Comment by DanBC | Hacker News Reader

Comment by DanBC | Hacker News Reader

The Convention on the Rights of People with Disabilities (CRPD) is here: https://www.un.org/development/desa/disabilities/convention-...

Read Article 14: https://www.un.org/development/desa/disabilities/convention-...

Art14 says "Are not deprived of their liberty unlawfully or arbitrarily, and that any deprivation of liberty is in conformity with the law, and that the existence of a disability shall in no case justify a deprivation of liberty."

The committee for the CRPD have said this means that involuntary treatment for people with mental illness is not allowed, and any laws that contain provision for involuntary treatment must be repealed. In England those would be the Mental Health Act and the Mental Capacity Act.

The committee have also said that work arounds - detaining people not because they are mentally ill but because they pose a risk of danger to themselves or others - are also forbidden.

Here's the thoughts of the committee: https://www.ohchr.org/Documents/HRBodies/CRPD/GC/GuidelinesA...

The position of the committee given in the guidelines on Article 14 appears to be completely untenable and fundamentally conflicts with the Article 10 right to life. Unless I have profoundly misunderstood their arguments, their position is that someone with a mental illness or intellectual disability may not be deprived of liberty on the basis of that illness or disability (or risks following from that illness or disability), ever, under any circumstances.

That interpretation would forbid the carer of someone with severe intellectual disabilities from stopping them if they tried to run into traffic. It would forbid a care home for people with severe dementia from preventing patients from wandering off, even if those patients are agitated, disoriented and non-verbal. It would forbid a paramedic from tackling someone who is distressed, delusional and trying to jump off a rooftop.

There is a perfectly legitimate argument to be had about the legitimacy of institutionalisation - even brief, time-limited institutionalisation - but these guidelines make a nonsense of the CPRD. It seems to me to be self-evident that some people lack the mental capacity to act in their own self-interests at least some of the time and would, left to their own devices, be at serious risk of death. I do not understand how the right to life and the absolute right to liberty can be compatible.

> detaining people [...] because they pose a risk of danger to themselves or others - are also forbidden.

What he actual fuck? If someone is out waving a knife around in the street because the voices in their head are telling them to, we very much DO need to detain them, for their safety and the safety of others. Who cares what any "committee" says about it?

You could have read the document before spewing toxic FUD about the kind of things mentally ill people supposedly do.

Here's the section that addresses your concern: "All persons, including those with disabilities, have a duty to do no harm. Legal systems based on the rule of law have criminal and other laws in place to deal with the breach of this obligation. Persons with disabilities are frequently denied equal protection under these laws by being diverted to a separate track of law, including through mental health laws. These laws and procedures commonly have a lower standard when it comes to human rights protection, particularly the right to due process and fair trial, and are incompatible with article 13 in conjunction with article 14 of the Convention."

But it seems wrong to put a mentally ill person in jail for crimes a lot of the time because it isn't necessarily within their control and/or they lack mens rhea.

So either we have 2 tracks or we continue to fill jails with the mentally ill even though it is obviously an incorrect application of justice.

A somewhat analogous issue has been pointed out with the juvenile justice system in the US. Ostensibly, these "softer" courts allow for a less formal approach that will help young offenders; in reality, that lack basic due process protections, hurting the innocent and helping only the guilty. Really, it's the same as any other argument for fewer protections against government: these hassles get in the way, so just get rid of them and trust us more.

> What results is an environment where boundaries are blurred and children accused of crimes are made to believe that everyone in the courtroom is there to “help” them when, in reality, defense attorneys are the only parties obligated to advocate on their behalf.

- The Marshall Project, https://www.themarshallproject.org/2017/05/15/give-juveniles...

There is no shortage of laws that can be used to do exactly that, and I think it's quite an extreme interpretation you put forth here.

Just to name a few:

* conspiracy to commit a whole range of crimes, including murder

* threatening people with an actual weapon

* threatening people

BUT this would prevent mental health "professionals" from detaining light or "highly functional" cases of things like autism and forcing "treatment" (confinement, nothing more) on them. And let's not forget that they are very much not above forcing themselves with brutal violence, locks and forced medication onto perfectly healthy patients when given the chance [1].

Nor are they above causing mental health issues in order to create themselves easy patients. [2] Or just lying. [3] (note: this is one of the centres where psychiatry was developed)

Those easy but involuntary patients would be replaced, out of necessity, with people with actual mental disabilities, homeless, who need constant care, are addicted, destroy the place and/or are actually dangerous to the staff. In other words, almost exclusively patients that cannot be helped and/or are dangerous. This would destroy psychiatry.

Good riddance.

[1] https://en.wikipedia.org/wiki/Rosenhan_experiment [2] https://en.wikipedia.org/wiki/Controversies_about_psychiatry [3] https://www.thelocal.ch/20190701/locked-up-for-being-differe...

Sure, but the idea is that if someone is schizophrenic and threatening people, it would be better for the patient and society if she was admitted to a psych unit and treated, and possibly able to return her life, rather than incarcerating her for some time, releasing her untreated and then the same thing happening again and now she has a criminal record.

As a resident psychiatrist, I can tell you that most of the time I'm not conflicted about involuntarily admitting a patient, at my institution it happens rarely, almost all patients sign in voluntarily and can request to leave, in fact most of the time we deal with patients who actually want to get admitted and will feign symptoms to do so, forcing us to admit them. The times we involuntarily admit patients are when they are so symptomatic that they would very likely die without treatment (e.g. they refuse to eat because they think their food is poisoned).

Every field has its history of controversies, that doesn't mean the field as a whole is inherently bad.

> Every field has its history of controversies, that doesn't mean the field as a whole is inherently bad.

