When mental health treatment becomes a violation

Health professionals believe they are delivering the best possible care when they treat a person’s mental illness. But why does so much of that care violate a person’s human rights?

Aug 30, 2018, updated Aug 30, 2018
Photo: Pexels

Photo: Pexels

In the early 2000s when I was detained in a psychiatric hospital I was treated against my will, I was even secluded. You see, I’d felt so ashamed of myself that I made a suicide attempt. The response of the staff was to lock me up, alone, in a tiny, bare room, for hours. And, of course, it just made me feel more ashamed and deserving of death.

To this day I cannot understand why they did this. I had no idea we still treated people this way – I thought it was just something in the movies.

I’ve survived lots of terrible things in my life: childhood sexual abuse, and years of mental health problems that I describe as madness. I’ve survived poverty, discrimination and violence as well. But nothing makes me quite so outraged as the way I was treated in hospital.

I guess that’s because everyone thinks hospitals are such good places, that doctors and nurses are so kind, that people get looked after. Even today, years later, it kind of leaves me astonished that the places where we go at our most distressed, frightened and vulnerable, are the places that can hurt us the most.

So, after my recovery and healing – which all happened outside of psychiatric services—I began to work in mental health myself, first as a support worker, then in providing alternative services with peer support. I couldn’t stand seeing the people I worked with still facing daily violations of their rights, so eventually, I moved to advocacy and policy work where I now focus more on human rights issues.

There are many human rights breaches in mental health care that I’d define as clear and serious, and many others that may not be clear, but can still have a serious impact.

For example, detention in hospital against your will deprives you of your right to liberty – most people get that. Similarly, psychiatric treatment against your will is a clear breach of the right to bodily integrity, to informed consent, and many other rights.

Then there are the less clear rights issues which are also important. An example of this is that many people have their mobile phone confiscated while in hospital – at least in Victoria. This is despite there being a general right to information, and a specific protection in our state Mental Health Act on the right to communicate.

So losing your phone might sound like a small thing. But if you’re locked away somewhere scary and you don’t know what’s going on, you really want that phone – it’s a life line. And phones aren’t just a phone any more – they’re our connection to friends and support networks, how we get information, how we soothe and entertain ourselves.

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I actually think many health professionals know they are breaching people’s rights, but they just don’t think it’s important. Well, not compared to what they think is important.  It’s like the staff and services are so used to doing what they’ve always done that they just can’t see any viable alternative.

There is no counselling or therapy, no support to make life changes, no time or space to work things out. Instead, it’s pills and electroconvulsive therapy, in big, rapid doses, then a quick discharge after two weeks or so.

Many health professionals see their job as reducing symptoms and risk as fast as possible, so they can discharge you and free up a bed for the next person. If you don’t cooperate by agreeing to their treatments, they’ll just force you to take them. If you don’t like the way you’re being treated and try to leave, they’ll forcibly detain you. The slightest risk is seen as being something to be controlled.

Our modern-day mental health services are a strange kind of beast. The average person knows very well that if you get really stressed, or bullied, or experience violence, that you might end up with a mental health problem. We all get that, because it’s true. We know that ‘mental illness’ is a kind of shorthand for really big emotional problems. And if you’re lucky enough to stay in control of your own mental health care, you can choose to see a therapist, or make changes in your life, or try some medication to give you some relief. But when you go to a mental health hospital service, all that common sense disappears.

There is no counselling or therapy, no support to make life changes, no time or space to work things out. Instead, it’s pills and electroconvulsive therapy, in big, rapid doses, then a quick discharge after two weeks or so.

So, for me, these services often appeared to reduce ‘symptoms’ because I was so sedated and broken by the time I left that I seemed low risk. But in reality, almost a decade since my last admission, I still have occasional nightmares about that place. I listen to people’s stories and my own personal traumas bubble up and give me days of distress and anxiety. Those violations of my rights were not neutral, they were injurious.

And I think this is maybe where the greatest opportunity is for the health profession to change: to get them to realise that breaching human rights is not a neutral act – it’s a harmful act. So even if they think it’s justified, we need them to see that every breach is like an injury, whether it’s to our dignity, our emotions, our safety, or our spirit.

Indigo Daya is a Senior Consumer Advisor in Victoria’s Office of the Chief Psychiatrist.

This is one of a series of articles published by InDaily this week in conjunction with the Mental Health Services Conference – an annual national event that challenges our current knowledge and ideas about mental health care and the systems that operate within it.

For support call Lifeline – 13 11 14

In a mental health emergency, call SA Health’s mental health triage service  – 13 14 65

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