in Denmark’s psychiatric care system, people from all corners of the world contacted me to say that Luise’s story could have been their own or their loved one’s story.

As a leader of the Danish association Dead in Psychiatric Care, I am constantly in contact with desperate people who have been committed or who have experienced some kind of forced treatment. They all talk about the tremendous amount of psychotropics they are forced to take. They feel powerless when they complain about horrible side effects and are told in response that the disease has developed and the dose has to be increased. I hear about the smug certainty of some mental health professionals, both doctors and caregivers, and the concomitant dehumanization of their patients through indifference, harassment, coercion and the use of force. Through my experience with my dear Luise, I saw this cold and dangerous treatment world.

Luise died in 2005 when her body and mind could not tolerate the inhumane treatment anymore. After her death, I got access to the hospital records. Reading Luise’s 600-page chart was a wretched experience. It presents an impersonal diagnosis, with signs of coercion, both direct and indirect, permeating the stack of chart notes. Luise wanted me to help her, but the psychiatrists didn’t want to hear my opinion. They believed that they knew better. So I watched powerlessly as Luise deteriorated both physically and psychologically. I witnessed arrogance and dishonesty, repeated misdiagnoses, professional collusion, missing official records, and falsified hospital charts.

Luise started down this path in 1992 at the age of 18. She was supposed to have a psychiatric examination without medication, however, she was heavily medicated from the very minute she set foot in the hospital. After eight days she was close to dying from medication poisoning. That was in August, 1992. In October of 1992, she was still deeply marked by the poisoning. I have no doubt that she suffered brain damage from this. Instead of treating this injury, the psychiatrists wanted to give her more medication.

Luise said no. She argued that the psychotropics had made her very ill, which was true. The psychiatrists interpreted her arguments as a sign of her illness. Shortly after that, the mandated medication began – administered by a syringe – along with the periodic use of belt restraints.

She fought for two months against the terrible drugs. The staff always won this battle, of course. They used manpower, the belt, and the syringe.

At a certain point, Luise gave up fighting. She was broken. My heart bleeds when I read the chart from November 11, 1992. Two and a half months after she first contacted the psychiatric ward for help, her chart reads, “Today the patient offers no physical resistance but is anxious about being medicated and holds hands (the psychiatrists), and afterward, she is somewhat tearful.”

After reading the chart notes, I realize that coercion, both overt and covert, plays a much greater role in treatment than I had ever imagined.

Initially, Luise fought back, which resulted in long-term coercive measures. I can see that eventually just the threat of forcible measures was enough to make Luise give in. It’s the same story I hear from many of the people who contact me. At a certain point, everybody gives up on fighting back.

July 14th, 2005, around four p.m., was the last time Luise experienced this act of cruelty. She was involuntarily committed to a closed psychiatric ward. She had a psychotropic injected. That was on top of the four other antipsychotics she was already on. On the 15th, during the night, she was walking around as usual (akathisia). A bump was heard. At 5 a.m. Luise was declared dead. The doctor’s attempt at resuscitation was in vain. My Luise was gone forever.

The hospital chart, written not many hours before she died: “The patient was persuaded today to take prolonged-release medicine.” Then a few words about the dose and about how she was feeling well and could be moved to an open ward the next day.

Luise did not want me visiting her, that afternoon of July 14. This was unusual, so I called the ward and was told that she was doing fine and she just did not want to see me. I asked if there had been a change in her medication ― I dreaded the injection the doctor had talked about, which I said would be Luise’s death. The woman on the telephone answered that, for the best of Luise, they had decided to inform me about any medication changes only once a week, so I could find out about this the following Thursday. That’s when I really got scared. Just a few words in the chart about such an important decision as giving a new drug by way of depot injection.

Medical law requires that a patient’s chart must record what information the patient has received about a new product, and what the patient has articulated about it. Nothing was noted in her chart. No informed consent. Luise would have done anything to avoid the syringe. So the sentence “The patient was persuaded today to take prolonged-release medicine” is ominous. I’m sure she fought against getting this injection, as she had earlier been about to die from injection with psychotropics.

The autopsy also revealed marks around her body, which the coroner could not explain. I have no doubt that these marks stem from the staff holding Luise down by force when she fought against getting the drug by syringe ― the injection she died from, eight to twelve hours later.

Mental health problems are not a deadly disease. Yet many people, far too many people, still die in psychiatric care. They die because they are treated with far too high doses of psychotropics, often given against their will and by force. Luise’s tragedy is far from unique in Denmark ― or indeed any other ‘advanced’ industrialized country.

After Luise’s death, I sent a complaint to the National Agency for Patient Rights and Complaints, and to The Patient Insurance Association. My complaint’s headline was “Death from drug poisoning.” I named the four different drugs she had been on, which all together was a huge cocktail.

According to these agencies, Luise received the highest standard of specialist treatment. They wrote:

The antipsychotic medication treatment has complied with the best professional standards. That the outcome has not been satisfactory is due to the nature of the condition and the circumstances that the profession’s knowledge and treatment options are limited.

As stated, I believe that the risk inherent in the medication treatment must be weighed against the sufferings Luise H.C. would have undergone without treatment.

It is incomprehensible that Luise’s treatment was judged up to standard, when in fact they administered psychoactive pharmaceuticals at three times the highest recommended dose. There was no informed consent of this polypharmacy, and nothing written in the hospital records about her treatment in the last days of Luise’s life.

According to the UN Convention, everybody should be equal under the law. So why is this equality not carried out in practice? And why is nobody held responsible when the law is violated? Will we accept a society where far too many people die from an illness that is not deadly? Can we accept a society where forced treatment is often the cause of severe disability?

My answer is NO. Please, STOP forced treatment. Why on earth are psychiatrists so keen on keeping up such dangerous and degrading treatment? I want to tell them: Please get down from your ivory tower. Down to the real world, with real people, and stop saying that this kind of treatment is “for the best of the patient.”

[youtube https://www.youtube.com/watch?v=YK9K1hpDbSU]

Dorrit Cato ChristensenDorrit Cato Christensen is an author, lecturer and chairman of the Danish association Dead in Psychiatric Care. She devoted her life to helping people who are caught in the psychiatric system after her daughter’s fatal contact with the Danish mental health system. She has chronicled her daughter’s story in her talks and in her book  “Dear Luise: A story of power and powerlessness in Denmark’s psychiatric care system”

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Le témoignage d’Agnès: traitements dégradants, traitements forcés en France.

http://depsychiatriser.blogspot.no/2016/03/le-temoignage-dagnes-traitements.html

En violation de l’article 16 de l’ONU, les personnes présentant un handicap psychiques subissent des traitement dégradants qui bafouent  toute dignité humaine.

Voici mon témoignage :

J’ai été hospitalisée 2 fois dernièrement à l’hôpital psychiatrique relevant de mon département
En juin, il m’ont placée dans une chambre d’isolation et m’ont attachée pendant 2 jours. J’étais allée aux toilettes le dimanche à midi et j’ai été hospitalisée vers 17heures. Le lendemain toujours attachée, j’ai crié que j’avais envie de faire pipi. Ne voyant personne venir, j’ai fini à bout par uriner dans mon lit. Des infirmiers sont venus. Ils m’ont déshabillée de force et m’ont écarté les jambes pour me placer une couche pour incontinents. Ils m’ont arraché la veste de pyjama et essayé d’ôter mon soutien-gorge, le tout avec une violence inouïe.Aujourd’hui encore j’ai un profond sentiment de honte tant je  ressens cet acte comme un viol de mon intimité. En y pensant ma gorge se noue et mon estomac se serre.

La 2éme fois en septembre cette fois, j’ai été placée en chambre d’isolement. Elle était pourvue de toilettes verrouillées de l’extérieur ce qui vous contraint à aller uriner dans un seau hygiénique sous “l’œil bienveillant” d’une caméra de vidéo-surveillance. Enfermée ainsi pendant 3 jours et 4 nuits, vous perdez la notion jour et nuit. Quand, vous sortez enfin, vous voilà docile comme un mouton prêt à quémander ou presque les médicaments que ‘l’on vous a prescrits et que l’on vous donne à heure fixe 3 fois par jour.

Tels sont les méthodes chocs employées par l’hôpital psychiatrique de mon département pour mâter les plus récalcitrants… Comment conserver l’estime de soi et se réintégrer socialement quand on a subi de tels traitements et qu’on ne peut communiquer sur ce qu’on a vécu ?

Je vis dans le sud de la France, pays des droits de l’Homme qui a pour devise “Liberté, Égalité, Fraternité”. J’ai une reconnaissance de handicap à 80%.

Je veux que vous apportiez mon témoignage pour que cessent ces méthodes indignes pour l’être humain et indignes du XXIe siècle.

Je voudrais dire aussi que lorsque j’ai été attachée, ils ont serré si fort les liens de contention que j’étais dans l’incapacité de bouger et que même sans bouger, ma cheville a été entaillée.

J’ajouterai que dans ce même hôpital, on utilise des mesures vexatoires à l’encontre des patients; on leur ôte toute dignité en les contraignant à rester en pyjama devant les autres patients pendant au moins 5 jours, le plus souvent une semaine, voire plus. C’est le médecin qui décide de la levée de la contrainte.

Enfin, il faut savoir que dans notre pays, les malades psychiatriques internés relèvent du “juge des liberté et de la détention” qui est aussi le juge des prisonniers de droit commun, alors que la plupart d’entre nous, n’avons commis aucun délit. Au bout de 10 jours environ, vous êtes admis à comparaître devant lui. Comment se défendre quand assommée de médicaments, on a peine à avoir les idées claires, à aligner ces phrases à trouver ses mots ? En fait le but de cette audience est avant tout de démontrer que vous n’êtes pas coopérant avec les soins ce qui justifie la poursuite de votre internement dans l’établissement.

Je pourrais aussi parler des effets qu’ont eu sur moi les neuroleptiques. Lorsqu’on me les a administrés pour la première fois, j’étais revenue à la réalité après 3 jours de bouffée délirante aiguë. Depuis chaque fois que je les arrête ou qu’on les baisse trop brusquement  ou qu’on me prescrit un traitement inadapté, je rechute.

On me disait brillante et aujourd’hui, je ne suis plus que l’ombre de moi-même: j’ai perdu mon affect, tout sens critique toute capacité d’analyser, toute intelligence émotionnelle et mes facultés cognitives. Comme ce sont les émotions qui fixent la mémoire, je suis vide de souvenirs depuis 17 ans. J’ai de grands trous noirs concernant des événements que j’ai vécus ce qui est terriblement angoissant. J’ai perdu toute curiosité intellectuelle, tout intérêt pour les choses y compris pour le domaine pour lequel j’ai effectué des études universitaires. Je subis la vie sans la vivre vraiment. Je suis une morte-vivante. A certains moments j’ai même été zombifiée. C’est ainsi qu’on m’a imposée une contrainte de soins après ma sortie de l’hôpital (loi qui a été généralisée en France par Nicolas Sarkozy en  2011) : tous les 14 jours, on m’administrait une piqûre de 50 mg de risperdal constat et les infirmiers passaient tous les soirs à mon domicile pour me contraindre à prendre un comprimé de 4 mg de risperdal (rispéridone). Incapable de me concentrer et souffrant de terribles anxiétés, j’ai été contrainte de prendre un travail à mi-temps.

Vous pouvez publier mon témoignage. J’ose espérer qu’il va servir à mettre fin à certaines méthodes utilisée par la psychiatrie moderne. Je sais qu’un jour, des gens s’étonneront de l’emploi de méthodes si barbares et  que peut-être dans un proche avenir des individus, avec l’avancée des connaissances, traîneront en justice les médecins et les industries pharmaceutiques, responsables de leur état.

