- Hi everyone, and welcome back to the Living Well With
Schizophrenia channel. In today's video, I'm going to be sharing with you my experience with forced medication. But first, if you're new here, my name is Lauren and I make
videos about what it's like living with schizoaffective
disorder or schizophrenia. If you would like to see
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any support you can give. So, what is forced medication? Technically it's referred
to as involuntary treatment. Now, it's kind of a polarizing issue where there are a lot of people
who are proponents of it, and there are a lot of people
who are opponents of it, and there's quite strong
feelings either way. So it's kind of a controversial
topic to be tackling. Proponents of it usually refer
to it as assisted treatment, and opponents of it usually
refer to it as forced drugging or forced medication. So, typically the proponents are people who are advocating for the expansion of forced medication or in their term, assisted treatment. And there are people who are
calling for the production of forced medication or
involuntary treatment, and there are people who are calling for just the complete elimination
of it, the opponents of it, and they see it as for
struggling and really unethical. So now there are two
kind of different types of forced medication that I'm
going to be talking about. One that is primarily what
my experience has been, which is the more acute
version of forced medication, where I was in a hospital and it was in the midst of
an acute psychotic episode where they administered
drugs against my will, but there is also the more
longterm use of forced medication where someone is mandated or
forced to take medications over an extended period of time under the supervision of
someone or something like that. But where there is a stipulation that they need to be taking medication for an extended period of time. Okay, so I'm going to share a bit about what my personal experience with forced medication was like. So, like I said before, it was in a hospital setting during an acute psychotic episode. So, I was very, very unwell at the time. And looking back, I can understand that. But what happened, I feel it was a little inexcusable. So, this happened actually several points throughout this hospitalization, which was about four years ago now. I was brought to the
hospital by the police, and really wasn't given much assessment or attention or anything trying
to like deescalate things 'cause I was very agitated
being brought by the police and very scared of being kept
in a cinder block white room with a metal bed frame. It was all very jarring and I was getting
agitated and upset by it. And I was suicidal at the time, and I was trying to harm myself repeatedly with different means. And instead of trying to talk to me and deescalate things or whatnot a flood of people just
came rushing into the room, lifted me up by all my limbs, slammed me down onto the
gurney that was in the room, strapped my arms, strap my legs to the bed so that I couldn't move, I was
in like a starfish position and I couldn't move, and they administered meds by
a shot into my buttocks area or the side of my thigh. And it was horrifically traumatizing. I just remember screaming at
the top of my lungs to stop, and to please stop,
and to please untie me, and to please not medicate me. I did not want the medication, I did not want to be there. I did not want to be held against my will, I did not want any of this. What I really needed at that
time was someone to talk to me and to try to deescalate things from a way more compassionate
perspective, but what was... What happened was this
horrifyingly authoritarian approach to just sedating and medicating someone who was posing a bit of a problem. This left quite a sour taste in my mouth in terms of the concept
of forced medication. And like I said, this happened a couple times
throughout that hospital stay. So that was in the emergency room. And then later on in the
actual psychiatric ward, it happened again where I was
in a solitary confinement room because I was getting upset again and agitated about the symptoms
that I was experiencing and about being in the hospital. And it was all just very
upsetting, and I was very scared. And what happened next, again, instead of someone coming
to try to talk to me, was, the door slammed open and six huge men, security guards and nurses, rushed in and pinned me to the ground, stripped me of all my clothes so that I was completely naked, and again, injected me with medication to sedate me and to... I think an anti-psychotic
was administered as well. Again, the way this was handled was just so, so dehumanizing and awful. And I have struggled with
it a lot ever since then, in terms of dealing with
the trauma of it all, in terms of dealing with
what it means for my trust in the medical system and in
the psychiatric care facilities that are supposed to be
helping me and people like me, who people are experiencing
things like me. And it just made me very
fearful of the system and of the people who are allegedly there to help and support me through this difficult
period of my illness, I think that's a really
important thing to consider when you're dealing with the
topic of forced medication is, at what cost? Because undoubtedly, if
you treat someone that way and if you violate their
trust so immensely like that, you're going to lose
their trust going forward. And part of the therapeutic relationship when treating mental illnesses is so contingent upon this relationship, this therapeutic relationship. And so, you are kind
of just shattering them when you take the approach to just aggressively,
forcibly drug the patient. And so, I feel that there is so much room that has not been adequately explored in terms of deescalation techniques before it gets to the
point of forced medication. Because looking back, I understand that I did need
medication in those instances, and maybe it was the right
thing that I got medication, but it absolutely was not the right thing how it was given to me and how I was not a part of the choice in any way, shape or form. My rights were completely
violated in both those instances. And it was just a really... Both times were just really dehumanizing and awful experiences. And I just feel that if a more compassionate approach was taken and there was a lot more
attempts at deescalation and about reaching me and
communicating with me, I feel that maybe we could
have gotten to the same point of me agreeing to take medication because they explained to
me why it was necessary and how it would help me. Because, again, like I said,
I was feeling so scared. And so, to have this happen on top of that just made me tenfold more scared and just so fearful of my surroundings, so fearful of the system,
