Jim Gottstein, JD from the Law Project on Psychiatric Rights, has written an op-ed on September 18 for Pharmalot about developments in the mental health rights field, how pharma has contributed, and how it appears the upcoming election may influence that environment. Jim, who received his legal education at Harvard Law School, has proven to be acutely sensitive to issues dealing with mental health care human rights, while consistently conveying a legal aptitude to deal with these issues that is unsurpassed in the legal community. Jim is a legal scholar, a humanist, and psychiatric survivor who, as reported by MindFreedom, has dedicated a large part of his career towards initiatives to stop forced psychiatric drugging, challenge psychiatric drug company fraud, and create humane alternatives in the mental health system.
Jim has pointed out that there is a prevailing public attitude that society needs to lock up people who are diagnosed with mental illness and make certain they take their “medications” to keep them from going on killing rampages. However, the truth is both of these approaches increase rather than decrease violence. People who are hit with labels of serious mental illness are no more likely to be violent than those in the general population. In fact these people are far more likely to be victims of violence than to be perpetrators. Furthermore, there has been an association found between violence and taking neuroleptics and other psychiatric drugs.
Jim goes on to quote award-winning science journalist and author Robert Whitaker in noting that the logic which is often used for outpatient commitment, or court ordered psychiatric drugging in the community, laws is that people labelled with diagnoses of severe mental illness need antipsychotic drugs. It is claimed by the the psychiatrists and their supporters that these medications are good for people with severe mental illness and that because they lack insight into their supposed illness they reject the medication. However, it has been found that antipsychotics over the long term worsen outcomes overall. People refusing antipsychotic medications may therefore have good medical reasons for doing so, therefore undermining the logic for forced treatment.
Jim has written, "If we look closely at … a long list of other research, there is good reason to believe that these medications increase psychotic symptoms over the long-term, increase feelings of anxiety, impair cognitive function, cause tardive dyskinesia with some frequency, and dramatically reduce the likelihood that people will fully recover and be able to work. If this is so, how can we, as a society, defend our increasing embrace of forced treatment laws?"
Jim has gone on to share that not just the judges hearing these cases, but also the attorneys representing such people, have the “if the defendant wasn’t crazy the patient would know this was good for him/her”, to such an extent they are known as “Public Pretenders,” which means they only provide pretend legal representation. Professor Michael Perlin, a preeminent legal scholar on mental health law, has been quoted as saying that mental health law as it exists “deprives individuals of liberty disingenuously and upon bases that have no relationship to case law or to statutes." Perlin has also said in these cases "dishonest testimony is often regularly (and unthinkingly) accepted, statutory and case law standards are frequently subverted, and insurmountable barriers are raised to insure that the allegedly “therapeutically correct” social end is met."
Furthermore, Jim has pointed out that a direct action approach to dealing with these issues has been meeting with some results. The Occupy Psychiatry movement has become a reality. On October 6 in New York City there will be a Human Rights Rally and March from the United Nations to an American Psychiatric Association meeting to protest human rights violations by psychiatry. And there have been some important developments at the United Nations. The Convention on the Rights of Persons With Disabilities (CRPD) is a groundbreaking treaty which guarantees "persons with disabilities including psychiatric disabilities, enjoy legal capacity on an equal basis with others in all aspects of life, and that they be provided access to to the support they may require in exercising their legal capacity." At this time this treaty is awaiting Senate ratification in the United States. Another important development has been the United Nations Interim report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment. This report has determined that psychiatric imprisonment, which is called involuntary commitment, and forced psychiatric drugging, can constitute torture.
Many mental health activists are hit hard with further abuses by the psychiatrists and others who work with them for saying the United States stands in the forefront of mental health human rights abuser nations. In fact the American psychiatrists often insist these people must be psychotic and paranoid to think and say such things about the United States of all countries. And yet, as pointed out by Jim, there are many violations of The Universal Declaration of Human Rights in the United States. Violations of International Human Rights do in fact often occur across the United States daily. Another serious problem in the psychiatric system, as highlighted by Jim, is the serious harm which is caused by unscientifically-based psychiatric diagnoses. Paula J. Caplan, Ph.D, who has attacked the unscientific way in which psychiatric diagnoses are invented, has spearheaded eight ethics complaints against people in the American Psychiatric Association on the grounds that this violates the ethical principles of the medical profession.
Also, as discussed by Jim, the pharmaceutical companies employ proxies that are used to deprive people of their mental health rights by using mainstream psychiatry to assert that forcing someone to take psychiatric drugs, primarily neuroleptics, against their will is in their patients’ best interest. However, it has become well known that the information which psychiatrists, along with other medical specialists for that matter, utilize to make prescribing decisions is so completely corrupted by the pharmaceutical companies as to be completely unreliable. It has been stated that the use of psychiatric drugs has been the primary cause of a six-fold increase in the rate of disability in the U.S. of people who are labelled with mental illness. And, the average life span of people who are labelled with serious mental illness in the public mental health system has decreased by 25 years because of these drugs. Overall, Jim sees little, if any, positive contribution by pharma to the improvement of mental health rights.
In the area of politics Jim sees the Libertarians as tending to be the most supportive of mental health rights, due to the fact that this is consistent with their philosophy to keep the government out of people’s private affairs. Overall mental health rights issues have never been on, let alone in the forefront, of either the Republicans’ or Democrats’ agendas. The more pro-government intervention approach of the Democrats ends up being less supportive of mental health rights. Democrats take the position that “we are from the government and here to help you."
However, although some think a Republican controlled White House and Congress could help by repealing the Affordable Care Act, and this would likely reduce the expansion in the use of psychiatric drugs, and therefore be of some benefit to mental health rights, this does not seem to be likely. Jim points out that the pharmaceutical companies are more closely aligned with the Republicans, and this is bad for mental health rights. Overall, as Jim notes, because activists in the area have not been able to make the issue of mental health care human rights a matter of general public interest and policy debate, it is hard to see any significant way in which the upcoming election will influence the mental health rights environment.