(Nov. 5, 2013) Opponents of court-ordered treatment often say an all-voluntary mental health system would work just fine. Totally voluntary? No provisions for involuntary treatment? Let’s think what such a system would look like.
Those seeking help for anxiety and depression would get it (as they should now). Those seeking treatment for learning disabilities, attention deficit disorder, sleep disturbances, interpersonal problems, relationship stress, and sexual dysfunction would get it (as they should now). Even those seeking help for auditory hallucinations, paranoia, manic episodes, OCD and eating disorders would get it (as they should now). That sounds good. This world of totally voluntary treatment may not be so bad.
But then there are the nearly 50% of people with schizophrenia and 40% of people with severe bipolar disorder who don’t realize that they are ill and therefore won’t be voluntarily seeking treatment. Some of them will barricade themselves in their homes and live in fear of their paranoid delusions, stop eating, cease all communication with family and the outside world, and spend their days scared and alone. Maybe some will commit “crimes” in response to their auditory hallucinations and end up in jail. Then they can be put in solitary confinement and begin to self-injure in response to their auditory hallucinations.
Some will become homeless and eat out of trash cans —so disorganized in their thought processes that they can’t get their basic needs met. Some will be dressed for the winter in shorts and shoes with holes in them—so busy responding to their voices that they don’t realize that their extremities are frostbitten. Some will perpetrate violence because they are convinced that others are evil or intending to hurt them. All the while, they will be “free” to choose to seek treatment for a disorder that they don’t believe they have.
Those in mental health institutions who sit naked smearing themselves in their own feces will be “set free” to decide if they need to voluntarily seek treatment. Those who have pulled out their own eyes because of visual hallucinations and delusional thinking with religious content (“and if thine eye offend thee…”) will be on their own to live their lives free of all of those pesky health care workers. Those who haven’t slept in days and believe that their mothers are possessed by the devil will return home to decide when the time is right to seek help. Those who believe that they are already dead with internal organs rotting inside them will be “liberated” to seek treatment on their own. Of course they will, right?
So, this world of completely voluntary mental health treatment . . . it sounds good for those who don’t have a severe mental illness; actually it sounds like the world we live in now. However, this world of completely voluntary mental health treatment doesn’t sound so nice for those who are too sick to realize that they need treatment. It doesn’t sound so good for the most ill among us, the most severely mentally ill who do not even know that they are ill.
It looks like those folks will end up homeless, scared and alone, in jails, freezing on the street, blind, covered in waste, or dead. Does that sound like a better world? The world in which we recognize the human right to starve, freeze, live in fear, permanently injure one’s self and spend one’s life incarcerated . . . all because that person doesn’t even know that they are sick.
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