C’est paradoxal. Les “psychiatres” comme leur nom l’indique devraient soigner la psychée (l’âme). Or justement en tant qu’handicapés psychiques, nous ne sommes pas traités comme des êtres humains par certains personnels soignants et cela dans l’indifférence presque totale de la société qui cautionne de tels traitements dégradants qui vont pourtant à l’encontre de la Convention de l’ONU contre la torture et les traitements dégradants. : il y a les végétaux, les animaux, les malades mentaux et l’espèce humaine. Que s’imaginent-ils? Que parce que nous perdons la raison, nous perdons notre conscience, que nous n’avons pas d’âme et que notre ressenti est celui d’un animal ? En fait je pense qu’ils ne font pas ça non parce que nous constituons un danger pour eux et pour les patients mais parce qu’ils croient qu’en nous traitant comme ça, cela nous dissuadera d’arrêter les médicament. Qu’ils se détrompent! Nous les arrêterons encore et encore pour leur prouver le contraire et nous prouver aussi à nous-même que nous sommes des êtres humains.

J’en ai moi-même fait l’expérience : en 2013, j’ai été hospitalisée une nouvelle fois à l’hôpital psychiatrique, après avoir arrêté mes médicaments,. Je n’y ai pas subi de sévices et cette fois là, et je suis tombée sur une psychiatre humaine qui m’a bien expliqué qu’il fallait que je sois stabilisée pendant 4 ans avant de pouvoir essayer (avec l’aide d’un médecin) d’arrêter les neuroleptiques. Je n’ai  plus jamais arrêté mes médicaments. J’ai rechuté en 2015 (j’avais des comprimés à cette époque que je prenais toute seule) peut-être parce que mes doses étaient trop basses. A l’hôpital sous la pression de ma famille, le psychiatre a instauré une injection retard d’abilify et comme ce traitement est destiné aux personnes atteintes de schizophrénie, j’ai rechuté une 2e fois, un mois après.

Aujourd’hui, j’aimerais bien revenir aux comprimés et être considéré comme un être humain responsable. Les injections retard sont dégradantes..Elles ne permettent pas de nuancer et d’ajuster au plus près les médicaments. Sans compter que leurs effets à long terme ne sont pas connus. Que se passerait-il en cas de syndrome malin des neuroleptiques ? C’est une question que je me pose. Malheureusement les psychiatres abusent de ces injections les généralisent et les banalisent sans mesurer les effets qu’elles engendrent. Quant à moi, je n’ arrêterai plus mon traitement car avec ce que j’ai lu là-dessus, j’ai bien compris que les neuroleptiques ou antipsychotiques sont comme une drogue et doivent être arrêtés très progressivement pendant une longue période avec des paliers de stabilisation. Les arrêter brutalement c’est le meilleur moyen de basculer dans la folie. Il m’aura fallu 17 ans pour que je comprenne tout ça, alors que si on m’avait expliqué cela dès le début(ou presque) en me considérant comme un adulte à part entière, un malade comme les autres, doué de conscience et de raison,  je n’en serais sûrement pas à ma 10ème ou 11éme hospitalisation.

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Workfare coercion in UK – Anne-Laure Donskoy

Workfare coercion in the UK: an assault on persons with disabilities and their human rights

Anne-Laure Donskoy_Survivor researcher, UK

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While there is a lot of focus on coercion organised and implemented in psychiatry, less attention is being paid to state engineered welfare measures based on libertarian paternalism1, which have coercive practices at their core. Among them are policies that strongly support behavioural change using positive psychology and cognitive behavioural therapy. Freidli and Stearn (2015)2 call this “psychocompulsion”. These policies and measures are increasingly used to ambush and coerce persons with disabilities and the long term sick into adopting new ways of being and living conditions under the constant threat of sanctions and which have driven many to attempt to their lives. This paper builds on the work of Friedli and Stearn3 as an attempt to highlight current coercive welfare policies, including forcing ‘therapy’ on individuals, as human rights violation of the CRPD.

 

Background: Psychocompulsion as state sponsored human rights violations

Psychocompulsion, the use of psychological strategies to “nudge” individuals to make “life changes” that fit a political ideology or programme, is not entirely new to the UK. Already in the 1970s, some long term job claimants would be sent for a medical examination, on the premise that if people were not physically ill then they should be able to find and take up work, any work. This had all the flavours of Victorian paternalism written all over it. The ‘mentally disordered’ and the ‘mentally handicapped’ experienced a particular brand of paternalism, hidden away from society and from consciousness in specialist homes and services, often suffering physical and mental abuse or used in rehabilitation work with little or no protection.

Today, psychocompulsion in the UK has been promoted by the Behavioural Insights Team (nicknamed the “Nudge Unit”), now in private hands as a social purpose company but still working closely with the Cabinet Office4, thereby guaranteeing prime influence on policy making. It is clear that psychocompulsion is being used to lock individuals, including the long term unemployed, the sick and persons with disabilities, into back-to-work schemes as a conditionality of welfare. In recent months and weeks, voices of dissent have arisen mostly from social movements, denouncing the use of coercion which put people’s lives at risk5.

As Friedli and Stearn’s paper show, this finger wagging attitude has taken on a far more sinister slant.

First, it turns on its head the idea that unemployment is the product of a failing economy by strongly suggesting that it is a state of mind, worse still a ‘mental illness’ that can be corrected by changing the psychology of claimants, thus placing the onus of responsibility for success, for betterment, for choice etc. on the individuals themselves. This totally ignores issues of social (in-)justice.

Second, it widens the scope by netting in the most vulnerable people in society, specifically the long term sick and those with disabilities, including psychosocial disabilities. This strategy narrowly avoids attracting full-on accusations of discrimination by putting these individuals on par with the long term unemployed and by stressing ad nauseam that the policy is about helping people which should be achieved through (any type of paid) employment. Paid employment becomes the embodiment and the “pinnacle of human experience”.6

Third, the underlying premise that ‘work is good for you’ ignores those dissenting voices which argue that without strong provisos (taking into account the complexity of individual circumstances, choice, timeliness, appropriateness as much as the quality of support and work on offer) the argument is both unhelpful and counterproductive7, and can have devastating consequences for those concerned.

Finally, the stance of the policy totally fits within the libertarian paternalism agenda which moves away from collective to total individual (libertarian) responsibility, slowly realising Ayn Rand’s vision for a permanently productive (and permanently disposable/replaceable) workforce serving an elite. In this scheme, all coercive strategies acquire a legitimacy that the psychiatric survivor movement rejects.

 

Being ill or disabled, and on welfare benefits: state coercion and the CRPD

The Welfare Reform Act 2012 introduced a wide range of reforms to the benefits and tax credits system. The stated aim was to reduce the financial burden of the cost of welfare. This is being achieved by introducing ever drastic and punitive policies under the guises of a responsibilisation agenda, underpinned with an intense authoritarian ideology not seen or experienced since Victorian times. The Tory manifesto of the 2015 general elections claimed it aimed to help people with mental health issues back in to work. The reality is very different and people with mental health issues clearly face discriminations which other groups do not.

 

Article 4: The rights and freedoms of persons with disabilities are violated under the social security scrutiny regime:

When people with mental health issues are on welfare benefits, they find themselves the object of intense, intrusive and inappropriate scrutiny by the system, notably through the Work Capability Assessment (WCA) which has consistently failed these claimants as it is totally unsuited to their singular predicaments and experiences. As a result, more and more people are placed on the Work Related Activity Group of the Employment and Support Allowance which comes with strict conditionalities. Also affected are those under the new Universal Credit (UC) system which is being rolled out for all benefits claimants which places yet another layer of scrutiny on individuals, possibly more so those in work.

 

Article 1-5: Discrimination

A judicial review in 2013 found that the WCA process actively discriminates against people with mental health issues. Since then very little has been done to change the process and the status quo remains.

The Centre for Welfare reform, in its recent report A Fair Society?, also shows that persons with disabilities are targeted the most despite the fact that they have the greatest and often most complex needs.

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Article 10: Right to life: “States Parties reaffirm that every human being has the inherent right to life and shall take all necessary measures to ensure its effective enjoyment by persons with disabilities on an equal basis with others”.

A poll of over 1,000 GPs commissioned by Rethink Mental Illness in 2015, found that over 20% have patients who have felt suicidal due to the WCA8.

In a report sent to the Department for Work and Pensions (DWP), the senior coroner for inner north London, Mary Hassell, said “the trigger” for the suicide was the man being found fit for work by the department”9.

[A Freedom of Information request has] revealed that the Department for Work and Pensions (DWP) has investigated decisions, via peer reviews, about the welfare payments of 60 claimants following their deaths. A peer review, according to the DWP guidance for employees, must be undertaken when suicide is associated with DWP activity to ensure that any DWP action or involvement with the person was appropriate and procedurally correct.10

 

Article 13: Access to justice: 13.1: “States Parties shall ensure effective access to justice for persons with disabilities on an equal basis with others, including through the provision of procedural and age-appropriate accommodations, in order to facilitate their effective role as direct and indirect participants, including as witnesses, in all legal proceedings, including at investigative and other preliminary stages.”

Benefit claimants who wish to appeal a decision need access to justice. This represents an expense they can ill afford (if at all) therefore need access to legal aid. However, the Ministry of Justice has removed welfare benefits matters from the scope of legal aid funding, thereby denying access to justice and discriminating against the most vulnerable and poorest, among whom people with mental health issues:

In order to challenge a decision of a First-tier Tribunal (FtT) the appellant needs to identify an error of law in the FtT’s decision and then request permission to appeal to the Upper Tribunal (UT). The process of appealing on a point of law to the UT has two stages, but, for the reasons set out below, the legal aid contract only covers the second stage … The absence of any legal aid at Stage One of an appeal to a UT on a point of law represents a major flaw in the current scheme as it is simply unrealistic to expect an appellant to draft an appeal on a point of law without any assistance.11

In the future, social security claimants who find themselves faced with an incorrect Upper Tribunal decision, or who win their case at the Upper Tribunal but find themselves on the receiving end of an appeal by the DWP12, HMRC13 or a local authority, could be facing the courts and the costs risks attached on their own or not at all.14

In practice, benefit claimants who wish to appeal decisions have to resort to charitable organisations to support them through the process. However these are seeing their funding cut, or they are not coping with increasing number of calls for help.15 There has also been some criticism from within the legal system with regard to persons with intellectual disabilities on matters of legal representation regarding privation of liberty; the same issues also apply to persons with psychosocial disabilities:

The Law Society, which represents solicitors throughout England and Wales, intervened [in a particular case]. Its president, Jonathan Smithers, said: “When a vulnerable person doesn’t have friends or family to represent them during a decision to restrict their liberty, it is vital that person is able to participate in the decision-making process . . . If this is not possible then they must have a legal representative to protect their rights as well as their health and general welfare. Those who are least able to defend themselves should not be sacrificed on the altar of austerity.” 16

 

Actively changing the narrative of workfare and welfare benefits

The narrative of welfare is changing drastically. As Friedi says, we are moving from a “what people have to do [to find work] to what they have to be [demonstrating the right attitude to be employable]17. This is exemplified through the new ‘Work and Health Programme’ planned to be rolled out in England and Wales.

This programme has many strands, including:

−   Embedding psychological services within Job Centres

−   Placing ‘job coaches’ within GP surgeries for people with certain conditions (specifically people with mental health issues): the ‘Working Better’ pilot scheme is funded by the Department for Work and Pensions and the coaches will be provided by welfare to work agency, Remploy (a welfare-to-work subsidiary of the Maximus).

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This programme blurs the boundary between health and welfare, health and work domains, in a way that has not happened before. This is a coordinated move to effectively bring in the benefits system within NHS care: joblessness, being unemployed becomes an illness, specifically a mental illness which needs to and care be cured through psychological therapies.

