In the aftermath of their service, many veterans face many challenges as they reintegrate into civilian life. Among the most pressing and often overlooked of these challenges is alcohol addiction. The reasons behind this are complex and multifaceted, involving psychological, social, and physiological factors. As we delve into this pressing issue, it is crucial to understand not just the prevalence of alcohol use among veterans but also the underlying causes and the paths toward recovery.
Understanding the Scope of the Issue
Alcohol addiction impacts a significant number of military veterans. Studies reveal that the rates of heavy drinking and alcohol use disorders (AUD) are notably higher among veterans compared to their civilian counterparts. The transition from military to civilian life can often be turbulent, marked by a loss of camaraderie and structure that the military environment provides. This can lead to feelings of isolation, depression, and anxiety, which some veterans may attempt to manage or mitigate through increased alcohol consumption.
The gravity of this issue is underscored by its consequences, which range from deteriorating physical health to strained family relationships and decreased quality of life. Addressing alcohol addiction in veterans is not just about treating the addiction itself but also about understanding and addressing the broader context of their mental health needs.
Why Veterans Struggle with Addiction
The root causes of why veterans struggle with addiction are deep and diverse. For many, the experiences of combat and the stress of deployments can leave lasting psychological scars, manifesting as post-traumatic stress disorder (PTSD) or other mental health disorders. Alcohol often becomes a coping mechanism to dull the pain of these memories and the stress of adjustment.
The military culture, which sometimes normalises drinking as a way to build camaraderie and unwind, can also play a role. This normalisation can make it difficult for veterans to recognise the onset of dependency. Additionally, the stigma associated with seeking help for mental health issues can prevent many from accessing the support they need, allowing the cycle of addiction to deepen.
A Pathway to Healing: Veterans Alcohol Rehab
Addressing alcohol addiction among veterans requires specialised approaches that cater to their unique experiences and needs. Thankfully, there are veterans alcohol rehab facilities that understand their unique needs, offering tailored treatment programmes that integrate mental health support with addiction recovery.
Such facilities are designed to provide a supportive environment where veterans can heal among peers who understand their specific struggles. These centres often employ therapies that address both PTSD and substance use disorders, acknowledging the interlinked nature of these issues. The treatment programmes may include cognitive-behavioural therapy, group sessions, and activities designed to rebuild the sense of camaraderie and support that many veterans miss after leaving the military.
Creating Sustainable Support Systems
While specialised treatment is critical, the recovery journey does not end when a veteran leaves a rehab facility. Sustainable support systems are vital for long-term recovery. This involves continuous care approaches, such as ongoing counselling and support groups specifically for veterans, that can provide ongoing encouragement and relapse prevention.
Community-based programmes that encourage social reintegration and the rebuilding of relationships can also play a crucial role. Many veterans benefit from peer support networks where they can share experiences and solutions in a non-judgemental space. Additionally, family therapy and education can equip loved ones with the tools needed to effectively support the veteran’s recovery journey.
Raising Awareness and Advocacy Efforts
Raising awareness is crucial in the battle against alcohol addiction in veterans. Advocacy efforts focus on educating the public and policymakers about the unique challenges veterans face and the critical need for comprehensive support services. These initiatives strive to foster a greater understanding and generate funding for more effective programmes. Advocacy also plays a key role in pushing for policy changes that improve care accessibility and quality for veterans struggling with addiction. By highlighting success stories and the positive impacts of specialised rehab facilities, advocates can inspire community involvement and enhance the support systems surrounding our veterans. These concerted efforts ensure that veterans do not fight this battle alone but are supported by a community committed to their health and well-being.
Summary
The fight against alcohol addiction among veterans is not just a personal battle; it is a community and societal imperative. By increasing awareness, reducing stigma, and enhancing access to specialised care, we can provide our veterans with the support they need to overcome addiction and lead fulfilling lives. This is not merely a health issue – it is a crucial aspect of honouring and supporting those who have served our country.
The National Empowerment Centre (NEC) is an advocacy and peer-support organisation in the United States (US) that promotes an empowerment-based recovery model of mental disorders. It is run by consumers/survivors/ex-patients “in recovery” and is located in Lawrence, Massachusetts in Essex County.
Brief History
The self-stated mission of NEC is to carry a message of recovery, empowerment, hope and healing to people who have been labelled with mental illness diagnosis. It argues that recovery and empowerment are not the privilege of a few but a process that is possible for everyone to embark on and find help with. Although unconventional to those accustomed only to a narrow medical model, the model is part of a recovery movement that comprises an emerging consensus.
NEC and other groups are working to implement the transformation to a recovery-based system recommended by the New Freedom Commission on Mental Health. It operates a toll-free information and referral line. It organises and speaks at conferences. Its staff have published in professional journals, scholastic books, popular press and alternative publications. NEC has “been involved” in many national boards and committees and in policy consultations at the White House, in Congress, in federal agencies such as HUD, the Social Security Administration, HCFA, the Joint Commission on Hospital Accreditation, and The President’s Commission on Disability, and at the regional and local level with organisations such as HMOs and state divisions of mental health programmes. It has developed educational, training and self-help resources. NEC staff have been featured by CNN, USA Today, The Boston Globe, National Public Radio and talk and radio shows in the US, Canada, Europe and other countries.
