Self-determination & Independence vs Force & Dependency

Morgan Brown (
Mon, 01 Dec 1997 16:54:53 PST

Self-determination and Independence versus Force and Dependency: 
Ideas about the changes needed within mental health systems 

By Morgan W. Brown 

For some time now, there has been much written about and even more talk 
concerning "restructuring," supposedly happening in various mental 
health systems. So far, everything I have read, or have heard of, 
indicates to me that all this "restructuring" is nothing more than an 
attempt to find new ways to do much of the same old thing within these 
systems and within the societies which foster and embrace them. The use 
of force within these mental health systems needs to be completely done 
away with before these systems can truly become ones of "empowerment" 
for everyone involved. This would be real change,
because it is what is needed and because it is also very long overdue. 
Whether on an inpatient, outpatient, or "community" basis, the use of 
force or coercion in mental health treatment is clearly wrong. Force and 
treatment do not go or work together. In fact, each works in opposition 
to the other. 

Force fosters dependency, victimization, anger, violence, helplessness, 
and irresponsibility. However, treatment which is free from the use of 
force or coercion embodies what is essential to what often becomes 
termed as "recovery": personhood, self-determination, hope, faith, 
responsibility, and independence, as well as interdependence. 

Force does not ensure safety or security, rather, it is the use of force 
that destroys them. Using force is easy. Choosing alternatives to force 
may be difficult, or seem so; but it need not be impossible. 
Many options are available, which are not possible when force is the 
governing paradigm. If the force/coercion paradigm were no longer in 
place, the power imbalance that currently exists would cease, or at 
least its base would lose its authority.

Resources which are currently being employed to bolster the force 
paradigm could be used instead, to meet the basic needs of individuals - 
needs now not met in a way of their choosing, or not met at all. These 
needs include: non-segregated non-congregate housing, home ownership 
programs (designed by persons they are meant to assist; and packaged to 
assist persons living on very low incomes), tenant-based rental 
assistance programs, income, food, support, training, employment, 
healthcare and transportation. Meals on wheels, personal
assistance services, and Part B - Independent Living Services can play
meaningful and vital roles in supporting individuals labeled with 
psychiatric disabilities to live independently. However, it would take a 
major shift in resources to fund these much needed programs for this 
population. In Vermont, information regarding these programs and about 
access to them, can be gained through the Vermont Center for Independent 
Living (V.C.I.L.) <>. 

We must do several things, including: 

* End civil commitment and abolish the insanity defense for persons 
labeled with psychiatric (or emotional) disabilities. 

* Hold people fully accountable for their actions if a crime is 
committed and then proven within the criminal justice and correctional 
systems, regardless of whether or not an individual is labeled with a 
psychiatric disability. 

* Shift resources to fund a system which helps to meet the needs of 
individuals labeled with psychiatric disabilities in a way of their 
choosing. Make mental health systems completely voluntary, and use 
vouchers to allow people real choices both in selecting care and/or 
service providers and the actual care and/or service that they may 
choose to receive. End the preferred provider status, sponsored
by state statutes, currently in place within community mental health 
systems across the United States. 

Often, there are concerns raised about what should be done if someone is 
"out of control" or "troubled" or "in need of treatment" when
their state of mind and/or behavior is being questioned. While the issue 
appears to be complicated by several factors including current 
constitutional law regarding an individual's rights in criminal 
proceedings; it is my belief that people can be held more accountable by 
changing how they are treated, by abolishing the insanity defense, and 
by ending civil commitment of individuals labeled with psychiatric 
disabilities. Being "out of control" or labeled with a psychiatric
disability should not be an excuse and should not be tolerated if a 
person is proven to have committed a crime. If no crime is committed, 
but the person appears to be "out of control" or "troubled", they should 
be offered voluntary assistance only or otherwise be left alone. More 
tolerance in this manner is actually needed, not less of it. If an 
individual is not committing a crime, but her or his actions are 
annoying others, then they should not be detained or interfered
with - just like anyone else. 
Being annoying, a jerk, or "out of control", or being labeled with a 
psychiatric disability - in itself - should not be grounds for imposing 
society's will. 
We shouldn't be able to hold people accountable for
actions that we think that they may do. People should, however, be fully 
accountable for proven criminal violations of the law. 

I do believe that it is possible for us to finally rid ourselves of the 
terrible burden of force and coercion within mental health systems. 

One of my favorite quotes which I need to constantly remind myself with 
and which I use often in this change work is: "Some men see things as 
they are, and ask, Why? I dream of things that never were and ask, Why 
not?" - Robert F. Kennedy. These words help carry me
through many tough times - both personal and political. I encourage 
everyone to dream and then to ask, "Why not?" This can be very 
liberating to one's mind, body and soul, especially when sharing with 
and supporting each other - as we journey into the unknown together. 

Note: Fourth revised version; written: September 22, 1997, for this 
entitled article first written: September of 1996, in Barton Vermont.
************* Morgan W. Brown; Montpelier Vermont************* 

Get Your Private, Free Email at