Can autonomy be promoted in a bio-medical model of psychiatry?

In less than eight minutes, retired Detective Marquez Claxton delivers a powerful message in support of Crisis Intervention Training.  
via MIWatch.org on youtube

Retired Det. Marquez Claxton, panelist at RIPPD

miwatch.org is a non-profit news site on mental illness

RIPPD.org Rights for Imprisoned People With Psychiatric Disabilities

 a Human Rights organization in New York City

via Canadian Mental Health Association BC Division on youtube

Crisis Intervention Team Training

The Crisis Intervention Team (CIT) model, developed in Memphis in 1988, is recognized as a gold standard in the United States in police response to persons in mental health crisis. 

via Schizophrenia Research Forum:

Violence in Schizophrenia: Other Risk Factors Matter More Than the Disease

an excerpt:

"Any increase in violence takes a tragic toll on human beings, but Swanson said, that contrary to perceptions of the general public, most patients with schizophrenia do not resort to violence. “If someone with schizophrenia commits a violent act, the immediate assumption is that the reason they did it is because of their disease,” he said. However, they may behave violently for the same reasons as anyone else, and those reasons could include drug addiction or family background." (emphasis mine)   read here

I have concerns about some aspects of CIT and other programs that have been developed to help people in crisis.

My main issue is the amount of misinformation being used to promote the programs and educate the public. I am more than a little uncomfortable with the idea that a person with a psychiatric diagnosis is not accountable for criminal behavior.  It is ludicrous that if they agree to comply with treatment, they are not accountable; in effect, sentencing them to psychiatric treatment as a penalty for criminal conduct---which can have permanent consequences a criminal conviction does not have.  This is coercion in order to gain compliance with the bio-medical paradigm of treatment.  The bio-medical model is reliant on coercive control (it is unethical) of patients to gain compliance with a 'treatment protocol,' regardless of safety or efficacy of the treatment for the individual patient.  

It is bad enough that biased and inaccurate information are stated as facts.  The belief that mental illnesses are genetic and life-long diseases requiring 'medical treatment' has already caused so much more stigmatization, misunderstanding and mistreatment of people with a psychiatric diagnosis, for a strategy that was supposed to 'help' them.  This specific belief has been stated as fact by special interest advocacy groups and bio-medical practitioners without any definitive empirical evidence of it's validity---it is not appropriate, or ethical to spread inaccurate information about a group of people one is advocating for, or professionally treating. 

The Bible refers to this as, "bearing false witness against one's neighbor."

In Civil Law it is slander; in Criminal Law, it is perjury.

My other concern has to do with the acceptance of coercion, manipulation and control as strategies, which are entrenched in the bio-medical paradigm.  Sheilagh Hodgins, Professor and Head, Department of Forensic Mental Health Science, Institute of Psychiatry, King’s College, University of London in an interview was asked, "What are the main ethical problems that psychiatrists will face in the future?"  Her answer, "Control. Thinking the professional knows best what the patient needs but respecting the patients’ right to make decisions about themselves and promoting their autonomy."  (emphasis mine)

As long as psychiatrists and mental health professionals think they know best, have legal authority to control, a patient's autonomy can only be illusory.  A 'right to make decisions' that is a privilege granted by professionals is not a right, but a reward based on approval, usually, compliance with treatment; In effect, it is used as a means of control.   A person being treated this way is not having their right to make decisions respected; but is having their rights controlled.  The psychiatric patient has no real autonomy, and is not free to make decisions.  When under a Court Order, has no Liberty.  Without Effective Assistance of Counsel, no effective  means of gaining their Liberty.

Autonomy can be respected, it can be encouraged, and it can be validated.  Autonomy, the right to make decisions is recognized and respected; or diminished and denied with abuse of power and control.  It is not something a mental health professional gives a person.  It is something a mental health professional takes from a person when determining that as 'the professional' he/she knows best; and therefore, the person's decisions do not deserve to be respected; or valued at all.