NEC conducted qualitative research with people who were severely mentally ill but have met criteria for recovery, from which 13 major principles of how people recover were extracted:
Trusting Oneself and Others
Valuing Self-Determination
Believing You’ll Recover and Having Hope
Believing in the Person’s Full Potential
Connecting at a Human, Deeply Emotional Level
Appreciating That People Are Always Making Meaning
Having a Voice of One’s Own
Validating All Feelings and Thoughts
Following Meaningful Dreams
Relating With Dignity and Respect
Healing From Emotional Distress
Transformation From Severe Emotional Distress
Recovery From Mental Illness
NEC research also identified characteristics distinguishing those in illness and those “in recovery”:
Dependent vs self-determining
Mental health system support vs Network of friends support
Identify solely as consumer or mental patient vs identify as worker, parent, student or other role
Medication essential vs one tool that may be chosen
Strong emotions treated as symptoms by professionals vs worked through and communicated with peers
Global Assessment of Functioning (GAF) score of 60 or below and untrained person would describe labeled person as sick vs score of 61 or above and untrained person would describe the recovered person as not sick (normal)
Weak sense of self defined by authority and little future direction vs strong self defined from within and peers, strong sense of purpose and future
NEC developed an approach termed Personal Assistance in Community Existence (PACE). It is based on the premise that people can potentially recover fully from even the most severe forms of mental illness, and on an Empowerment Model of Recovery and prevention. It is an education programme to help shift the culture of mental health from institutional thinking to recovery thinking, designed for people training to become peer coaches, people furthering their recovery, and people learning new skills to help others. It has previously been deliberately contrasted with “PACT” – Program of Assertive Community Treatment – a form of outpatient commitment that was originally designed to enable people to live in the community, rather than in psychiatric hospitals, but according to NEC has become a “coercive, lifelong, and nonclient-directed system with medication compliance as its most important tenet” NEC conducted a national survey of the use of PACE in the mental health system.
NEC co-founder Patricia Deegan was featured on the award-winning radio show a “This American Life” in “Edge of Sanity,” first aired on 1997. Deegan herself is a psychologist who became highly successful despite multiple psychiatric hospitalisations. She was diagnosed as having schizophrenia as a teenager.
Founders
The co-founder and executive director is Daniel B. Fisher, now a board-certified psychiatrist. A graduate of Princeton University, he completed a PhD in biochemistry at the University of Wisconsin, medical training at George Washington University, and a psychiatric residency at Harvard Medical School. While working as a biomedical researcher at the National Institute of Mental Health before he was a psychiatrist, Fisher had a psychotic episode including hallucinations and delusions. After three months at Bethesda Naval Hospital at age 25, which included forced seclusion and antipsychotic haloperidol, he was discharged with a diagnosis of schizophrenia. He was involuntarily hospitalised three times. He reports being influenced by those who were able to show they cared about the person inside and gave him hope that he might some day recover. He went on to become a psychiatrist. He was told during psychiatric training that “You can’t talk to an illness” but believed that talking to the person inside is a key method for building trust and recovery. He has since worked as a psychiatrist in hospitals and clinics, while also being a part of the consumer movement. He said that a very significant part of the reason for becoming a psychiatrist was wanting to bring to the field what he wished had been there when he was going through psychosis He was a member of the White House Commission on Mental Health, 2002-2003.
Laurie Ahern and Patricia Deegan were the co-founders and directors of NEC for several years.
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A flyer for a Mad Pride event in London, 2003. Featured performers include Pete Shaughnessy, Alternative TV, Nikki Sudden, The Fish Brothers, Ceramic Hobs, Melanie Clifford, and Caesar Reel.
Mad Pride is a mass movement of current and former users of mental health services, as well as those who have never used mental health services but are aligned with the Mad Pride framework. The movement advocates that individuals with mental illness should be proud of their ‘mad’ identity.
Mad Pride activists seek to reclaim terms such as “mad”, “nutter”, and “psycho” from misuse, such as in tabloid newspapers, and in order to switch it from a negative view into a positive view. Through mass media campaigns, Mad Pride activists seek to re-educate the general public on the causes of mental disabilities and the experiences of those using the mental health system.
Mad Pride was formed in 1993 in response to local community prejudices towards people with a psychiatric history living in boarding homes in the Parkdale area of Toronto, Ontario, Canada; since then, an event has been held in Toronto every year (except for 1996). A similar movement began around the same time in the United Kingdom, and by the late 1990s, Mad Pride events were organized around the globe, including in Australia, Brazil, France, Ireland, Portugal, Madagascar, South Africa, South Korea, and the United States. Events draw thousands of participants, according to MindFreedom International, a United States mental health advocacy organisation that promotes and tracks events spawned by the movement.
Brief History
Mad Studies grew out of mad pride and the psychiatric survivor framework, and focuses on developing scholarly thinking around “mental health” by academics who self-identify as mad. As noted in Mad matters: a critical reader in Canadian mad studies, “Mad Studies can be defined in general terms as a project of inquiry, knowledge production, and political action devoted to the critique and transcendence of psy-centred ways of thinking, behaving, relating, and being”. Mad studies posits to offer “a critical discussion of mental health and madness in ways that demonstrate the struggles, oppression, resistance, agency and perspectives of Mad people to challenge dominant understandings of ‘mental illness’.” “Mad studies is a growing, evolving, multi-voiced and interdisciplinary field of activism, theory, praxis and scholarship.”
The first known event, held on 18 September 1993, was called Psychiatric Survivor Pride Day, and was organised by and for people who identified as survivors, consumers, or ex-patients of psychiatric practices.
Founders
Mad Pride’s founding activists in the UK include Simon Barnett, Pete Shaughnessy, and Robert Dellar.
Books and Articles
Mad Pride: A celebration of mad culture records the early Mad Pride movement. On Our Own: Patient-Controlled Alternatives to the Mental Health System, published in 1978 by Judi Chamberlin, is a foundational text in the Mad Pride movement, although it was published before the movement was launched.
Mad Pride was launched shortly before a book of the same name, Mad Pride: A celebration of mad culture, published in 2000. On 11 May 2008, Gabrielle Glaser documented Mad Pride in The New York Times. Glaser stated:
“Just as gay-rights activists reclaimed the word queer as a badge of honor rather than a slur, these advocates proudly call themselves mad; they say their conditions do not preclude them from productive lives.”
Culture and Events
Mad Pride and disability pride are both celebrated in July in many countries, including Canada, Ireland, and the United Kingdom. There is a connection to Bastille Day, a French national holiday which occurs annually on 14 July to commemorate the Storming of the Bastille on 14 July 1789. This event was adopted a symbol of Mad Pride, representing liberation and freedom.
The Mad Pride movement has spawned recurring cultural events in Toronto, London, Dublin, and other cities around the world. These events often include live music, poetry readings, film screenings, and street theatre. “Bed push” protests are one form of street theatre unique to Mad Pride events; their aim is to raise awareness about the barriers that prevent people from accessing quality treatment – which disproportionately affect people who are oppressed for other aspects such as race or class – as well as the widespread use of force in psychiatric hospitals. Past events have included British journalist Jonathan Freedland and novelist Clare Allan. Mad Pride cultural events take a variety of forms, such as the South London collective Creative Routes, the Chipmunka Publishing enterprise, and the many works of Dolly Sen.