Psychiatry has gotten caught, repeatedly, at a 100% false positive rate. Think about it, from a mathematical point of view: anything significantly over 50% can only be the result of fraud. Or more specifically, declaring patients ill irrespective of the variable: the patient. Just being completely wrong will only ever get you to 50%, so let's say you might get to 55% on a particularly bad day, but anything higher is fraud.

This has not happened in just 1 experiment but has been repeated, and repeated, and repeated again. In the 19th, 20th and 21st century.

Furthermore actual diseases have systematically been removed from psychiatry. Everything from epilepsy, seizures, milk allergies in children (yes, really), multiple sclerosis, cancer (esp. brain tumors), various hormone imbalances, a number of parasitic infections and other "unexplained" diseases that may interfere with normal behavior (either directly, or for example by causing long-term pain. Or simply by having symptoms but being undiagnoseable (or merely undiagnosed). For example, in both cancer and multiple sclerosis patients may present with symptoms in some cases years before a test for the disease shows a positive result. In the case of cancer a test may in fact remain negative right up to the point the patient dies, diagnoses have been corrected through autopsies where it really wasn't the docter's fault. But the problem is, when referred to psychiatrists, these patients were generally diagnosed with mental illnesses, and treated, in quite a few cases right into the grave.

Psychiatrists had all sorts of very convincing theories (except not really if you read them) how they were going to fix these. Needless to say, none of them were ever verified experimentally, and quite a few have been caught at outright fraud. Even Freud himself is known to have knowingly contributed to help perpetrators of rape hide their crimes by convincing women they didn't happen, and using violence when that failed.

And when you read today's psychiatric theories, for example about EMDR, you know: give it 10 years, and we'll know it to be a fraud as well. Shapiro had plenty of chances, more than enough data, patients, and all the authority and places to publish she could possibly want to verify her treatment. She didn't. Not in over 2 decades. Give it 10 years, and we'll know: it's because she knows it, and herself, to be a fraud. Even if you believe that she wasn't sure, that would mean you concede that she experimented on patients for 2 decades. Any other medical practitioner would not just have been fired, they would have been convicted to decades of prison.

And let's take today's favorite diagnosis Autism/ADHD/Autism Spectrum Disorder. I'm going to have to violate Godwin's law on that one. It sounds absurd, but it's true: Hans Asperger invented that ... to "justify" the large scale killing of Polish and Jewish children in "Aktion T4". Let me just provide a link because I would readily understand you not believing me [1]. This guy is revered by today's psychiatrists, for the same reason Freud was. Not, of course, because he helped people, in fact he killed far more than Dr. Mengele, but because he enabled psychiatry to grow.

Even the more benign theories, like famously Taylorism, turned out to be ... a fraud. Quite simply a fraud. There is zero chance Taylor believed in his theories himself, as he paid people to lie about them.

Second, clear patterns of fraud keep coming forward over time. Famously "hysteria" and, of course, running away from a slave master ("drapetomania"), getting raped, being female in general, being gay (although choosing voluntarily for prostitution is still "being treated" with the patients incarcerated. Well, only for women of course). It turns out psychiatry was only used for social control in those (many) cases. The fight against psychiatrists was an important (and now de-emphasized) part of emancipation in both cases.

HIV actually manages to fall into both categories. God's punishment for being gay, with of course psychiatrists making sure some of that heavenly punishment is not just restricted to posthumous roasting.

Today is different ? Let me just say "VERY unlikely". If something was true for 200 years, and there haven't been any big changes ... why would anyone believe it has changed ?

And psychiatry doesn't actually help patients. This is a somewhat problematic issue that keeps popping up. In empirical studies, it keeps coming forward that many psychiatric treatments don't work better than a placebo. A great number of treatments, that are nevertheless used, are known to be far worse than doing nothing at all. There isn't a single involuntary treatment that's empirically verified better than a placebo despite more than a hundred years of searching for one. Antidepressants are famous for their incredibly bad long-term effects, yet psychiatrists keep prescribing them. Before you say "pharmacological industry", THEY label their products as having a maximum indicated usage of weeks to months. Psychiatrists and even nurses however, give them to patients for years, with disastrous effects. For children Ritalin (and Valium before it) are known to have extreme negative effects on child development with anything but extreme short term use. Valium was in fact quite exceptional in that it's long term effects were relatively benign, but it was addictive and therefore a drug. But it gave much less serious long term problems, especially compared to prozac/fluoxetin/SSRIs, what they use now. The problem with Valium was also that it was abused on a large scale, and when push comes to shove, it's similar to keeping a kid drunk for years, even if liver failure is much less likely. But of course sedation leads to serious problems if it's used for any length of time. Again, any other medical practitioner giving patients medications beyond their indicated usage with known bad effects on the patient ... would lead to jail time.

It's time that the same becomes true for psychiatrists and social workers.

[1] https://www.nature.com/articles/d41586-018-05112-1

Freud is not really revered by most psychology professors, at least from the textbooks and professors I had had. They all characterized him as somehow who was one of the first to start looking at psychology in a new way, but one who whose theories had little relevance to the modern world, little basis in fact, and serious problems with its view toward humans.

Also: he systematically defended serial rapists by using violence against women and kids and there are even some indications he did more than just defend them.

He, like a LOT of famous psychiatrists, certainly also including Hans Asperger, should be treated like dr. Mengele and excised from the profession, all their theories replaced in psychological texts, to be replaced with a warning. Like in medical texts that there were famous and incredibly horrible crimes committed by famous psychiatrists.

The only use Freud and Asperger should have for the profession is to illustrate the need for an ethical code of conduct and severe penalties for even mild violations of it. Because you just cannot imagine how horrible the lives of quite a few people got with "help" from these people.

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