The Need for Deinstitutionalization

Irit Shimrat

All provincial and territorial legislation allowing psychiatric hospitalization and community treatment or outpatient committal orders must be abolished.

People who behave strangely routinely get locked up at the instigation of friends, relatives, employers, landlords and others. Police are summoned, and we are handcuffed, forced into ambulances, and taken to the hospital. There, we are stripped naked, shackled, injected with dangerous drugs, and locked into solitary-confinement cells. Some of us are subjected to electroshock treatment. Only when we become helpless and submissive can we begin to earn such privileges as wearing clothes, participating in group activities, and, eventually, being discharged.

Even then, our physical freedom – not to mention our access to housing, employment and other basic needs – may depend on “treatment compliance.” Right now, too many of my friends are being coerced into taking drugs that cause grave physical harms, cognitive problems and emotional suffering. Refusal means re-hospitalization and forced drugging. Psychiatric labels and treatments are cruel, degrading and arbitrary. No other branch of medicine keeps trying, unsuccessfully, to prove that the diseases it purports to treat actually exist.

By forcing us into “treatment compliance” outside of the hospital, outpatient committal turns our own communities, homes and brains into inescapable prisons. More generally, psychiatry denies the reality of social ills – of problems between people – by blaming them on supposed chemical imbalances in individuals’ brains.

Canada’s ratification of the Convention on the Rights or Persons with Disabilities is a joke, given our country’s refusal to be bound by Article 12 of the Convention – the article governing our right to legal capacity, which is meant to protect our right to make decisions about our own health care, including the right to refuse treatment.

Psychiatry and its drugs are big business, providing powerful tools for social control and convenient explanations for thought, speech and behaviour that does not conform to most people’s ideas of what is “normal.” But these “advantages” do not excuse our suffering and deprivation of liberty, or the fact that those who stay on the drugs long-term, as we are all told to do, have a shorter life expectancy and a much lower quality of life than those who do not.

Around the world, many alternatives to psychiatric interventions have been created and practised (you can read about many examples at www.madinamerica.com/2021/06/calls-radical-change-global-mental-health. Even people in the most extreme states have found real help in small, non-institutional settings that prioritize patience, kindness, listening, dignity and respect, rather than attempts to “fix” us.

As required by the CRPD, countries must invest in such alternatives, and in a wide variety of independent organizations composed exclusively of survivors of psychiatric treatment. They must also invest in accessible opportunities for good nutrition, employment, housing, education, creative expression, physical activity, and practices such as yoga, tai chi, meditation, and breathing techniques – always emphasizing the right to privacy, freedom from prejudice, and access to people we choose, with whom to engage in activities and get help that we choose, in places we choose. Such investments would improve the lives, not only of those labelled mentally ill, but of everyone.