Bed Push
A Bed Push is a method of activism employed by multiple mental health agencies and advocates as a method of raising awareness about psychiatric care. Activists wheel a gurney through public spaces to provoke discussion about mental health care. MindFreedom has a recipe for a successful Bed Push on their website, urging participants to remain peaceful but also ensure they are seen, using attention-grabbing tactics such as blowing horns, mild traffic disruptions, and loud music. Often patients in psychiatric care feel silenced and powerless, so the act of intentionally securing visibility and showing off resilience is one method of regaining dignity.
Mad Pride Week in Toronto is recognised by the city itself. The festivities surrounding this week are highlighted by the Mad Pride Bed Push, which typically takes place on the 14th of July. The event is staged at Toronto’s Queen Street West “to raise public awareness about the use of force and lack of choice for people ensnared in the Ontario mental health system”. This week is officially run by Toronto Mad Pride which partners a number of mental health agencies in the city. In recent years, some advocates have pushed for Parkdale, Toronto to be renamed MAD! Village, to reclaim pride in its surrounding communities’ long history of struggle with mental health and addictions.
A series of bed push events take place around London each year.
Psychiatric Patient-Built Wall Tours
The Psychiatric Patient-Built Wall Tours take place in Toronto, at the CAMH facility on Queen St West. The tours show the patient-built walls from the 19th century that are located at present day CAMH. The purpose of the tours is to give a history on the lives of the patients who built the walls, and bring attention to the harsh realities of psychiatry.
Geoffrey Reaume and Heinz Klein first came up with the idea of walking tours as part of a Mad Pride event in 2000. The first wall tour occurred on what is now known as Mad Pride Day, on 14 July 2000, with an attendance of about fifty people. Reaume solely leads the tours, and they have grown from annual events for Mad Pride, to occurring several times throughout the year in all non-winter months.
Mad Pride Today
Mad Pride continues to grow with each event. 16 July 2022, in Burlington, VT, Vermonters who identify with the cause came to support it with a showing of speakers, musicians, and food vendors.
In the UK on 14 July 2022, 70 individuals gathered outside Parliament Square to protest the treatment of patients in psychiatric institutions.
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AH vs West London Mental Health Trust was a landmark case in England, which established a legal precedent in 2011 when Albert Laszlo Haines (AH), a patient in Broadmoor Hospital, a high security psychiatric hospital, was able to exercise a right to a fully open public mental health review tribunal to hear his appeal for release. The case and the legal principles it affirmed have been described as opening up the secret world of tribunals and National Health Service secure units, and as having substantial ramifications for mental health professionals and solicitors, though how frequently patients will be willing or able to exercise the right is not yet clear.
The detention of Haines under the Mental Health Act 1983 had been continuous since 1986, mainly at Broadmoor Hospital run by West London Mental Health NHS Trust. The tribunal panel ultimately decided there were sufficient grounds for continued psychiatric detention but recommended better collaborative work towards psychiatric rehabilitation and gradual supported pathways to lower security then release to community mental health services.
Legal Process
Gaining the Right
Haines’s request for his mental health tribunal to be fully open to the public was first made in 2009 but was turned down twice by the First-tier Tribunal. The justification for the refusal included claims that: Haines’s primary intention was to air ‘subjective grievances’; his evidence would not be ‘objectively sensible’; he would be more difficult to control; the public would not be accurately informed; and the cost and the risk to the patient’s health and conduct were disproportionate to any possible benefits.
In 2010 the Upper Tribunal ruled that the First Tier had erred in law, having not correctly identified or applied the principles it should have. In effect it had failed to uphold the fundamental principle that open justice is a right and it is the exceptions that must be justified, rather than vice versa. In addition to such a principle in common law, under Article 6 of the European Convention on Human Rights (Right to a fair trial), reinforced by the Convention on the Rights of Persons with Disabilities (Article 13 Access to justice), detained psychiatric patients have the same right as non-disabled detainees to have their case heard in public, provided they are mentally capable of giving informed consent for their right to patient confidentiality to be waived.
The Upper Tribunal therefore set aside the First Tier’s decision, and was then at liberty to substitute its own decision. A short hearing was held for that purpose in February 2011, taking testimony from Broadmoor staff and Haines by video link. The panel concluded there was a sufficient rationale in Haines’s case to grant an open appeal hearing, and that this was not offset by possible risks or extra costs. Broadmoor Hospital, run by West London Mental Health NHS Trust since 2001, had fought the decision.
Engaging in the Hearing
The appeal hearing itself, the first ever to be open to the public and media, commenced in September 2011 in central London and lasted for two days. Mr Haines’s consultant psychiatrist, Dr Jose Romero-Urcelay, was cross-examined for one day. Haines’s ward clinical nurse manager, social worker and hospital ‘independent’ patient advocate also testified. Haines himself submitted a written report and testified for 20 minutes. Evidence was also heard from an independent social worker and from Albert Haines’s brother Leigh, who was offering to house and support him should he be released.
The decision was that Haines should not yet be released, even conditionally to a lower security facility. The reasons for the decision were published two weeks later, for the first time ever and contrary to a written representation submitted on behalf of Haines. The three-member panel headed by Judge McGregor-Johnson, Honorary Recorder, concluded that under the Mental Health Act Mr Haines was still considered to have a mental disorder of a nature or degree to justify detention in hospital for treatment, and that he still presented a sufficient risk to others and himself. However, Broadmoor Hospital staff were urged to find a way to better engage with Haines, even if that meant starting treatment on his own terms, and to put a clear pathway in place so that Haines could see an acceptable way to progress to lower security facilities and eventual release.
