Mental illness is the only disease in which the government intervenes. We live in a society where mental health treatment is not always freedom of choice. People diagnosed with other illnesses, such as high blood pressure, diabetes, and asthma, are given the right to refuse medical treatment. Mentally ill people, that are at risk of harm to themselves or others and have a treatable mental illness, can legally be forced to receive treatment. Treatment can include involuntary hospitalization, institutionalization, and psychotropic medications that have severe side effects; which are often irreversible. We should not force mentally ill patients to receive treatment to control the symptoms of their disease. Mental illness is a disease that affects the brain. Testimony given by Hillary Clinton and Dr. Steven Hyman, during a White House conference on mental health, reveals that “these are real illnesses of a real organ—the brain. Just like coronary artery disease is a disease of a real organ—the heart.” (Hyman, paragraph 5). It was once thought …show more content…
that mental illness was nothing more than improper parenting. Per Dr. Hyman, in his article The Genetics of Mental Illness, “It is well established that the risk of mental illness runs in families. Family, twin, and adoption studies have shown that … the transmission of risk is due to heredity” (Hyman 456). Swint 2 Mental illness is a disease that is growing larger every year. “In 2015, there was an estimated 43.3 million adults aged 18 or older in the United States with AMI (Any Mental Illness) within the past year. This number represented 17.9% of all U.S. adults” (National Institute of Mental Health). Mental illness diagnosis range from Any Mental Illness (AMI), where there are little to no impairments, to Severe Mental Illness (SMI), where debilitating impairment can occur. Some common diagnoses are depression, post-traumatic stress disorder, bipolar depression, and schizophrenia. These diagnosis can lead to behaviors that may end in forced treatment. Forced treatment for mental illness has become more humane over the years. In the past, there were several forms of treatment; such as lobotomy, electroconvulsive treatment (ECT), teeth extractions, and organ amputations. Research conducted by Joel Braslow, in regards to mental health treatment in the late 1940s to early 1950s, revealed that, at California’s Stockton State Hospital for Women, masturbation was “a troubling symptom and one of the indications for lobotomy” (Bassman, 492). ECT is a procedure that is still in use. It involves the process of sending small waves of electricity through the brain to intentionally cause a seizure. This procedure is used to change brain chemistry to reverse symptoms in certain mental illness. Unlike the past, sedation is now used. Using sedation for this procedure makes an effective treatment more humane. Pharmaceutical interventions, classified as psychotropic medications, have many side effects. “Serious side effects are common to the psychoactive drugs and include death…liver and kidney disease, neurological movement disorders…lethargy, depression, disruptions of memory, cognitive deficits, and drug-induced psychoses” (Bassman, 493). These side effects, caused by the medications, often are worse than the symptoms of the disease itself. Swint 3 Untreated mental illness can lead to suicidal or homicidal actions; thus requiring intervention from law enforcement. Per Carly Vanko, LCSW, police officers intervene and take mentally ill patients, with a treatable illness, to a hospital or mental institution for emergency detainment. The individual can be detained for seventy-two hours. A probable cause hearing occurs during this period of time. The hearings decide if the officer was correct in their detention of the person. She goes on to report that there are three outcomes that can result from the hearing: dismissal, a settlement agreement, or an order of detention. A settlement agreement is when the patient agrees to follow rules set forth by a judge; which can include taking medication or attending appointments. An order of detention means that the patient will continue their treatment in an approved facility. A court appointed psychologist and psychiatrist will test the patient before an order of detention occurs. These mental health professionals are responsible for determining the course of treatment. Treatment can involve involuntary institutionalization, medications, and sometimes an order to treat which requires the patient to take the medication. If the patient refuses to take the medication, and they have an order to treat, the medication is given in the form of an injection. The patient is physically restrained, by staff or using tethers, to administer the injection. Vanco concludes that fourteen days after emergency detention, a final hearing occurs. The final hearing results in either dismissal, a settlement agreement, or a civil commitment; also known as Chapter 51. This step also requires evaluation by a psychologist and a psychiatrist. Criteria to renew a Chapter 51 is that if the treatment stops, would the patient become a danger to themselves or others (Vanko, interview). Swint 4 There are ethical issues in the involuntary treatment of mental illness.
