Opinion: Coercion for mentally ill can also be a form of compassion

Sacramento women with bipolar disorder reflects on her experience with involuntary hospitalization

My maternal grandmother’s China closet houses her favorite art deco vase, a single ceramic swan, and eight Desert Rose plates, cups, and saucers. She, like me, had bipolar disorder and had episodes in which she rants about being sexually assaulted by her 10-year-old brother or injected with drugs by strangers in the middle of the night who also poisoned her food.

Grandma was admitted to a sanitarium in 1950, where she received cold water treatment and who knows what else. I shudder at the thought of her being wrapped in icy wet blankets, half-drowned, freezing water cascading down on her as she thrashed and cried out, helpless to escape.

Her husband arranged for her to be there. Was it simple? Was it solely on his word? Had she raised an objection? What had she desired? If I could, I’d summon her ghost and inquire about it.

Summoning the ghosts of those days causes nightmares and dread in those of us who suffer from strange thoughts, mania, or obsessions and see the world through fear-filled windows. I understand the strong desire to avoid involuntary treatment. However, the shoe does not fit well, pinching my toes and rubbing my heel.

My own involuntary hospitalizations were akin to wearing steel-toe boots without the proper socks. They slid around a little, but my toes were safe from unspecified impulses.

As I responded to treatment and gradually regained my sanity, I witnessed my peers’ journeys and, on occasion, miracles that I mistook for the resurrection of the dead.

I witnessed these transformations in locked wards, as the catatonic were brought back to life, the utterly fearful were restored to trust, and the fearless were saved from ruin and certain death. Where there was only despair, delusion, rictus grins, or silent stares, I’ve seen sanity restored.

Some people were healed by the location itself. The unhoused can sometimes recover if they are given a safe place to sleep, three meals a day, structure, empathetic support, and abstinence from the street drugs they rely on to stay awake all night – the most dangerous part of their day.

However, it appeared that for others, it was the pills, shots, or shock treatments, taken willingly or unwillingly, that produced the most profound changes.

In California, they can’t force you to take medication without a court order, which is reserved for the sickest. As a result, many people refuse. Some people become as thin as a shadow because they refuse to eat. Others become numb to everything except hallucination and delusion.

A few minds shrink until they resemble a wooden doll leaking urine. Some men and women become so ill that they require medical intervention to save their lives – what has been dubbed “dying with their rights on.” Even so, advocates for everyone’s right to refuse treatment argue for the bare minimum of intervention.

I think about them, the men and women whose lack of comprehension puts their lives in danger. I was fortunate; I knew I was sick and that I was in the right place. My salvation had arrived in the form of a capsule, I realized. Medication isn’t perfect, as evidenced by my tremor, but the alternative would have been my own death.

On my way home in the rain, I saw an emaciated man in nothing but shorts standing on the freeway onramp. He twisted in space, arms outstretched, twisting down to the ground, up into space, an animated bird made of tinker toys. As I took out my phone to call for assistance, I considered the importance of having shoes that fit and when coercion might become compassion.

There’s no need to summon my ghost to find out what I’d want if I were in his shoes. I’d prefer involuntary confinement and treatment. Every day, I thank God for the imperfect steel-toe boots of the twenty-first century.