Haines’s solicitor, Kate Luscombe of the firm Duncan Lewis, said her client had received fair public support, had been able to air his grievances, and had followed the proceedings appropriately throughout; however she said Haines was disappointed at the final judgements and questioned whether his treatment over 25 years had promoted his rehabilitation. A spokesperson for West London NHS stated they were pleased the hearing was over due to the burden it being public put on the hospital’s resources, that they thought the verdict agreed that Broadmoor was the best treatment environment presently, but that they would continue to seek ways to engage Haines in treatment. Albert Haines’s sister Denise, however, stated that she believed Albert could not get the kind of help he needs at Broadmoor and fears he would not come out alive.
Personal Background
The legal process made extensive reference to Haines’s life as a child and adult, and he was the focus of some national press coverage which included personal interviews. Born in 1959 in Hammersmith, London, Albert Haines suffered neglect and abuse from a young age. He was put in residential care for many years, as were his three sisters and two brothers. A mental health assessment at just five years of age described him as ’emotionally maladjusted’. He was sexually and physically abused. After leaving residential homes once an adult, Haines stayed in hostels, bedsits or on the streets. He drank alcohol and took cannabis, cocaine and amphetamines. He was convicted of criminal damage in 1979 and in 1980 for possession of an offensive weapon. He was in and out of psychiatric hospitals.
In May 1986 while a patient of the Maudsley Hospital run by South London and Maudsley NHS Trust, Haines went in carrying a machete and a small knife. There is some disagreement between media reports as to whether he threatened staff and gave himself up, or tried to attack a member of staff but was prevented. No one was physically hurt. Later that year he pleaded guilty to attempted wounding. Rather than being sentenced to prison, he was sent to Broadmoor high-security psychiatric hospital for treatment under the Mental Health Act.
In 1992 Haines was transferred to the medium secure Three Bridges Unit in Ealing, London, also now run by West London Mental Health NHS Trust. While there he made successful visits out of hospital and worked in catering without incident, but after a confrontation with hospital staff involving being put in seclusion after brandishing a fire extinguisher and climbing onto the roof, he was returned to Broadmoor in 2008.
Psychiatric Context
According to the tribunal, Albert Haines was long diagnosed with a personality disorder – meaning an enduring and pervasive difficulty that developed by at least adolescence/early adulthood and which especially affects social interaction. The panel noted that several psychiatric reports have concluded that Haines demonstrates features of either emotionally unstable personality disorder and/or antisocial personality disorder. They also referred to childhood conduct disorder being demonstrated by his historical records. References were also made to ‘psychopathic disorder’, a legal category in the Mental Health Act 1983 which could cover any persistent mental disorder if it appeared to lead (in the individual case) to abnormally aggressive or irresponsible conduct; the category was abolished by amendments in the Mental Health Act 2007 which came into force in 2008. A separate political-administrative category of “Dangerous and Severe Personality Disorder” had been introduced in the UK from the turn of the 21st century, and one of four DSPD units nationwide was at Broadmoor Hospital although it is not clear whether Haines was considered under this category.
According to the tribunal, Mr Haines was also long found to have a mental illness in addition to underlying personality disorder, but in 2008 was rediagnosed as having a personality disorder only. Dr Romero-Urcelay of Broadmoor testified that Haines does suffer from a psychotic illness with specific persecutory delusions, at least since he was returned to Broadmoor from Three Bridges in 2008 and refused to accept any treatment from them. Other psychiatrists have not concluded that he has a psychotic illness at all, while others have gone further in concluding that he has a generalised psychosis which meets the criteria for schizoaffective disorder.
At his hearing, Haines disputed the diagnoses of personality disorder and psychosis, although he accepted that he had difficulties. He refused to accept the type of treatment offered by Broadmoor even if any release or step-down in security was conditional on it. He said that as a vulnerable young man he had looked to the experts for help but had been given multiple diagnoses, forced medication and incarceration. He said that trauma from his childhood abuse had not been properly recognised or reported for 25 years and that non-directive counselling had never been offered despite his asking for it ever since he could remember.
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John Hunt (born 16 July 1981) is an Irish citizen who was involuntarily detained as a psychiatric patient. The conditions of Hunt’s detention have been the subject of a sustained campaign by his former partner and mother of his child Gráinne Humphrys. He was committed as an involuntary psychiatric patient in 2005 and was detained at a secure psychiatric unit at Our Lady’s Hospital in Cork until August 2011 when he was transferred to the Central Mental Hospital, Dundrum, Dublin. Until 2010 he was not granted leave for any temporary release from the Cork facility to visit his family. As a result of the campaign of his former partner that year, the Cork hospital allowed Hunt six hours of unsupervised leave every two weeks. Later, following a violent altercation with a psychiatric nurse, this leave was rescinded, and Hunt was transferred to the main Irish forensic psychiatric unit in Dundrum.
John Hunt and Gráinne Humphrys.
As of 2013, Humphrys is still being quoted in the Irish press about Hunt’s apparently ongoing psychiatric detention:
“I am very critical about how his admission was dealt with – it was with the use of force and coercion. He didn’t want to take the medication at the time of his admission and I thought, fair enough. I couldn’t understand why there was not a better method of communication that we could use with him, like open dialogue.”
Early Life
At the time of Hunt’s birth, his family lived in the small, coastal town of Greystones in Wicklow, Ireland. His father was a violent alcoholic and his mother had few supports in raising her children. His four-year-old brother drowned when he was eleven years old. Thereafter, Hunt began getting into fights and taking drugs. Humphrys attributes these behaviours to his history of trauma and low self-esteem. His first breakdown occurred shortly after the end of his relationship with his first long-term girlfriend. Humphrys has expressed the view in relation to Hunt’s history that, “trauma and loss, amongst other factors, form the bedrock of John’s problems — his so-called attachment disorder and paranoid schizophrenia.”
Involuntary Committal and Medication
John Hunt was a resident of Cork, Ireland. He experienced a breakdown while his then partner, Gráinne Humphrys, was pregnant with their child, Joshua. Frightened for his safety, Hunt’s mother, Marion Hunt, instigated committal proceedings against her son. As he was deemed a danger to himself, this led to his involuntary committal in 2006 at the Carrig Mór Centre, a Psychiatric Intensive Care Unit (PICU) in Shanakiel, Cork. The Carraig Mór Centre is a two-storey building that was formerly part of the now defunct Our Lady’s Hospital (Cork District Mental Hospital). Hunt was under the management of a forensic psychiatric team in an 18-bed unit for involuntary patients deemed to have behavioural difficulties arising from their mental condition. Subsequent to his admission, he received a variety of diagnoses including drug-induced psychosis, bipolar disorder and schizophrenia. Family visits at Carraig Mór were carried out in a small CCTV-monitored room at the facility that has been described as “cramped” and “uninviting”.