and it was just really awful. So I feel that there's so much
room for just trying harder, the system and the medical
professionals just trying harder to treat the patient as a person and to not take away their
rights through forced medication, because what happened
to me in the hospital can only be described
as forced medication. There's no way that a
proponent of assisted treatment would call this assisted treatment, because no one was assisting me and this wasn't healthy treatment, this was forced drugging
or forced medication. I talked about there being
the acute forced medication, which is what I experienced, and then I also talked about there being the more longterm
prolonged assisted treatment or forced medication or
whatever you wanna call it. I wanna talk a bit more about that too, because there are... We did some research on this video and there are just so
many studies out there that provide evidence both
for assisted treatment or forced medication and
both evidence against it. And it's just such a
conflicting area right now in terms of the mental health care system and mental health care treatment. And so, we're really in this phase where we need to flush out
the ethics of everything, and we need to flush
out where our values lie and how our stance on this
position affects our values and is affected by our values. Okay, so in terms of the more longterm involuntary
treatment methods, there are a multitude of different ways that this can be went about. The most common are kind of
community treatment orders or some semblance thereof where there is conservatorship
in the United States or some sort of community treatment order. Now, I do have some experience with this, not necessarily under a strict
community treatment order, but more under the coercion or threat of a community treatment order. So my psychiatrist years back was worried about me not being super great at taking my medication regularly, because I was having symptoms and I was scared of the medication because I thought it was poisoned and all that kind of stuff. And so, he said to me, he was like, "You know, Lauren, I could put you on a community
treatment order right now, and we could just have you mandated to take your medication as prescribed or you'd be hospitalized." And obviously my red flags
went flinging up and was like, "No, no, no, no, no!" And he knew that, he knew that I was very
opposed to that kind of thing, but he was like, "Or we could figure out
something else together that feels better for both of us." Now, he did take a really good approach and I do appreciate the
approach that he took in terms of wanting to come
up with something with me, in collaboration with me,
that felt good for me. And what we ended up coming up with was that I would go to the
pharmacy every day to take my... First it was, I would go
to the clinic every day to take my medication there under the supervision of a nurse. And when they were closed, I would go to the local pharmacy
to take my medication there under the supervision of the pharmacist. And so, it was kind of this
checks and balances system where someone was always witnessing that I was taking my medication and then reporting back to him so that he knew if I was
taking my medication or not. Now, this felt okay to me at the time, because it felt like I
was making that decision in conjunction with him. But this was something that is used very often in psychiatry in terms of coercion of taking medication where the threat of a community treatment or the threat of hospitalization leads the patient to take
their medication as prescribed so as to avoid that threat. This seems harmless, this seems like, if this happens, this will follow, or if this doesn't
happen, this will happen, and that's kind of okay
to wrap your mind around. But that's not really taking
into account the power dynamics that are at play between
a psychiatrist or a doctor and the patient. And oftentimes the patient
hears what the doctor is saying and reacts in fear or reacts emotionally or reacts as if this figure of authority is telling them to do something. And so, coercion is kind of a murky area in terms of forced medication and it's something to be aware of. If you're a medical professional and you are trying to
encourage your patient to take their medication, it's important to step back sometimes and reevaluate the ethics
of what you're doing in order to encourage them to do so. So another way that this
kind of coercion can happen is when a patient just
doesn't really understand what treatments are voluntary
and what are involuntary, and what their rights are. Now, this happened to
me too in the hospital, four years ago or so, where my psychiatrist was saying to me... So, I was refusing food and medication for fear of being poisoned by both, and so, I wasn't eating. And so, my psychiatrist said to me, "If you don't start eating,
we're going to give you ECT." Which is electroconvulsive therapy or sometimes referred to as
shock treatment or whatnot. That scared me so much
because I have had ECT before, and it wasn't a good experience for me. It helps some people, but it wasn't a good experience for me. And I did not want ECT again. So that scared me to the
point where I was like, "Oh my God, I have to eat now. He's forcing me to eat, I'm going to die." It just was this awful spiral. I didn't trust him, I didn't trust the hospital. It was awful. But I didn't understand
that he had no right to be threatening me with that. He could not force me to get ECT because I had the right to refuse that. But the way the information
was presented to me, it felt like it was an
involuntary process, and it felt like I had
no say in the matter. So, this is another way where
we really need to be mindful of how coercion is happening
in terms of forced medication or in terms of involuntary treatment. So, part of the research
that we did for this video was reading the involuntary
treatment section of this book, "Surviving Schizophrenia" which we've recommended before as well. I had a bit of a hard time
reading this chapter of this book because I have a hard time
with a lot of the things. So the author of this book is a proponent of involuntary treatment and he refers to it as assisted treatment. And he goes through a lot
of different statistics and studies and whatnot
that support this view. And he does actually a pretty good job of giving you a detailed understanding of the benefits to the greater society in terms of having less
recidivism in terms of crime with people who are
diagnosed with schizophrenia, having less violent crimes with people who are
living with schizophrenia, having lower rates of homelessness for people who are living
with schizophrenia, and just generally proving
