From the brain injury article:

"The researchers emphasize that the study was small and that the moral decisions were hypothetical; the results cannot predict how people with or without brain injuries will act in real life-or-death situations."

TBI (traumatic brain injury) often leaves a person with a more violent 'personality'. I have a niece who was ran over outside of her high school last year. She became very violent and often unpredictable. I read many books on TBI while on my breaks at work; this is common. I also spoke extensively to some staff who work in a TBI unit at a hospital, and they see this as well. I also feel strongly, that medications can affect a person's brain as much as a head injury. It is interesting, and speaking from the Chiari malformation viewpoint I have now; the school administration is considering classifying my daughter as a TBI patient. Everyone agrees who has known her (school-wise)through all of her jr. and high school years, that her decline is so profound from educator's point of view; that they feel it's either the medication use or the Chiari that is causing her to present in their opinion: as a brain injured person.
It is very interesting indeed.

Depression and caregiving:

"The study also found while quality of life was higher in caregivers than in patients at the beginning of the study, quality of life was higher in patients by the end."

The best thing a caregiver can do is not lose sense of self; and never lose a sense of humor. I do believe that the person receiving the care benefits from a loving caregiver; and remaining by a person's side until they die is a gift one can do for another. I have a dear friend who has early onset Alzheimers. She and my daughter were pals.Some days, when life is hard for me, and I can't see the purpose and all of that; I call her husband who is my friend as well. We laugh a lot. One day, I was in the woods and gave my windchime a ding and told him not to forget to breathe and laughed. [mindfulness relaxation] he says to hold on a minute: I hear this unbelievable gong in the background. He basically out did my cheap windchimes on that one.Interestingly, we see many similar behaviors and actions in my daughter and his wife with Alzheimers. Toothpaste in the freezer; just things all upside down.
Anyone who is dying, needs people the most. The people who recognize that and are willing to take the journey with them are beautiful spirits. Eventually, the person dies, and the caregiver rejuvenates. The small price to pay, in being tired or depressed in my opinion is worth sending a person toward a peaceful departure.

Miss Illinois:

I hope she wins. She will be making public appearances for a year; and have plenty of time to answer questions re: Pharma in a public forum. I can guarantee she won't be taking Seroquel to sleep; no way can she afford to have puffy eyelids in the morning. Any good Miss America also knows how to take care of puffy eyelids;and it isn't stuff Pharma reps sell.

This research is very interesting if you believe it and feed it back into the psychiatric paradigm.

If you take Koenigs et al at face value, utilitarianism is a delusion or cognitive distortion with a clear neurological antecedent.

Sufferers would usually deny they are ill at all and presumably they would refuse treatment (i.e. utilitarianism has a strong component of Anosognosia - patients lack insight into their condition).

So utilitarianism is clearly a serious mental illness.

What's more, people suffering from utilitarianism have killed millions over the last century. Utilitarian reasoning was at the root of the Nazi T4 program and Cambodian genocide, justifies 'collateral damage' in Iraq & Afghanistan and is a major component in many suicides.

It is obviously the most dangerous mental illness known to mankind.

Now, when psychiatrists come across a mental illness which severely endangers the patient or others, they usually advocate immediate intervention - whether or not the patient wants it. (e.g. "Mental illness x can kill, so we must administer potentially dangerous drug y").

However, this rationale itself is a symptom of utilitarianism.

So any psychiatrist who advocates the use of harmful meds against the will of a patient is clearly suffering from a dangerous case of utilitarianism and should be subjected to coercive therapy immediately.

Michael, so what is supposed to happen when a person who is hallucinating is shooting holes in their front door? Because it's not legal, as far as I know, to shoot holes in your apartment door. So, should she go to jail? Do you just let that go? What do you think is the correct thing to do? If I was hallucinating a tiger coming after me, I'm not sure that a big shot of Vitamin H in my butt would be such a bad idea.

I think the problem with psychiatry is that they take things too far. I think it's ass backwards to coerce a patient with depression into being admitted to a psych hospital. I'm not sure how a degrading environment with an aroma of urine is going to lead a person out of depression. I think psych hospitals generally suck. It made me feel 10 times worse. But, if someone is shooting up their door because of a hallucination, a psych hospital as bad it is seems like the better of some terrible options.

Lisa, you are addressing a point [actually, many points quite well]I want to make: psychiatric hospitals are not hospitals.

Some units may be in medical hospitals; but the ones that are not are awful. I totally believe, that my daughter got worse as a result of all of the medication roulette the docs played with; as well as the environment.

The fear alone kept her in a flight or fight mood. Who can get well if they are in fear and residing rotten conditions, sleeping on plastic mattresses; stench of urine, gross bathrooms; suffering the indignity of having to earn points by attending those groups to earn a trip outside.

The word hospital should be removed from the description of the care people receive in psych wards. Especially long-term ones like state institutions.

No one should imagine a sterile hospital environment when wondering what those places are like. Patients generally see the attending psych 5-10 minutes a day top. Quick notes are taken, and the rest is maintaining the other 23 or so hours in your day.