It will not only extend benefit conditionality into the NHS but also compromise clinical independence and clinical ethics. In practice, people who display the wrong attitude to work, to work placements or who have been unemployed for a long time will be referred to psychologists and given forced Cognitive Behavioural Therapy, and be sent many motivational emails and text messages throughout the week; or they will be prescribed referrals to an in-house ‘job coach’. Failure to comply with these forced prescriptions will trigger an immediate sanction regime. This will inevitably threaten if not destroy that first quality that patients place in their doctor, trust. People may become reluctant to say anything whether it is about their situation or their health for fear of being forced into the schemes.

 

CRPD violations:

Articles 1-5: (equality, choice, autonomy, capacity)

Persons with disabilities are specifically targeted by the new measures

 

Article 25 (Right to health):

Currently both schemes are in the early stages of being rolled out (pilot stage) and the official line claims that they are voluntary. However, as the Tory manifesto stated “We will help you back into work if you have a long-term yet treatable condition”, this is set to become compulsory: “People who might benefit from treatment should get the medical help they need so they can return to work. If they refuse a recommended treatment, we will review whether their benefits should be reduced.”(p. 28). However, being forced to receive “therapy” for a “treatable condition” is not the same thing as being offered support, which would imply that the individual is free to choose to take it up or not. Most observers agree that what is currently taking place on a voluntary basis as part of the pilot projects will become compulsory, which would only follow the UK Government’s own stance of applying any means to get people “back to work”18.

This means that people with mental health problems will no longer be able to freely choose to consent, or withhold their consent, to ‘treatment’. There is also a high risk that people will feel intimidated into consenting to undergo these ‘therapies’. This is very similar to what happens in psychiatry whereby the right to health is invoked to forcibly treat people for their own good, “in their best interest” … but as their only option. To decline a recommended treatment or to fail to comply to the letter with the injunctions and expectations of the system will result in benefits sanctions.

Cognitive behavioural therapy (CBT), the approach chosen by the Government is highly controversial and does not suit everybody. Therefore a one-fits-all approach, whether it is applied forcibly or not, will be counterproductive as it may make some people feel worse (counter to their right to health) and shows the total lack of understanding of the often complex and singular situations of persons with disabilities.

 

Art 10: (Right to life)

Any Government that uses coercion and sanctions as a means to a political end must take full responsibility for the consequences of its actions. As with the Work Capability Assessment, people being coerced into receiving behavioural or any therapy they did not fully consent to, may experience adverse effects (making people even more unwell by making them even poorer and forcing them to live in a constant state of anxiety, making them suicidal).

It also denies the person as an autonomous individual able to make their own choices (Art 12, Equal recognition before the law; Art 16, Freedom from exploitation, violence and abuse and threatens their integrity (Art 17)).

It also contradicts the Government’s own claims that it is doing everything to make UK domestic law compliant with the CRPD:

The Convention is not legally binding in domestic law in the UK but is given effect through the comprehensive range of existing and developing legislation, policies and programmes that are collectively delivering the Government’s vision of equality.19

 

Article 17 (Protecting the integrity of the person): The issue of coercion goes beyond “designating work as a cure for unemployment and poverty”20 as Friedli puts it; this is also about changing people’s societal status and identity. In the new narrative, there are productive and unproductive individuals, therefore there is no such thing as a long-term sick or disabled person (all disabilities included). These notions pretty much disappear in the name of inclusiveness and fairness (in relation to so-called “hard working people”21 who are deserving of help and will do their utmost not to rely on the state for their individual needs).

Language is indeed important in this context, and language is shifting. As many have observed, ‘sick notes’ have become ‘fit notes’, the term ‘disability’ too is being erased as ‘Disability Living Allowance’ becomes ‘Personal Individual Payment’. This speaks to a simplistic but powerful narrative of ‘can-do-no-matter-what’ supported by having a compulsory ‘right attitude, which is where psychocompulsion comes in. Nudging then forcing people into having the ‘right attitude’.

 

Forcing people back to work by reducing their welfare benefits

Persons with disabilities are clearly targeted over and above other categories of individuals (Art 1-5 equality, discrimination, choice, autonomy). Indeed, another form of coercion has emerged through a recent drastic to the ESA in weekly support from £103 to £73, contained in the Welfare Reform and Work Bill. It will apply to new ESA claimants in the work-related activity group. This vote, pushed through Parliament on 7 March 201622, is meant to “incentivise disabled people to find work quicker”. This (purely ideological) decision will not only strip them of financial security but also reinforce the idea, by bringing the rate into line with Jobseeker’s Allowance, that disability no longer exists, that anyone can and should work, that there are only productive (deserving) and unproductive (undeserving) people.

 

An unethical social experiment

It has come to light that these new programmes are also the subject of ‘research’. The new Work and Health Programme is currently at a research and trialing stage23. As Kitty Jones writes,

Part of the experimental nudge element of this research entails enlisting GPs to “prescribe” job coaches, and to participate in constructing “a health and work passport to collate employment and health information.24

However, this ‘research’ (if one can call it so), has been heavily criticised because it is not sanctioned according to the usual robust ethical guidelines. Research that adheres to robust ethical guidelines would absolutely seek not to cause harm to its participants, and would seek their informed consent beforehand25. This is not the case here where claimants are the participants are the involuntary and ‘unconsented’ participants of an experiment they know nothing about.

There are a wide range of legal and Human Rights implications connected with experimentation and research trials conducted on social groups and human subjects.26

A spokesperson for Disabled People Against Cuts (DPAC), talked of the UN CRPD Committee’s visit to the UK and described the situation thus:

It means the UN will examine the vicious and punitive attacks on disabled people’s independent living as well as the cuts which have seen so many placed in inhuman circumstances and has led to unnecessary deaths.27

 

Articles 1-5: discrimination against persons with disabilities who are targeted through this programme.

Article 9: right to communication: The existence of this experiment and the format of its conduct has not been communicated with the claimants (the participants).

 

Article 10 (Right to Life): when coercion brings people to the brink of suicide or they succeed in killing themselves (one court case at least has pronounced on the clear link between benefits sanctions and reasons for suicide):

Research from the Black Triangle campaign group found more than 80 cases of suicide directly linked to billions of pounds in benefit cuts. John McArdle, co-founder of Black Triangle, said: “The Dept of Work and Pensions refuses to reveal the findings of their own peer reviews of suicides linked to the sanctions so we will never know the truth in those cases. . . He said the Work Capability Assessment regime applied to all sick and disabled people, without adequate risk assessment ‘built into the system’28

Mortality rates bring their own tales of woe:

[The government] published or, rather, was forced to after several Freedom of Information requests – that show more than 80 people a month are dying after being declared “fit for work”. These are complex figures but early analysis points to two notable facts. First that

2,380 people died between December 2011 and February 2014 shortly after being judged “fit for work” and rejected for the sickness and disability benefit, Employment and Support Allowance (ESA). We also now know that 7,200 claimants died after being awarded ESA and being placed in the work-related activity group – by definition, people whom the government had judged were able to “prepare” to get back to work.29

 

Articles 12, 17, 19: Coercive measures embedded in all aspects of the Work and Health Programme and its various tools and strategies run counter to the premise that the person is free and able to make choices for themselves, and considerably threatens their right to independent living when they are forced into poverty.

Nothing seems to shift the current UK Government’s assault on people with disabilities or long term sickness, and on their human rights. Not the many Freedom of Information requests which have revealed that the DWP did look into the death of 60 benefits claimants but sat on the findings; nor a Commons Select Committee inquiry into benefits sanctions in April 2015, nor the visit by the UN CRPD committee at the request of a disability group (DPAC) in the late autumn of 2015, nor a coroner’s report clearly linking a claimant’s suicide to the stress caused by the Work Capability Assessment. The UK is effectively engineering and encouraging coercive and punitive policies that specifically target people with disabilities and the long term sick, putting their lives and their future at high risk. Many have observed that ‘austerity’ was only ever an excuse to establish and implement ideological policies. This is not about saving money in hard times; this is about the willful annihilation of the disabled, either through language or deeds.

 

Anne-Laure Donskoy

March 2016

 

Notes:

1https://kittysjones.wordpress.com/2015/11/28/the-goverments-reductive-positivistic-approach-to-social-research- is-a-nudge-back-to-the-nineteenth-century/– The idea that it is both possible and legitimate for governments, public and private institutions to affect and change the behaviours of citizens whilst also [controversially] “respecting freedom of choice.”

2 Friedli L, et al. Med Humanit 2015;41:40–47. doi:10.1136/medhum-2014-010622

3 See also this short film: https://vimeo.com/157125824

4 http://www.behaviouralinsights.co.uk/

5 http://www.disabilitynewsservice.com/coroners-ground-breaking-verdict-suicide-was-triggered-by-fit-for-work-test/

6Cole M. Sociology contra government? The contest for the meaning of unemployment in UK policy debates. Work Employment Soc 2008;22(1):27–43.

7 Even the Department of Work and Pensions (DWP) who are driving these policies, acknowledged in a 2006 study have put forth provisos that “account must be taken of the nature and quality of work and its social context” and that, for sick and disabled people, “there is little direct reference or linkage to scientific evidence on the physical or mental health benefits of (early) (return to) work for sick or disabled people.” 8https://www.gov.uk/government/publications/is-work-good-for-your-health-and-well-being

https://www.rethink.org/media-centre/2012/09/new-gp-survey-shows-government-welfare-test-is-pushing- vulnerable-people-to-the-brink

9 See note 3

10 https://www.wsws.org/en/articles/2015/02/05/welf-f05.html

11 https://gclaw.wordpress.com/2014/05/30/what-legal-aid-is-still-available-for-work-undertaken-on-welfare-benefits-post-laspo/

12 Department of Works and Pensions

13 Her Majesty’s Revenue and Customs

14 http://www.cpag.org.uk/content/legal-aid-reform-or-termination

15 http://www.theguardian.com/society/2014/feb/25/benefit-cuts-welfare-linked-mental-health

16 http://www.theguardian.com/society/2016/mar/10/judge-challenges-government-over-legal-representation-for-

vulnerable-people?CMP=share_btn_tw

17 https://www.youtube.com/watch?v=Dt-V0e0-ipY

18 A side point has been made by Friedli and others about the questionable ethics of those clinical psychologists who accept to take part in such initiatives and about the rapid expansion of the back-to-work industry.

19 Office for Disability Issues, UK Initial Report On the UN Convention on the Rights of Persons with Disabilities, May 2011,

www.odi.gov.uk/un-report

20 https://www.youtube.com/watch?v=Dt-V0e0-ipY

21 An expression used as a constant leitmotiv by the UK government.

22 Ministers claimed “financial privilege” to assert the Commons’ right to have the final say on budgetary measures

23 http://php.york.ac.uk/inst/spru/research/summs/esa.php

24 https://kittysjones.wordpress.com/2015/12/14/the-department-for-work-and-pensions-dont-know-what-their-ethical-and- safeguarding-guidelines-are-but-still-claim-they-have-some/

25 https://en.wikipedia.org/wiki/Ethical_research_in_social_science

26 See note 15

27 http://www.disabilitynewsservice.com/confirmed-un-is-investigating-uks-grave-violations-of-disabled-peoples-rights/

28http://www.mirror.co.uk/news/uk-news/more-80-suicide-cases-directly-5634404

29 http://www.theguardian.com/commentisfree/2015/aug/27/death-britains-benefits-system-fit-for-work-safety-net

 

 

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“Where Would I Be if I Didn’t Believe in Me?” – Corrine A. Taylor

Where Would I Be If I Didn’t Believe in Me

 

My name is Corrine A. Taylor, I just titled this piece, “Where would I be if I didn’t believe in me?” Every time I sit down to share an aspect of my story I do it from a place of my heart space wanting to share awareness in the world, knowing there was a period of my life where I knew nothing and only accepted what the psychiatrist and social workers told me. I was desperate to live a well life but didn’t know how. I have learned that I am not the only one and there are many more people just not knowing and accepting to be labeled and drugged. However, I have come to a place of awareness to know that this is just my story and everyone else’s story needs to be respected and validated as I choose to tell my own, knowing that each and everyone of us is worthy to live a well life. I am focusing on the aspect of my life of not being forced to take drugs and why I chose this title, “Where would I be if I didn’t believe in me?” for the Campaign to Support CRPD Absolute Prohibition of Commitment and Forced Treatment.

