Saturday Survivors: MindFreedom International Founder, David Oaks

Psychiatrist and author Loren Mosher, former director of the National Institute of Mental Health Scizophrenia section, said in the LA Times, "The fact that the movement has survived is due in large part to David's ability to work like a dog for almost no money and his ability to mollify those people who are outraged. He has managed to keep a lot of disparate opinions under the tent."

David Oaks Psychiatric Survivor visionary leader 

Director of MindFreedom International 

leader in the Human Rights movement

MindFreedom International is extending an invitation to Boycott Normal!

via MindFreedom:

A brief biography about David W. Oaks

David W. Oaks, Executive Director of MindFreedom International, has been a psychiatric survivor human rights activist since 1976.

David is also on the Board of Directors of the United States International Council on Disabilityand Oregon Consumer/Survivor Coalition.

"My recruitment room..."

David was born on 16 September 1955 in Chicago, Illinois, USA. All of his grandparents were immigrants from Lithuania. Both of his grandfathers were coal miners in rural Illinois before moving to Chicago.

David's parents were working class loving parents who both worked in offices. David had a brief encounter with mental health care after his high school graduation from St. Ignatius College Prep in 1973.

In the Fall of 1973 David attended Harvard University on scholarships, including one from his father's Teamster's Union.

In David's sophomore, junior and senior year he experienced the psychiatric system. David was placed in psychiatric institutions five times. He was diagnosed both "schizophrenic" and "manic depressive" (now known as "bipolar") and underwent forced psychiatric drugging and solitary confinement. David has been given neuroleptics (including Thorazine, Stelazine, Haldol, Mellaril, Navane), lithium, anti-depressants, etc.

It was while in a psychiatric solitary confinement cell in Bowditch Hall in McLean Hospital in Belmont, Massachusetts, that David decided he wanted, once freed, to take action to improve the mental health system.

A psychiatrist at McLean Hospital, a Harvard teaching institution, told David that because he had a genetically-caused chemical imbalance he would have to remain on powerful neuroleptic psychiatric drugs the rest of his life.

That psychiatrist turned out to be incorrect.

Community Organizer Since 1976

In 1976, Harvard's student volunteer agency Phillips Brooks House placed David with one of the early psychiatric survivor human rights organizations, Mental Patients Liberation Front, which met at Vocations for Social Change near Central Square in Cambridge, Massachusetts. David wrote his senior paper about community organizing with psychiatric survivors, and graduated with honors in 1977.

With support from peers and his family, David used exercise, nutrition, counseling, wilderness trips, and employment to recover mental and emotional well being. He has been off all psychiatric drugs since 1977.

David helped form one of the first user-run psychiatric survivor activist drop-in centers with MPLF at the Stone Soup Art and Poetry Gallery, and later at an MPLF office across from the Boston Garden.

As well as his activist work in the field of human rights in the mental health system, David has also worked in the environmental, peace and social justice movements.

In 1986, David helped found what was to become MindFreedom International, which an independent activist coalition united to win human rights and alternatives in mental health. MFI is now one of the main organizations winning campaigns for the vision of a peaceful revolution in the mental health system. While a majority of the members identify as individuals who have experienced human rights violations in the mental health system, MFI also includes family members, attorneys, mental health professionals and supportive members of the general public. 

David lives with his wife Debra in Oregon and loves camping and gardening. David helped found and is a member of a men's support group which has met since 1989.

David was named by Utne Reader in 2009 as one of "50 Visionaries Who Are Changing Your World." 

David has received several other awards and honors, to read about these click here, or click on "Related Content" below.

How to Inquire About Workshops, Presentations and Interviews with David W. Oaks

David is available for speaking engagements and workshops. He has presented on topics such as "community organizing for independent systems change in the mental health system" and working with the cross-disability movement, to a diverse range of participants including in Chile, Norway, Ireland, Turkey, Italy, Germany, Canada, Ghana and throughout the USA.

You may read recommendations about some of these speaking engagements by clicking here.