Since his committal Hunt has been forcibly medicated with a diverse range of psychoactive drugs including the typical antipsychoticszuclopenthixol and chlorpromazine, the atypical antipsychoticamisulpride, benzodiazepines and sleeping tablets. They have had various adverse side effects and Humphrys expressed the view that he was “completely over-medicated”. The hospital authorities at Carraig Mór considered Hunt a ‘chronic’ patient and ‘suitable’ for long-term hospitalisation.
Campaign
In 2007, Humphrys began a campaign seeking to end ‘The Incarceration of John’. The Irish Examiner has noted that she gained substantial attention to his case, powerfully portraying him as a lost soul imprisoned against his will and cut off from his family.
In the summer of 2010 former Green Party Senator, Dan Boyle, visited Hunt at the Carraig Mór facility. Senator Boyle acknowledged that Hunt was ‘physically cared for’ but expressed concern ‘about the overriding culture of excessive medication there’. He also noted that Hunt ‘was only allowed minimum contact with the outside world’ and that he did not have access to a rehabilitation programme. Humphrys argues that Hunt’s treatment at the facility damaged him mentally and physically and she has characterised the mental health system as punitive and fostering dependency in patients. She has also alleged that her former partner suffered in the facility as he has been perceived as non-compliant.
Three days after Senator Boyle’s visit to Hunt he called for a debate in the Seanad on ‘the culture of mental health and psychiatric care services’ in Ireland. In his address Senator Boyle referred to his visit to the Cork psychiatric hospital and the fact that Hunt had only seen his son outside of that institution once in the previous four years.
Later in 2010, following the campaign’s expanded media presence and Senator Boyle’s visit to Carraig Mór, Hunt was granted day release without supervision. Hunt was allowed a six-hour pass every two weeks and, according to Humphrys, this reconnection with the world outside of the secure psychiatric hospital gave him ‘new hope for his future’. Reflecting on Hunt’s experience of the mental health system as a patient and her own as the partner and advocate of a psychiatric patient, Humphrys wrote to the medical authorities of the Carraig Mór Centre in early 2011 outlining her grievances, which was reproduced in the press.
Transfer to the Central Mental Hospital
Hunt’s fortnightly passes were rescinded following an incident in June 2011 when he struck a male member of staff. The authorities at the Carraig Mór Centre also barred all visits to Hunt by non-family members. The context and causes of the incident, surrounding an attempted phonecall to his son, and whether it was properly investigated, were highlighted and contested by his family. The authorities at Carraig Mór reported the incident to the Gardaí (the Irish police force) and also sent a report to the Mental Health Commission, who directed that the incident should be addressed by a Mental Health Tribunal. His family and solicitor were not allowed to attend and were not consulted. The tribunal ruled that Hunt should be transferred to the Central Mental Hospital, Dundrum, the main forensic psychiatric facility in Ireland.
The Irish Health Service Executive has responded that it is the goal of the mental health services to “work in a collaborative way with patients and their families to ensure the best outcome possible for people who need mental health services”. They also stated that, “All patients detained under the Mental Health Act have access to independent legal advice. Their detention under the mental health act is reviewed at regular intervals by an independent mental health review tribunal. This tribunal has the power to end the patient’s detention”.
Prior to his transfer Humphreys stated that she and Hunt’s family were apprehensive about the plan to relocate him but that they remained hopeful that better rehabilitative services would be available to him in Dundrum than were accessible at Carraig Mór; she said Hunt was very worried about it but also it may be something new, though he was concerned he would never be released. John McCarthy, a mental health campaigner and the founder of Mad Pride Ireland, likened the facilities of John’s detention as a form of “jail” where patients were held with “no judge, jury or release date”.
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The Icarus Project (2002–2020) was a network of peer support groups and media projects with the stated aim of changing the social stigmas regarding mental health.
Brief History
In 2002, Sascha Altman DuBrul wrote an article published in the San Francisco Bay Guardian about his experiences being diagnosed with bipolar disorder. He founded the Icarus Project with Jacks McNamara, an artist and writer. The Project sought to create spaces where people could talk freely about their lived experiences in regards to their mental health.
Years later, musician-activist Bonfire Madigan Shive and counsellor/activist Will Hall became key members in The Icarus Project’s administration and development.
Mission
The Icarus Project’s stated aims were to provide a:
“support network and education project by and for people who experience the world in ways that are often diagnosed as mental illness.”
The responsibilities of the group are to gather people locally for support, and access to alternatives to mainstream medical diagnosis and treatment. The Project advocates self-determination and caution when approaching psychiatric care. It encourages alternatives to the medical model that is accepted by mental health professionals.
In 2005, journalist Jennifer Itzenson noted that while the Icarus Project may accept those with a wide range of “perspectives” on mental health issues, there is also “an edge of militancy within the group,” particularly among those who reject medication. Itzenson also writes that’s the group’s questioning of medical care is “misguided” and that rejecting medication is a “potentially fatal choice” for those with bipolar disorder.
While Icarus Project staff have described their expertise in social activism, herbalism, and labour organising; none of them are licensed medical or mental health professionals. The Icarus Project advisory board members describe their members as educators, artists, activists, writers, healers, community organisers, and other creative types. Some members of the group identify as Latinx, queer, trans, people of colour or mixed race, and trauma survivors.
Structure/Funding
The Icarus Project was under the fiscal sponsorship of FJC, a non-profit 501(c)3 umbrella organisation arm of an investment firm, based in New York City. The Icarus Project formerly got the bulk of its money from foundation grants, including the Ittleson Foundation, but it also had many individual donors.
