Enforced Psychiatric Treatment

Enforced Psychiatric Treatment: a case study

By Les Ruthven, Ph.D. Clinical psychology/health management

Health blog: http://www.ruthvenassessments.com/

Charles Helmer, a 20 year old, was hospitalized at a psychiatric facility with court approval on an involuntary commitment. On the unit he was said to be threatening of staff, irritable, distracted, and easily agitated. I do not know if this description of his behavior was prior to or following the court ordered initiation of neuroleptic medications and later enforced electroconvulsive therapy (ECT). While in the hospital, and prior to ECT, Charles was placed on Clozaril, Abilify and Risperdal, all current generation atypical antipsychotic medications. These 3 medications were said to be partially or not effective. These 3 medications are FDA approved for schizophrenia, Charles’ diagnosis (schizoaffective schizophrenia was another diagnosis), but such treatment is off-label or non FDA approved if either of these medications are used concurrently or serially. I suspect these medications were used serially because of an inadequate response to any of these drugs. The latter is very likely because the experimental drug parade did not stop with these three drugs. Later court permission was granted for other enforceable drugs such as Haldol (a 1^st generation antipsychotic), prolixin (a 1^st generation injectable antipsychotic drug) and still later another course of Clozaril, Invega (another 2^nd generation antipsychotic) and Zyprexia!

From such a history of drug failures one might think a psychiatrist might consider another path than biological treatments and taper all drugs to determine what the patient is really like without the drugs and any of their adverse side effects, which would be my recommendation. Actually another psychiatrist reviewed the medical record and advised a new path of addressing psycho social factors in the patient’s life. Actually the World Health Organization conducted two schizophrenia treatment studies (see Reference) in European countries and the U.S. (primarily drug therapy) vs. 3 third world countries (no drug therapy with schizophrenic patients) and the latter had substantially better outcomes (including fewer re-hospitalizations) than in the drug treated countries! However, when Charles did not obviously respond to drug treatment the decision was to turn to another biologic, ECT. In view of the history of Charles’ treatment thus far I hope his treating psychiatrist will not ask the court for an enforced lobotomy!

From my review of the health literature for my book I find that many psychiatric drugs have little or no clinical effectives but these drugs also impair brain functions (in some cases permanently with long term drug use) and when the brain is impaired the patient’s learning ability is also impaired! Patients with depression, anxiety, PTSD, borderline personality and yes, even schizophrenia, certainly need their ability to learn in their recovery.

Reference: World Health Organization (WHO). “Schizophrenia: an international follow up study”. Chictrester. John Wiley&Sons: 1997.

The author’s new book is available at: https://www.amazon.com/Whats-Wrong-U-S-Healthcare-how-ebook/dp/B08NKCZ24T/ref=pd_rhf_pe_p_img_3?_encoding=UTF8&psc=1&refRID=EJ5RM2G6Q46HMFQFXH80