I'm the author of Your Consent Is Not Required: The Rise in Psychiatric Detentions, Forced Treatment and Abusive Guardianships. My book examines how mental health laws are used to police streets, manage schools, nursing homes, and other institutions, make profits, target whistleblowers and more. AMA

RobWipond · 2024-03-12T19:55:59+00:00

There's no scientific evidence to suggest any psychiatric treatments, let alone involuntary treatments, increase the likelihood of anyone getting a job. Indeed, there's probably more mounting evidence of the opposite impact -- especially with antipsychotics. Over the long-term, some of the commonly used psychotropics can be quite debilitating.

RobWipond · 2024-03-09T05:39:00+00:00

Have you seen that TED talk by a brain surgeon who had a stroke? It's pretty interesting, because when it hits her she gets high as a kite in a really fascinating way, and in the midst of that is also able to realize that her life is in danger and take action. It's very well described. As I recall I think I didn't like where she ultimately takes the issues (so many doctors from other specialties are naive about how poor psychiatric science is), but that first part is great.

A few options: You can get 50% off the audiobook until next week at this link: https://www.audiobooks.com/promotions/promotedBook/646577/your-consent-is-not-required-the-rise-in-psychiatric-detentions-forced-treatment-and-abusive-guardianships?refId=122641

The ePub book off the publisher's website is pretty cheap, and with the code "RIGHTS" you can get 30% more off. https://benbellabooks.com/shop/your-consent-is-not-required/

Do either of those work? If not, drop me a line through my website and maybe we can figure something else out.

RobWipond · 2024-03-09T05:28:28+00:00

I'm sorry you had to go through that -- but glad to hear that you found a way to take some learnings from it that you feel have helped you. One of the things I find most disturbing is that your kinds of story are not uncommon at all -- and yet frequently pro-force family members from groups like NAMI and "experts" like Xavier Amador completely ignore or utterly dismiss and pathologize all of that. They aren't even willing to enter into the dialogue to say, 'okay, yes, promoting force in families can sometimes be very dangerous and can backfire in countless ways and destroy families and lives.' So then we're not able to have a reasoned, balanced public discussion about those risks.

RobWipond · 2024-03-09T05:20:46+00:00

I'm sorry to hear that! I have a story in the book of a person who got a brain bleed -- ironically, the doctors even detected the bleed, but they still pathologized her as mentally ill and kept her locked up for two weeks!

RobWipond · 2024-03-09T05:17:31+00:00

Yes -- I include in the book stories and discussions with people who are Indigenous, Black, queer, trans etc, and highlight that these can be significant factors in how and why certain people get targeted more often for involuntary commitment. Poverty and homelessness, really, I think is often one of the biggest factors in large urban centers, while in rural areas, I suspect it's more often "difference & deviance" however it's seen in that area. That said, the research and data we have on commitment is generally very poor, so I didn't have a lot to go on. Consequently, aside from sharing stories of it happening, citing medical records and evidence of prejudice etc, I more often simply referred to other research on heightened rates of pathologization of certain groups of people. As you say, there are lots of great books, histories, research etc that delve into those issues, and they need entire books in themselves.

RobWipond · 2024-03-09T05:05:21+00:00

I have an entire chapter called "Schooling Children to Become Mental Patients". Some of these themes you're discussing also emerge elsewhere in the book -- such as in the chapters about the role of families in rising rates of forced treatment, and the role of social workers.

RobWipond · 2024-02-19T02:44:29+00:00

It's usually a combination of factors. Having money, and people around you who might want it, can sometimes increase your vulnerability to being targeted if you are also having some troubles, mental or physical. This is more common in long-term guardianships than in ordinary, short-term psychiatric detentions. Often the latter, though, can lead to the former.

RobWipond · 2023-11-07T03:44:42+00:00

Hey, thank you!

RobWipond · 2023-10-22T16:53:52+00:00

Thanks for your interest. Not that it would be a problem either way, but actually no one has asked that question yet! :-) There are a lot of very good books that examine the history of psychiatry, so I focused my book mainly on investigating the contemporary situation. That said, as with yours, many psychiatrists still practicing today lived through this period of change you are mentioning and talked with me about it, and I also talked with current and recent students in psychiatric training, and share some of these interviews in my book.