Those groups sure don't last all day and night either. Once those are done for the day, you can have a folding chair and sit and stare at a television that's on too loud, and on the news day and night.

I caused a patient revolt of sorts at one institution- hold-over for psych patients: I brought in the video "Grease". The staff complained to me the next day the patients played that video repeatedly several times day and night.

I saw people dance, sing and smile for the first time in months watching "Grease". What's there to complain about there? because staff was tired of hearing "Go greased Light'nin'"!?

It sure does not take much to dignify an undignified existence in a psych ward. [funding does not allow much, but hell.]

Stephany, I agree. Maybe they should change the name to psychiatric containment facility rather than hospital, because it's not treatment that's taking place there. Unless it's treatment to medicate people into oblivion. Some facilities are definitely worse than others. I think are some facilities are probably, actually pretty good, but those tend to be substance abuse treatment facilities not strictly psych hospitals. The one I was in that was free standing was a lot worse than the one attached to a regular hospital. They were so disrespectful to patients. I had one guy, an orderly or whatever they call them these days, who went through my belongings at admission. He held my underwear up in front of other patients and said, "Oooh, these are nice." He also liked to come sit next to me and be oh so caring and rub my leg. I told the psychiatrist that if that guy laid his hands on me one more time I would be defending myself and it would be wise to keep him away from me. The doc wrote an order for that psych tech not to touch me (did they fire his ass, of course not). I had other male patients propositioning me, and I was scared to go to sleep at night for fear that someone would come in my room. One nurse attempted to reassure me by saying that most of the men were so drugged they wouldn't be able to perform sexually, so I didn't have anything to worry about. That was supposed to make me feel better, I guess. I refused Ambien or anything that I felt would make it difficult for me to awaken quickly. There was also a psychiatrist under Board order for molesting female patients who still had privileges at that hospital (and in fact he still does) during the time that I was there. I was terrified. Not a lot of treatment going on for me. I never did calm down during my stay.

You raise a very important consideration Lisa and while it sure isn't one I shrink from (no pun intended) its not one I have a practical short term answer to either.

I'm a member of an organisation that is part of a loose, world-wide affiliation of prison abolitionists. We don't distinguish between locked cells and locked wards except inasmuch as the latter usually tend to allow better access for outsiders.

Like most prison abolitionists, we support the principles of restorative justice over punitive measures like incarceration.

Basically, every 'offence' is as unique as the people caught up in it and a production-lined one-size-fits-all approach imposed by distant authorities is inherently abusive to offenders, victims and their communities.

All of that said, we accept that forcible detention of certain people under certain circumstances can be necessary at times - but at nowhere near the industrial scale on which it is practiced even in Australia, much less the US. The point is that the decision on what to do has to be arrived at by the parties most directly affected (offender, victims, community, organisations and professionals involved in the response such as law enforcement, doctors, etc when relevant) and the answer needs to be one that attempts to repair the damage done to all concerned (or at least minimise the potential for ongoing or future damage) rather than the isolating and alienating responses the criminal justice and mental health systems currently seem to prefer.

Seems to me that mental health issues in particular are canditates for restorative justice responses like community conferencing and circle sentencing as the 'offences' are most often committed against people known to the 'offender' and who have a stake in their rehabilitation as well as in their own health and safety and the integrity of their community.

Of course I can see why responses like that might be more difficult in the US than here in Australia. Communities over there seem even more atomised and it seems that everyone has a gun.

So there might be a bit of work to do on building up the social capital of communities before constructive restorative justice approaches can be applied to most offences (we don't want any lynch mobs around here). But an excellent way of building up that capital is to implement restorative justice in the areas where the community can manage it (maybe 'disturbing the peace' type offences, low level domestic violence or relatively minor juvenile offending) and use those experiences and connections to build towards restorative justice programs for more serious offences.

Under restorative justice, you no longer need to make such strong distinctions between 'criminal offenders' and those 'not guilty due to mental illness'. Its up to those directly affected and most familiar with the circumstances of the offence to determine culpability and how to respond.

The degree to which such factors as mental illness, socioeconomic disadvantage, poor communication, etc may have contributed to the offence are best determined by those closest to it - not by some formula from case law or DSM-IV.

Lisa,

The first night my daughter arrived to a state institution; the nurse asked me "Can your daughter say NO to sexual assault?"
"There are some patients obsessed with sex here."

At the time, my daughter was non-verbal, and had just turned 18 years old.

I demanded a 24/7 line of sight staff for her; and wrote a letter to the Governor, which landed in the hands of the director of the hospital just days later.

No patient, woman or man, should EVER have being able to say no to sexual assault be part of admit criteria.

It is a deplorable outrage that most people do not know exists behind the walls of self-contained mental institutions that offer medications as the only treatment option. Basing discharge on medication induced-stability, and if stability does not happen; the person remains locked up. Sometimes for their entire lifetime.

This is about so much more than psychiatric medications. It's about loss of dignity, loss of spirit, mind and soul, and maybe even virginity.

