Refusing Care: Forced Treatment and the Rights of the Mentally Ill New Edition

Refusing Care focuses on the former problem—that of overintervention—asking when, if ever, the mentally ill should be treated against their will. Basing her analysis on both compelling case histories and empirical studies, Elyn R. Saks brings together her experience in law and in psychiatry to explore the dilemmas raised by forced treatment in three contexts: civil commitment, or forced hospitalization for noncriminals; medication; and seclusion and restraints. Saks argues that the best way to solve each of these dilemmas is, paradoxically, to be both more protective of individual autonomy and more paternalistic than current law calls for. For instance, while Saks advocates relaxing the standards for first commitment after a psychotic episode, she would also prohibit extreme mechanical restraints, such as tying someone spread-eagled to a bed. Finally, because of the often extreme prejudice against the mentally ill in American society, Saks proposes standards that as much as possible, should apply equally to non-mentally ill and mentally ill people alike.

Mental health professionals, lawyers, disability rights activists, and anyone who wants to learn more about the way the mentally ill are treated—and ought to be treated—in the United States should read Refusing Care.

Refusing Care focuses on the former problem—that of overintervention—asking when, if ever, the mentally ill should be treated against their will. Basing her analysis on both compelling case histories and empirical studies, Elyn R. Saks brings together her experience in law and in psychiatry to explore the dilemmas raised by forced treatment in three contexts: civil commitment, or forced hospitalization for noncriminals; medication; and seclusion and restraints. Saks argues that the best way to solve each of these dilemmas is, paradoxically, to be both more protective of individual autonomy and more paternalistic than current law calls for. For instance, while Saks advocates relaxing the standards for first commitment after a psychotic episode, she would also prohibit extreme mechanical restraints, such as tying someone spread-eagled to a bed. Finally, because of the often extreme prejudice against the mentally ill in American society, Saks proposes standards that as much as possible, should apply equally to non-mentally ill and mentally ill people alike.

Mental health professionals, lawyers, disability rights activists, and anyone who wants to learn more about the way the mentally ill are treated—and ought to be treated—in the United States should read Refusing Care.