Publications
Educational materials published by The Icarus Project have been published in Spanish, German, French, Italian, Japanese, Greek, and Bosnian/Croatian. Some of these publications are listed below:
Navigating the Space Between Brilliance and Madness; A Reader and Roadmap of Bipolar Worlds (2004)
Friends Make the Best Medicine: A Guide to Creating Community Mental Health Support Networks. (2006)
Through the Labyrinth; A Harm Reduction Guide to Coming Off Psychiatric Drugs (2009)
Mindful Occupation: Rising Up without Burning Out (2012)
Madness and Oppression: Personal Paths to Transformation and Collective Liberation (2015)
Filmography
Films about Icarus Project members are listed below:
Ken Paul Rosenthal (2010). Crooked Beauty. 30 min. Poetic documentary featuring Jacks McNamara. In Mad Dance Mental Health Film Trilogy.
Ken Paul Rosenthal (2018). Whisper Rapture. 36 min. A doc-opera featuring Bonfire Madigan Shive.
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Elizabeth Parsons Ware Packard (28 December 1816 to 25 July 1897), also known as E.P.W. Packard, was an American advocate for the rights of women and people accused of insanity. She was wrongfully committed to an insane asylum by her husband, who claimed that she had been insane for more than three years. At her trial, however, a jury concluded that she was not insane after only seven minutes of deliberation. She later founded the Anti-Insane Asylum Society, campaigning for divorced women to retain custody of their children.
Life
Elizabeth Packard
Elizabeth Packard, born in Ware, Massachusetts, was the oldest of three children and the only daughter of Samuel and Lucy Ware. Samuel was a Congregational minister in the Connecticut Valley of the Ware Congregational Church from 1810 to 1826. She was educated at the Amherst Female Seminary, where she studied French, algebra, and the new classics, thanks to the “adequate wealth” of her parents. In 1835, at age 19, she was diagnosed with brain fever, a nineteenth-century term for an illness thought to be caused by a severe emotional upset. When the family physician failed to help her, Samuel Ware decided to admit her to Worcester State Hospital, with Dr. Samuel Woodard at the helm; he was highly regarded for patient care. On the admission papers, Samuel Ware wrote that she suffered from “mental labor” from her occupation as a teacher. She remained in the hospital for six weeks.
At the insistence of her parents, Ware married Calvinist minister Theophilus Packard, fourteen years her senior and said to be “cold and domineering”, on 21 May 1839. The couple had six children: Theophilus (b. 1842), Ira Ware (b. 1844), Samuel Ware (b. 1847), Elizabeth Ware (b. 1850), George Hastings (b. 1853), and Arthur Dwight (b. 1858). They lived in Western Massachusetts until September 1854. Beginning in 1857, after having lived in Ohio and Iowa for short periods, the family moved to Manteno, Illinois, and appeared to have a peaceful and uneventful marriage.
Theophilus, however, held quite decisive religious beliefs. After many years of marriage, Elizabeth Packard outwardly questioned her husband’s beliefs and began expressing opinions that were contrary to his. While the main subject of their dispute was religion, the couple also disagreed on methods of child rearing and managing family finances, as well as the morality of slavery, with Elizabeth defending abolitionist John Brown, which embarrassed Theophilus.
When Illinois opened its first hospital for the mentally ill in 1851, the state legislature passed a law that within two years of its passage was amended to require a public hearing before a person could be committed against their will with the exception that a husband could have his wife committed without either a public hearing or her consent. In 1860, Theophilus Packard judged that his wife was “slightly insane”, a condition he attributed to “excessive application of body and mind”. He arranged for a doctor, J.W. Brown, to speak with her. The doctor pretended to be a sewing machine salesman. During their conversation, Elizabeth complained of her husband’s domination and his accusations to others that she was insane. Brown reported this conversation to Theophilus (along with the observation that Mrs. Packard “exhibited a great dislike to me”). Theophilus decided to have Elizabeth committed. She learned of this decision on 18 June 1860, when the county sheriff arrived at the Packard home to take her into custody.
Elizabeth Packard spent the next three years at the Jacksonville Insane Asylum in Jacksonville, Illinois (now the Jacksonville Developmental Centre). She was regularly questioned by doctors, but refused to agree that she was insane or to change her religious views. In June 1863, due, in part, to pressure from her children, who wished her to be released, the doctors declared that she was incurable and discharged her. Upon her discharge, Theophilus locked her in the nursery of their home and nailed the windows shut. Elizabeth managed to drop a letter complaining of this treatment out of the window, which was delivered to her friend Sarah Haslett. Sarah Haslett in turn delivered the letter to Judge Charles Starr, who issued a writ of habeas corpus ordering Theophilus to bring Elizabeth to his chambers to discuss the matter. After being presented with Theophilus’ evidence, Judge Starr scheduled a jury trial to allow a legal determination of Elizabeth’s sanity to take place.
Packard v. Packard
At the subsequent trial of Packard v. Packard, which lasted five days, Theophilus’s lawyers produced witnesses from his family who testified that Elizabeth had argued with her husband and tried to withdraw from his congregation. These witnesses concurred with Theophilus that this was a sign of insanity. The record from the Illinois State Hospital stating that Mrs. Packard’s condition was incurable was also entered into the court record.
Elizabeth’s lawyers, Stephen Moore and John W. Orr, responded by calling witnesses from the neighbourhood who knew the Packards but were not members of Theophilus’ church. These witnesses testified they never saw Elizabeth exhibit any signs of insanity, while discussing religion or otherwise. The final witness was Dr. Duncanson, who was both a physician and a theologian. Dr. Duncanson had interviewed Elizabeth and he testified that while not necessarily in agreement with all her religious beliefs, she was sane in his view, arguing that “I do not call people insane because they differ with me. I pronounce her a sane woman and wish we had a nation of such women.”
The jury deliberated for only seven minutes before deciding the case in Elizabeth’s favour. She was legally declared sane, and Judge Charles Starr, who had changed the trial from one about habeas corpus to one about sanity, issued an order that she should not be confined. As scholar Kathryn Burns-Howard described it, “we will never know Elizabeth’s true mental state or the details of her family life.”
