Involuntary treatment can be twisted to fit in the shoes of the critics to refer to the assisted treatment or else forced drugging about medicine taken without the patient’s awareness. This medication is administered to patients thought to cause a threat to society.
A mental illness: definition
A mental illness or else mental disorder can be defined as a psychological pattern or clinical behavior that occurs in a person is normally associated with disability, distress, or increased risk of suffering (William G, 2006). However, this definition may change depending on the legal, social, and even political context. The more severe and long-lasting disorder may be termed as “serious mental illness” (SMI). Substance dependence, mental retardation, personality disorder, and even mental disorder may cover a broader definition. Mental disorder is mainly diagnosed by mental health professionals like clinical psychologists. Assessments and treatment of the majority of these mental problems are done by family physicians at the time of consultations (Sheila, 2001).
The majority of the countries in the world have mental health legislation. Involuntary treatment or commitment is a compulsory admission to the facilities of mental health. However, this involuntary commitment has been causing arguments year after year impinging on personal liberty and the right of choice and at the same time, it can carry with it the risk of social and political abuse. On the other hand, the involuntary treatment enables some patients to attain their rights to health care and can also prevent harm to others and even to themselves. Considerations for involuntary admission depend on the seriousness to cause harm to either yourself or others and the need for treatment (Robert H (1999). The decision for a person to be under involuntary admission depends on either the practitioner a close relative or a member of the society (Jeffrey, R, (2001). Some laws were orientated by human rights activists that stipulated that a person can only be admitted under involuntary treatment if credited y an independent medical practitioner or other mental health professions and with conditions that they must examine the person for a long time and regularly. Laws on involuntary treatment may also be applied to those living in the community as used in countries like New Zealand, Australia, and the US under Community Treatment Orders (CTOs). A report by the World Health Organization indicated that many are the time’s mental health legislation ignored the rights of the person (Lawrence E, (2000).
Sometimes it is necessary to admit persons with severe mental illness (SMI) for reasons based on humane, scientific, practical reasons and public protection. On the grounds of Science, individuals suffering from bipolar or schizophrenia disorders range from 40%-50% and are unaware of their illness-“impaired insight”. This is the situation whereby the part of the brain used for self-reflection and appreciating one’s needs is damaged. This part of the brain is called the prefrontal cortex thus the need to have involuntary legislation. On humanitarian grounds, it would only be fair to place these patients under involuntary legislation since the failure to consider these patients may ultimately lead to homelessness, street sheltering, and even lead to jails. It would be unfair to let the mentally ill feed from garbage cans and no streets. Another major reason for putting patients under involuntary legislation and treatment is due to public protection concerns. Some patients who are seriously mentally ill may pose danger to the public due to their delusions. If these individuals were treated, most of the homicides would not be happening today. On practical grounds, involuntary treatment should be put in place simply because this method works. A good example is in New Hampshire where the use of conditional release was found to comply with the medication in that it reduced the number of violent episodes caused by the SMI patients (William G, 2006).
In as much as involuntary treatment is beneficial to the patients and the general public, this treatment may be ill-founded. For example, it is argued that a patient may seek out mental health services if they are attracted to them but individuals who are not aware of their illness may never go for the health services since they do not believe that they are sick. It is also said that these patients do not like getting under involuntary medication. Thus, involuntary commitment drives patients away (Robert H (1999). There is the feat that involuntary treatment can be abused. A good example is what happened in NAZI Germany finally human rights activities oppose involuntary treatment accusing this kind of health service of a violation of human rights (Sheila, 2001).
People with mental illness received poor treatment. These living in colonies of North America in the 17th and 18th centuries interpreted that the mentally ill individuals got the disorder as a punishment from God while others attributed the disorder to be the work of the devil. Some of the patients were either helped by their families or jailed while others were put in almshouses. The first hospital to admit mentally ill patients in American colonies was the Pennsylvania Hospital located in Philadelphia in 1752 (Jeffrey, R, (2001). These patients were however chained to the walls of the ward. In 1780s Benjamin Rush an American physician made changes in the Pennsylvania hospital that improved the conditions of the patients. He came up with programs that offered work and recreation to patients (Sheila, 2001)
The year 1817 to 1828 saw the rise of institutions that catered for mentally ill patients exclusively. A Boston schoolteacher named Dorothea Dix openly campaigned to sensitive the public on being aware of the plight of the mentally ill. This campaign led to the establishment of 32 psychiatric hospitals in 1880 (Robert H (1999). Consequently, overcrowding and understaffing became the order of the day. The result was for these institutions to change their approach of treating mentally ill patients from moral therapy to punishments and warehousing. In 1908 and later 1909, new concerns for the mentally ill patients were aroused by Clifford Beers who founded a National committee for mentally Hygiene (Sheila, 2001)
The deinstitutionalization movement was formed in the United States after the Second World War to refer psychiatric hospital systems (Lawrence E, (2000). The patients lived in isolated places for decades thus mental health professionals saw the need to address certain issues concerning mentally ill patients and hospital programs (Robert H (1999). Some of the changes they made included; hospitalizing the severe patients and releasing the rest. Additionally, these professionals came up with antipsychotic drugs in the 1950s which helped to control the quire behaviors in the patients. The movement agitated for the release of the mentally ill patient who had been hospitalized. This led to the release of over hundred of thousand patients to be released (William G, 2006)
The number of patients in hospitals reduced significantly from 513,000 in 1950 to 92,000 by 1990. Most of these patients either went back to their families or were referred to nursing homes depending on their conditions (Robert H (1999). While the few who did not have a place to go live in the streets. Further improvements were realized when the National Mental Health Act of 1946 gave the National Institute of Mental Health a green light to be the head for research and also the center for funding research based on mental illness. In 1963 community mental health centers Act bill was passed by congress and authorized the construction of community mental health centers all over the country (Gerald L, (2002).
The most recent development in the field of mental health has been the establishment of the National Alliance for the Mentally Ill (NAMI) (Jeffrey, R, 2001). This Alliance aims at improving the lives of severely mentally ill patients and their families against discrimination. In 1996, congress passed the Mental Health Party Act of 1996 which advocated for private medical plans that offer mental health coverage. Equal Employment Opportunity Commission of the US issued new guidelines in 1997 that intended to prevent discrimination in workplaces for mentally ill workers (Gerald L, 2002).
In a general conclusion, a mental illness or else mental disorder can be defined as a psychological pattern or clinical behavior that occurs in a person is normally associated with disability, distress, or increased risk of suffering (William G, 2006). Involuntary treatment or commitment is a compulsory admission to the facilities of mental health it is necessary to admit persons with severe mental illness (SMI) for reasons based on humane, scientific, practical reasons, and public protection. Involuntary treatment is beneficial to the patients and the general public.
Gerald L, (2002) serving mentally ill offenders. Springer pub. Company, London. Pp 32-69.
Jeffrey, R, (2001) Psychological assessment and treatment of SMI in America. Harvard university press. Pp112-342.
Lawrence E, (2000), Mental health in America. Dorrance pub. New York. Pp23-76.
Robert H (1999), Intro. To community based nursing. Arnold pub. Oxford university press.pp 78-99.
Sheila L. (2001) Pschiatric mental health nursing. Wilkings pub. London. Pp65-89.
William g, (2006), American health care nursing: historical perspective. Brookings pub. Company. Pp45-68.