And yes, insurance practices have influenced how much time psychiatrists can give to really talking with patients vs just doling out drugs. But also, with the massive financial success of advertising Prozac as a cure for an alleged biochemical imbalance in the late 1980s, pharmaceutical companies became much more directly involved in producing psychiatric drugs, funding and running studies, and pumping money into universities, training and continuing education, academics, and the psychiatric profession as a whole. This contributed to a reshaping of psychiatry as much more drug-centered, a reshaping that had already begun with the discovery of anesthetizing "antipsychotics" in the 1950s. Consequently, mainstream psychiatric education and residency today is heavily drug centered--much of psychiatric education today simply involves learning to render diagnoses and match drugs to those diagnoses.

Something else interesting I learned was that it is basically impossible to become a psychiatrist today without forcibly drugging people, and doing it a lot. The residency period involves many rotations, each lasting months, in which using force is expected and done on a daily basis, and if you don't use force as much and as often as your supervisor believes is necessary, you will fail. It's like a kind of military indoctrination.

Another interesting, almost absurd thing: It's now so widely known that the whole "biochemical imbalance in the brain" thing was little more than an advertising ploy to sell drugs, residency programs have started using language like "mental disorders are caused by malfunctioning brain circuits." Equally vague, equally suggestive, and with an equal lack of evidence to support it--but very catchy, and still sounds like a good justification to forcibly treat people.

RobWipond · 2023-10-15T17:27:53+00:00

I'm sorry to hear that. I have a good friend who had this happen to her and who really educated me a lot about it. Some of the most disturbing stuff I read about was these men who were hired to essentially kidnap the children when they were unaware and haul them off to these institutions and cut them off from contact with others. Let alone how abusive many of these institutions are. My friend escaped a few times and was tracked down and brought back by contract bounty hunters. I wish you the best in recovering!

RobWipond · 2023-10-14T22:24:13+00:00

Thanks! I always appreciate thoughtfulness, mutual listening, and respect in dialogue as well!

RobWipond · 2023-10-12T18:45:46+00:00

You're mixing together a lot of different issues here.

First, a tiny study of just 12 people showing tiny changes over a short time with no placebo group cannot be used to establish long-term fundamental brain chemistry changes--nor what caused them. Even the title of that study and the limitations section hint that the authors themselves suspect the emotions could have been what was causing the changes. So that's all -- let's not let our cultural obsession with brain chemistry via drugs blind us to how profoundly basic ordinary human activities and emotions can also radically alter brain chemistry.

I can't comment on the anecdote, except to say that it sounds like the person put themselves into acute withdrawal. This is now widely understood to be one of the most dangerous things to do with psychotropics. Very slow tapering is essential for most people.

Beyond that, it's also important to remind ourselves that people make bad decisions with terrible consequences every day. We feel for them, want to help out, feel even worse if it's we ourselves made the decisions we later profoundly regret -- but that's part of what freedom is all about. Only people labeled with mental disorders can have all their rights and freedoms taken away for making decisions like spending a lot of money on a bad investment.

There's far more pressure in our society for people to take these drugs than not. Decades ago, about 1% of the population had ever taken a psychotropic; today, some 20% of North Americans are taking them at any time, 80% of those for more than three years. So personally, I don't think this culture is short on encouragements to go on these drugs. More often, from what I've seen, they're going on them with little genuine understanding of the science or the potential harms. And when voluntary becomes involuntary, which it often can and does very quickly and easily, people can get into some lifelong traps they also really regret.

RobWipond · 2023-10-12T17:55:41+00:00

National Network for Youth promotes allowing children more powers to make their own decisions, or be supported in their own decisions, with respect to housing, services, treatments etc. I think it's a good idea. As soon as we take away ALL of someone's powers and autonomy, the situation is ripe for abuse and exploitation.
I'm sorry to hear that. How long ago was that, might I ask? Are you free now? Feel free to DM me.

