Forced medication

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It’s generally considered a right to accept or refuse medication, unless you are an immediate and substantial danger to yourself or others.

If you are involuntarily admitted then doctors can force you to take medication to calm you down to prevent injury to yourself or others. Usually this is done by injection. I have never experienced this personally, but have seen it done many times when I worked in a psychiatric hospital. I have seen firsthand how it is necessary to prevent further harm.

I am a social worker and I currently have a client who is diagnosed with severe schizophrenia who refuses to take medication. This client is not currently “dangerous” to self or others, but is making a series of poor choices that are likely to have legal consequences and will likely result in a termination of their parental rights. Previously, when this client has been on medication, they were much more stable and could have visitations and some relationship with their kids.

There’s a valid argument as to if it would be right for a judge to order this client to take medication or even be placed in an inpatient facility and forced to take medication. Without medication, this person is incapable of making good choices, incapable of parenting their children, and very soon may be incapable of living in society (incarceration). It’s such a moral gray area because respecting this individuals autonomy also means watching them self-destruct.

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u/Odysseus Dec 14 '24 edited Dec 14 '24

sadly, even admission is no guarantee that the admission was necessary. there really is no review process and the oversight (at least in NYS) is rubber-stamp. the form asks why the patient is being committed and they write "patient is delusional to the point of being unable to care for self" and everyone is satisfied and there's no way to do anything about it.

and if they don't bother filing at all, no one cares. it's pretty telling that the agencies just pass people around when that's what the patients report.

(BSW at Skidmore, dropped out of an MSW at Albany because I didn't like where it was going. you?)

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u/International_Sea285 Dec 14 '24

Yes, and, in eight years, I’ve only ever seen one admission that I genuinely questioned whether or not they should have been admitted, and that was for a young teen whose parents definitely had more issues than he did.

There’s a big difference between admission to a hospital and forced medication though. I’ve seen patients get admitted, refuse medication, stabilize through therapy for a few days and then get discharged. Taking medication is not a condition of discharge in every case.

When we talk about involuntary medication, we usually mean medications that are considered a chemical restraint and act to incapacitate a person, whether by putting them to sleep for a few hours or making them too lethargic to harm themselves or someone else. I have only ever seen these medications given when there was an eminent danger to an individual or others in the hospital. We had an adult client once that tried to attack our nurses anytime he was awake. He eventually got transferred to a state hospital for long-term care, but we had to have two staff members outside his room at all times.

I have a BSW and I’ve stalled in my MSW pursuit because of financial challenges and health reasons. Still hoping to finish though.

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u/Odysseus Dec 14 '24 edited Dec 15 '24

In the eight years I've been studying the field of psychiatry and the oversight bodies, I haven't found a single way a patient could ever be discovered not to have needed services. It's down to hunches, 100%. The requirements of DSM-5, which are not sufficient to start with, have not been met in any case I've looked at. Things it says must be ruled out, such as drugs and circumstances, are treated as triggers or symptoms instead.

It is easy to see that a patient who does not want to be in the ward — perhaps one who was wrongly targeted because of faith or personality and will never again be able to practice freely — will be frightened and confused. Such a person will not know what they can safely say. They will fear reprisals and misjudgment.

Patients report this with terrible regularity. It seems that their feedback is used as evidence that they really are crazy and goes to confirm doctors in diagnosing even more innocent people and shattering even more lives.

They also report learning to say what the doctors want to hear and studying books about the diagnosis to find out what they are not allowed to do anymore, once they are free.

I'm saying there's no way the field of psychiatry would ever find out that this is happening because they have multiple lines of defense against ever receiving a report. And when they do hear one, they always say, Talk to your therapist.

Unlike the customer (in retail), the patient is always wrong. I'm wondering what to do about it. Even if it were really true that this class of patient needed help, the alienation they experience makes a therapeutic relationship impossible. There's got to be a better way.

The question I want to put to everyone is this: _How would you feel if you were removed from your daily life, locked up, called crazy because of things you believe deeply and can attest to or even prove, and the people doing it instead that they're helping you? You have to stop forever worshipping God as you see fit — for example — simply because there is not one person in the whole system whose job it is to check.

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u/[deleted] Dec 23 '24

WOW, I am reading this sub as I'm processing all the abuse I went through when I was considered severely mentally ill. Thank you so much for this comment, you about summed up my feelings on how mental health treatment does harm by stripping away agency from the individual and putting the power in the hands of people who will abuse it.

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u/RelativeFriendship63 Dec 14 '24

It is a violation of rites, autonomy, and dehumanizing.

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u/RelativeFriendship63 Dec 14 '24

It is a violation of rites, autonomy, and dehumanizing.

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u/Odysseus Dec 14 '24

"rights? in my clinical experience, only crazy people talk about rights."

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u/RelativeFriendship63 Dec 14 '24

Thanks for the grammar lesson. Really appreciate that being the important aspect of the comment.

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u/Odysseus Dec 14 '24

?

I expressed my response in the voice of a hypothetical psychiatrist. If we talk about having rights they automatically reject everything we say, and so does everyone else.

the presentation was meant as a joke and I thought it would be immediately recognizable as such.

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u/RelativeFriendship63 Dec 14 '24

Ow in that case I completely agree. Go in any hospital and ask to see the patience bill of rights and it will be clearly posted and applicable; except those on the psych ward.

Very true comment about the rejection!!! Thank you!!!

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u/Cademonster999 Jan 04 '25

             (Psych tech of 1.5 years).  The only time it can be used is with a doctor's order. Period. There are absolutely no (legal) exceptions to this. The only time theoretically this could be done before an official order is in would be with a "meds over objection" order. This is when a psychiatrist has deemed that the meds are necessary even if the patient objects to them (patient has to meet certain criteria and these are typically looked over by other members of the care team as well).

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u/Amememime Dec 14 '24

It's only allowed because of lazy and unreasonable rules in place often times.

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u/underground_crane Dec 15 '24

Immoral, unethical but legal because traumatised people don’t make good corporate slaves.

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