Physicians struggle between their ethical duty to not cause harm to their patient and their obligation to give services that will benefit the patient. Psychiatrists all too often face the challenge of patients that desperately need treatment yet refuse to comply. “When an individual is suffering from a severe mental illness that grossly distorts his perception of reality…the individual is not truly autonomous…and the decision to override their wishes…does not cause much conflict for the psychiatrist” (Testa and West, 31). When treated with pharmaceuticals, many patients become stable. There are times, though, when their illness is not effectively under control and they stop treatment. Some medications require time to reach a therapeutic level in your system for the desired affect. Discontinuance of the treatment can lead to undesirable
behaviors. In the past, asylums housed the mentally ill. Asylums for the mentally ill began operating in London in the early 1400’s at Bedlam Hospital. Prior to asylums opening in the U.S., housing for the mentally ill patients occurred in prisons and shelters for the poor. Housing the mentally ill in prisons or shelters provided safety to the community, but they were not given any treatment. “Between 1817 and 1824, four privately funded asylums were established in the northeastern states…and the widespread establishment of state-run mental institutions soon followed” (Testa et al., 32). Treatment in these asylums consisted of sedative medications or experimental treatment; neither of which were affective in curing their illness. Populations in the American asylums “swelled to more than 500,000 during the 1950s, with an all-time high of 559,000…in 1953” (Testa et al., 32). By the 1980s asylums were losing their appeal and they discharged patients into the community for outpatient treatment; thus ending the era of insane asylums. Swint 5 Those diagnosed with mental illness, the communities they live in, and their families suffer when mental illnesses are left untreated. If a mentally ill person commits a crime, they can end up in the penal system where they may not have access to proper medical care. This lack of medical care compounds the problem even more. Because of their behaviors, they typically end up in a segregated environment to protect staff and other inmates. Those that do not commit crimes still have daily hurdles they must conquer. Something as simple as finding and keeping a job are more difficult for them. Because of their behaviors, interaction with their family members are difficult. Some might argue that these reasons alone are enough to enforce mental health treatment. Many patients experience mental stability when treated with medications. There are times though, the patient feels so well, they believe treatment is not needed and stop taking their medications. Schizophrenia is one of the mental illnesses in which patients tend to stop medication therapy. Those suffering from schizophrenia may experience visual, auditory, or tactile hallucinations. Visual hallucinations are when the patient is seeing something that is not there. Auditory hallucinations are when the patient hears voices or noises that no one else can hear. Tactile hallucinations are when the patient feels things, such as bugs crawling on their skin. These hallucinations can range from mild to severe and can frighten the patient causing disruptions in their lives. Should we consider these symptoms reason enough to enforce mental health treatment? Some may say that leaving mental illness untreated could be considered inhumane. Many of these patients suffer from debilitating symptoms. For example, depression, can become so severe that the person is unable to complete simple activities, such as being unable to get out of bed, go Swint 6 to work, or interact with their families. Often times they no longer wish to take part in activities that used to give them pleasure. Another example is bipolar depression; which has symptoms that are polar opposites. They experience manic episodes that range from feeling really exuberant about life to severe depressive episodes. These extremely low periods of depression can lead to suicidal thoughts or actions. People with diagnoses that have characteristics of aggressive or violent behavior create a safety issue for the community. Enforced treatment enables mentally ill patients to become stable and potentially avoid any self harm actions, harm to others, or incarceration. It also provides a safer environment for communities. There are alternate forms of treatment that can aid in controlling some behaviors in mental illness. These may include seeing a mental health professional for talk therapy, expressive therapies, acupuncture, yoga, relaxation exercises, and stress reduction techniques. These therapies are the same therapies offered to people with non-mental health illnesses. If we urge non-pharmaceutical treatments in patients without mental illness, then why are they not encouraged for the mentally ill? Why are mentally ill patients, with undesirable behaviors, forced to comply with medication therapy? People with other chronic medical illnesses, which could lead to death if left untreated, have the freedom of choice to seek treatment. Crime is not always committed by mentally ill people, yet they are the only ones forced to submit to treatment. Going forward, we should allow mentally ill patients the freedom to choose; which is their right, given to them by the fourteenth amendment.
