Ask The Audience: Mental Health

A reader writes:

I appreciate your opening things up to include our questions/concerns especially with Judge Posner in the mix. I work in the field of public mental health as a clinician and ethicist and have serious reservations about the implications of diagnoses of mental "illnesses" like depression, or addictions, for our civil rights. I don't want here to enter the debate about the scientific bases, or lack of, for particular diagnoses but am interested in having a public conversation about what it would mean for someone to either not be held accountable for their actions because of their having been diagnosed as mentally ill, and also for someone to be denied their rights to make choices, as has been suggested in cases where someone who has been diagnosed as depressed is denied their rights to refuse medical treatment. As more people are being diagnosed all the time as parts of public health initiatives in schools and elsewhere, massive campaigns by drug companies, and in wider use by courts of mental health services these issues are starting to reach a critical mass. As they have impacts far beyond the reach of private medical care they should be brought into the realm of public debate.

The best book I have read about this conflict is Crazy by Pete Earley. His book focuses on his inability to get his son treatment for severe mental illness. But the balance between individual autonomy and helping the truly sick is anything but obvious. Give the mentally ill too much freedom and a number of them end up in jail. Give too much power to relatives and relatively healthy people can lose their freedom.