MFI Blog written by David Oaks

David W. Oaks wrote this chapter in the book "Coercive Treatment in Psychiatry: Clinical, legal and ethical aspects," published in 2011. The book editors were Kallert, Mezzich, Monahan.

The moral imperative for dialog with organizations of survivors of coerced psychiatric human rights violations  

BOYCOTT NORMAL 

We are all connected

we are all connected...

I have come to realize that it is only when I am more aware of a lack of harmony that I am in pain. 

This makes me fighting mad: Military continues off-label drug use

via Broken Warriors
BY BOB BREWIN 09/28/2011

This is the fifteenth story in an ongoing series.

a few excerpts:

"The U.S Central Command continues to back the use of Seroquel, a powerful antipsychotic, to treat insomnia in troops deployed to combat zones despite an expert panel's recommendation six months ago to cease the practice. The drug, known generically as quetiapine, has been linked to adverse effects, including heart failure.

In May, the Defense Pharmacy and Therapeutics Committee at its semiannual meeting said that the Food and Drug Administration had not approved any drugs in the class known as atypical antipsychotics, which includes Seroquel, for treatment of insomnia. Nonetheless, CENTCOM has approved the use of Seroquel in low, 25-milligram doses to treat sleep disorders.

In minutes of that meeting signed Aug. 5 by Dr. Jonathan Woodson, assistant secretary of Defense for Health Affairs, and posted to its website the same day, the committee said, "the use of low-dose AAPs [atypical antipsychotics] should be discouraged due to the lack of supportive evidence, risk of adverse events (metabolic and cardiac) and lack of monitoring (e.g. EKG) for adverse events in theater."

The Defense Health Board, a federal advisory group chartered to provide independent advice to the secretary of Defense, recommended in a draft report last month that Defense review its current guidance on the off-label or non-FDA-approved use of drugs, including Seroquel.
The pharmacy committee urged CENTCOM to use less dangerous drugs to treat insomnia. It said, "Other drug options to treat insomnia are available on the CENTCOM formulary, which have a lower risk of adverse events than the AAPs." Researchers at Vanderbilt University and the Nashville Veterans Affairs Medical Center reported in a January 2009 New England Journal of Medicine article that patients prescribed atypical antipsychotics, including Seroquel, had a significantly higher risk of sudden death from cardiac arrhythmias and other cardiac causes than patients who did not take these medications."

"An Army doctor who declined to be identified for publication, said he found it "quite remarkable that despite clear opposition to the continued use of the antipsychotics by [Office of the Assistant Secretary of Defense for] Health Affairs, and the [Pharmacy and Therapeutics] Committee, CENTCOM and the services continued to defend their use, all the while without anything but weak anecdotal evidence of efficacy."  read

hat tip:
D. Bunker at Psychiatry, It's a Killing

Bunker has a whole lot more on his site check it out!

Criminal trials need not be based on the facts

A handful of Police Officers were involved in killing a mentally disabled man named Otto Zehm, in Spokane Washington in March of 2006.  Otto had committed no crime.  No effort whatsoever was made to bring his murderer to trial. Ultimately the DOJ filed charges, charging one officer (there were a total of seven involved) with lying to investigators, and for using "unreasonable force." Karl Thompson struck Otto Zehm seven times and tazered him twice within 32 seconds after rushing up to him with a raised baton... 


The Federal Judge is hinting that a plea bargain should be made for this miscreant.  The Judge ruled the Assistant Police Chief can not tell the jury that Karl F. Thompson, the Police Officer on trial, did not follow Department Procedures when he chased a frightened Otto Zehm through a mini-market; before commencing to beat him in the head with his police baton---even though these events were caught on video.  Otto Zehm was "armed" with a 2-liter bottle of soda; and had committed no crime. Ultimately, Otto Zehm was beaten, tazered and then hogtied before he stopped breathing--


Federal Judge Van Sickle issued a ruling that the jury will not be told that Karl F. Thompson's actions led to Otto Zehm's death, which was ruled a homicide; because this fact the Judge ruled is, “irrelevant and becomes confusing for the jurors.  It’s not something that needs to be addressed or should be addressed..." 