(Justia US Law website, n.d.) This means that involuntarily committed patients do have the right to refuse psychiatric treatment as long as they do not pose a danger to themselves or others as determined by a medical provider using professional judgement. (Wortzel, 2006, para. 6) The refusal of treatment is an issue because mental health professionals know that the medications will help the patient, however also knowing that forcing medication could be a liability. (Oriol & Oriol,
Forcing someone to take medication or be hospitalized against their will seems contrary to an individual’s right to refuse medical treatment, however, the issue becomes complicated when it involves individuals suffering from a mental illness. What should be done when a person has lost their grasp on reality, or if they are at a risk of harming themselves or others? Would that justify denying individuals the right to refuse treatment and issuing involuntary treatment? Numerous books and articles have been written which debates this issue and presents the recommendations of assorted experts.
In today’s society, a lot of emphasis is placed on administering drugs and medicating people with psychological issues; however, most of these ailments and issues have the ability be treated through the use of talk therapy rather than medication. Americans are particularly guilty of over medicating when it comes to our more common mental health diagnosis such as, ADHD, depression, and anxiety. We as a society expect things to be done at the snap of a finger; in our advancement of science, we have been able to discover ways of offering the results we want quickly, inexpensively, and with little effort. Unfortunately, although the use of medications, also known as psychoactive drugs, occasionally remove the symptoms, but they do little to remove the causes of these mental health issues. In addition, to the lack of solution that the use of psychoactive drugs offer, they can also have unwanted and dangerous side effects. These can include simple physical irritants such as dry mouth and head aches, and can range up to dependency and substance abuse, and in some cases even death. Moreover, there are cases of inappropriate prescribing, where doctors are authorizing the use of medications that don’t work or are not pertinent to the issue the patient is experiencing. Furthermore, some of these doctors are issuing these medications without subjecting the patient to a proper mental health evaluation by a psychological professional.
Mental healthcare has a long and murky past in the United States. In the early 1900s, patients could live in institutions for many years. The treatments and conditions were, at times, inhumane. Legislation in the 1980s and 1990s created programs to protect this vulnerable population from abuse and discrimination. In the last 20 years, mental health advocacy groups and legislators have made gains in bringing attention to the disparity between physical and mental health programs. However, diagnosis and treatment of mental illnesses continues to be less than optimal. Mental health disparities continue to exist in all areas of the world.
In the mental health profession of counseling, therapy, psychology, psychiatric and social services ethical dilemmas are faced primarily on a daily basis. Being that mental health professionals are working with clients who are often fragile and vulnerable, they must develop an intense awareness of ethical issues. On the other hand, mental health professionals would never intentionally harm their clients, students or colleagues and others whom they work with. Unfortunately, good intentions are not enough to ensure that wrong doings will not occur and mental health professionals have no choice but to make ethically determined decisions. Depending upon the experience and expertise of the professional determines the outcome of the ethical circumstance. For example, if you were practicing mental health professional and had a friend who’s a licensed psychologist, who is invited to attend the wedding of a patient that she has been seeing in court-ordered therapy for a year; what advice would you give your friend?
Mental illness is an increasing problem in America. Currently about 26.2% of Americans suffer from a mental disorder. A mental illness/disorder is a medical condition that disrupts a person’s thinking, feeling, mood, and ability to relate to others and daily functions. Mental illness can affect humans of any age, race, gender and socioeconomic status. However the care that is needed to effectively cure and help the people affected by the illness is not equal for everyone here in American, especially for African Americans.
The field of clinical mental health is one of great reward, but also one of grave responsibility. It is the duty of the counselor to provide the client with a safe environment and an open mind, in order to foster a healthy therapeutic relationship. The majority of mental health counselors would never intentionally harm their clients; however; good intentions are not enough to ensure that wrong will not occur. The ethical expectations and boundaries are regulated by both laws and professional codes. When discussing ethics, one must realize there are two categories, mandatory and aspirational. (Corey, Corey & Callanan, 2007)
A mental disorder, or illness, is defined as “a mental… condition marked primarily by sufficient disorganization of personality, mind, and emotions to seriously impair the normal psychological functioning of the individual” (Merriam & Webster, 2014). Mental illness affects approximately 1 of 4 people in the United States over the age of 18, or 26.2%. Of that 26.2%, six percent of them suffer from a mental disorder that is considered serious and 45% of them have characteristics that meet the criteria for more than one mental disorder. On any given day, 6.7% of United States citizens are suffering from depression, 1.5% are suffering from dysthymic disorder, 2.6% are exhibiting signs and symptoms of bipolar disorder, 1.1% are diagnosed with schizophrenia, 18.1% are suffering from anxiety, and 13.8% of the population are battling conditions such as eating disorders, attention deficient hyperactivity disorder, or a personality disorder (National Institute of Mental Health, 2014).
