Rob Wipond’s book, Your Consent Is Not Required: The Rise in Psychiatric Detentions, Forced Treatment and Abusive Guardianships, begins as many journeys begin, with personal experience. His dad, an active and vibrant man, survives prostate cancer but the surgery renders him permanently incontinent and impotent. Understandably, he has difficulty coming to terms with the loss. He slides into a deep depression and the family become concerned. They seek medical help, but rather than any sort of counseling or support, his dad is admitted to an in-patient psychiatric facility, involuntarily. During which time, he is heavily medicated and given 21 rounds of ECT. When each new drug came with obvious side effects, those effects were treated with more drugs. The polypharmacy grew. When patient and the family complained and requested some of the medications be withdrawn, drug withdrawal was abrupt. This of course, led to serious drug serious withdrawal effects but rather than recognize the drug withdrawal as such, these symptoms were considered evidence of his worsening psychological illness and of his continued need for these meds.
Antidepressants don’t cause withdrawal, the psychiatrist claimed. That’s his underlying mental illness manifesting more strongly. (pg. 5)
When his health continued to decline, ECT was coercively promoted and eventually, despite the reluctance of the patient and family, given. Nine rounds over three weeks. And when he didn’t improve, another 12 rounds.
When the family was finally able to extract their father from the facility, he had lost an entire year of memories and was considerably worse off than when he entered. This experience was the impetus for the book. As an investigative journalist, Mr. Wipond wanted to know whether his family’s experience was common. Was this what psychiatric care in Canada and the US really looked like? What he found was disturbing. His father’s experience was the norm and not the exception.
Throughout the book, Mr. Wipond weaves personal accounts with extensive research to present a picture of a deeply corrupt and ineffectual industry that is no better, and likely much worse, than the asylums of yesteryear. The treatments are aggressive, invasive, abusive even, and largely ineffective and often harmful, while the industry itself is rife with fraud. He learned that there are networks of patient recruiters targeting vulnerable populations to fill beds and bilk insurers; that physicians receive kickbacks and bribes for simply signing fraudulent patient reports; and that an entire system of fraudulent paper trails exists to hide these activities.
The body brokers, the facility staff, the psychiatrists and the owners will ‘obfuscate their roles’ and activities through bogus titles, sham contracts, and falsified patient progress reports…’an assembly line of fraud’. (pg. 143)
All of this is made possible by the arbitrary and untestable definitions of mental illness designed not only to diagnose said illness, but also to prove the safety and efficacy of the pharmaceutical drugs that will be used to treat those illnesses and to justify mandated treatments and involuntary internments. Accordingly, these tools ‘shrink the pool of normality to a puddle, with more and more people being given a diagnosis of mental illness’ (pg. 23) for what are essentially normal responses to normal stressors.
Even the courts are perfunctory at best. From Michael Perlin, public defender, New York Law School professor and author of: Mental Disability Law: Civil and Criminal.
…despite occasional cutting edge higher court decisions upholding constitutional rights, thousands of commitment hearings take place daily around the country in ‘unknown cases involving unknown litigants, where justice is often administered in assembly line fashion. Sophisticated legal arguments are rarely made, expert witnesses are infrequently called to testify, and lawyers all too often provide barely perfunctory representation.’ Consequently, most civil commitment hearings are ‘meaningless rituals, serving only to provide a façade of respectability to illegitimate proceedings’. (pg. 32)
This is the perfect business model, one that fills maximal beds and provides maximal revenue to all involved. An industry analyst described psychiatric hospitals as the kid in the candy story. “They could keep patients as long as they wanted and charge anything they liked.” (pg. 141)
As with any business, growth is king. This is true of psychiatric internment where, despite claims to the contrary, the per capita number of private psychiatric beds has more than doubled in the US since the 1950s, while general hospital psychiatric beds have increased by 76% and the number of residential treatment beds have more than tripled (pg. 72).
All of this is just the tip of iceberg.
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