Commentary

Perspectives on Mental Illness: Rethinking Right to Refuse Treatment

In response to our March cover story, a reader argues that the United States needs to stop "overprotecting" mentally ill patients' right to refuse medication and treatment.

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After reading the article “Taking Aim at Mental Illness” (Clinician Reviews. 2013;23[3]:26-28), I felt compelled to respond. I have been practicing in forensic psychiatric facilities for 27 years and believe that our state and federal laws for involuntary medication and hospitalization are outdated. It is time for the pendulum to move back toward the middle of this issue.

We do a disservice to our mentally ill population and their families in America by overprotecting the right to refuse medication and treatment. It is cruel to allow mentally ill individuals to wander the streets while they are unstable. It is cruel for mental health professionals, who dedicate their practice to helping mentally ill individuals, to be subjected to verbal and physical assault, because the right to refuse treatment requires the treatment staff and families of these individuals to wait until a violent act occurs before they can institute involuntary medication and treatment.

I could share several examples of mentally ill individuals who are now incarcerated or institutionalized indefinitely due to the current parameters of involuntary treatment. And that’s not to mention the successful suicides that could have been prevented.

Billions of health care dollars are sacrificed due to these outdated parameters. The revolving door in mental health services is spinning out of control. Individuals get released before they are stable and then return to noncompliance over and over again.

The time has come to readjust involuntary treatment laws, because violent acts by mentally ill individuals and victimization of the mentally ill are epidemic in America. Yes! Take aim at the legal parameters of the right to refuse.
Lucien Morin, MSN, PMHNP, Morro Bay, CA

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