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Freedom from Dehumanizing Treatment

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Austen Riggs Center

Freedom from Dehumanizing Treatment is one of the Four Freedoms that is a foundation of mental health. Dehumanizing treatment is different from stigma, which is another of the Four Freedoms of Mental Health, as it refers to treatment itself as opposed to more general beliefs, attitudes, and actions related to stigma in the larger world. 

Dehumanizing treatment includes: unnecessary restriction, seclusion, or restraint of those struggling with mental disorders; treating mentally ill individuals as merely a diagnosis rather than full people; or treatment that regards patients as mouths to swallow pills instead of people with stories that are meaningful. Underfunding mental health treatment generally is the result of stigma, but this results in dehumanizing treatment. 

Underfunding of Mental Health Treatment 

One in four individuals in this country has a diagnosed mental illness and more are projected to develop a mental illness at some point in their lives. Despite these statistics and the fact that they continue to worsen, funding for mental health services continues to decrease. From 2009 to 2012, states cut funding for mental health services by $5 billion, while also eliminating ten percent (4,500) of public psychiatric beds (1). These days, the largest mental health facilities in the country are often the jails of Cook County, Illinois, or Los Angeles, California. Moving the treatment of those with mental disorders into jails instead of treatment facilities is dehumanizing. When the data about the need for treatment tell one story, but political decisions either contradict or ignore the data, the result is often dehumanizing treatment. 

One goal of treatment is providing effective, medically necessary options for a given individual, a goal that should be pursued in a clinically informed and adequately funded manner. Despite the 2014 Final Rules of the 2008 Mental Health Parity and Addiction Equity Act, which specify that parity applies to intermediate levels of care like residential treatment, it is not uncommon for insurance companies to deny access to residential treatment or limit its duration severely. We will touch on this issue more fully in a future newsletter, when we address another of the Four Freedoms of Mental Health, freedom of access to medically necessary treatment. 

Mass Shootings and the Mentally Ill 

Every time there is another horrific mass shooting in our country, mental illness is raised as a possible motivating factor. While we all struggle to find reason or meaning in such tragic events, linking them directly and solely to mental illness is inaccurate and contributes to stigma. The fact is that most individuals with a mental illness are not violent, are far more likely to be victims of violent behavior than perpetrators, and are more likely to turn any violent impulses inward on themselves; more than half of all suicides involve a firearm (2). 

What’s more, researchers have determined that even if we cured all major mental illnesses, the prevalence of gun violence in our country would only go down by around four percent (3), a finding that paints a far more complex picture of the underpinnings of gun violence in our country. Professional organizations such as the American Psychiatric Association (APA) and American Psychological Association (APA), and advocacy groups such as the National Alliance on Mental Illness (NAMI) and Mental Health America (MHA), agree that focusing on mental illness as a cause of violence is stigmatizing and unhelpful. The real focus, when it comes to mental health, should be on increasing access to treatment. 

Patients’ Stories 

Those struggling with mental disorders deserve to be met with human compassion, which requires engaging them genuinely as people with a story. The importance of patients having the opportunity to tell their stories is recognized as part of the healing process; we must advocate for listening to their narratives as a central part of treatment. 

At Riggs, we adhere to a treatment model that is built around patients’ narratives as part of understanding root causes of patients’ mental health issues—and their solutions. This, along with our steadfast commitment to the importance of human relationships, respect for the voices of our patients, and the meaning of their symptoms and struggles, gives us an opportunity to advocate for freedom from dehumanizing treatment for anyone who seeks treatment for mental illness, not only our own patients. Solving this problem, along with the many others faced by those struggling with and those helping to treat mental illness, will require a social movement; and that is something that each of us can join, no matter how large or small our voice. 

Read more about the Four Freedoms: www.austenriggs.org/four-freedoms-mental-health

(1) Cummings Graduate Institute for Behavioral Health Studies, 2019 

(2) Centers for Disease Control and Prevention, 2016 

(3) PBS News Hour, 2019 

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