Re: “…but have mental disorders, and I think it’s perfectly alright if you don’t want to be cured”? From context here, I’m taking “cured” as ‘treated’ since often chronic or severe mis can’t be entirely cured, please correct me if i’m wrong. I agree with your answer - that people shouldn’t be allowed to refuse treatment if they’re hurting others - but I’d say it’s important sometimes when they’re hurting themselves.
I feel like this is another issue of conflating different mis with different problems, honestly. I see this opinion around a lot on tumblr, and while I definitely agree that it’s a complicated issue and that patients should be active participants in their own treatment to a degree that’s extremely rare today, I have to wonder if these people have ever been so delusional or so psychotic that they were unable to reasonably make decisions about their own wellbeing.
I have been. I’ve fought with the police, I’ve been handcuffed and arrested (under the mental health act) and I’ve been sectioned. And as much as I’ve gotten mostly really shitty care and treatment in the mental health care system, treating me against my will was a lifeline. I’ve also had other really bad times when I look back and thing, wow, I was really fucking crazy, why didn’t anyone do something? Because in the long run, the only person that hurt was me. I lost time, I alienated people, and I came very, very close to death.
Again, I’m not saying it’s not complex. I know people have had really horrific experiences with forced treatment - I mean, I’ve had some horrific experiences even though I feel it was necessary overall, and those are a drop in the ocean compared to some stories I’ve heard. I overwhelmingly think that institutionalization (forcing patients to become reliant on being institutionalized or keeping them in hospital for long periods of times) is wrong, but I also realise that hospitalizations of a shorter nature are necessary for some of the population some of the time. I recognize that the system of community care that should have replaced the old psychiatric hospitalizations after de-institutionalization is in shambles or, more often, was simply never built. The fact that the system that exists is entirely inadequate, both in terms of active patient participation, community care, and care in-hospital doesn’t in my mind negate the fact that sometimes treatment is necessary for a small percentage of the population a small percent of the time who are unable to make that decision for themselves.
All of the above are serious problems facing the mentally ill population today, but just like in terms of other care, the fact that the system is criminally inadequate does not mean that treatment is unnecessary.
However, I do think this is a conversation in which experience matters. Mental illness and disability cannot be represented in a yes or no manner. Different mental illnesses carry different problems and different stigmas. People with chronic mental illnesses often have different needs than those with shorter-term (but still debilitating) ones. Furthermore, not all mental illnesses are disabilities.
In my experience, the people who are heavy users of the public mental health care system (by which I mean psychiatric hospitals, emergency rooms, police, etc) and who are mostly likely to be treated against their will are often hard to hear in the conversations about mental illness. It makes sense - mental illnesses that cause the kind of disconnect from reality that I’m talking about are statistically rarer than those that don’t. Schizophrenia, bipolar disorder, bpd, appear in the population at rates of 1-2%. Psychotic depression and anxiety are similarily fairly rare. So it makes sense that our voices are often hard to hear, since there are less of us. However, it also means it’s incredibly important to listen to people with other mental illnesses, and not speak over us just because you also happen to be mentally ill.
My incredibly long-winded point is this: Mental illnesses are incredibly varied; in experience, stigma, treatment, disability, severity, and chronicity. I would like to see more voices of those who have been heavy consumers in conversations like this, and people with psychotic symptoms, since this is an issue that disproportionately affects us.
Thanks, and sorry about the far-too-long post.
(and, just in case anyone asks - I am not at all trying to belittle what people with depression, anxiety, or other mental illnesses go through. I have struggled with a fairly severe anxiety disorder as well for much of my life, so I am not at all trying to make a hierarchy of mental illness oppression. Rather, I’m just asking that we don’t speak for those with mental illnesses we don’t have, experiences we don’t have, on behalf of the entire mentally ill community, or on behalf of the entire disabled community.)