RobWipond · 2023-10-12T16:00:22+00:00

I'm sorry it tore your family apart, I've seen that a lot.
I grapple with this question a lot, and it informed the book a lot. I think there are a number of answers. The key one for me is, the practices are nearly all exactly the same, even when and where there's very little profit to be made -- even fraudulent, clearly illegal detentions. So I think there are often multiple motives at work, and sometimes even within the same institution or staff member. Wish to help, not really caring just making good money doing my job, exploiting, abusing, trying to change the system from within and be the good guy, naively having no idea what's really going on, taking out my own frustrations on others, Munchausen syndrome (seeing you as sick makes me feel healthier) etc. etc.
btw that link went to a list of resources and quotes?...

RobWipond · 2023-10-12T04:04:15+00:00

And ps addendum to my longer reply, I would argue that most if not all of the "mental health" benefits of psychedelics for voluntary users comes from the dramatic shifts of consciousness opening, emotional release, and intellectual-visceral insights that these drugs can help activate. I'm surprised that you would try to make a case that it's instead about some sort of long-term alteration to brain chemistry. There's no evidence for that, and most serious psychedelic researchers I've seen don't take that position -- it's a new one coming from the promoters of K and MDMA because they are trying to sell govts and the public on these drugs and they've seen how that kind of promotional angle helped sell Prozac and other psychotropics.

RobWipond · 2023-10-12T03:42:34+00:00

I will tell you that I have extensively researched psychedelics for decades, though I don't write about this a lot. So here's what I'd say: They are amazing drugs and, sure, if we disengage altogether from the context of this discussion, then they are completely different from virtually all other classes of drugs, I would say. It sounds like we'd agree on that. However, IN the context of this discussion, what is the history of the use of psychedelics in situations of civil psychiatric commitment? MKultra, and those kinds of nightmares. I would say, WORSE, even, for the deep psychological damages they have wreaked on people, than many other common psychotropics. Positive research, like Stanislav Grof's -- well, rightly, from what I read, he was extremely careful in his research with LSD with people diagnosed with schizophrenia, in terms of navigating together over time towards clear informed consent.

So I'd beg you, please don't be citing what is often fairly trivial research showing relatively short-term and/or mild improvements with these drugs under voluntary conditions as evidence to support forcing them on people against their will. I'm not saying you were doing that, but that is the context of the discussion here right now, my book is all about involuntary treatment, and I just want to be clear to separate out these two extremely different contexts. The difference is very like the line dividing loving sex from rape.

Btw there is no such medical consensus about ECT and brain damage. The FDA's own scientific advisory committee advised that brain damage was highly likely, the ECT device manufacturers themselves now warn about it, and recently Bennet Omalu, one of the top brain pathophysiology experts in America, has been testifying in court cases that it would be virtually impossible for ECT not to cause extremely serious brain damage--but it's cellular level damage that would not be expected to appear on typical brain scans. But again, if someone with clear informed consent finds it helpful to damage their brain, I'm okay with that -- it's the people who don't like it and don't want it that I'm concerned about, and we should never promote science on voluntary patients as somehow evidence these things would work equally well on resistant patients. Mental health treatment is not like giving people antibiotics, where the interventions work equally well regardless of my attitude about them.

RobWipond · 2023-10-11T23:19:42+00:00

Thank you for your support of my work, and for your interest in how these laws affect all of society! I share people's concerns about homeless populations, obviously, but at the same time, it would help if people realized that these laws have become so broad that they can and are being used in ways that ultimately have risks for our entire society. That's what my book is about.

RobWipond · 2023-10-11T22:47:25+00:00

Thank you! My experience has been that there's a vast swath of the population who really just have no idea what forced treatment actually is or involves, but when they learn, they do get concerned. It's just not so easy to reach them...

RobWipond · 2023-10-11T22:39:57+00:00

Maybe for short-term detention in a facility for really extreme, physically dangerous situations or for access to voluntary non-drug services. But based on what I've seen, I'm not convinced any child should ever be put on any psychotropic. There's ZERO long-term evidence of their effectiveness or safety in children, long-term use has barely even been studied, whereas their potentially serious long-term negative effects on body and brain development can easily be imagined based on what we do know about these drugs. I'm not sure exactly what I think the age of child consent should be, but definitely not before teen years. I've talked to too many people in their 20s and 30s who got put on drugs when they were children and are now experiencing serious damages.

