Feb 22, 2006 01:00 AM

Below are the letters to the editor the Wall St. Journal published in response to their 1 February 2006 article about involuntary outpatient psychiatric drugging, which featured two MindFreedom members and mentioned MindFreedom International’s support of individuals escaping outpatient forced drugging via “underground railroads.”

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Wall Street Journal

Wed., February 22, 2006

LETTERS

MindFreedom International sends out alerts as part of our “MindFreedom Shield” to encourage and support people who are seeking an underground railroad to shelter them from coerced psychiatric drugging. Such underground railroads provide support and assistance in a manner that is completely legal and essential for these individuals. But an underground railroad itself isn’t a program of MindFreedom, as you reported.

You described MindFreedom as an organization of “mentally ill people that opposes coerced drug treatment.” While many members are people who have experienced abuse in the mental health system, or “psychiatric survivors” as we call ourselves, we don’t refer to our membership as “mentally ill.” In fact, many have spent much of their lives passionately defending themselves against such damaging, false and unscientific labels.

While you quoted several proponents of forced drugging, you ought to have quoted even one of the many organized groups of psychiatric survivors. After all, we are the ones who end up on the sharp end of the needle.

David Oaks, Director; MindFreedom International; Eugene, Ore.

[other letters:]

For the Mentally Ill: Caring or Incarceration?

One of the great tragedies of modern psychiatry is the large number of incarcerated individuals who are mentally ill or drug addicted (“A Doctor’s Fight: More Forced Care for the Mentally Ill,” page one, Feb. 1). This is the inevitable consequence of our reluctance to use caring, coercive approaches, such as assisted outpatient treatment. A person suffering from paranoid schizophrenia with a history of multiple hospitalizations for being dangerous and a reluctance to abide by outpatient treatment is a perfect example of someone who would benefit from these approaches. We must balance individual rights and freedom with policies aimed at caring coercion. Our responsibility to each other and our respect for personal rights lie at the center of our social and moral choices as Americans.

The Treatment Advocacy Center is to be commended for its sustained advocacy on behalf of the most vulnerable mentally ill patients who lack the insight to seek and continue effective care and benefit from assisted outpatient treatment.

Steven S. Sharfstein, M.D., President; American Psychiatric Association; Arlington, Va.

While forced care is sometimes necessary when a person is a danger to himself or others, the call to expand its usage underestimates the risks of imposing a different standard of civil liberty onto people with mental illness than is guaranteed to the rest of us.

E. Fuller Torrey’s movement is part of an attitude of paternalism from which people with mental illness are working hard to break free. Moreover, his database of anecdotes on violence is misleading since most people with mental illness aren’t violent and are more often the victims of crime, not the assailants. There is a long history of our country taking away the rights of people with mental illness who are penalized merely for being “scary” and “burdensome.” It is time to go forward, not backward.

Anthony M. Zipple, Sc.D., M.B.A.; Chief Executive Officer; Thresholds Psychiatric Rehabilitation Centers; Chicago

My 41-year-old brother has suffered from serious mental illness since he was 15. At times, his behavior has become sufficiently threatening or dangerous to require involuntary hospitalization. Like many others with this disease, he doesn’t believe that he is ill (a neurological deficit known as anosognosia) and therefore refuses to voluntarily comply with treatment or to take medication, even though it has proven remarkably effective. As a result, my smart, funny and talented brother has spent much of the past 25 years homeless, jobless and delusional. I can safely say to the civil libertarians that this isn’t the life he would have chosen for himself; it was chosen for him by his untreated illness.

Before Kendra’s Law, there was nothing my family could do to force him to obtain treatment. Although the law isn’t a panacea and the mental health system is a disgrace, being forced to stay in treatment is the only chance he has of resurrecting his life.

Shari L. Steinberg; New York

Dr. Torrey complains about “taking heat” for being “politically incorrect,” but he’s not really paying any penalty for his position. A real penalty, however, is being paid by those who are targeted by the laws he pushes through. To force outpatient “treatment” on anyone who has ever been on the wrong end of the mental health system because of the actions of the criminals in Dr. Torrey’s database is as unfair as it would be to force such treatment on all physicians because of the actions of Dr. Mengele.

Kent Reedy; San Diego

Using the term “force” to describe state laws authorizing court-ordered treatment overlooks the point about what these laws are intended to accomplish. Most people with serious mental illnesses are able to make informed decisions about treatment. In a minority of cases, mental illness negatively affects insight and ability to recognize the need for treatment. The greatest risk is to the individuals themselves.

A New York State Office of Mental Health report shows that the impact of Kendra’s Law has been positive in reducing hospitalizations, arrests, homelessness and other consequences from lack of treatment. And most people treated under Kendra’s Law say it has helped them. When narrowly crafted and sufficiently protective of civil liberties, laws authorizing court-ordered outpatient treatment can be both humane and beneficial.

Michael Fitzpatrick, Executive Director; National Alliance on Mental Illness; Arlington, Va.