“Insurance companies often cover mental illness in a more limited fashion than physical illness” (Christensen). The lack of mental health care provided for the mentally ill has been a growing issue in the US during the previous years, and there has been some progress. For example, there has been the Mental Health Care and Parity Law of 2008 that was enacted so that the insurers would cover mental illness just as they would cover other illnesses. In addition, the Affordable Care Act was enacted to enforce that the insurers abide by the rules. Unfortunately, that hasn’t helped much, hence: the sneaky behavior of insurance companies. This sneaky behavior seems to be unnoticed by the government the majority of the time unless the patient or his family decides to file a lawsuit. Until then, insurance companies have been constantly bending rules and finding loopholes to not pay insurance for mental illness.
If the United States had unlimited funds, the appropriate response to such a high number of mentally ill Americans should naturally be to provide universal coverage that doesn’t discriminate between healthcare and mental healthcare. The United States doesn’t have unlimited funds to provide universal healthcare at this point, but the country does have the ability to stop coverage discrimination. A quarter of the 15.7 million Americans who received mental health care listed themselves as the main payer for the services, according to one survey that looked at those services from 2005 to 2009. 3 Separate research from the same agency found 45 percent of those not receiving mental health care listing cost as a barrier.3 President Obama and the advisors who helped construct The Affordable Care Act recognized the problem that confronts the mentally ill. Mental healthcare had to be more affordable and different measures had to be taken to help patients recover. Although The Affordable Care Act doesn’t provide mentally ill patients will universal coverage, the act has made substantial changes to the options available to them.
As a society, we try to get rid of things we are afraid of, things which make us nervous and things we don't understand. Perhaps mental illness is not so much a problem for the mentally ill, but for their communities who can not and will not empathize with them. I wonder if people suffering from a mental illness are not really suffering at all, but are simply a behavioral minority. Their behavior prevents them from being accepted by the majority. They can not find work or often even a place to live, as these things are controlled by the majority. Instead, for those that are ironically considered lucky, the majority gives them medication and often sends them away to a locked facility.
As a result of research and advancements in biomedical science, psychotropic medications have become a primary tool in the holistic treatment of mental health concerns (Kaut & Dickinson, 2007). Education regarding psychopharmacology is now recommended for all mental health professionals in accordance with the ethical codes for the profession (King & Anderson, 2004). Counselors must also navigate their roles with regard to medication and client concerns carefully to avoid liability, while acting in the best interest of the client.
There are so many types of mental illnesses that affect people every day. When some people think of mental illnesses they think of the ones that would cause people to have physical symptoms as well, but that’s untrue, there are many more that you would never know anyone has if you were to see them on the street. As defined by the 2008 encyclopedia “a mental illness is any disease of the mind or brain that seriously affects a person’s ability or behavior. Symptoms of a mental illness may include extreme moods, such as excessive sadness or anxiety, or a decreased ability to think clearly or remember well.” A mentally ill person has severe symptoms that damage the person’s ability to function in everyday activities and situations. Every nation and every economic level can be affected by a mental illness. In the United States alone about 3% of the population has severe mental illness and to add to that number about 40% of people will experience a type of mental illness at least once in their lives. Some cases of mental illnesses can go away on their own, but some cases are so severe that they require professional treatment. There is so much more available to help people recover from their symptoms than in the past.
Advocates for people with mental illnesses have urged the government
Since it has become more understood better treatment plans have been created. There a various therapies and medications that can help manage mental health. However, there is an estimated 50 million people in America that has a mental disorder(s) and sadly only about 10 million will receive mental healthcare. Why is this? This happens simply because mental illness does not care who you are and how much money you do or do not have in the bank. Mental illnesses can effect anyone and it can be anyone of the numerous different psychological disorders. When mental illness effects a person it disrupts their whole life, this would include their daily living as well as effecting how preform at work. Take for instance, if they work a production job it can cause them not to make production. If they cannot function well enough to work at their required performance, then this could and probably would lead into them being fired from their job. Without a job they would not only lose their income but they would also have say bye-bye to their insurance plan as well. This would leave them without and mental healthcare. Did you know that if 50% of those with schizophrenia, 25% of those with anxiety disorders, 33% of those with depression are currently receiving successful treatment and the likely success rate will be around 80 to 90%? A number of people with