The New York Times has done an admirable job since the Sandy Hook shootings in keeping a spotlight on our mental health system. Here’s an exchange about mandated treatment — sparked by a Harvard psychiatrist — that is worth reading.
To the Editor:
Recent tragic events have linked mental illness and violence. Some people — I, for one — consider this link dangerously stigmatizing. People with mental illness are far more likely to be victims of violence than perpetrators. Moreover, psychiatrists have limited capacity to reliably predict violence. Nonetheless, these events increase pressure to identify people who might conceivably commit violent acts, and to mandate treatment with antipsychotic medications.
For a tiny minority of patients who have committed serious crimes, mandated treatment can be effective, particularly as an alternative to incarceration. But for most patients experiencing psychotic states, mandated treatment may create more problems than it solves.
For many medical conditions, better outcomes occur when patients share in treatment design and disease management. Imposed treatments tend to engender resistance and resentment. This is also true for psychiatric conditions.
