National Post Jul 29, 2011 – 7:30 AM ET | Last Updated: Jul 28, 2011 4:07 PM ET
By Susan Inman
Our daughter doesn’t want you to protect her “right” to be mentally ill. Through no fault of hers, or ours, she has spent the past 11 years experiencing the extraordinary challenges of learning to live with a schizoaffective disorder. This illness, a combination of schizophrenia and bipolar disorder, has at various times thrown her into the horrors of prolonged psychotic episodes. Perhaps the most dangerous part of her illness is the fact that, when in the grips of a psychotic episode, my well-educated daughter is not capable of realizing that she’s ill.
Psychotic disorders present a unique challenge to the people who live with them and to the safety of the public. While people with these disorders who are being treated pose no greater threat than the rest of the population, research has clearly shown that people who are not being treated do have a higher rate of violent behavior. Many of these victims of mental illness end up committing crimes and are relegated to the penal system, where they become further damaged and isolated while making no progress towards a healthy, normal life.
We are currently hearing a lot of justified criticism in the media about the pathologizing of normal human experiences both by psychiatry, with its revision of the already problematic Diagnostic and Statistical Manual, and by pharmaceutical companies who want the public to take ever-increasing amounts of unneeded medication. These are
legitimate problems. But psychiatry and medication are still badly needed by some, those who suffer from genuine mental illnesses and would benefit from any of a number of readily available anti-psychotic medications.
There are many reasons that some people may be unable to obtain anti-psychotic medication. But there is also anosognosia. This well-researched neurological phenomenon means that 40-50% of psychotic people, due to their mental illness, are simply not able to understand that they are in fact sick. In these tragic cases, the only effective way to treat the illness is to force people to take medication. Many are uncomfortable with this approach, but when a symptom of the illness is a literal inability to realize that one is sick, there are no other logical options.
Forty four U.S. states have recognized that the only humane option in these cases is to force patients to be medicated, and have developed some form of mandated treatment. The Mental Health Commission of Canada, however, appears to be headed in a different direction. It currently is partnering with the Canadian Mental Health Association (CMHA) on a research project looking at human-rights issues related to mental illnesses. The CMHA has a long-standing position, published on their website, opposing involuntary treatment. They believe that people must have the choice to reject treatment. They don’t discuss the indisputable research demonstrating how many people experiencing psychosis aren’t able to freely choose the option that could liberate them from the chaos of psychosis.
My daughter is the fortunate beneficiary of several excellent psychoeducation programs that exist in Vancouver for people with severe mental illnesses. These programs, which need to be better funded, help people learn to accept their mental disorders and better manage them. Despite our daughter’s very healthy acceptance of her quirky brain and her extensive knowledge about these disorders, during relapses her understanding of her illness vanishes; she counts on us to take care of her during these episodes and ensure that she isn’t left to deteriorate in an untreated psychosis. Current trends among people who want to protect her “human rights” will make it even more difficult than it already is to protect her genuine human right to be sane.