The Spokane County Medical Examiner ruled Otto Zehm died as the result of homicide in May of 2006, with lack of oxygen to the brain as the official cause.  Thompson is not charged with homicide: The fact that Thompson had a sworn duty to protect and to serve, but brutally attacked a handicapped man who died as a direct result of Thompson's beating; is "irrelevant."

The Judge's ruling in effect means:

 CRIMINAL TRIALS NEED NOT BE BASED ON THE FACTS

WHEN

The victim is "mentally handicapped" and the perpetrator is a Police Officer who ignores Police Procedure and THE LAW.

Via The Spokesman Review:October 4, 2011 in News, City

Thomas Clouse The Spokesman-Review 

Zehm trial will be moved to Yakima 

a couple of excepts:
"Thompson, responding to an erroneous report that Zehm had stolen money from an ATM, approached Zehm inside the Zip Trip at 1712 N. Division St. and began striking him with a baton. Six other officers responded, hogtied Zehm and placed a plastic oxygen mask over his face to prevent him from spitting. Zehm stopped breathing and did not regain consciousness."

"At the end of the hearing, Van Sickle asked the attorneys whether plea negotiations were under way." here

Learn More about the Otto Zehm Case:
Updates and videos from The Spokesman review
Assistant US Attorney alleges Spokane Mayor misled the press and the public

Washington State DSHS Continues to violate Medicaid Law in defiance of Washington State Supreme Court Jenkins Decision

On the first of September I received the current CARE assessment for Isaac from the local Aging and Long Term Care office.  I am his care provider and his in-home care is funded by the federal Medicaid program.   Once again, I noted that the hours assessed are not the hours authorized.  I know that this is in fact illegal, done in defiance a Washington State Supreme Court ruling for the entire time I have been his provider. 


In 2006 there was a lawsuit brought by people who received in home care through this program.  The lawsuit was brought by people who lived with their providers and were being denied some of  the hours of care they were assessed to meet their needs by the State of Washington because they lived with their care providers.  In May of 2007, the Washington State Supreme Court ruled that this practice was in fact illegal, that it violated Medicaid's comparability requirement in Jenkins v. Washington State Department and Social and Health Services.


I became Isaac's provider in December of 2008, after resolving an issue with the State of Washington that took just over two years to resolve.  The issue was the State of Washington  placed my name on a list of people who could not work in any capacity with children or vulnerable adults.  It took me two years to get an answer as to why my name had been put on this list.  


The State required me to make my son a Ward of the State in order for him to continue being eligible for the mental health services he needed to be covered by Medicaid.  He had needed mental health services since he had been victimized when he was three years old---while in foster care.  The State requiring me to make my son a Ward of the State for this reason was in fact a violation of Federal Law, I later discovered.  He was in fact already on Medicaid.    


The reason it was done I believe, is once he was a Ward of the State, the Federal Government paid a larger portion of the cost of his care.  Back to why my name was on this list.  I was put on the list once Isaac came home and his dependency was dismissed.  Once dismissed, the dependency that was illegally sought and obtained, was then falsely claimed to be due to "a founded allegation of abuse or neglect."  This was not true, and ultimately, in December 2008, I was authorized to be my son's provider two years and one month after first applying.  


The entire time the State of Washington has been authorizing fewer hours than are assessed as needed for Isaac's care.  Every time I have questioned this disparity, I have been told it is because he lives with me.  When this current assessment arrived in the mail, last month, I called his case manager and told him that I know this practice is illegal and I requested that the hours assessed be the hours that are authorized; I was told that he did not have the authority to do that.  I told him that I wanted an explanation why the hours assessed are not the hours that are in fact authorized for payment, and he told me I would be mailed this information.  


