In 2022, the Ohio House passed Bill 439 to dramatically expand state powers of involuntary psychiatric commitment and forced treatment in Ohio. Amid concerns about the bill’s undermining of civil rights, the Senate referred it to committee. The bill will almost certainly re-emerge, though — the proposed legislation mirrors similar laws that, in recent years, have been pushed through in many states.

The bill is dangerous. Currently in Ohio, a person can be involuntarily committed if they pose a risk of causing physical harm to themselves or others or of being unable to meet their own basic physical needs. These notions can already be interpreted fairly broadly by psychiatrists and probate judges — but Bill 439 goes much further. It declares that you can be committed if you could potentially experience “mental deterioration” which might, in future, lead to you harming yourself in some way. It’s a purely speculative, Kafka-esque kind of circular logic: You can be legally committed now if you could potentially become legally committable in future. How can anyone prove they’ll never in future mentally deteriorate? Essentially, the law gives much more discretionary powers to psychiatrists.

At the same time, the government is heavily promoting the new 988 mental health hotline.

Essentially a rebranding of the National Suicide Prevention Lifeline, calls have climbed enormously even as 988 call centers continue their controversial practice of breaching the anonymity of some callers, getting calls traced, and sending police or ambulances to take callers to psychiatric hospitals against their will. It’s often claimed that this happens only “rarely,” but internal data show it happens to 2 percent of all callers, and to as high as 10 percent of those calling to discuss depression and suicidal feelings. The practice has been intensely criticized by some — even by the organization’s own committee of people with lived experience.

Meanwhile, under-discussed is the behind-the-scenes politics of 988 expansion: The federal legislation authorizes states to levy a tax to fund 988, and if that happens, every independent hotline in Ohio that currently respects caller confidentiality will soon feel financial pressures to join 988 and implement call tracing.

All of this highlights a key reason Bill 439 is so dangerous—there are many different ways that relatively ordinary people going through emotional distress can already get swept up by the broad reach of mental health laws. When an anxious teen seeks help at an emergency room, a depressed worker calls 988 and gets taken to a psychiatric hospital, or a lonely senior reaches out to a family doctor — can any well-meaning physician not feel some level of concern and responsibility about how any of these people might, in future, “deteriorate?”

Some counter that we’re anyhow “better safe than sorry,” but psychiatric detentions and forced treatment have immense risks. The US Supreme Court has recognized that civil psychiatric detentions are “a massive curtailment of liberty.” Otherwise law-abiding, generally non-violent people can be subjected to frightening and even brutal experiences involving threats, security guards, restraints, and injections of tranquilizing drugs that last for weeks. And antipsychotics, the most common drugs used in forced treatment, can dull emotions and cognitive capacity and have various severe adverse neurological and metabolic impacts.

So, before we propose detaining and forcibly drugging many more people, shouldn’t we first know how many are already being detained and forcibly treated, and what impacts it’s been having on their lives?

I asked the Ohio Department of Mental Health and Addiction Services—and was told they do not have any idea how many people are detained each year under mental health laws in the state.

Obviously, then, the department and legislators also have no idea whether the numbers have been trending up or down, or whether these people have actually been helped or instead harmed by forced treatment.

This neglectful lack of tracking of outcomes of involuntary commitment itself says a lot about how much the government and proponents of forced treatment truly “care” about people labeled with mental disorders. But the evidence we do have is also cause for concern.

During the course of researching my book, I personally interviewed hundreds of people who’d experienced psychiatric detentions and forced treatment — many described it as one of the worst experiences of their lives. And most major studies have found that forced treatment has no medical evidence base to support its use — researchers who’ve published studies and scientific

reviews have variously concluded that the practice is “based on tradition rather than evidence,” is “not associated with improved outcome,” and is for many people “highly distressing and even traumatic.”

Ohioans should demand that their public mental health services, at the very least, operate in line with medical evidence.

Rob Wipond is an investigative journalist and author of Your Consent Is Not Required: The Rise in Psychiatric Detentions, Forced Treatment, and Abusive Guardianships (BenBella, 2023). He is speaking at the Ashland Public Library Stockwell Room at 5:30 pm on March 28. He is also appearing at the Mental Health & Recovery Board of Ashland County RSVP Conference March 29 (online registration still available).

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