Life after the Trial
When Elizabeth Packard returned to the home she shared with her husband in Manteno, Illinois, she found that the night before her release, her husband had rented their home to another family, sold her furniture, had taken her money, notes, wardrobe and children, and had left the state. She appealed to the Supreme Courts of both Illinois and Massachusetts, to where her husband had taken her children, but had no legal recourse, as married women in these states at the time had no legal rights to their property or children (refer to the term Coverture). As such, the Anti-Insane Asylum Society was formed.
Packard did not return to her former life, but became a national celebrity, publishing “an armload of books and criss-crossing the United States on a decades-long reform campaign”, not only advocating for married women’s rights and freedom of speech, but speaking out against “the power of insane asylums”. She became what some scholars call “a publicist and lobbyist for better insanity laws”. As scholar Kathryn Burns-Howard has argued, Packard reinvented herself in this role, earning enough to support her children and even her estranged husband, from whom she remained separated for the rest of her life. Ultimately, moderate supporters of women’s rights in the northern United States embraced her. Some argued that in the midst of the Civil War that a country in the midst of freeing slaves should do the same for others who suffered from abusive husbands. Some argue that she seemed oblivious to her racial prejudice in arguing that White women had a “moral and spiritual nature” and suffered more “spiritual agony” than formerly enslaved African-Americans. Even so, others say that her story provided “a stirring example of oppressed womanhood” that others did not.
Packard petitioned the Illinois and Massachusetts legislatures, and in 1869 legislation was passed in those states allowing married women equal rights to property and custody of their children. Upon the passing of this legislation, Packard’s husband voluntarily ceded custody of their children back to her, and her children came to live with her in Chicago.
Packard realized how narrow her legal victory had been, and that the underlying social principles which had led to her confinement still existed. She founded the Anti-Insane Asylum Society and published several books, including Marital Power Exemplified, or Three Years Imprisonment for Religious Belief (1864), Great Disclosure of Spiritual Wickedness in High Places (1865), The Mystic Key or the Asylum Secret Unlocked (1866), and The Prisoners’ Hidden Life, Or Insane Asylums Unveiled (1868). In 1867, the State of Illinois passed a “Bill for the Protection of Personal Liberty” which guaranteed that all people accused of insanity, including wives, had the right to a public hearing, as did Massachusetts.
Packard also saw similar laws passed in three other states. Even so, she was strongly attacked by medical professionals and anonymous citizens, unlike others such as Dorothea Dix, with her former doctor from the Jacksonville Insane Asylum, Dr. Andrew McFarland, who privately called her “a sort of Joan D’Arc in the matter of stirring up the personal prejudices”. As such, Elizabeth’s work on this front was “broadly unappreciated” while she was alive. She only received broader recognition, starting in the 1930s, by a well-known historian of mental illness, Albert Deutsch, and again in the 1960s from those who were “attacking the medical model of insanity”.
She died on 25 July 1897. In her obituary, The Inter Ocean described her as “the reformer of insane asylum methods”
Scholarship and Legacy
Scholars have written various books and articles about Elizabeth Packard. This has included articles by scholars Myra Samuels Himelhoch and Arthur H. Shaffer in 1979, Paul A. Lombardo in 1992, and Jennifer Rebecca Levinson in 2003. In 1991, Barbara Sapinsley wrote the first book which focused on Elizabeth Packard, entitled The Private War of Mrs. Packard. It was informed by Packard’s family in the late 1960s/early 1970s, and took 20 years to find a publisher. Linda V. Carlisle wrote another biography, published by University of Illinois Press in 2010, entitled Elizabeth Packard: A Noble Fight. In part, she focuses on individual legislation that Packard campaigned for and/or helped bring about. In 2021, Kate Moore wrote a detailed and highly researched story highlighting the character of kindness, service, and perseverance of Elizabeth Packard entitled The Woman They Could Not Silence: One Woman, Her Incredible Fight for Freedom, and the Men Who Tried to Make Her Disappear. Previously, in 2005, Barbara Hambly had referred to Elizabeth Packard, in some detail, in her novel on the insanity of Mary Todd Lincoln, entitled The Emancipator’s Wife: A Novel of Mary Todd Lincoln, since the 1867 law Packard advocated for required a jury trial for anyone who was “committed to an insane asylum.” Moore would later say that Packard was not mentally ill and was “merely independent,” and argued that people should “take inspiration from women like Elizabeth.” Troy Rondinone, a professor at Southern Connecticut State University, made a similar argument, arguing that people should remember “Packard’s battle for women in the mental health care system.”
Emily Mann wrote the play Mrs. Packard, which premiered in May 2007. In Mann’s play, Packard describes her life fully in the insane asylum; it is considered historically accurate.
On 10 August 2023, Illinois Governor J. B. Pritzker renamed the mental health hospital in Springfield Illinois from Andrew McFarland Mental Health Centre to the Elizabeth Packard Mental Health Centre, in Packard’s honour.
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The World Federation for Mental Health (WFMH) is an international, multi-professional non-governmental organisation (NGO), including citizen volunteers and former patients. It was founded in 1948 in the same era as the United Nations (UN) and the World Health Organisation (WHO).
Outline
The goal of this international organisation includes;
The prevention of mental and emotional disorders;
The proper treatment and care of those with such disorders; and
And the promotion of mental health.
The Federation, through its members and contacts in more than 94 countries on six continents, has responded to international mental health crises through its role as the only worldwide grassroots advocacy and public education organisation in the mental health field. Its organisational and individual membership includes mental health workers of all disciplines, consumers of mental health services, family members, and concerned citizens. At its very outset the WFMH was concerned with educating both the public and influential professionals, and with human relations, with a view both to the health of individuals and that of groups and nations. The WFMH founding document, “Mental Health and World Citizenship”, understood “world citizenship” in terms of a “common humanity” respecting individual and cultural differences, and declared that “the ultimate goal of mental health is to help [people] live with their fellows in one world.