More than three weeks passed, with no information.  I again called the case manager to inquire about the information promised.  That was last Friday, today I received a letter which does not answer my question, "What gives ALTC the authority to authorize less hours than are assessed for my son's care?"  The letter that I received today in answer to this question clearly demonstrates that it is being done in violation of the Medicaid's comparability requirement; and in violation of the Washington State Supreme Court Jenkins ruling:  

The letter explains how hours are assessed, but does not in fact say with what authority hours assessed are not authorized for payment.  The reason that is given on my son's assessment is that he lives with me, his care provider.  According to the Jenkins ruling this is not allowed.


from Jenkins:

¶ 28 Also, DSHS argues that the shared living rule is a valid part of their CARE assessment in determining the level of need for public assistance.   We agree that DSHS may use the CARE assessment program to initially classify, rate, and determine a recipient's level of need because this process is consistent with the Medicaid program's purpose.   DSHS violates the comparability requirement when it reduces a recipient's benefits based on a consideration other than the recipient's actual need.   A 15 percent reduction across the board for all recipients who live with their caregivers does not address, and in fact ignores, the realities of the recipients' individual situations.

¶ 29 Neither DSHS nor the study provides any explanation of how the 15 percent amount is derived from the study's data.   Furthermore, the study does not provide data to distinguish clients who are clinically complex from clients who are not.   In each case before us, the evidence  established that before any reduction, the hours required to provide for the needs of the individual plaintiffs greatly exceeded the hours actually reimbursed.

¶ 30 Once a person is assessed to require and receive a certain number of care hours, the assessment cannot be reduced absent a specific showing that fewer hours are required.   To “presume” some recipients need fewer hours of care without individualized determination violates the comparability requirement.   A recipient who does not live with a caregiver is assessed an amount needed for meal preparation, housekeeping, and shopping under WAC 388-106-0130.   Likewise, a recipient who does live with a caregiver should also be assessed with the same criteria for those same needs on an individualized basis.   The needs of a recipient are not presumed met without an individual assessment." (emphasis mine)

What all of this means is that the State of Washington continues to violate the comparability requirement of the Medicaid program, and has ignored the Washington State Supreme Court Ruling of Jenkins v. Washington State Department of Social and Health Services.   

Final Note:  The dependency court ordered the State of Washington at the final hearing dismissing his dependency to do several things, none of the Court's Orders were followed.  One of the things the Department was ordered to do was to assist me in transitioning Isaac to the adult system, (including facilitating my application to be his care provider)  I was already a State Certified Care Provider and had partially supported myself while Isaac was hospitalized by working as a State paid care provider.   

The CARE assessment tool used in Washington State is geared to assess needs of people with physical disabilities, not individuals like my son who are cognitively and/ or intellectually disabled, and in this respect, it is seriously flawed.

Antidepressants prescribed without a psychiatric diagnosis in spite of Black Box warnings

WHAT IS THE POINT OF THIS ?

Why would psychotropic drugs, specifically, antidepressants be prescribed without a psychiatric diagnosis? The drugs have an FDA Black Box warning for suicide; the strongest warning issued by the FDA. A warning  is obviously useless if it is not shared with patients or parents of children who are prescribed antidepressants. The warning is minimized, if shared at all with patients prescribed the drugs. 


via Psychiatric News, an online publication of the American Psychiatric Association:


an excerpt from "Analysis Continues of Fallout from FDA's SSRI Warning"                                                                                             
“We observed a decline among children in the number of depression visits with an antidepressant prescribed after the FDA advisory, a trend that seemed to parallel an overall decrease in depression visits,” authors Shih-Yin Chen, Ph.D., and Sengwee Toh, Sc.D., wrote. “When we further assessed the trend in terms of proportion, the likelihood of prescribing an antidepressant among visits with a diagnosis of depression among children remained relatively stable at approximately 65 percent just before and after the advisory.... These findings suggest that the FDA advisory might have led to fewer numbers of depression visits overall and of depression visits with an antidepressant prescribed. But even with this decline, if children were actually diagnosed as having depression, they might not have been any less likely to have been prescribed an antidepressant after the advisory than they had been before.


