Using Britney Spears To Argue For Forced Treatment

Yesterday, the New York Times' op-ed page had an opinion piece by a 25-year-old former drug addict and author arguing that Britney Spears is an example of how commitment laws in California--and one assumes elsewhere--are messed up. Why? Because Spears was able to sign herself out of a 14-day hold, which, as I understand it, was a voluntary hold at that point (she started her second psych unit trip on a 3-day involuntary hold). Nevermind that in the week or so since, all is quiet on the Spears news front and one assumes she's more or less OK.

Before I disembowel this piece, I have to really question why the Times chose to run it. I hate to be a nitpicker, but Spear's clinical diagnosis is not known and neither is her situation with drugs. She has issued no statement and I have read no interview with her where she 'fesses up to anything. Everything we "know" at this point is mere third-hand speculation, so I think it's a an ethical breach on the paper's part to let someone write an op-ed, which is essentially an advertisement for the author's book, and stand there and point fingers at Spears, especially absent a compelling news hook. This makes me think the paper's editorial board has an agenda when it comes to commitment issues and it's not one that I like.

It's also not one that is well thought out in the author's hands. She, Mia Fontaine, recounts her own history as a teen heroin junkie hanging out with dealers--one assumes she was doing more than hanging out in order to get her fix, but she skips that part--before she wound up in forced treatment after getting busted in Utah. She cleaned up and moved on with her life and has written a mother-daughter account of her experiences. That's very touching and it's nice to hear she got her act together, but to turn her experience into an argument that commitment laws are too weak and that parents ought to be able to commit their kids when they think it's necessary and that all these court hearings required by law to impose 14-day involuntary holds is somehow detrimental to people is a pile of BS. A steaming pile in fact.

Those court hearings are there to protect the Liberty of all citizens, so that the state or a cop angry at a girlfriend (yes, it's happened) cannot commit someone to a psych unit against their will without a legitimate underlying threat to the person or to society at large. It's not a perfect system, but unless you want to live in a dictatorship then it's roughly about as good as we are going to get. I know the weakness of this system very well, and will get into them another day.

Of course, various commentators with an agenda to push have been writing similar op-eds for the last decade or so. Fontaine does little to advance their cause, except for the luck of being published in the most important newspaper in the world. But as it is, she commits a whole series of journalistic sins, ones that an intelligent editor should have caught.

I've already mentioned that using Spears as the example for the article is incredibly weak and unethical in my mind. Spears has no way of clearing the record. Unless she wants to pen her own op-ed. I've also mentioned that Fontaine seems to have no idea that we've reached the point in time where there are appropriate tradeoffs between individual liberties and social safety carved into most commitment laws already.

Anyway, throughout the piece, Fontaine conflates mental health treatment with chemical dependency treatment. That's just stupid. You can't stop being depressed just by doing it, but you can certainly halt a CD issue by stopping use of the drug in question. While I know there's a fair amount of dual diagnoses afoot in the mental health world, the two things are still different beasts. In fact, most psych docs I know won't even diagnose someone who has an underlying drug addiction or alcohol problem until they are clear of said problem. There is plenty of alcohol-induced psychosis out there and I've seen cases where once the booze is gone the person ends up with a realistic diagnosis instead of schizophrenia, say.

Also, Fontaine makes the implicit argument that junkies should be forced into treatment. That's also dumb. If someone falls into the clutches of the law and works out a treatment plan with a judge in exchange for less jail time, fine. If a parent wants to force their kid into chem dep treatment, fine. But the sad fact is that the only junkies who ever get clean are the ones who want to get clean. I know this to be true of heroin and I know from personal experience that it is true of cocaine. If someone fundamentally doesn't want to be clean, then they will relapse again and again. Forcing them into treatment absent a criminal case or their being a non-emancipated minor is a waste of resources in a system that is so overburdened that it hardly has room for people who do want to get clean. What's more, the success rates of chem dep programs are hardly anything to cheer--they hover at around 20 percent, depending on the program, the person and the drug.

My larger point here, just to be clear, is that getting clean of drugs requires will power and desire. Just tossing someone into treatment doesn't provide that. How that point got left out of this op-ed is beyond me. Again, that makes me wonder what the agenda is over at the paper's editorial offices.

Here are some of Fontaine's thoughts:

"Hamstrung by the new laws, parents of mentally ill and drug-addicted young adults can now do little but stand by helplessly.

"Ms. Spears’s situation outlines the dangers of blurring the line between socially celebrated behavior and behavior with profound psychological causes. And while her friends and relatives (and a world of transfixed fans) seem to be able to differentiate the two, and recognize that Ms. Spears needs help, now our legal system can’t or doesn’t care to treat someone until he or she has endangered others or themselves, often irreversibly.

"Granted, the laws that once allowed us to force adults into treatment could be abused: extreme electroshock therapy, lobotomies, philandering husbands committing their wives, embarrassingly promiscuous daughters being locked up. But in trying to eliminate the possibility that someone could be wrongly committed, we have cast out Britney Spears, and others much less famous, from the havens where they might have been helped.

"They need to be brought back."

I'm sorry, but what's the argument that the parents of young adults--I presume we're talking 18 and 19-year-olds here--have anything to say about what their former minor-aged kids should or shouldn't do? Second, Fontaine sure seems to have a lot of faith in psych units--but calling them havens is a bit of a stretch and a political statement. When you can show me a class of psych meds that works 80 percent of the time and without injuring the patient, then maybe I'd buy that thinking.

I'm not sure if Spears and others need to be "brought back," but I'm pretty certain Fontaine's piece needs to be brought back for editing by an intelligent adult.