(Feb. 6, 2013) As a psychiatrist and son of a woman with schizophrenia, Dr. Gary Tsai views court-ordered treatment from the perspective of a family member who has seen a loved one improve as a result.
“After decades of relentless psychosis, forced treatment was the only way that my mother was able to begin her path to recovery. As a psychiatrist and a family member of a loved one with schizophrenia, I know well the challenges of caring for individuals who firmly and consistently refuse help."
“For me, the dilemma of forced treatment is an issue of access to care, and should be based on whether an individual is able to fully understand the nature, risks, benefits and alternatives of treatment, or of refusing that treatment. Because of a phenomenon known as anosognosia, certain psychotic and manic individuals do not recognize their symptoms. Without compelling treatment for this population, they rarely voluntarily seek the care that they desperately need and deserve, often leading to heartbreaking outcomes such as homelessness and incarceration."
“For my mother, and for hundreds of thousands of others with severe mental illness, declining treatment is not about providers not listening, side effects of medications or stubborn denial. She fundamentally does not believe she needs help, despite a wealth of reality-based evidence to the contrary."
“While mandated treatment involves complex considerations and should be an approach of last resort, for individuals with a clear history of serious mental illness who are unable to make reasonable medical decisions, it is at times the difference between empowering the person with the illness, rather than empowering the illness itself.”
GARY TSAI San Francisco
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