Child psychiatrist and APA Treasurer David Fassler, M.D., said the study results are broadly consistent with several previous reports on the effects of the 2003 advisory. “The FDA hearings on SSRI antidepressants and the subsequent 'black box' warnings clearly had a significant impact on the recognition and treatment of depression in children and adolescents,” he told Psychiatric News. “Following the FDA's actions, young people were less likely to be diagnosed with depression, and many physicians became reluctant to prescribe SSRIs for pediatric patients.” read here     

The September 2011 issue of Health Affairs  had an article, "Proportion of antidepressants prescribed without a psychiatric diagnosis is growing" 

"Over the past two decades, the use antidepressants between 1996 and 2007, the proportion of visits ant medications has grown to the point that they are now the third most commonly prescribed class of medications in the United States.  Much of this growth has been driven by a substantial increase in antidepressant prescriptions by nonpsychiatrist providers without an accompanying psychiatric diagnosis.  Our analysis found that between 1996 and 2007, the proportion of visits at which antidepressants were prescribed but no psychiatric diagnosis were noted increased from 59.5 % to 72.7 percent." read here


One of the things that really bothers me about mental health research is the overwhelming bias towards drugs being used to treat depression and every other psychiatric diagnosis.  Psychiatric drugs used  have some pretty serious risks, including dependence.  This is troubling to me in that any ethical clinician is duty bound to share such risks with patients---but many do not. 

I am not a doctor, but this does not sound science-based, so it cannot be Evidence-Based Medicine.
   

 hat tip: Gary Schweitzer 

NIMH Drug Trials: More Trials Recommended For Drugs No More Effective Than Placebo

Effectiveness of Pimozide in Augmenting the Effects of Clozapine in the Treatment of Schizophrenia

Sponsor:

National Institute of Mental Health (NIMH)

Information provided by:

National Institute of Mental Health (NIMH)

ClinicalTrials.gov Identifier:

NCT00158223

Detailed Description:
A significant number of schizophrenics exhibit partial or no response to typical antipsychotic medications. Clozapine has been shown to be more effective in treating schizophrenia than typical antipsychotic drugs. However, only an estimated 30% to 60% of people who are unresponsive to treatment with typical antipsychotics will respond to treatment with clozapine. Taking clozapine with pimozide, an antipsychotic drug, can increase clozapine's effects. However, sufficient research on this approach has not yet been performed. This study will assess the effectiveness of pimozide in enhancing the effects of clozapine in the treatment of schizophrenia. (emphasis mine) read the rest.

via PMC Neuropsychopharmacology. 2011 May;36(6):1289-95. Epub 2011 Feb 23.
Pimozide augmentation of clozapine inpatients with schizophrenia and schizoaffective disorder unresponsive to clozapine monotherapy.


Joseph I Friedman,^1,2,* Jean-Pierre Lindenmayer,^3,4 Frances Alcantara,⁵ Stephanie Bowler,² Mohan Parak,³ Leonard White,² Adel Iskander,³ Michael Parrella,² David N Adler,⁶ Nicholas D Tsopelas,⁷ Wei-Yann Tsai,⁸ Vladan Novakovick,¹Philip D Harvey,⁹ and Kenneth L Davis¹
Source
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA. jfriedman1@rcn.com

Abstract
Despite its superior efficacy, clozapine is helpful in only a subset of patients with schizophrenia unresponsive to other antipsychotics. This lack of complete success has prompted the frequent use of various clozapine combination strategies despite a paucity of evidence from randomized controlled trials supporting their efficacy. Pimozide, a diphenylbutylpiperidine, possesses pharmacological and clinical properties distinct from other typical antipsychotics. An open-label trial of pimozide adjunctive treatment to clozapine provided promising pilot data in support of a larger controlled trial. Therefore, we conducted a double-blind, placebo-controlled, parallel-designed 12-week trial of pimozide adjunctive treatment added to ongoing optimal clozapine treatment in 53 patients with schizophrenia and schizoaffective disorder partially or completely unresponsive to clozapine monotherapy. An average dose of 6.48 mg/day of pimozide was found to be no better than placebo in combination with clozapine at reducing Positive and Negative Syndrome Scale total, positive, negative, and general psychopathology scores. There is no suggestion from this rigorously conducted trial to suggest that pimozide is an effective augmenting agent if an optimal clozapine trial is ineffective. However, given the lack of evidence to guide clinicians and patients when clozapine does not work well, more controlled trials of innovative strategies are warranted.