When I got to a place of awareness of what is happening with psychiatry and choosing to accept a mental illness diagnosis and label for so long, accepting drugs, dying slowly waiting for the cure to be better, to live the life I wanted, I decided, no more. I had been on a journey for peace in my mind body spirit since I was a child, but was interrupted by abandonment, physical, sexual and emotional abuse, along with poverty and poor education. When I said no more to the last psychiatrist I was seeing and she offered me more drugs, I had been involved with the recovery community and learned a lot of the history about mental health in our world. So I was informed and I had a choice. I choice to feel what I needed to feel, let go what I needed to let go, forgive others and myself, and to learn, relearn and learn each and every day. That meant I could no longer accept the mind numbing drugs that never allowed me to fully accept and let go the affects of trauma.

When I had that last session with the psychiatrist and she offered me more drugs, different drugs, I had to tell her no each time. I could still remember the look on her face. I could still remember the confidence in my being that I knew what I needed and what I was asking for and what I expected to get as my human rights. I could still remember the last session with the therapist I saw, giving me suggestions that I should still see her or come back to her soon, that I would need to come and dump on her all the things happening in my life instead of dealing with them. Talking to her and dumping them on her that meant, not facing the situations that I was dealing with outside of her office. That meant not connecting and disconnecting, not building relationships, and more than that, not trusting myself.

But I believed in myself that day. I believed in the journey that I have been living. I saw all the hard lessons things that I past through, learn and like sharing with others, the way that I learn from others. I had people who became friends who supported me and believed in me and helped to ease the burden of an oppressive existence of poverty and lacking. Gave me strength within the Bible stories I learned as a child of not giving up and persevering. I choose to share my story at www.theproject321.com it is the lessons I learned taking the time to take care of myself and learning the lessons from all of my experiences, especially the hard ones.

I am glad I believed in me. Working behind the scenes at a mental health clinic really helped, as I saw the psychiatrist and social workers have all there faults, insecurities, judgments, behavior issues, or really just being as human as I am. It made me strong to believe in myself. When they came at me with negative reports, I was able to stand up for myself. I saw them with all their human flaws, but deserving dignity and respect and I knew that I deserve the same and so does everyone else. If that last psychiatrist with the look on her face that she new what was best for me, had decided to call the cops and lock me up, forced the drugs on me that she was offering me, where would I be today. I have been working to live for the last five years, connecting with my children and supporting them emotionally. Made friends and allies in the community, and living my life included in society, not on the couch drugged, overdosed, dying slowly accepting a diagnosis, and label. I ask again, “Where would I be if I didn’t believe in me?” I know where I ended up when I didn’t believe in me, accepting one mental illness diagnosis one after the other, one drug after the other, and not living up to my full potential as a human being. That is all that I want. Feel I deserve and so does each and everyone of us.

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Contribution Jules Malleus à la Campagne pour soutenir l’Abolition totale des soins et de l’hospitalisation sans consentement en application de la CDPH de l’ONU

http://depsychiatriser.blogspot.no/2016/03/contribution-jules-malleus-la-campagne.html

Merci au Comité de la Convention Droits des Personnes Handicapées.
Merci aux Usagers et Survivants de la Psychiatrie.
Vous avez su vous exprimer, vous avez su les écouter.
Grâce à vous, les bases sont en place pour faire respecter les droits de l’homme là où ils sont bafoués.
Merci du fond du cœur à chacun d’entre vous.
Je m’appelle Jules Malleus.

Sous ce nom, j’écris des articles et des contes qui sont souvent en rapport avec la psychiatrie.

Je ne prétends pas être un expert en quoi que ce soit, mais je voudrais vous expliquer ici pourquoi je participe à la Campagne pour soutenir l’Abolition totale des soins et de l’hospitalisation sans consentement en application de la CDPH de l’ONU.

https://absoluteprohibition.org
www.absoluteprohibition.org

Je souhaiterais vous parler d’une machine.
Une machine avec des engrenages et avec des pistons.
Une machine inventée par les hommes.
Cette machine, je lui en veux. Je peux même dire que je la hais.
J’accuse cette machine d’avoir détruit peu à peu ma mère, mon père, et certains de mes amis.
C’est la machine des traitements psychopharmacologiques imposés aux personnes.

Vous connaissez cette machine: C’est la machine du film Metropolis de Fritz Lang, sorti en 1927. Le héros du film recule frappé d’effroi, car il a compris que la machine est un Moloch, c’est à dire une sorte de culte maléfique auquel on sacrifie les êtres humains.En haut de l’escalier de la machine, il y a des êtres humains. Les mains liées dans le dos. Maltraités par les gardes, qui sont aux ordres des deux personnages porteurs d’une haute coiffe. Analogiquement, ce sont les patients psychiatriques traités sans leur consentement.

Ils sont poussés dans l’antre de la machine. En tous points, ils ressemblent à des esclaves. Ils ont perdus tous leurs droits  : leur corps et leur psychisme sont à la merci de la machine.

Les deux personnages à l’entrée du four portent un masque d’impassibilité  : ils ne manifestent pas d’émotion. Leur coiffe est une mitre de prétention à une connaissance supérieure  : dans l’analogie, ce sont les médecins qui désignent les prisonniers et décident de leur sort.

Quand je pense aux traitements forcés, et bien je pense à ceci  :

 
«  Toute résistance est inutile. Vous allez être assimilée.  »

La capitaine Janeway subit un traitement forcé dans l’épisode 146 de la série Star Trek Voyager. Le traitement servira à assimiler la victime dans le collectif auquel appartient le vilain monsieur.

J’ai placé cette photo parce que l’objectif d’un traitement psychiatrique est de rendre la personne moins «  anormale  », c’est à dire de la normaliser en quelque sorte. L’injection prive la victime de sa volonté  : celle-ci devient esclave du collectif.

C’est à dire que la différence, la diversité, vouloir être «  hors norme  », par exemple, est considéré comme une maladie, qu’on se propose d’éliminer, par la force.

Le traitement forcé n’est que le début  :

Dans le film «  Le Seigneur des Anneaux III  », de Peter Jackson, 2003, le héros Frodo reçoit une injection forcée de l’araignée géante Shelob, ce qui a pour effet de le faire baver et de lui faire perdre ses moyens. L’araignée entortille alors sa victime de sécrétions gluantes afin de laisser sa viande faisander quelque temps dans sa caverne.

C’est à dire que le venin sert à paralyser la victime. Les traitements dits anti-psychotiques font de même et diminuent les capacités de défense du patient. Il devient alors plus facile de briser la personnalité afin de faire consentir à ce que l’on veut.

J’ai appris la programmation informatique, afin d’essayer de gagner ma vie. Et ce que je vous propose c’est un algorithme. L’algorithme qui suit n’existe pas dans les textes, il n’est pas enseigné non plus.
Il représente davantage une sorte de boutade destinée à faire comprendre l’absurdité d’un système.

C’est mon analyse de ce qui se passe quand une institution et ses rouages se mettent à tourner sans rien prouver de concret. Le mot-clé est non-compliance. Non-compliance au traitement signifie que vous êtes aussi dans le déni du trouble, donc on vous classe dans la case psychotique.

J’ai montré cet algorithme à des survivants: certains m’ont confirmé ceci. Ils m’ont expliqué qu’ils étaient obligés de jouer la comédie du malade et de la guérison pour parvenir à sortir de l’enfer des droguages abrutissants qui leur étaient imposés.

Quand une indication n’est pas étayée par des preuves biologiques, quand la maladie supposée n’a pas été caractérisée par des pathologistes, alors il me semble légitime de qualifier le traitement d’expérimental.

J’estime aussi que la mécanique d’augmentation des doses que j’ai décrite dans cet algorithme n’est pas autre chose qu’une machine de torture.

Les victimes du traitement forcé ont été diffamées. On n’a plus confiance en elles. Elles font peur. Les personnes n’ont plus confiance en elles-mêmes. Certaines présentent des maladies iatrogènes. Beaucoup sont traumatisées par l’expérience. Elles vivent dans la peur d’un nouveau traitement forcé, elles sont menacées de «  rechuter  ». Beaucoup restent engluées dans des addictions psychopharmacologiques auto-destructrices. Il en résulte la perte de son potentiel, l’empêchement de se réaliser, l’échec, le désespoir, la culpabilité, le chômage, la précarité, et cela conduit souvent à la fuite dans l’addiction, et au suicide.

Témoignage d’Agnès:

“Ayant été hospitalisée à 10 reprises, j’ai subi des traitements
dégradants, des humiliations. Nous sommes traités là-bas comme des animaux. On nous attache, on nous met à l’isolation etc…
Ce n’est pas parce que nous sommes en crise et donc soit-disant dangereux que l’on nous traite ainsi. Non, le but est de nous casser pour nous faire avaler des médicaments et nous donner une leçon pour que nous n’arrêtions plus de les prendre. Et toute la société accepte cela comme une chose normale.”

Et voilà …

Moloch est repus. Moloch vous remercie.

Et cela va continuer à moins que …

Ensemble exigeons que les lois de santé mentale de notre pays ne permettent plus, mais au contraire abolissent, le traitement forcé.

Références:

La convention ONU relative aux droits des personnes handicapées (CDPH)
http://www.un.org/french/disabilities/default.asp?id=1413

L’Observation générale n° 1 sur l’article 12
http://www.ohchr.org/EN/HRBodies/CRPD/Pages/GC.aspx

Statistiques 2014 Psychiatrie France
http://www.atih.sante.fr/sites/default/files/public/content/2790/rapport_2014_psychiatrie.xlsx

Statistiques judiciaires sur les hospitalisations psychiatriques sans consentement en 2014 en France
http://psychiatrie.crpa.asso.fr/2015-07-28-cm-Statistiques-judiciaires-sur-les-hospitalisations-psychiatriques-sans-consentement-en-2014?lang=fr

Le dossier de presse et les photos du rapport 2015 de la Contrôleure générale des lieux de privation de liberté en France
http://www.cglpl.fr/2016/publication-du-rapport-dactivite-2015/

Les UMD, “Unités pour Malades Difficiles”, un témoignage.
http://psychiatrie.crpa.asso.fr/IMG/pdf/2016-02-16-temoignage-sdre-epsm-rhone-alpes_2.pdf

Dimitri, 19 ans de maltraitance d’une personne adulte handicapée en institution: attaché, drogué, envoyé en UMD.
https://www.facebook.com/Soutien-%C3%A0-Dimitri-Fargette-1665872200308023/

Thomas Szasz, 1997: “Insanity: the idea and its consequences.”

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Paula Caplan – Myths are Used to Justify Depriving People Diagnosed as Mentally Ill of Their Human Rights

http://www.madinamerica.com/2016/03/myths-are-used-to-justify-depriving-people-diagnosed-as-mentally-ill-of-their-human-rights/

By 

Featured Blogs March 14, 2016

Who in this world ought to have the right to make decisions about their lives, and who is required to lose that right and have the medical community and the courts take over?