Members include mental health service providers and service users. In 2009, the World Fellowship for Schizophrenia and Allied Disorders, an international network of families of people with serious mental illness, merged with the World Federation. The World Federation has close ties with the World Health Organization. For many years after its founding, the WFMH was the only NGO of its kind with a close working relationship with UN agencies, particularly the WHO. In recent decades, though, a number of international mental health organisations, often limited to members of particular professions, have developed. In varying degree they have filled needs formerly addressed mainly by WFMH. The WFMH envisions a world in which mental health is a priority for all people. Public policies and programs reflect the crucial importance of mental health in the lives of individuals. The first Director General of the WHO, G. Brock Chisholm, who was a psychiatrist, was one of the leaders in forming the federation with the goal of creating a representative organisation that could consult with the UN on mental health issues.
The mission of the World Federation for Mental Health is to promote the advancement of mental health awareness, prevention of mental disorders, advocacy, and best practice recovery focused interventions worldwide. Mental health day is celebrated at the initiative of the World Federation of Mental Health and WHO supports this initiative through raising awareness on mental health issues using its strong relationships with the Ministries of health and civil society organisations across the globe. Mental Illness Awareness Week (MIAW) is an annual national public education campaign designed to help open the eyes of Canadians to the reality of mental illness. The week was established in 1992 by the Canadian Psychiatric Association, and is now coordinated by the Canadian Alliance on Mental Illness and Mental Health (CAMIMH) in cooperation with all its member organisations and many other supporters across Canada.
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Clifford Whittingham Beers (30 March 1876 to 09 July 1943) was the founder of the American mental hygiene movement.
Biography
Beers in 1908, from the frontispiece
of his book.
Beers was born in New Haven, Connecticut, to Ida and Robert Beers on 30 March 1876. He was one of five children, all of whom would suffer from psychological distress and would spend time in mental institutions, including Beers himself (see “Clifford W. Beers, Advocate for the Insane”). He graduated from the Sheffield Scientific School at Yale in 1897, where he was business manager of The Yale Record and a member of Berzelius.
In 1900 he was first confined to a private mental institution for depression and paranoia. He would later be confined to another private hospital as well as a state institution. During these periods he experienced and witnessed serious maltreatment at the hands of the staff. His book A Mind That Found Itself (1908), an autobiographical account of his hospitalisation and the abuses he suffered, was widely and favourably reviewed, became a bestseller, and is still in print.
Beers gained the support of the medical profession and others in the work to reform the treatment of the mentally ill. In 1908 Beers founded the “Connecticut Society for Mental Hygiene”, now named Mental Health Connecticut. In 1909 Beers founded the “National Committee for Mental Hygiene”, renamed “National Mental Health Association”, now named “Mental Health America”, in order to continue the reform for the treatment of the mentally ill.
He also started the Clifford Beers Clinic in New Haven in 1913, the first outpatient mental health clinic in the United States.
Beers was a leader in the field until his retirement in 1939. He died in Providence, Rhode Island, on 09 July 1943.
The Extra Mile in Washington, D.C., selected Beers as one of its 37 honourees. The Extra Mile pays homage to Americans like Beers who set their own self-interest aside to help others and successfully brought positive social change to the United States.
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MindFreedom International is an international coalition of over one hundred grassroots groups and thousands of individual members from fourteen nations.
Based in the United States, it was founded in 1990 to advocate against forced medication, medical restraints, and involuntary electroconvulsive therapy. Its stated mission is to protect the rights of people who have been labelled with psychiatric disorders. Membership is open to anyone who supports human rights, including mental health professionals, advocates, activists, and family members. MindFreedom has been recognised by the United Nations Economic and Social Council as a human rights non-governmental organisation (NGO) with Consultative Roster Status.
Origins and Purpose
MindFreedom International is rooted in the psychiatric survivors movement, which arose out of the civil rights ferment of the late 1960s and early 1970s and the personal histories of psychiatric abuse experienced by some ex-patients rather than the intradisciplinary discourse of antipsychiatry. The precursors of MFI include ex-patient groups of the 1970s such as the Portland, Oregon-based Insane Liberation Front and the Mental Patients’ Liberation Front in New York. The key text in the intellectual development of the survivor movement, at least in the US, was Judi Chamberlin’s 1978 text, On Our Own: Patient Controlled Alternatives to the Mental Health System. Chamberlin was an ex-patient and co-founder of the Mental Patients’ Liberation Front. Coalescing around the ex-patient newsletter Dendron, in late 1988 leaders from several of the main national and grassroots psychiatric survivor groups felt that an independent, human rights coalition focused on problems in the mental health system was needed. That year the Support Coalition International (SCI) was formed. In 2005 the SCI changed its name to MFI with David W. Oaks as its director. SCI’s first public action was to stage a counter-conference and protest in May 1990 in New York City at the same time as (and directly outside of) the American Psychiatric Association’s annual meeting.
Many of the members of MFI, who feel that their human rights were violated by the mental health system, refer to themselves as ‘psychiatric survivors’. MFI is a contemporary and active coalition of grassroots groups which are carrying forward the historical tradition of survivor opposition to coercive psychiatry. It does not define itself as an antipsychiatry organisation and its members point to the role which ‘compassionate’ psychiatrists have played in MFI. Activists within the coalition have been drawn from both left and right wing of politics.
MFI functions as a forum for its thousands of members to express their views and experiences, to form support networks and to organise activist campaigns in support of human rights in psychiatry. The coalition regards the psychiatric practices of ‘unscientific labelling, forced drugging, solitary confinement, restraints, involuntary commitment, electroshock’ as human rights violations.
In 2003, eight Mindfreedom members, led by then-executive director David Oaks, went on a hunger strike to publicise a series of “challenges” they had put forth to the American Psychiatric Association (APA), the US Surgeon General and the National Alliance on Mental Illness (NAMI). The eight MFI members challenged the APA, US Surgeon General and NAMI to present MFI with “unambiguous proof that mental illness is brain disorder.” By sustaining the hunger-strike for more than one month, MFI forced the APA and NAMI to enter into a debate with them on this and other issues.
MindFreedom describes their Shield Programme as “an all for one and one for all” network of members. When a registered member is receiving (or is being considered for) involuntary psychiatric treatment, an alert is sent to the MindFreedom Solidarity Network on that person’s behalf. Members of the network are then expected to participate in organised, constructive, nonviolent actions—e.g. political action, publicity and media alerts, passive resistance, etc. – to stop or prevent the forced treatment.
Mental Health Matters 
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