[ExI] insanity plea

[Henry Rivera]

?? wrote:
> There are ways to guarantee the patient is medicated, for example with
> monthly injections.

Then Mirco responded:
The problem is many of these patients have a long history of
discontinuing their medications. What to do with an individual declared
"not guilty" but dangerous when he discontinue his medications?
Do you arrest him and jail him as soon as he try to avoid to be
medicated or refuse to take his pills? And how much do you keep him in
jail for skipping his drugs?

---

Injectable antipsychotics have helped with such issues immensely (vs.
having to take medication daily to reap its benefits). In the case where a
patient decides he no longer wants to take his antipsychotic medication,
when there is a history of violence when the patient has not been on an
antipsychotic, you wouldn't arrest the patient to put him in jail, you
would petition the court to hospitalize him for the purpose of
administering the antipsychotic medication (like an injection that will
work for 30 days). The reliable assumption is that the patient's condition
will improve once he is back on the medication such that he can be released
from the hospital and return home. This is called a Rogers Order where I
live. See:
http://www.massguardianshipassociation.org/information/guardianship-of-an-adult-2/rogers-guardianship/

I am aware that there are people who oppose such "forced drugging."
Nevertheless, I have seen this system used effectively to prevent harm to
patients and to the public many times. Every time I have followed up with
recipients of such "forced drugging," they say they are grateful to be back
on their medication and grateful that no one was hurt while they were not
thinking clearly.

This makes me think of the potential benefit of making a movie to yourself,
sort of like in Total Recall. You have the patient make it when stable for
the purpose of viewing when unstable. In it, they could tell themselves, "I
know you are thinking of stopping your medication, but trust me, that won't
lead to anything good happening. Trust your doctor, she won't hurt you.
Etc."

-Henry

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