Despite the fact that no one in history, not even the omnipotent American Psychiatric Association — which produces and profits mightily from the “Bible” of mental disorders — has come up with a halfway good definition of “mental illness,” and despite the fact that the process of creating and applying the labels of mental illness is unscientific, any of those labels can be used to deprive the person so labeled of their human rights. This is terrifying. It ought to terrify those who are so labeled and those who are not, because deprivation of human rights on totally arbitrary grounds is inhumane and immoral.

The combination of the specter of terrorism and highly publicized incidents of gun violence have led rapidly to politicians, therapists, and the general public blaming “the mentally ill” for these dangers, and that is used to justify depriving not just terrorists and other killers but anyone with a label of mental disorder of their rights. They can be locked up against their will, they can be ordered to comply with just about anything that a professional calls “treatment of the mentally ill,” no matter how these actions can harm the person and in the absence of scientific evidence that the “treatments” of people who have been psychiatrically labeled will prevent violence. In other words, the huge leap is often made from “This person has a psychiatric label” to “This person is therefore dangerous to themselves and others,” even in the absence of any history or current indication of such dangerousness, and that leap is then used to lock people up and/or otherwise “treat” them against their will.

Now the United Nations human rights treaty called the Convention on the Rights of Persons with Disabilities includes the absolute prohibition of forced commitment and forced treatment, and the brilliant and tireless advocate Tina Minkowitz is leading a campaign to show that there is a wide base of support for these prohibitions. This is especially important in the United States, because 162 nations have ratified the CRPD, but the U.S. has not.

Minkowitz worked on drafting and negotiations for the treaty from 2002-2006 and helped ensure the incorporation in the CRPD of Article 12, which says that “states,” countries and national governments bound by international law recognize that people with disabilities have the right to make their own decisions in all aspects of life and to do so free from coercion. Note that “people with disabilities” applies to anyone who has received a diagnosis of any mental disorder (in addition to other disabilities). It is important to note the CRPD’s Article14, which specifies according to the text and the authoritative interpretation by the Committee on the Rights of Persons with Disabilities that the existence of disability or perceived disability cannot be used to justify deprivation of liberty, and Article 25 requires that healthcare be provided on the basis of free and informed consent. The word “perceived” is crucial, in light of the fact that the ballooning numbers of categories listed as mental disorders in the two primary handbooks used to classify people as mentally ill have made it possible, even likely, that anyone entering a therapist’s or other professional’s office in other than a calm and happy state will be diagnosed as psychiatrically disordered, moving just about anyone into the “perceived as disabled” category. So one crucial myth that is relevant to the CRPD is that psychiatric diagnoses are scientific and usually appropriately applied.

If no harm came from being classified as mentally ill, there would be less cause for alarm. But it is easy, even likely, for laypeople, therapists and other healthcare professionals, and judges to assume wrongly that having a disability (even a perceived disability) means that one’s judgment is impaired and that one should not be allowed to make choices about their lives, their bodies, and the treatments to which they will be subjected. Frequently, the criterion of “dangerous to oneself and/or others” is used to justify forced commitment or forced treatment, and this is done despite the proven fact that people diagnosed as mentally ill are actually less likely than others to commit acts of violence and more likely to be victims of violence. The evidence for this pattern is all the more remarkable, given that for a number of reasons (e.g., defense attorneys trying to get psychiatric labels for their clients in order to obtain reduced sentences or diversion from prison to the mental health system; the skyhigh frequency of prisoners being diagnosed as mentally ill so that they can be heavily medicated and thus reduce the need for prison staff), statistics in the near future are likely to show an increasingly high correlation between psychiatric labels and violence. Thus, two other crucial myths that are relevant to the CRPD are that people who have received psychiatric labels are likely to be incompetent to make choices about their lives and that they are more likely than other people to be violent.

A fourth crucial myth is that forced commitment and forced treatment are beneficial (and, by implication, not harmful). That this is a myth is reflected in the high rates of suicide that follow inpatient treatment and the increased rates of suicide caused by many psychiatric drugs, as well as the plummeting rates of recovery and increased rates of longterm disability that have followed the introduction of various psychiatric drugs into the market and the use of electroshock.

Another myth is this: The important word “orthogonal” applies to the question of whether people diagnosed as mentally ill are able to make their own choices and whether they have good judgment. We all know people who have no psychiatric labels but who make terrible choices and poor judgment, yet those limitations are not used to deprive the of their human rights. These capacities are orthogonal to whether or not one has been diagnosed as mentally ill, meaning that knowing whether or not a person has a diagnosis is simply not a predictor of their judgment and ability to make good choices for themselves. A related myth is that if someone is diagnosed as mentally ill, all of their decision making power must be wrenched away from them, when — as with many people who are not so diagnosed — sometimes what the person needs is a little support of various kinds, including assistance with filling out forms or practical help with cooking or shopping or getting a service animal during times when they are struggling.

The CRPD standard is for people who have or are perceived to have disabilities must be provided the opportunity to give free and informed consent. That is very far from what happens with the vast majority of people treated by psychotherapists, not to mention those who are deprived of their human rights. Consider this: Psychiatric diagnosis is the bedrock, the first cause of everything bad that happens to people in and through the mental health system. If they do not diagnose you, they cannot treat (or “treat”) you, whether or not the treatments are helpful to you. But almost no one who enters a therapist’s office is ever fully informed and thus almost no one is put in a position where they even might give informed consent. Why? There are three reasons:

  1. They are almost never told, “In order for your insurance to pay my bills, I will have to give you a psychiatric diagnosis, but you have the right to know that psychiatric diagnoses are unscientific, that getting one does not help alleviate suffering, and that getting one carries a wide array of risks of harm, from plummeting self-confidence to loss of employment and of child custody and of security clearance…even to death from treatments that are justified on the basis of your label.”
  2. They are almost never told, “I am recommending Treatment X, but I am going to tell you everything about the potential benefits and potential kinds of harm that can result.” The reason they are almost never told this is that these days, the vast majority of treatments are with psychiatric drugs, and lawsuits have repeatedly revealed that the drug companies purposefully conceal much of the harm, so there is no way for conscientious therapists to get that information and thus no way for them to convey it to their patients. Something similar happens with electroshock and with expensive but intensively marketed programs called things like “neurobiofeedback” that have not been shown to be helpful but that are often very costly.
  3. They are almost never told, “I am recommending Treatment X, but I am also going to describe for you the huge array of approaches that have been helpful to people who are going through what you are going through … and that often carry little or no risks of harm.”

Alarmed about the lack of disclosure, which puts suffering people who seek help in the mental health system at huge risk of harm with no way even to know what questions to ask and what recommendations to challenge, I organized the filing of nine complaints to the Ethics Department of the American Psychiatric Association, because that APA publishes and hugely profits from the Diagnostic and Statistical Manual of Mental Disorders (DSM), whose categories had been used against the complaints with tragic effects. We said that if the APA had honestly disclosed the unscientific nature of its categories and the risks of harm, as well as that getting a label would be helpful largely or only in order to get insurance coverage for treatment, the complainants would not have blindly accepted their labels and the treatments that were justified to them on the basis of the labels (“You have Disorder Y, so you should accept Treatment Z, because that is what is used for people with Y”). The APA dismissed the complaints on spurious grounds and with not one iota of attention to their merits.

Five of those complainants then filed complaints with the U.S. Department of Health and Human Services’s Office of Civil Rights (OCR). The complaints were filed pursuant to the Americans with Disabilities Act, according to which people can be discriminated against by being treated as though they are disabled (mentally ill in these cases) when in fact they are not. All of the complainants had been experiencing upsetting life situations but should by no means have been diagnosed as mentally ill. Yet according to the (falsely-marketed as scientific) DSM, they were mentally ill, and the treatments that were justified on the basis of their labels had had devastating consequences for them. The OCR dismissed the complaints on spurious grounds and with no attention to their merits.

The outcomes of these complaints provide a solid paper trail revealing that in the United States, the enterprise of psychiatric diagnosis is entirely unregulated. This makes it even less regulated than the major financial institutions whose unregulated actions seriously damaged the economy. The paper trail shows that both the lobby group called the APA, which earned more than $100 million from the last edition of the DSM and spent not one cent to reveal the truth about its manual or to warn of the harms they knew about, and the government entity (OCR of HHS) that by all rights ought to provide oversight and regulation, have chosen to do nothing. This makes it all the more compelling for all of us to press for the United States government to ratify the CRPD. The loss of human rights of just one of us through fraudulent advertising, cover-ups, and perpetuation of dangerous myths is the loss of human rights of us all.

As a U.S. citizen, I am embarrassed and appalled that as this country discusses whether or not to ratify the CRPD, it wants to add what are called “RUDs,” reservations, understandings, and declarations created by the current federal administration and the Senate Foreign Relations Committee. According to Minkowitz, these include the claim that U.S law already fulfills or exceeds the obligations our country would have under the CRPD treaty. The above described complaints that we filed — and the rejection of those complaints by the U.S. Department of Health and Human Services’s Office of Civil Rights gives the lie to that claim, since there is simply no governmental regulation of psychiatric diagnosis, and diagnosis is the sine qua non of forced commitment and forced treatment.

* * * * *

Originally posted on paulajcaplan.net

This blog is a contribution to the Campaign to Support the CRPD Absolute Prohibition of Commitment and Forced Treatment. To see all of the Mad in America blogs for this campaign click here.

Paula J. Caplan, PhDPaula J. Caplan, PhD, is a clinical and research psychologist, activist, Associate at the DuBois Institute, Harvard University, and the author of 11 books, including one that won three national awards for nonfiction and two about psychiatric diagnosis. Her books include They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal and the edited Bias in Psychiatric Diagnosis.

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-We are not violating the human rights. -Yes, you are! by Anne Grethe Teien

http://agteien.blogspot.no/2016/03/we-are-not-violating-human-rights-yes_74.html

Introduction

Psychiatric human rights violations are often  denied and trivialized, even distortedly re-defined as “human rights” and “right to necessary health help”. The UN convention for the rights of persons with disabilities, CRPD,  is changing that. CRPD demands an absolute prohibition of forced psychiatric treatment and involuntary commitment. These are important requirements in giving people with psychosocial disabilities equal human rights. In this text, I will look at different aspects of the CRPD related to that demand. I will illustrate with some references to Norway, the country where I live, showing ways in which the Norwegian Mental Health Act does not comply with the convention. I will also share some further reflections. Towards the end I have written a short version of my own experiences from forced psychiatry.  Mental health laws may vary between countries, but some elements are prevalent: the laws are typically directed specifically towards people with psychosocial disabilities and involve forced treatment and involuntary commitment . This text is written for the Campaign to Support CRPD Absolute Prohibition of Forced Treatment and Involuntary Commitment (17). Procrastinations must stop – CRPD-based law reforms must begin!

Norway and the CRPD 

Norway ratified the CRPD June 3rd 2013, but came up with some interpretative declarations of article 12, 14 and 25 that undermine central parts of the convention (1).  Norway uses these declarations to try to defend the Mental Health Act and forced psychiatric treatment. In February 2015, the president of the Norwegian Psychological Association, Tor Levin Hofgaard, wrote an article asking for a clarification from the government whether health personnel violate the human rights when they follow the coercion regulations in the Mental Health Act (2). He referred to a report sent to the authorities in December 2013 by the then Equality and Anti-Discrimination Ombud –  LDO, Sunniva Ørstavik (3). The report said that the Mental Health Act is discriminatory and does not comply with the CRPD. LDO also urged Norway to quickly withdraw its interpretative declarations. In public, the LDO report was met with a noisy silence by the authorities.  So, as time had went on, Hofgaard asked for the mentioned clarification.  Anne Grethe Erlandsen, State Secretary in the Ministry of Health and Care Services, answered on behalf of the Norwegian authorities: “Vi bryter ikke menneskerettighetene” / – We are not violating the human rights (4). That answer is absolutely not right.

