Involuntary treatment

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For treatment in hospital wards see Involuntary commitment

Involuntary treatment (also referred to by proponents as assisted treatment and by critics as forced drugging) refers to medical treatment undertaken without a patient's consent. In almost all circumstances, involuntary treatment refers to psychiatric treatment administered despite an individual's objections. These are typically individuals who have been diagnosed with a mental illness and are deemed to be a danger to themselves or others.

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[edit] Justifications and criticisms

Justification for involuntary treatment is often attempted by emphasizing the potential for severe consequences that may result from lack of treatment, such as homelessness, victimization, suicide, violence. However, critics argue that psychiatric treatment can also have severe consequences such as misdiagnosis, psychiatric assault and disabling drug side effects.

Involuntary treatment is generally undertaken at the behest of family members. Supporters of involuntary treatment include mainstream organizations such as the National Alliance on Mental Illness (NAMI) and the American Psychiatric Association. Involuntary treatment's biggest supporter in the United States is the Treatment Advocacy Center.

Anti-psychiatry groups, loosely allied with members of the psychiatric survivors movement, vigorously oppose involuntary treatment on civil rights grounds. Also, critics oppose involuntary treatment because of the significant potential for side effects, ranging from mild to severe structural brain damage, and because of its emphasis upon enforcing compliance via chemical restraints over practices aimed at achieving mental health.

The Church of Scientology is also aggressively opposed to involuntary treatment, although its methods of dealing with mental disorders (e.g., Introversion Rundown) have led to tragedies such as the confinement and death of Lisa McPherson.

[edit] Methods

Psychiatric treatment primarily involves psychotropic medications, such as antidepressants, mood stabilizers, tranquillizers and 'anti-psychotic' or neuroleptic medication. These medications are generally considered effective by the medical community in treating severe and persistent mental illness [1] although they may have common adverse side effects. Opponents of treatment point to other studies that suggest that long-range outcomes are much worse with treatment.[2] Involuntary treatment can also include commitment to a psychiatric ward and electroconvulsive therapy (also known as electroshock).

[edit] Mental health law

Every state in the US allows for some form of involuntary treatment, although criteria varies.[3] Since the late 1990s, there has been a growing number of states that have adopted Assisted Outpatient Commitment (AOC) laws.[4]

Under 'assisted' outpatient commitment, involuntary patients can live outside the psychiatric hospital, sometimes under strict conditions including reporting to mandatory psychiatric appointments, taking psychiatric drugs in the presence of a nursing team, and proving medication blood levels. Forty-two states presently allow for outpatient commitment.[5]

[edit] Effects of involuntary medication

In some studies, the majority of patients retrospectively agreed that involuntary medication had been in their best interest, with little or no consideration given to those who disagreed with their treatment. Anecdotal reports from opponents of involuntary medication, indicating that involuntary treatment has widespread, devastating, and lasting effects, are downplayed by studies cited by supporters, including TAC.[6] However, other studies cast much doubt on the efficacy of involuntary treatment.[7]

[edit] See also

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