Acknowledging that clozapine only helps between 30 and 60% of people who do not respond to other neuroleptics, this trial is funded to see if pimozide will be an effective adjunct to add to clozapine and effectively treat schizophrenia. It was no more effectivethan placebo. So the researchers recommend conducting additional controlled trials, a recommendation which brings to mind an Albert Einstein quote about the definition of insanity. "Insanity is doing the same thing over and over again, expecting different results."

The patients had an increased cardiac risk they were given weekly EKGs. 

When my son was bullied, I became a MadMother

When crimes committed against my son are not investigated, this MadMother wants to know why, wouldn't you?  There is nothing right about felonious behavior committed by "mental health" professionals and attorneys.  Ultimately, my son's Constitutional Rights to Procedural Due Process of Law were violated.  The fact that he has minimal awareness of exactly what this means, and is not able to file complaints, or defend himself; makes these crimes even more heinous.  I would really like to know why victimizing MY son because he is handicapped is acceptable?   My son can not defend himself due to the cognitive and intellectual damage done by the neuroleptic and other psychotropic drugs given to him.   The damage is profound and much of it was done when he was used in the TEOSS Drug Trials in a Washington State psychiatric facility for children without my consent.

He was used in drug trials conducted to gain the FDA endorsement for the drugs so they could be prescribed to children; doing so would change their status from being "off-label" to approved for pediatric use in treating early on-set schizophrenia; so billing Medicaid would not be fraud.  The drugs used on my son were NOT approved for use in children; the drugs are known to cause brain damage and to literally SHRINK BRAIN tissue; among other horrifying effects.  At seven years old, my son was able to do triple digit addition in his head; he had an IQ of 146, and an 8th grade level vocabulary.  He liked puzzles and put together 1,000 piece jigsaw puzzles by himself.  He loved to draw.  Isaac and Nathan would spend hours building with Legos and Knex or mining gold and diamonds in the yard.  He never used his fingers to count--ever.  Last December, he needed to use  his fingers to count the seven days remaining until Christmas.

 At times, he is acutely aware of how much he has lost.  I am grateful that he does not dwell on it.  He is in some ways, at times, emotionally very "grown-up."  But as far as day to day functioning, the ability to schedule appointments, and take care of the business side of life, he needs a lot of help.  He does not socialize much, and isn't really interested in "making friends," but can be very friendly, occasionally.  The more aware he becomes, the more he remembers, the less he has wanted to be around people.  I can't say that I blame him.  It is sad that his awareness, his recovery and improved functioning ultimately led to him experiencing a crisis last year although completely understandable.  Instead of being recognized for what it was: awareness of an overwhelming sense of loss, and grief over the fact he does not have the abilities he had in second grade.   His crisis was perceived by "mental health professionals," as a sign that he needed more of the same sort of "treatment" which had already caused him so much harm.

I am outraged how he was AGAIN assaulted by unethical "mental health professionals" whose erroneous perceptions and inefficacious drugs were used as weapons; that have ultimately caused further decline, due to their traumatic impact on his brain and entire parasympathetic nervous system.  This could not have happened without the culture of control, utilizing unethical treatment practices which permeates Central Washington Comprehensive Mental Health.  A typical "mental health" agency, CWCMH, uses psychiatric drugs as the primary 'treatment method.'  Some employees use coercion and abuse their power and authority by threatening people with a psychiatric diagnosis with a court order if they complain about the negative effects of neuroleptic drugs.

