The UN General Assembly has just put out its 2013 report of the special rapporteur on torture and other cruel, inhuman, or degrading treatment or punishment. I was not surprised at the majority of the content (e.g., forced sterilization) but then I came to this on page 14: "absolute ban on restraints and seclusion."
What would they do with me now, were I re-hospitalized?
Over a period of six years (when I was in my early to mid-20s) whenever I was hospitalized for my schizophrenia, restraints and seclusion were used repeatedly, readily, and beyond necessity. Also, I was over-medicated, probably not for my own sake, but to make me a more manageable patient. I was lost in my psychotic world, to the point of bashing my head on the concrete walls on the psych ward. For this, I understand the use of restraints. However, they, along with seclusion, were over-used, to the point of being a punishment rather than for my safety.
By my 12th certification (forced hospitalization) for schizophrenia they would outfit a stretcher with restraints while I was still waiting in Emergency. As soon as I was admitted, they would call a Code White -- aggression -- and within seconds, it seemed, a group of four to five Security officers was there, holding me down as I flailed and kicked and screamed with rage as they restrained me. Wrists, ankles, chest; I couldn't even wipe my falling tears away.
I wept not only because of being tied up; I cried for the high doses of sedatives and anti-psychotics the nurses injected into me, for the strip-search, for the forced changing from street clothes into hospital pajamas in front of all those (mostly male) Security guards.
Then, the stretcher-bound, pajama-clad, medicated me was placed in solitary confinement.
This did not happen just once. Or twice. Try over dozens of incidents. Restraints would last hours, hours, hours; later, when untied, I would be locked in a seclusion cell for as long as a week at a time. Cell, not room: a thin mattress on a concrete "frame," silver toilet in the corner, camera, and a door with no knob on the inside reminds one of a jail cell.
They did all this because I was bashing my forehead bloody on the concrete walls. See, in my schizophrenia, I strongly believed that miniscule rats were eating my brain and, reminiscent of leeching, bleeding them out was most effective.
What else could they do?
Restraint and seclusion: banned?
What would they do with me now?
A short series of electroshock. They did try to get informed consent, but because I agreed to it on the basis of it electrocuting those brain-eating rats, they determined I was unable to make medical decisions for myself. So off to "treatment," their signature on the papers waiving my rights.
And then there are the forced injections. These terrified me, as I delusionally believed that they had more rats in them, enough to eat my entire brain. Nevertheless, amid my screaming cries, pleadings, and sheer panic, in went the needles. That absolute terror certainly falls within the guidelines that "fear and anxiety produced by indefinite detention, the infliction of forced medication or electroshock, the use of restraints and seclusion, and the segregation from family and community, etc., should be taken into account" (pg 16).
Much of what happened to me while held involuntarily could have been averted. For example, when well and on the "outside" I walk everywhere. Confined, I pace. This calms me, and lulls those rats to sleep, further decreasing my anxiety. The nurses, however, see it differently. They call it agitation, and agitation means you must take their PRN pills. Rat-filled pills.
So I decline; they insist.
But there are rats in them! I protest.
Erin, there are NO RATS in this medication. Now take it orally, or we will have to restrain you and inject.
No! No! No!
Look, see how agitated you are!
They win, with the help of security.
What trickle-down effects will banning such practices have? How enforced, and with what consequences? And how will they deal with acutely psychotic and delusional patients such as I have been?
What would they do with me now?
They are still allowed to declare me of "unsound mind" and a "danger to self," the exception to the ban. I will certainly admit that I was of unsound mind (rats?) and a danger to myself (bashing my head). They may detain me ("deprivation of liberty") but where does the line between sound and unsound fall?
What is abusive and what is humane? In the moment, I cannot tell; I am delusional. Somebody has to decide for me, and for many others, that forced treatment is more compassionate than neglect of persons with severe mental illness, neglect that leads many such people to live disconnected lives on the street or in jail.
The UN is, at a certain level, one such somebody.
Interested in my experience with schizophrenia? My memoir, When Quietness Came: A Neuroscientist's Personal Journey With Schizophrenia, is available from Amazon.