Norway uses much coercion in psychiatry. In spite of reduction strategies, the use of coercion stays at stably high levels (3: p.6-8; 5: p.20-23). Also, reduction strategies instead of CRPD-based abolishment strategies do not go to the core of the issue. Norway is used to see itself as a human rights protective nation and often does not hesitate to criticize other countries for their human rights violations. So it is maybe hard for the authorities to take in that the state of Norway  is actually accepting torture and other severe human rights abuses in its own mental health system, via the Mental Health Act.  Point 42 of the CRPD General Comments No 1 says as follows:

“As has been stated by the Committee in several concluding observations, forced treatment by psychiatric and other health and medical professionals is a violation of the right to equal recognition before the law and an infringement of the rights to personal integrity (art. 17); freedom from torture (art. 15); and freedom from violence, exploitation and abuse (art. 16). This practice denies the legal capacity of a person to choose medical treatment and is therefore a violation of article 12 of the Convention. States parties must, instead, respect the legal capacity of persons with disabilities to make decisions at all times, including in crisis situations; must ensure that accurate and accessible information is provided about service options and that non-medical approaches are made available; and must provide access to independent support. States parties have an obligation to provide access to support for decisions regarding psychiatric and other medical treatment. Forced treatment is a particular problem for persons with psychosocial, intellectual and other cognitive disabilities. States parties must abolish policies and legislative provisions that allow or perpetrate forced treatment, as it is an ongoing violation found in mental health laws across the globe, despite empirical evidence indicating its lack of effectiveness and the views of people using mental health systems who have experienced deep pain and trauma as a result of forced treatment. The Committee recommends that States parties ensure that decisions relating to a person’s physical or mental integrity can only be taken with the free and informed consent of the person concerned.“ (6: #42)

Neglected harms and traumas – and the need for reparations

Long-term studies have shown higher recovery rates for people who were not on neuroleptics and on very low doses (14, 15). The list of potential harmful effects from neuroleptic drugs is long, including tardive dyskinesia, brain damage, cognitive decline, neuroleptic-induced supersensitivity psychosis, Parkinsonism, sexual dysfunction, weight gain, diabetes, demotivation, anxiety, aggression, suicide, akathisia [ an extreme form of restlessness which in itself can lead to suicide], neuroleptic malignant syndrome — a potentially lethal complication of treatment etc (14, 18). In a research summary on possible harms from forced psychiatry done by nurse and researcher Reidun Norvoll, she listed the following main categories:  1) violation of autonomy and of psychological and physical integrity. Deprivation of freedom of movement (deprivation of freedom). 2) Physical harm and death. 3) Violence and abuse. 4) Trauma, retraumatisation and posttraumatic stress syndrome. 5) Offences/violations, loss of dignity and experiences of punishment. 6) Psychological agony in the forms of shame, anxiety, feeling unsafe, anger, powerlessness, depression and loss of self esteem. 7) Social problems  and loss of social identity. 8) Loss of access to own coping skills and of possibilities to self development. 9) Loss of access to voluntary treatment. 10) Harmed therapeutic relationships, resentment against- and distrust in mental health services. (7: p. 16; 8: #5.3).

It can be hard to process traumas that are not acknowledged and understood as such by society in general. When mental health services represents the abuser and as it is officially seen as the mental health helper, one can be left in a very lonely situation trying to handle psychiatry-induced traumas.  I think, as part of the implementation of CRPD, there should be provided access to help and support to those who struggle with traumas and other harms from forced psychiatry.  I imagine a reality where it is possible for everyone to ask for help when they feel they need it, knowing that they have the CRPD on their side; that the state can not expose them to torture and other terrible human rights violations for being in mental pain (!).

When the necessary abolishment of discriminatory mental health laws and the prohibition of forced psychiatric treatment and commitment has become reality, I think that representatives from politics and psychiatry should publicly perform statements about- and apologies for -the severe human rights abuses that have been going on for so long towards people with psychosocial disabilities. After all the societal acceptance, silence and denial of these kinds of abuses, I think such an acknowledgement and apology is of significant importance for starting reparation work. Compensations  is also a relevant part of this.  At the same time, there should be no pressure towards victims of forced psychiatry to forgive and get over.  I strongly recommend survivor and lawyer Hege Orefellen’s appeal on the urgent need for effective remedies, redress and guarantees of non-repetition regarding torture and other ill-treatment in psychiatry (9). Her appeal was held during a CRPD side-event about article 15 and its potential to end impunity for torture in psychiatry (10). Also, in Guidelines on article 14 of the CRPD, point 24 (a-f) one can read about “access to justice, reparation and redress to persons with disabilities deprived of their liberty in infringement of article 14 taken alone, and taken in conjunction with article 12 and/or article 15 of the Convention” (11).

Danger- and treatment criteria 

The Norwegian Mental Health Act has, in addition to its danger criteria, a criterion called the treatment criterion, which does not require danger to oneself or others. The treatment criterion allows for psychiatric coercion if the person is claimed to have a severe mental disorder,  and application of forced psychiatry is seen as necessary to prevent the person from having his/her prospects for recovery or significant improvement seriously reduced; alternatively that it’s seen as very possible that the person’s condition in the very near future will significantly deteriorate without coercion (12: Section 3 – 3. 3 a). A very wishy-washy criterion indeed, which is much in use. In 2014 the treatment criterion alone was used in 72% of the cases among people commited (16: p.37).

Both the treatment criterion and the criteria regarding danger to oneself or others discriminate against people with psychosocial disabilities in that disability, or ‘serious mental disorder’,  is a premise for psychiatric coercion to apply. In other words, this discrimination is a violation of CRPD article 14 which says that the existence of a disability shall in no case justify a deprivation of liberty (13). Secondly, as the Mental Health Act allows for forced psychiatric treatment, it violates the right to personal integrity (art. 17); freedom from torture (art. 15); and freedom from violence, exploitation and abuse (art. 16). (6:#42).

Points 13-15 in the Guidelines on article 14 are also relevant in this context:

“VII. Deprivation of liberty on the basis of perceived dangerousness of persons with disabilities, alleged need for care or treatment, or any other reasons. 

  1. Throughout all the reviews of State party reports, the Committee has established that it is contrary to article 14 to allow for the detention of persons with disabilities based on the perceived danger of persons to themselves or to others. The involuntary detention of persons with disabilities based on risk or dangerousness, alleged need of care or treatment or other reasons tied to impairment or health diagnosis is contrary to the right to liberty, and amounts to arbitrary deprivation of liberty.
  1. Persons with intellectual or psychosocial impairments are frequently considered dangerous to themselves and others when they do not consent to and/or resist medical or therapeutic treatment. All persons, including those with disabilities, have a duty to do no harm. Legal systems based on the rule of law have criminal and other laws in place to deal with the breach of this obligation. Persons with disabilities are frequently denied equal protection under these laws by being diverted to a separate track of law, including through mental health laws. These laws and procedures commonly have a lower standard when it comes to human rights protection, particularly the right to due process and fair trial, and are incompatible with article 13 in conjunction with article 14 of the Convention. 
  1. The freedom to make one’s own choices established as a principle in article 3(a) of the Convention includes the freedom to take risks and make mistakes on an equal basis with others. In its General Comment No. 1, the Committee stated that decisions about medical and psychiatric treatment must be based on the free and informed consent of the person concerned and respect the person’s autonomy, will and preferences.  Deprivation of liberty on the basis of actual or perceived impairment or health conditions in mental health institutions which deprives persons with disabilities of their legal capacity also amounts to a violation of article 12 of the Convention.” (11: #13-15)

The laws that apply to people in the rest of society regarding acute situations and in the criminal justice system, must apply to people with disabilities too in non-discriminatory ways. The CRPD’s demand for absolute prohibition of forced treatment and involuntary commitment means that it applies both in criminal justice- and civil contexts. (11: #14, 16, 20-21, also 10-12). For people with psychosocial disabilities who come in contact with the criminal justice system, necessary support must be provided to ensure the right to legal capacity, equal recognition before the law and a fair trial. Forced psychiatric treatment and involuntary commitment can not be applied as sanctions for criminal acts and/or for the prevention of such.

Replacing substituted decision-making with supported decision-making

Substituted decision making must be replaced by supported decision making systems. Giving access to supported decision-making for some but still maintaining substitute decision-making regimes, is not sufficient to comply with article 12 of the CRPD (6: #28). From General Comment No 1:

“A supported decision-making regime comprises various support options which give primacy to a person’s will and preferences and respect human rights norms. It should provide protection for all rights, including those related to autonomy (right to legal capacity, right to equal recognition before the law, right to choose where to live, etc.) and rights related to freedom from abuse and ill-treatment (…).” (6: #29)

Some who agree with the CRPD in that diagnostic criteria for coercion should be abolished, still seem fine with the idea that ‘mental incapacity’ can be used as criteria for psychiatric coercion. This is not in line with the CRPD, which neither accepts disability criteria for the deprivation of freedom nor psychiatric coercion. Here is a relevant point to note, from General Comments No1:  “The provision of support to exercise legal capacity should not hinge on mental capacity assessments; new, non-discriminatory indicators of support needs are required in the provision of support to exercise legal capacity.” (6:#29 i)

A summary of my own experiences from forced psychiatry 

I was not suicidal when psychiatry put me under the Mental Health Act and decided I should get forced neuroleptic “treatment”. I had never been suicidal. The former mentioned treatment criterion is the criterion that was used on me.  Forced psychiatry, with its locking me up, restraining me, drugging me, and keeping me on CTO when discharged from hospital, certainly did not make my life better  in any way– everything became indescribably much worse. I experienced forced psychiatry as one long punishment for having mental problems. After having been on neuroleptics for a while, my cognition, my intellectual abilities, were severely affected and reduced – and so was my language: from usually having a rich vocabulary I could just utter short, simple sentences. My body became rigid and lost its fine motor skills so I couldn’t dance anymore. A period I also had akathisia, a terrible restlessness which made me walk endlessly back and forth, back and forth. I’m trained a professional dancer and having my dance abilities medicated away was a big loss in itself. The medication took away my vitality, my sensitivity. My emotions were numbed. My personality faded away.  Then a severe depression set in – just a complete state of hopelessness – and for the first time in my life I became suicidal. Again and again I said to the staff, psychologists, doctors: – I can not be on meds. I tried to have them understand that the neuroleptics were destroying me and my life.  They communicated to me that they thought I was being fussy. They were a big wall that just would not listen to me. Respectlessly enough, some even told me –yes, told me -that I was doing better. The doctors said I would need to be on meds for the rest of my life. That was a message which just manifested the complete hopeless situation. From entering psychiatry, indeed having mental problems, but being a vital, thoughtful, and expressive person who was dancing several times a week, psychiatry  had coercively medicated me away from myself and iatrogenically made me severely depressed and suicidal . In effect a slow form of forced euthanasia . One day, while on CTO, shortly after a new forced injection in the buttocks with those horrible meds, I did a dramatic suicide attempt. I was put back into the hospital. I am very glad that I survived. Because unbelievably, a couple of months later, I was told that someone had made a bureaucratic mistake: the coercion documents had not been renewed in time, so there was nothing they could do to hold me back. Of course they would recommend me to stick to the treatment (Ha!) and not leave the hospital too fast (Ha!). I left the hospital the same day. It took me about half a year to become myself again, to be able to think and speak freely, to get my sensitivity, my emotions back, to dance, to feel human again, to feel life. I have never been in a mental hospital since then. I have never had another dose of neuroleptics. And I have never been suicidal again.  More than a decade later, I am still traumatized by my experiences from forced psychiatry.