Neuroleptic and other psychiatric drugs can and do cause brains to malfunction, why would anyone believe the drugs are "treating" "brain diseases" and/or "chemical imbalances" which do not exist---if they do in fact exist, they remain undiscovered, after 50 years of diligent searching by bio-psychiatry's devotees.   Why would anyone believe causing brain damage is going to effectively treat or be at all therapeutic?   Yet, there are those who believe teratogenic drugs are 'necessary medical treatment' and are only refused, because the person with the psychiatric diagnosis 'lacks insight and don't know what's good for them.'  This claim is usually supported with the mythology that a psychiatric diagnosis is in itself evidence the individual has a Brain pathology that is incurable but must be treated with the drugs.  Which by the way, actually cause iatrogenic diseases and disabilities.

How can so many people with college educations and Medical degrees believe that lying to patients and their families, educating the general public by lying about what is and is not known about "mental illnesses" and the people who are given psychiatric diagnoses, will cause society to treat people better, and stop discriminating against people with a psychiatric label?

Traditional bio-psychiatric practice relies two major errors of attribution.  The first is classifying a patient's symptoms as evidence of disease or defect, in the absence of empirical evidence to support the claim, i.e. validity. The second, is that iatrogenic injuries and illnesses caused by the teratogenic drugs are attributed to the psychiatric diagnosis itself.  The patient's protests of negative effects are dismissed.  Because after all, so the circular reasoning seems to be, what does a psychiatric patient know, they have a brain disease or a chemical imbalance... 

No one has perfect insight---what utterly angers me is these claims without ANY valid empirical support have been used as a justification for manipulating and coercing patients and family members and worse used to dismiss altogether countless patient's claims of distress and actual harm!  Psychiatric treatment traumatizes patients; and I can attest it is traumatizing as a parent to be  prevented from protecting my own child...There are two obvious reasons for patient noncompliance besides the spurious allegation it is due to anosognosia:  One is the actual effects experienced, including the very real neurological, metabolic and cognitive dysfunction which the drugs can cause, and the second is the inefficacy of the drugs.  

Altogether, it is classic bullying behavior abuse of power and authority; use of intimidation and coercion to exert control and instill fear.  The psychiatrists and mental health practitioners who are proponents of these tactics, have the authority of the Courts to help them institute 'treatment compliance.'

As the "authority" in the diagnosis and treatment of mental illnesses, it is psychiatry that has ensured those given a psychiatric diagnosis are stigmatized, and discriminated against. It begins with what is claimed about the nature of mental illness, what is told to the world, the patients, and their families that a psychiatric diagnosis means.  Once given a diagnosis of schizophrenia, treatment is done to, not necessarily 'for' the patient...Compliance with psychiatric treatment is the main goal, and 'psycho-education' is the 'Evidence-Based' practice which teaches family members how to coerce and manipulate a loved one 'for their own good' in support of the psychiatric professionals to maintain treatment compliance.  The primary end-point for 'successful treatment' for the diagnosis of schizophrenia in the bio-disease paradigm, is treatment compliance; not safety, effectiveness or any real world outcome.

Psychiatric patients are marginalized and discriminated against by their family members who believe and trust "the professionals" who teach them to manipulate, coerce and control their loved one in distress; instead of understand, support, protect and assist them when they are in crisis.  The "professionals" claim these tactics are justified and necessary to gain the all important control of the patient; so the patient learns how very important it is to take the drugs and be treatment compliant.  It is in this way that people who diagnosed are then effectively invalidated by their "mental health providers," who then teach their families and communities to use the very same control methods; claiming it is what the patient "needs"!

A person who experiences being invalidated repeatedly, is traumatized by these experiences.  Instead of learning to care for and about themselves more effectively; they learn to invalidate themselves. They learn they are not important enough to care about.  What they feel, and what they think is reduced to being a symptom of their "disease"; instead of simply being evidence of their humanity.  The ultimate invalidation is psychiatry claiming patients "lack insight" if and when they do not want to be a compliant psychiatric any longer.   Are we so naive to believe that the only reason patients with a diagnosis of schizophrenia do not want to take neuroleptic drugs is due to a lack of insight?  I'd be willing to bet that noncompliance is  more often than not due to the fact these teratogenic drugs DO NOT WORK for the majority of people with a diagnosis of schizophrenia.