Michael, sometimes I wish I were in one camp or the other (antipsychiatry or pro psychiatry). I think it would be easier. The problem is I'm in this weird middle ground place, and frankly it's giving me a headache. I look at my own experiences with mental health care and some of the quacks I encountered, and it was absolutely the wrong thing for me. But, I can't say that my experience is everyone else's experience. Some people say they have been helped by mental health care and psych meds. Who am I to question that? Then I look at other people like the relative I mentioned, and I just don't know what the answer is. She's seeing tigers. Maybe being drugged into oblivion would be preferrable to the hell she's living in. I just don't know.

.."Of course I can see why responses like that might be more difficult in the US than here in Australia. Communities over there seem even more atomised and it seems that everyone has a gun." --michael

That's a pretty broad statement michael. It's not the wild-wild west here. Neither I, or anyone else in my entire extended family owns a gun.

Lisa,

I have the middle ground headache, you do not stand alone.

Stephany, what a stupid thing for them to ask you. Doesn't sexual assault mean, by definition, that saying no or being unable to consent is kind of the whole point otherwise it would be called consensual in the first place? Obviously someone who would commit sexual assault doesn't care too much about a person saying no. That nurse is a complete idiot.

I think part of the problem is the general lack of accountability in some of these places. For the life of me I don't understand how a hospital can be accredited and have a person on staff who is under Board order for molesting patients. And as I've mentioned before my own psychiatrist had been arrested (and convicted) more than once for various things, and he also had hospital privileges. I just get really, really angry when I think about this. I, at least, had a fighting chance when I was in there because I was depressed not psychotic. But what about those patients who are psychotic? Who is looking out for them?

Exactly Lisa. These patients, men and women both, are in their most vulnerable state of mind, and the nurse that asked me if she [could say no], a few days later,ended up getting attacked by another patient and having stitches in the forehead from it. That place was not in any way, shape or form, in a position to be called "hospital". NO patient should ever have to watch their back like that. This is why I spent HOURS there, as many as I could, and watched her.
EVEN with a line of sight staff[which left the floor under-staffed as a result]and myself watching her; one of the last nights there a male patient was able to get on top of her. 2 male staff yanked the guy off of her by the back of the neck. It was horrible. Right in front of me, right in the visitor room.
They loaded that male patient up with drugs and told me 'not to worry, he will be sleeping for a long time.'. I don't approve of that either!
It was a awful situation for everyone involved.
That is the long-term care facility for this state.

That is unacceptable. My daughter is lucky she got out of there. Most never do.

Lisa,
Yes, to be more direct: most rapes will happen whether or not someone says NO.

Saying the word NO is not a guarantee of anything to keep safe.

If anything they should have asked me if she knows self-defense moves, or how to yell "Fire!" because that would have prevented something more than "No."
In a wild ass psych ward, who the hell listens to one person yell no anyway. For that matter, I'm sorry, staff barely listen to the patients at all.
Saying NO wouldn't have did a damn thing.

I'm pretty damn sure of 2 things: I'm glad the nurse was at least up front with me; and I'm pretty sure sexual assault is common there, and other places. The whole thing makes me sick.

"Some people say they have been helped by mental health care and psych meds. Who am I to question that?"

Yeah, that's the position I take too.

I've probably spent more time advocating for people to get the psychiatric treatment they want (including pills) than advocating for them to refuse the treatment they don't want. That often brings me into conflict with the authority of the psychiatrist (rather than the therapy they offer) and earns me the label 'anti-psychiatry'.

I'm also just about the only one with a science background in the organisations I'm involved with and that means I'm usually the one doing the critique of forensic science. I've received a lot of support for my criticalist stance from forensic serologists & chemists, ballistics experts, etc, but mostly defensiveness and hostility from forensic psychiatrists. The serologists don't call me 'anti-DNA' - in fact they invite me to write for their journals and speak at their conferences - even though I've spent a lot more time and text attacking their assumptions and methodology than I have the forensic psychiatrists.

Sorry if my rhetoric about guns upset you Stephany. Just clumsily making the point that in societies with the firearm homicide rate you've got in the US it can be pretty hard to convince people that a community response is what's needed rather than a SWAT one. I know I'd be pretty uncomfortable attending community conferencing (which can get pretty confrontational at times) if people around here could get handguns as easily as they can in the US.

Thanks for the clarification michael, regarding gun ownership, etc.
I also agree with what you quoted, that is from a post of Lisa's I believe: about gaining help for others who ask for the medications.

It becomes a precarious position to be placed in, when others seek help for medication and as a result; they themselves may not be happy w/ the outcome; and as an advocate we may not like what we are advocating for, yet also need to speak for those who ask us for help.

Lisa, I appreciate you sharing you story here. I think you are brave to do that, and I believe it will help others (like me)understand what it's like to be inpatient in a psych ward, and the many issues that are raised as a result.

I appreciate all of the discussion here.

Stephany, thank you for your kind words. I realize I probably had it pretty good compared to what people in a state hospital go through.