Conclusion

I am very thankful to the CRPD committee for their important work. The CRPD represents a paradigm shift, and there is clearly a resistance out there to accept the full width and depth of the convention. That human rights and non-discrimination applies equally to people with disabilities should not be seen as a radical message in 2016, but sadly, it still is. Societies with their leaders need to realize that systematic, legalized discrimination and abuse of people with disabilities is based on tradition and habitual ways of thinking –not on human rights. That something has been brutally wrong for a long time does not make it more right. Forced psychiatric treatment and involuntary commitment need to be absolutely prohibited.

Thank you for your attention.

References:

1) MDAC:  Legal Opinion on Norway’s Declaration/Reservation to the UN Convention on the Rights of Persons with Disabilities http://mdac.org/sites/mdac.org/files/norway_declaration_-_legal_opinion.pdf

2)

Tor Levin Hofgaard:  Bryter vi menneskerettighetene?

http://www.dagensmedisin.no/blogger/tor-levin-hofgaard/2015/02/19/avklaring-etterlyses-bryter-vi-menneskerettighetene/

3)

In Norwegian: Equality and anti-discrimination ombud (LDO): CRPD report to Norwegian authorities 2013 – summary http://www.ldo.no/globalassets/brosjyrer-handboker-rapporter/rapporter_analyser/crpd–2013/crpd_report_sammendrag_pdf_ok.pdf

4)

Anne Grethe Erlandsen: Vi bryter ikke menneskerettighetene http://www.dagensmedisin.no/artikler/2015/02/27/vi-bryter-ikke-menneskerettighetene/

5)

In Norwegian: LDO’s report to the CRPD committee 2015 – a supplement to Norway’s 1st periodic report http://www.ldo.no/globalassets/03_nyheter-og-fag/publikasjoner/crpd2015rapport.pdf

6)

Link to download of CRPD General Comment No 1:  http://www.ohchr.org/EN/HRBodies/CRPD/Pages/GC.aspx

7)

In Norwegian: Equality and anti-discrimination ombud (LDO): CRPD report to Norwegian authorities 2013- full version  http://www.ldo.no/globalassets/brosjyrer-handboker-rapporter/rapporter_analyser/crpd–2013/rapportcrpd_psykiskhelsevern_pdf.pdf

8)

NOU 2011: 9. Økt selvbestemmelse og rettssikkerhet — Balansegangen mellom selvbestemmelsesrett og omsorgsansvar i psykisk helsevern. 5. Kunnskapsstatus med hensyn til skadevirkninger av tvang i det psykiske helsevernet. Utredning for Paulsrud-utvalget https://www.regjeringen.no/no/dokumenter/nou-2011-9/id647625/?q=&ch=12

9)

Hege Orefellen: Torture and other ill-treatment in psychiatry – urgent need for effective remedies, redress and guarantees of non-repetition https://absoluteprohibition.wordpress.com/2016/02/06/hege-orefellen-on-reparations/

10)

CRPD 13: WNUSP side event on Article 15: Its Potential to End Impunity for Torture in Psychiatry  http://www.treatybodywebcast.org/crpd-13-wnusp-side-event-on-article-15-english-audio/

11)

Link to guidelines on article 14 of the CRPD under “Recent Events and Developments” http://www.ohchr.org/EN/HRBodies/CRPD/Pages/CRPDIndex.aspx

12)

Norwegian Mental Health Act translated to English http://app.uio.no/ub/ujur/oversatte-lover/data/lov-19990702-062-eng.pdf

13)

CRPD Convention http://www.ohchr.org/EN/HRBodies/CRPD/Pages/ConventionRightsPersonsWithDisabilities.aspx#14

14)

Via Mad in America / ‘Anatomy of an Epidemic’ (Robert Whitaker):  List of long-term outcomes literature for antipsychotics http://www.madinamerica.com/mia-manual/antipsychoticsschizophrenia/

15)

Lex Wunderink et al: Recovery in Remitted First-Episode Psychosis at 7 Years of Follow-up of an Early Dose Reduction/Discontinuation or Maintenance Treatment Strategy. Long-term Follow-up of a 2-Year Randomized Clinical Trial http://archpsyc.jamanetwork.com/article.aspx?articleid=1707650

16)

Bruk av tvang i psykisk helsevern for voksne i 2014 (report on the use of coercion in psychiatry in Norway 2014) https://helsedirektoratet.no/Lists/Publikasjoner/Attachments/1161/Rapport%20om%20tvang%20IS-2452.pdf

17)

Campaign to Support CRPD Absolute Prohibition of Forced Treatment and Involuntary Commitment https://absoluteprohibition.wordpress.com/

18)

RxISK Guide: Antipsychotics for Prescribers: What are the risks? http://rxisk.org/antipsychotics-for-prescribers/#How_likely_are_the_listed_side_effects_of_antipsychotics_to_happen

Other:

Status of Ratification Interactive Dashboard – Convention on the Rights of Persons with Disabilities http://indicators.ohchr.org/

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Peter Gøtzsche – FORCED ADMISSION AND FORCED TREATMENT IN PSYCHIATRY CAUSES MORE HARM THAN GOOD

http://www.deadlymedicines.dk/forced-admission-and-forced-treatment-in-psychiatry-causes-more-harm-than-good/

By Peter C. Gøtzsche, Professor, MD, DrMedSci, MSc

8 March 2016

Forced treatment in psychiatry as we currently know it cannot be defended, neither on ethical, legal or scientific grounds. Ethically, the patients’ values and preferences are not being respected, although the fundamental human right to equal recognition before the law applies to everyone, also to people with mental disorders.1,2 This is clear from the United Nations Convention on the Rights of Persons with Disabilities,2 which virtually all countries have ratified. However, we ignore the convention and continue to discriminate against people with mental problems.

Please consider this. Doctors cannot give patients insulin without their permission, not even if the lack of insulin might kill them, and they cannot give adult Jehova’s witnesses blood transfusions without their permission, even if the lack of blood might kill them. The only drugs that can be given without permission are also some of the most dangerous ones. Psychiatric drugs are the third major killer after heart disease and cancer, with an estimated 539,000 deaths in the United States and European Union combined.1,3 Only soldiers at war and psychiatric patients are forced to run risks against their will that might kill or cripple them. But there is an important, ethically relevant difference: soldiers have chosen to become soldiers; psychiatric patients have not chosen to become psychiatric patients.

In many countries, a person considered insane, or in a similar condition, can be admitted to a psychiatric ward on an involuntary basis if the prospect of cure or substantial and significant improvement of the condition would otherwise be significantly impaired. After having studied the science carefully over many years, I have come to doubt that this is ever the case.1

Forced treatment most commonly involves the use of antipsychotics, but they are very poor drugs. The placebo controlled trials are seriously flawed because they have not been adequately blinded.1 Antipsychotics have many and conspicuous side effects, so most doctors and patients can guess whether an active drug or a placebo is given, which exaggerates the measured effect markedly.1 Furthermore, almost all patients in these trials were already in treatment with an antipsychotic drug before they were randomised after a short wash-out period. This cold turkey design means that abstinence symptoms – which may include psychosis – are being inflicted on patients who get placebo. Even helped by these formidable biases in the trials, the outcome is poor. The minimal improvement on the Clinical Global Impressions Ratings corresponds to about 15 points on the Positive and Negative Syndrome Scale,4 but what was obtained in recent placebo controlled trials in submissions to the FDA for newer antipsychotics was only 6 points,5 although it is easy for scores to improve quite a bit if people are knocked down by a tranquilliser and express their abnormal ideas less frequently. Thus, the FDA has approved newer antipsychotic drugs whose effect is far below what is clinically relevant. Old drugs are similarly ineffective.1

Whereas the benefits of antipsychotics are doubtful, the harms are certain, and the cold turkey design is lethal. One in every 145 patients who entered the trials for risperidone, olanzapine, quetiapine and sertindole died, but none of these deaths were mentioned in the scientific literature.6 Therefore, if we want to find out how lethal these drugs are, we should look at trials in dementia, as such patients are not so likely to have received antipsychotics before randomisation. Randomised trials in dementia shows that for every 100 patients treated for a few weeks, one is killed by an antipsychotic, compared to those treated with placebo.7 It could even be worse than this because deaths are seriously underreported in published trials. For example, a review found that only 19 of 50 deaths and 1 of 9 suicides on olanzapine described in trial summaries on websites also appeared in journal articles.8

There is no evidence that mechanical restraint in belts or seclusion has any benefits, but these treatments can also be lethal. Violence breeds violence and when psychotic patients become violent, it is very often because of the inhumane treatment they receive. It may also be because they get abstinence symptoms when they drop a few doses of an antipsychotic because they are very unpleasant to take, which can include akathisia – an extreme form of restlessness that predisposes to both suicide and homicide.1

Electroshock is also forced on people although it doesn’t seem to work for schizophrenia and although the effect on depression is temporary, which often results in a series of shocks.1 About half of the patients get memory loss1 and the more treatments they get, the more severe is the memory loss.9 Some psychiatrists claim that electroshock can be lifesaving but this has never been documented whereas we know that electroshock may kill people: about 1 in 1000 patients die.10

Another reason for using force is if patients present an obvious and substantial danger to themselves or others, in which case they can be involuntarily admitted. However, this is not necessary. The National Italian Mental Health Law specifies that a reason for involuntary treatment cannot be that the patient is dangerous. This is a matter for the police, as it also is in Iceland, and patients in Italy can decide that they want treatment elsewhere.1

Forced treatment does more harm than good and it kills many people, not only because of the direct harms of the drugs but also because of suicide. A register study of 2,429 suicides showed that the closer the contact with psychiatric staff – which often involves forced treatment – the worse the outcome.11 Compared to people who had not received any psychiatric treatment in the preceding year, the adjusted rate ratio for suicide was 44 (95% confidence interval 36 to 54) for people who had been admitted to a psychiatric hospital. These patients would be expected to be at greater risk of suicide than other patients (confounding by indication), but most of the potential biases in the study favoured the null hypothesis of there being no relationship. An accompanying editorial noted that some of the people who commit suicide during or after an admission to hospital do so because of conditions inherent in that hospitalisation.12

I fully admit that some patients are very difficult to treat optimally without using force. But it seems that, with adequate leadership and training of staff in de-escalation techniques, it is possible to practice psychiatry without using force.1,13,14 In Iceland, belts have not been used since 1932, and there are psychiatrists all over the world who have dealt with deeply disturbed patients for their entire career without ever having used antipsychotics, ECT or force.1

I believe we have to abolish laws of forced admission and treatment, in accordance with the United Nations Convention on the Rights of Persons with Disabilities.2 Abandoning using force will be harmful to some patients but it will benefit vastly many more. We will need to work out how we may best deal with those patients who would have benefited from forced treatment in a future where force is no longer allowed.

Peter C Gøtzsche graduated as a Master of Science in biology and chemistry in 1974 and as a physician 1984. He is a specialist in internal medicine. Co-founded the Cochrane Collaboration in 1993 and established The Nordic Cochrane Centre the same year. He became professor of Clinical Research Design and Analysis in 2010 at the University of Copenhagen.

References

1 Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015.

2 United Nations Convention on the Rights of Persons with Disabilities. General comment No. 1 2014 May 19. http://daccess-dds-ny.un.org/doc/UNDOC/GEN/G14/031/20/PDF/G1403120.pdf?OpenElement (accessed 1 April 2015).

3 Gøtzsche PC. Does long term use of psychiatric drugs cause more harm than good? BMJ 2015;350:h2435.

4 Leucht S, Kane JM, Etschel E, et al. Linking the PANSS, BPRS, and CGI: clinical implications. Neuropsychopharmacology 2006;31:2318-25.

5 Khin NA, Chen YF, Yang Y, et al. Exploratory analyses of efficacy data from schizophrenia trials in support of new drug applications submitted to the US Food and Drug Administration. J Clin Psychiatry 2012;73:856–64.