Psychiatric survivors have for decades been telling about the abuse and harm that they have endured being BULLIED by psychiatry.  Some have been disabled; and were never informed of the risks.  Psychiatry claims that the people who are diagnosed who claim the drugs do not help them; or claim the drugs make them sick and cause them harm are given additional diagnoses: oppositional defiant disorder, anosognosia, treatment resistant, and ironically, these patients are labeled as "paranoid" because they are rightfully suspicious and disrespectful of psychiatric authority!

My son, continues to pay a steep price for being victimized by psychiatric bullies.  I know I was bullied by my son's psychiatrists who were aided and abetted by public servants all of whom ignored the law and the ethical codes of conduct for their chosen professions.  Psychiatrists who bully their patients are criminals.  Psychiatric practice relies on subverting the truth about the diagnoses it "validates" in a quasi-democratic process.  Diagnoses are conferred, not made through conducting a scientific investigation; conferred absent reliable, replicable, empirically validated, i.e. scientific diagnostic criteria.  Psychiatry relies on consensus-based  diagnostic criteria, practice parameters and standard practices; every other branch of medicine, the diagnostic criteria, practice parameters and standard practices used are derived from empirical data and supported by subjective opinions.  Psychiatry is a long way from being 'Evidence-Based.'

Doctors who determine who is "sick" and in "need of medical treatment" by consensus then use toxic drugs to "treat" patients/victims, but fail to Inform or gain Consent for "treatment" are conducting experiments on Humans, not providing ethical medical treatment.  The scientific Evidence Base does not support neuroleptic drugs as a 'first line' treatment for schizophrenia; nonetheless, it is public policy and the Law in most states.  Being "legal" does not in fact make this a valid, therapeutic, ethical or even a medical treatment protocol; it more closely resembles a political process.  It does make the Stigma of a psychiatric diagnosis horrifyingly real.  A diagnosis may 'legally require' potentially fatal treatment... 

Having a medical license does not make bullying of vulnerable people and their families a valid or ethical way to provide medical treatment.  Medicine is based on science---Attitudes, actions and behaviors that in any other context would be recognized as abusive, coercive and manipulative are not magically transformed simply because college educated, licensed medical professionals are exhibiting the behaviors.  The nature of subterfuge, manipulation and coercion are still what they are: dishonest methods used to gain control over others.  Relying on the respect given to medical experts, psychiatry lobbied for and gained the legal authority to Court Order individuals.  Obviously, there is no ethical duty or legal obligation to comply with the Rules of Evidence when obtaining Court Orders for Involuntary Treatment---it would require empirical evidence of disease, not a consensus of subjective opinions
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Let's be clear why Stigma is real: Diagnostic criteria is based on a consensus of opinions of a relative (albeit educated) few, a person given a psychiatric diagnosis can lose the right to choose where they live and whether to take dangerous teratogenic drugs or not to treat their symptoms; a significant, if not total loss of liberty. A diagnosed person can be confined in a locked psychiatric ward under Court Order, their Civil Rights are not preserved or defended in the Court proceedings, and the proceedings  do not follow Standard Court Procedures used in every other Court proceeding.  Loss of liberty, and  loss of hope from the invalidating, abusive, discriminatory treatment that is "for their own good." The Stigma is attached to the diagnosis and can be legally applied--like a criminal conviction. Psychiatric treatment becomes a life sentence once legally adjudicated; one is "mentally defective" and considered to be less than human, without Human Rights. A psychiatric diagnosis stigmatizes; it diminishes a person's legal and political power.  A diagnosis immediately puts the person at risk of losing their liberty, and it increases their risks of dying suddenly or decades early from the treatment. The Stigma is real. The Stigma of a psychiatric diagnosis is firmly entrenched in American culture and the public psyche. Psychiatry has undermined the integrity of medical science and ignores the ethical standards of medical research and the clinical practice of medicine. Psychiatry has corrupted the Justice system and does not need, value or respect ethical legal standards.