Tuesday, May 07, 2013

Starlets, mental illness, and autonomy

Cathy Reisenwitz at Sex and the State has a post on the call for a conservatorship for Amanda Bynes (who appears to be the latest controversial starlet). Conservatorship is normally used to take control from patients suffering from severe dementia or Alzheimer's, but is better known for giving control of Britney Spears' money and life to her father.

I'm not sure this special treatment is being suggested for Bynes because she is a woman acting without propriety as Reisenwitz suggests, but if that's why it's being suggested, it's been made possible by growing acceptance of the ideas that people who act differently should be explained through diagnosis of mental illness, and that anyone who is mentally ill is unfit to make their own decisions.

Thomas Szasz was a controversial figure because of his belief that all mental illness is manufactured. That's too strong an assertion,* but cases like Bynes' make it more understandable. This young woman may benefit from counseling if she's serious about changing her life. She may find that she prefers to be on some sort of medication. But these are choices she should make - there is no evidence that she needs to have her decision-making ability taken away on what may become a long-term basis. If she's breaking the law then punish her, but it should end there. It's unfortunate that Szasz pushed his assertions about mental illness as far as he did, because his arguments for patient autonomy should be taken very seriously.

Those concerned with individual liberty in particular would do well to call forward Szasz's main concern - that unusual or inconvenient behaviour diagnosed as mental illness (justly or not) is used to strip people of autonomy, dignity, and responsibility. It's a mistake to treat someone acting irresponsibly as an invalid - a mistake rooted in unwillingness to accept decisions that we don't agree with.

This is dangerous to autonomy. It trivializes the plight of those who are truly debilitated by mental illness. It may be becoming dangerous to women's rights. It deserves our attention and discussion.

*Before this devolves into a fight about me denying the existence of mental illness, I want to make it clear that I do believe that mental illness exists, but that we would do better starting with the assumption that patients can help themselves with assistance through highly personalized treatment than we do with the blanket assumption attached to many diagnoses of an inability to improve or manage one's life at all or without mandatory prescription of (often debilitating) medication as first-round, permanent treatment.

These are assertions I make based on close personal relationships with people struggling through the mental health system and not as a trained psychological or psychiatric professional. 

1 comment:

Sebastian Daniels said...

I agree with you. Mental illness does exist. I for one have been diagnosed as mentally ill and have been in therapy for the past two years. It has been a rough ride, but well worth it. I have grown so much. The problem is some people aren't willing to admit they have a problem. They don't want to take responsibility.

What do you do about them? I guess you have to let them hit rock bottom.