ON reading this book, I was reminded of Jim, who lived in a hostel for many years. He would be considered eccentric, I suppose, by some researchers. He had lost contact with his family, or so I was told. I was also told he exhibited signs of disturbance but I could never get anyone to explain or elaborate - they were certainly not visible to me.
One day we in Trust heard he had been admitted to a psychiatric hostel. I decided to visit him with my colleague, Paddy. We found him sitting motionless in a chair, apart from the others, badly dressed. Someone had shaved off the lovely beard he had been so fond of. We gave him cigarettes. He was not inclined to talk.
As we were leaving, the man who let us in complained that Jim would say nothing about himself or his history to the people who ran the hostel. He was annoyed when I refused to give him the information that Jim had denied him. As we left, he told us that Jim was "having all his tests done".
This, it struck me, is what it means to have no freedom - to be locked away from the world and within oneself, powerless at times to even hide your identity. It seems a small thing that such a man should be locked away, yet many of us would be outraged if we were locked up to have "tests" done on us for no good reason.
Every day I work with people who refuse much needed help; with others who want help but who cannot get help of the right kind; with people who believe they have been unjustly denied their liberty in the past by the psychiatric service; and with people who are fearful for their own safety, at home, in a hostel or in the workplace.
For these people our expectations - real and unreal - of the psychiatric services and our attitudes - respectful or dismissive - towards their civil rights are of the first importance. Therefore, I welcome the publication of this very well produced book on the issue of detention and of the rights of people labelled as psychiatric.
The book is a critique of the current law on civil commitment. Its starting point is that the human rights of people with mental disorders must be respected and that limitation of such rights should be allowed only when demonstrably necessary and when there are compelling reasons for it.
The authors argue that forthcoming mental health legislation should enshrine this principle, and they outline the minimal legal safeguards they believe ought to be observed throughout the process of psychiatric detention. They raise the question as to whether voluntary admission to psychiatric institutions is truly voluntary in all cases, especially when it is children who are being admitted, an area in which they believe the law needs reform.
They point to the awkward - for the psychiatric profession - fact that there is no consensus among mental health disciplines about the value of various treatments. On drug treatment, they observe that "it is sometimes difficult to separate the integrity of the medical approach to drug treatment from the interest of drug producers".
In these circumstances, it seems reasonable to suggest, as they do, that competent involuntary patients should be entitled, not only to consent to or refuse treatment, but be given whatever information is needed to enable them to make informed choices.
The price of this book looks prohibitive, but it could be used with great success in a workshop forum - and it's a great deal cheaper than sending droves of people to seminars on the topic all over the world, as we do.