that there is more stability in terms of people who are
receiving assisted treatment or involuntary treatment. Reading through this chapter, if I were to completely remove myself of any experience with this topic and to just take kind of a cold look at the statistics and
figures that he's presenting, I might consider it as a viable option. But the problem is that,
reading this section, all I could think was, this is completely devoid of any empathy for the people who are
experiencing this illness. I think that's a major problem in terms of the conversation
around forced medication or around involuntary treatment. I can understand that there is a benefit
to society as a whole because we don't have to deal
as much with the problems that people who are
living with schizophrenia potentially pose to society. But to me, that feels so wrong. And that does not feel like the answer to forcibly medicate these people, to subdue them in terms of society's view. That doesn't feel right to me and that doesn't feel ethical. I think that, again, like I said before, there is so, so much
unexplored room in terms of, for the acute episodes deescalation and for the longterm
treatment orders education and discussing treatment options and treatment benefits with the patient, instead of just forcing them to take their medication
against their will. It was very commonplace 50 years or so ago to sterilize people with mental illness, with severe mental illness. And that was seen as okay because, why would we want to increase the risk of passing on
a severe mental illness to their offspring? And that serving the
greater greater society well in terms of reducing the amount
of severe mental illness. But that is completely ignoring the fact that you are robbing this individual off their rights and freedoms, and their freedom to
choose their own life path and if they want to have children or not. And likewise, when we
forcibly medicate people, we are robbing them of their
freedom of choice as well, and their freedom to
live how they see fit. If it was a matter of there
being this miracle drug that just completely eradicated symptoms and had no side effects or anything and did no harm to the
person, I would think, "Okay, maybe I can get on board with forced medication a little bit more in order to get the person
to a point of stability where they can understand why that medication is
a benefit for them." But this is not the case. Psychiatric medication is no joke. I have been on medications that have left me drooling and so sedated, I felt like a zombie, I
did not feel like a person. And if somebody was forcing
me to be on that medication against my will, that is worse than being in
prison or being in a hospital or anything like that. And so, I think that as a
society, we need to step up, we can't just fall back on
forcibly medicating these people in terms of reducing the amount
of woes they cause society, we need to figure out how to better accommodate
these people within society. It shouldn't be a matter of subduing them or drugging them to
make them fit in better. It should be a matter of figuring out how we can as a society come together to support these
individuals in a better way. So, I think I've made it
pretty clear where I lie in terms of the debate
around forced medication. I am strongly for the reduction of it. Now, that said, I don't think I'm completely
for the elimination of it because there are times I understand where someone is a
direct harm to themselves or to other people especially, and medication may need to be administered in order to either calm the situation down in this acute phase and
to keep everyone safe, or in order to prevent
harm to other people. But that said, I still think that there
is so, so, so much room for working with the individual. Forced medication should
never be a frontline defense, it should never even be
second or third on the list in terms of approaches that you take. There is so many things
that you need to do before it gets to a point
of forced medication. So now, again, when we were
doing our research on this, we found that as a polarizing topic, there were a lot of different
national organizations, national mental health organizations that have taken a stance
one way or the other. And we found that it
was kind of interesting that these huge mental
health organizations are primarily funded by Big
Pharma, big pharmaceuticals. And how ethical is that, that they are being directly funded by pharmaceutical companies and they are proponents
of forced medication? Which is exactly what
Big Pharma would want, people being forced to take their product. And so, I just had a bit of
uncomfortable reaction to that. Again, I feel that these positions that these organizations are taking are a little bit devoid of empathy for the people who it actually affects. And so, I just want to encourage
a lot more conversation around the use of these treatment methods and a lot more reflection
by the medical community in terms of how they're administering it and how they're approaching
things with their patients. And also, if you are a patient, you need to be ready to advocate for yourself in this position, or you need to be ready to find people who will go to bat for you. So there are patient
advocacy organizations across the country who are set
up to help advocate for you in terms of instances where you feel that force
medication was used improperly. So thank you so much for
watching that very long video. I hope that it was helpful
or insightful in some way. And something that I really
want to point out is that, hopefully medical professionals are going to be watching this and they're going to
be learning from this. And what I would really love is if they could learn
from you all as well. So if you have any experiences
with involuntary treatment, whether it's good or bad or neutral, I would really, really love it if you felt comfortable to
share it in the comments below so that hopefully medical professionals or people in the industry can learn more from your
experiences as well. Thank you so much for
participating in this conversation. So, if you like this video or
found it insightful at all, please make sure to give it a thumbs up and also make sure to subscribe so as not to miss any future videos. Also, just a quick reminder again, that if you would like to help support the creation of videos like this one, please check out the
link to our Patreon page, it's in the description below. Thank you so much again for watching and as always, wishing you and
your loved ones good health. See you in the next video. Bye. (soft music)
Threatening ECT on a patient you know it doesn't work on just to get compliance elsewhere is so unethical
This is difficult to watch. It makes me so sad to watch this girl's content. Seriously wish her the best life.