Let’s say that someone finds out they are diagnosed with a failing vital organ. The doctor gives the bad news and the patient responds by saying that they do not want to pursue treatment. The doctor hears this, sighs and then tells the patient that if they do not comply that the patient will be held against their will so they can receive the proper treatment.
Upon hearing this many people would think this situation to be very unethical, demoralizing and controlling and I would be inclined to agree. However, to deal with “mental” health patients in this way is rather common. If someone in in such a state of mind that they are deemed a threat to themselves, they can be locked away. But not so for our friend with the failing organ who chooses self-destruction. Why the difference?
In the case of “mental” health there is a huge power differential. Those struggling with mental instability are seen as vulnerable, weak, dangerous, unpredictable and high risk and at second glance someone with physical instability may share many of these same characteristics. Nonetheless it is the “loony” that is shut up and locked away. We may view the physically ill patient as stubborn or maybe even stupid, but still empowered.
I will be the first to say that in both cases some form of treatment is necessary, but let us reexamine our double standard. The moment “mental” health come into play the cycles of oppression are set into gear (even subconsciously) and the individual is now being viewed as a negative on the whole. Often times mental disorders affect behavior, but too often times we take the behaviors as aspects of personality and judge people accordingly. The difference can be subtle, but making the distinction between behavior and personality has importance that cannot be overstated. Even if the patient is receiving the perfect tailored treatment plan on paper, the whole process will be slowed or halted if these power differentials are not observed and addressed.
Consider how these power differentials may affect treatment. The patient not only my struggle to control their mind, but now outside forces are taking even more power and control away from them. This not only takes away options and power from an individual but also may result in vicious cycles and repeat institutionalization. It is very important that an individual is empowered to be the means of their own emancipation with their support network as a catalyst. Not the other way around.
We must reexamine under what conditions care providers choose to exact a psychiatric hold or other forms of restraint. Though safety and longevity are of a high concern we must also make sure that the healing process is not being encumbered. The ultimate concern is not whether or not physical restriction protects an individual from physical harm, because it does. However, it can be very damaging to the mind, which is ultimately the source of the harm. To apply a physical solution to a mental problem is very reflective of biased mentality and should be avoided at all costs.
It is very likely that as a society we have not moved as far beyond lobotomy as we may think we have. Though the practice of lobotomy has stopped can we say the same of the society that justified it in the first place? How have these past assumptions and worldviews lingered in our current practice of medicine? My opinion is that they are very much in play.
*Erich is the pen name of our guest student blogger who can be contacted by e-mail at: firstname.lastname@example.org
Disclaimer: The views expressed by guest bloggers do not necessarily represent the views of Disability Access Services or those of Oregon State University.