8. Punishing the Patient: human rights and psychiatric coercion

When psychiatrists diagnose people with schizophrenia they are not interested in making distinctions between types of schizophrenics along the lines discussed in this book. Although medical psychiatrists may acknowledge there are different symptoms for the disease, and different circumstances leading to a diagnosis, these differences are essentially irrelevant to them. Psychiatrists assume that all schizophrenics identified by clinical procedures have the same basic disease of the mind or brain underlying their variety of symptoms and circumstances.

Most schizophrenics, therefore, are treated in much the same way after diagnosis. They are usually  hospitalised for observation and treated with neuroleptic drugs. If the diagnosed person disagrees with this procedure legal sanctions are invoked and it is conducted by force. The person is usually held in this captive situation until a demonstration of 'insight' is made. This is an acknowledgment by the patient that the diagnosis is correct and that a mental disease is indeed present. The patient is also expected to demonstrate willingness to continue drug treatment after release from hospital.

The seemingly unreasonable treatment of people diagnosed with schizophrenia can only be partly explained by the psychiatric belief in an underlying disease. It takes an understanding of the stressful conditions imposed on psychiatrists by the existence of the insanity plea to complete the explanation.

Next: Background to the Insanity Plea