We’ve been absorbing this article from the New York Times lately.
At Sound Behavioral Health, we believe that people with serious mental illness ought to have informed choice and family and institutional support in their care. We’ve worked too long in the system, seen too much punishment for “noncompliance,” and have seen too many people slip through the cracks to not wonder if there is another way.
The more coercive paradigm described in this article often leaves folks with serious mental illness with what feels like a double bind: either get with the program or go it alone. This paradigm is not just coercive to patients — it is coercive to psychiatrists and other providers, who bear some risk and liability in straying from established standards of care that are represented by medication and ‘swift discharges,’ even if those standards do not really work in the long term.
As Kelly Wilson points out: “Major organizations like the British Psychiatric Association are beginning to endorse real choice and real informed consent about the risks and benefits of medications. We are beginning to see clinical trials of no medication and minimal medication approaches to psychosis. And there are some very promising data out there showing that some, not all, but some, can thrive on alternatives to coerced high dose meds.”