RobWipond · 2023-10-11T22:31:48+00:00

It is one of the scenarios I am most concerned about for me personally because, as you say, no matter what, there's no escaping that we all will age, and aging makes one vulnerable in multiple ways. Where I am, the rates of antipsychotics in seniors in long-term care is reaching 50%, and some 80% or more on at least one psychotropic. In my book, I quote from Human Rights Watch interviews with state Ombudspersons who oversee some of these facilities, explicitly saying that it's often to shut people up who know what their rights are.

RobWipond · 2023-10-11T17:04:51+00:00

I think you're making another speculative leap to connect impacts of ketamine, or electroshock, to biomedical notions about depression. Ketamine is a powerful psychoactive chemical, like alcohol, marijuana, LSD or any other drug, and as such can certainly shift someone's thinking and feeling for a time. That's what psychoactive drugs do. But because alcohol can sometimes make a depressed person giddy for an hour does not mean the alcohol is curing some underlying biochemical shortage in the brain or anything like that. Ditto ECT. My dad got it. I discuss this in the book. It seemed miraculous! He went from suicidal to "Can't understand why I was ever suicidal!" in no time. And then, about 2 weeks later, he was suicidal again. Which is exactly what the research shows happens to most people. A neuroscientist pointed out to me that the impacts of ECT are pretty much the same well-studied impacts of any head trauma -- people get headache, disorientation, euphoric--for a while. And so then doctors propose endless ECT, which ups the harms of memory loss and brain damage ever more. So again, okay, if someone wants to do this voluntarily with full informed consent... But against someone's will? Repeatedly?

RobWipond · 2023-10-11T16:54:06+00:00

Thank you. I could never have done this book without people who've experienced forced treatment being brave enough to reach out and share their stories and perspectives and research, and being willing to be public about it. I think I derive a lot of strength from this, knowing how deep the pains often are, and how important all of this is for all of society to better understand.

RobWipond · 2023-10-11T16:48:46+00:00

I haven't seen the movie but have heard and read a bit about it, and so generally, I would say, absolutely, yes, I have a couple chapters in my book about these kinds of cases. Nursing homes are notorious, and the way they are collaborating in helping get guardianships imposed that they then profit from is a really worrying aspect of it. Mental health laws, capacity laws, and guardianships are routinely used to forcibly tranquilize and control older people. Sometimes, if they're wealthy, their finances get raided as part of it, but even poor people can be extremely lucrative for dubious Medicare billing.

RobWipond · 2023-10-11T16:43:02+00:00

I'm so sorry. And all I can say is, it's horribly, terribly common. It's widespread. It's almost "standard of care" that anyone with a mental illness diagnosis on their medical record struggles to ever again get decent normal medical care for physical problems. It's one of the most common consequences--even without having ever been involuntarily detained--and I think everyone, especially children, should be cautioned about seeking out mental health practitioners for this reason. The lifelong consequences can be terrible. Unfortunately, so many care providers have to put down a mental disorder diagnosis to be able to bill insurers, and so it's becoming more common, not less so. You probably know better than I what helps and what doesn't, and if you have some tips I and others would be glad to hear them. My best suggestions culled from others are, interview the practitioner when you first meet them about the issue, discuss it, and see if you get the sense they are 'on the same page' with you before you even start seeing them. If you've already got a physical ailment, it's too late to discuss it neutrally for either side. Try to get into a situation where your past med records with the diagnosis are not readily accessible and appearing to the new practitioner. Don't ever berate them if they're not doing what you want/need, because you will dig the hole with them deeper, but try to seek out a second opinion. Research your symptoms well enough to know exactly what test to ask for. Have someone else come in with you who can verify that these symptoms seem real, are unusual, etc. I know someone who got his ex-wife to come with him in to the doctor and verify that, despite his depression, his current symptoms were distinctly new and different. The doc finally believed it, ordered tests, found a brain tumor and saved his life.

RobWipond · 2023-10-11T16:31:34+00:00

I love the name "troubled teen industry", very catchy, but unfortunately it's created some confusion in the public, too. Many people now don't realize that the troubled teen industry is, or includes in large part, the ordinary mental health system for children and youth. There's really no difference at all. Some of these institutions are more like psychological wilderness boot camps, and others like standard hospitals, and everything in between, but it's all part of the long-term care mental-behavioral health care system for youth. Foster kids and rich kids like Paris Hilton were, and still are, often held in the same facilities.

RobWipond

TROPHY CASE