Should mental health patients be forced to take medication? by Sanchita Islam

I suffered from postpartum psychosis, and last June, at Rich Mix, in London, I had an exhibition that dealt with issues related to that condition. There was also a debate exploring the link between creativity and madness, and whether art could be used as a substitute or in conjunction with medication.

Being creative has worked for me. And since 2014, when I stopped breastfeeding, the auditory and visual visions have both abated. Although I remain vulnerable to psychosis, I am aware of the symptoms and, in effect, know how to stop the mental descent.

There were three psychiatrists on the panel for the debate: my former psychiatrist, Dr Bass, my former psychiatrist in Brussels, Dr Thys, and my publisher at Muswell Hill Press, Dr Read. Each was adamant that I was an atypical case, and that most of the mentally ill patients they knew didn’t possess the same creative outlet or facility. Each advocated medication as the best option for anyone with a severe mental illness.

I have been diagnosed with schizo-affective disorder. I assume that counts as a serious mental illness, but the way I manage my condition is not the norm. I have never argued that people should emulate my approach, but I do argue that creativity has a palliative impact on the brain.

In August Dr Bass asked to see me. Staying in my flat in East London brought back memories of the psychosis. As I walked to the hospital, I experienced flashbacks of standing on the corner of Valance Road, singing at the top of my voice and believing that all the drivers were clones. Entering the hospital, I saw patients who were visibly mentally unwell, and recalled my time at Mile End hospital – I loathed sitting in the waiting room, feeling stigmatised just by being there. When I was receiving care I became mentally more debilitated than when I was not. I see no-one now, take no medication, and deal with my mental issues my way.

In my book Schizophrenics Can Be Good Mothers, Too, there is an essay that asks: ‘Do psychiatrists have all the answers?’ Since first seeking help with my mental health issues, I have seen more than forty different health care practitioners – an experience which unquestionably exacerbated my mental health problems.

Entering Dr Bass’s new office, I thought he was going to talk about the book or the exhibition. Officially, Dr Bass is no longer my psychiatrist, and hasn’t been since 2009. So I was shocked when he said ‘Do you think you might reconsider taking medication?’ An uncomfortable conversation ensued, but I remained adamant, and said, ‘I just don’t believe in a miracle panacea in the form of a pill.’

I respect Dr Bass, and maybe he believes medication would take the edge off my condition. I can get triggered easily, I go through extremities of mood, my behaviour can verge onto the reckless, and so on. But I have always found a way out of the mental pit.

Dr Bass’s insistence that I should take meds reminded me of Julie Burchill’s son, Jack Landesman. In July 2015, after a long battle with mental health problems, at the age of 29 he committed suicide. Julie Burchill then gave a candid interview in The Sunday Times magazine in which she argued: ‘In my opinion, people with extreme mental health issues should be forcibly injected with the medication which helps them – screw human rights.’

This controversial view also reminded me of the late playwright, Sarah Kane, who had battled with crippling depression. Her last play, 4.48 Psychosis, resonated with me profoundly. I have tried meds in the past – none suited me and the side effects were horrific – and apart from poignantly portraying the complex battle with the demons that can plague the mind, the protagonist in that play describes her experiences with medication. Tragically, after going into care in a psychiatric ward at King’s College Hospital, 28-year-old Sarah Kane hung herself with her shoelaces. Staff had not checked her for more than ninety minutes. She was in hospital for overdosing on antidepressants and remaining suicidal. Would forcible administration of medication have saved either life? No one can answer this question.

Surely it is my fundamental right to decline medication. If I didn’t have that choice and I had been coerced into taking medication, I don’t think I would be sitting here typing coherent sentences. I have been in a severely psychotic state, and I know that the condition poses a danger to the person or to others, and that mental health practitioners have a duty of care to administer appropriate medication. If my husband hadn’t been with me during my second psychotic episode, and I had not received the anti-psychotic that knocked me out, I dread to think what would have happened. But now I am not psychotic, and haven’t been for a long time. Once you are diagnosed with a mental health condition, does that mean you have to carry the label for life? It seems so. All the same, please let me manage my own mind through art, writing, ideas, publications and exhibitions, because this is the best way of controlling my life and the best way I can contribute meaningfully to society.

Julie Burchill’s statement was provocative, and as a mother of two sons, I can’t even begin to fathom her pain. Living with someone with mental health issues is not easy – it is lonely, thankless, and sometimes relentless. However, I think coercing people to take medication should be the last resort. There will be times that are challenging, but living medication-free is my decision. Everyone has the right to manage their own minds, to make choices about their mental health, and for those choices to be respected.

This is a sample article from Asylum 23.1.  To access the latest issue in full,  SUBSCRIBE HERE.

Image to go with Should You Be Forced article (scaryselfportraitscan1)

Self Portrait