6 Whitaker R. Mad in America. Cambridge: Perseus Books Group; 2002.
7 Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-

analysis of randomized placebo-controlled trials. JAMA 2005;294:1934–43.

8 Hughes S, Cohen D, Jaggi R. Differences in reporting serious adverse events in industry sponsored clinical trial registries and journal articles on antidepressant and antipsychotic drugs: a cross-sectional study. BMJ Open 2014;4:e005535.

9 Sackeim HA, Prudic J, Fuller R, et al. The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology 2007;32:244-54.

10 Read J, Bentall R. The effectiveness of electroconvulsive therapy: a literature review. Epidemiol Psichiatr Soc 2010 Oct-Dec;19:333-47.

11 Hjorthøj CR, Madsen T, Agerbo E, et al. Risk of suicide according to level of psychiatric treatment: a nationwide nested case-control study. Soc Psychiatry Psychiatr Epidemiol 2014;49:1357–65.

12 Large MM, Ryan CJ. Disturbing findings about the risk of suicide and psychiatric hospitals. Soc Psychiatry Psychiatr Epidemiol 2014;49:1353–5.

13 Fiorillo A, De Rosa C, Del Vecchio V, et al. How to improve clinical practice on involuntary hospital admissions of psychiatric patients: Suggestions from the EUNOMIA study. Eur Psychiat 2011;26:201-7.

14 Scanlan JN. Interventions to reduce the use of seclusion and restraint in inpatient psychiatric settings: what we know so far, a review of the literature. Int J Soc Psychiat 2010;56:412–23.

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Una campaña en contra de los internamientos involuntarios y las intervenciones psiquiátricas forzadas, por Ana María Sánchez

http://congresovisible.org/agora/post/una-campana-en-contra-de-los-internamientos-involuntarios-y-las-intervenciones-psiquiatricas-forzadas-por-ana-maria-sanchez/8152/

Escribo en apoyo a la campaña contra la prohibición absoluta de los internamientos involuntarios y las intervenciones psiquiátricas forzadas. Me piden argumentar con base a la Convención de los Derechos de las personas con Discapacidad y lo haré, aunque el argumento que expongo es el de la salvaguarda de la dignidad de todas las personas con respeto absoluto a sus derechos.

Me motiva escribir esta invitación a sumarnos en la insistente y motivada convocatoria que hace CHRUSP, Center for the Human Rights of Users and Survivors of Psychiatry, pero también ante la posibilidad de generar los cambios profundos que den un vuelco a paradigmas que estigmatizan y discriminan. Me sumo contra los internamientos involuntarios y las intervenciones psiquiátricas forzadas porque:

1. Reducen a la persona a un objeto al quien se le busca controlar, aniquilan la voluntad y la creatividad, acabando con su libertad.

2. Atemorizan, estigmatizan y desinforman sobre la discapacidad psicosocial.

3. No resuelven la parte estructural de una sociedad que actúa desde el paradigma de la “normalidad” encerrando a todos los que no se adaptan a los convencionalismos sociales.

4. Es una respuesta política cómoda e insuficiente que no responde a las necesidades específicas de las personas con discapacidad psicosocial y de sus familias.

5. Descarta y abandona a las personas con discapacidad psicosocial, las confina a vivir en aislamiento, privadas de su libertad y sometidas a tratos crueles e inhumanos.

6. Promueve el olvido social y la negligencia política ante los abusos y violaciones de los derechos de las personas con discapacidad psicosocial.

 

Me sumo hoy a esta causa, convencida desde mi propia lucha a favor del reconocimiento de los derechos de las personas con discapacidad. Desde las experiencias de personas que se han visto coartadas y obligadas a vivir aletargadas, forzadas a un tratamiento y confinamiento, separadas de una sociedad que busca normalizar, homogeneizar y catalogar a quienes somos diferentes. A partir de los testimonios de personas con discapacidad psicosocial y sus familiares que sufren rechazo y discriminación, padecen la falta de servicios adecuados y el abandono en reclusión o en calle, entre otros. No nos olvidemos por ejemplo, de la violencia contra mujeres con discapacidad psicosocial, sus derechos son negados y olvidados y por lo general no se retoma la lucha desde los movimientos a favor de los derechos de las mujeres.

La Convención de los derechos de las personas con discapacidad y otros instrumentos internacionales nos hacen la invitación a pensar y actuar para que los derechos de todos y todas se promuevan y respeten. No es suficiente estar en contra de los internamientos y tratamientos forzados, se requiere pensar creativamente para hacer del modelo de derechos humanos una realidad y exigir al estado las políticas públicas que promuevan y garanticen la realización de los derechos de las personas con discapacidad psicosocial.

Para más información sobre esta campaña: https://absoluteprohibition.wordpress.com/page/2/

 

 

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¿Qué ganamos con abolir la psiquiatría forzosa? -Andrea Cortés

http://congresovisible.org/agora/post/que-ganamos-con-abolir-la-psiquiatria-forzosa/8154/

Estamos impulsando cambios muy importantes que se sitúan al margen del conjunto de reivindicaciones sociales que son respaldadas por las mayorías. Me refiero al reconocimiento de los derechos de las personas con discapacidad psicosocial o discapacidad cognitiva.

Se cree erróneamente que la atención que recibimos constituye asunto resuelto y por consiguiente, la gente confía en las bondades de la psiquiatría, la farmacología, las terapias de cualquier índole y sobre todo, de la posibilidad de aislar y mantener en esa situación a quienes  no se acoplan a lo comúnmente aceptado. La sociedad crea los problemas, luego los oculta y finge no tener nada que ver en esto, de esta forma los hospitales psiquiátricos son reductos en los que se encierra a seres “molestos” y/o etiquetados como “violentos y peligrosos”, bajo la dudosa promesa de un restablecimiento de sus facultades, o de una rehabilitación. La psiquiatría biologista ha contribuído a justificar estas acciones al atribuir como causas inequívocas de los trastornos mentales a daños cerebrales, descartando de plano toda la vida y el contexto familiar y social de las persona afectadas.

En realidad, el deshacerse de las personas con discapacidad psicosocial o cognitiva mediante el encierro, ya sea temporal o permanente en una institución psiquiátrica, es una práctica común y de buen recibo entre la población colombiana. Aprovechando en algunos casos la existencia de una interdicción para disponer de la vida de alguien, sin necesidad de matarla en forma física, pero sí, matándola en vida a fin de acceder a beneficios económicos. También existen abundantes casos en los que la libertad se suprime como castigo por tener una característica personal como orientación sexual o de género diversa, o también como única respuesta ante la carencia absoluta de estrategias de apoyo desde la familia y la comunidad para manejar los ‘trastornos mentales’ y procurar un nivel de vida apropiado a quienes viven con ellos.

La aceptación social de la institucionalización forzada hacia personas con discapacidad psicosocial o cognitiva, real o percibida, demuestra la ignorancia y el desinterés de la población por entender la naturaleza de los trastornos mentales debido al miedo y a los tabúes que alientan la estigmatización. En lugar de informarse y capacitarse para convivir, no solamente cuidar, a las personas con discapacidad psicosocial, éstas y las personas del entorno prefieren asumir que los “expertos” en el tema ya tienen todas las respuestas y que las soluciones sólo provienen de ellos, de la psiquiatría organizada. Muy pocos se atreven a dudar y los que los hacen jamás son escuchados. Como resultado las personas con discapacidad quedamos expuestas a ser maltratadas dentro de las instituciones con métodos denominados como terapéuticos pero que en realidad son tortura, puesto que no curan ni ayudan a mejorar la condición mental, claramente se trata de castigos para aplacar a los anormales e inadaptados. La indiferencia de la sociedad ante estos hechos los hace parecer legítimos.

Las personas con discapacidad en Colombia no conocemos cuáles son las posibilidades de impugnar o demandar una hospitalización forzada, desconocemos cómo reclamar una reparación por haber recibido torturas y tratamientos contra la propia voluntad, no contamos con la más mínima posibilidad de rechazar un tratamiento y acogernos a otro, así como tampoco de abandonar una institución voluntariamente.

Los psiquiatras y su personal de apoyo dentro de las clínicas cuentan con todas las ventajas, empezando por la credibilidad de las agobiadas familias. Controlan la información que les brindan sobre las enfermedades, los tratamientos y justifican todas sus acciones hacia los internos. Desatienden la obligación de ofrecernos a cuidadores y personas con discapacidad toda la información necesaria para que exista un verdadero consentimiento informado, contando con la opinión de quienes vamos a recibir los tratamientos.  Las clínicas psiquiátricas son cárceles.

La abolición de la institucionalización forzada implicaría impulsar todos los cambios necesarios para brindar una atención eficaz y respetuosa hacia las personas con discapacidad psicosocial y cognitiva y le haría un aporte inmenso a la sociedad en términos de aprendizaje sobre respeto, inclusión y convivencia. También es evidente que puede contrariar a quienes vean amenazados sus intereses y privilegios. Pero somos más los afectados por el abuso de poder de los psiquiatras, de los laboratorios farmacológicos y de las instituciones que obtienen dinero a partir de nuestros padecimientos contribuyendo a empeorarlos. Nuestro bienestar físico y mental debe prevalecer ante los intereses institucionales, industriales y de personas particulares.

 

Andrea Cortés

Persona con discapacidad psicosocial

Activista independiente

 

Este texto fue escrito en el marco de la Campaña de Apoyo a la Prohibición Absoluta de la CDPD de los Tratamientos Forzosos y los Internamientos Involuntarios. Para obtener más información consulte el siguiente link: https://absoluteprohibition.wordpress.com/page/2/

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“I Must Have Died and Gone to Hell” Katherine Tapley-Milton

KT-ForcedDrugging(1) (docx)   KT-ForcedDrugging(1) (pdf)

I MUST HAVE DIED AND GONE TO HELL

by Katherine Tapley-Milton[1]

 

My psychiatrist at Centracare[2] was foreign and had an accent that was hard to understand. He always treated me like I was a bad child. When he was going away for a couple of days he overdosed me with 30 mgs of Haldol. He said that it was “to keep me out of trouble”. You had to stand in line for your pills and I had no option but to take the medication or else the staff would have gotten nasty and forced me to take it.

You didn’t want to buck the hospital staff or you would end up being pinned down with a needle in your butt. I heard that political prisoners from Russia complained to the Western media that they were tortured with a horrible drug. That drug was called Haldol. Psychiatrists here affectionately call it Vitamin “H”. The overdose of Haldol put me into an “oculorgyric crisis”, which is what happens when your eye balls roll back in your head and stick there.

Wikipedia comments: “Oculogyric crisis (OGC) is the name of a dystonic reaction to certain drugs or medical conditions characterized by a prolonged involuntary upward deviation of the eyes. The term “oculogyric” refers to the bilateral elevation of the visual gaze.”

It is excruciatingly uncomfortable and terrifying. When this reaction started to happen to me I went to the nurse’s station and begged for the side effect pill called Cogentin. She rudely informed me “You’ll have to get a lot worse before we’ll do anything about it.” I went into a small room and my neck arched back and my eyeballs were stuck staring up at a light bulb. I was in physical and mental agony and could not believe the cruelty of someone who would just leave me like that. The side effects of the medication went on for days and days. It seemed like an eternity.

The pay phone was my only contact with the outside world, but the competition for its use was fierce among the patients. Also, it was difficult to hear over the din of the ward. There was moaning, crying, and screaming. I remember calling my parents long distance and begging them to get me out of Centracare. However, I was certified which meant that legally I couldn’t leave. Sobbing into the phone I told my father, “I must have died and gone to hell.”

 

[1] The author is from Sackville, Canada

[2] Centracare was Canada’s oldest psychiatric institution. It has since been demolish.

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