[ExI] A Small Request

[Stathis Papaioannou]

On 10/02/2008, Amara Graps <amara at amara.com> wrote:

> While they are in the middle of it, I would agree. There's glimpses when
> they are passing in and out of mental illness, however, that something
> is not quite right. I don't know how long that phase is, though, if it
> is long enough to be useful to the family and friends around to do be
> able to do something constructive with the ill person in that time.

It varies in every case. Some patients are fully aware that their
symptoms are due to an illness and actively seek out treatment, just
as they would if they had a distressing physical symptom. Others can
never see it, even when they are better: the voices haven't stopped
because of the medication, they stopped because the devil decided to
leave me alone for the moment. Lack of insight is not just a
side-effect of being psychotic but a specific neurological symptom
(anosognosia) that is found in other neurological disorders in
addition to schizophrenia. For example, patients with lesions to the
visual cortex causing blindness sometimes deny that they are blind and
walk around stumbling into objects, making up excuses when they fall
over, for example claiming that someone pushed a chair into their path
at the last moment. This is called Anton's syndrome, and for obvious
reasons sufferers will not seek out treatment.  Are there readers who
would prefer to be left alone to walk into traffic if they developed
this condition, because the thought of involuntary treatment is so
much worse?

> BTW, we had this conversation before, but the extropy archives don't
> go back to 2000. I'll paste several posts from my records.

Thank-you for that. Every country/state will have its own laws
relating to involuntary treatment of the mentally ill, and in some it
is easier to do than in others. I work as a doctor on a psychiatric
crisis team in the Australian state of Victoria, and my job consists
of deciding who gets involuntary treatment, what that treatment will
be and how long it will last. It is relatively easy to force treatment
in Victoria and it is generally acknowledged that we have one of the
better public mental health systems in Australia, and our Mental
Health Act has been copied in other states.

It is interesting that although patients sometimes get angry at their
involuntary status (I have been physically assaulted several times),
most complaints from families are about us not being assertive enough,
dismissing aberrant behaviour as not due to mental illness, and
discharging patients from hospital or from involuntary status too
early.



-- 
Stathis Papaioannou