Thanks for posting this, pachyderm. I too struggle with this issue - but from the point of view of the parent of an adult son with a severe and persistent mental illness. After his first episode, I thought I'd just get him to "help" and if necessary force the medications. Once he was thinking clearly he'd see how helpful the meds were. Or so I thought.

After years of aligning myself with the "professionals" and trying to force my son to do what he didn't want to do, I finally realized that it wasn't going to work. I had to align myself with my son and explore other options.

Other reasons not to force treatment - aside from the civil liberties issues DocJohn discusses:

1. Treatment should be collaborative between the patient and the professional. Forcing unwanted treatment often does more harm than if you'd simply left the person alone. IMO forced treatment does not qualify as treatment at all. It's something else - not treatment.

2. In the case of paranoid people, the tricks you have to play to get around the system reinforce the paranoid world view. If you think people are trying to hurt and poison you, there's nothing like the treatment meted out by the mental health system to confirm that view.

I remember my aunt - who also has a mentally ill son - advising me to call the police and lie, to tell them my son was threatening me and I was in fear for my safety. That's how she got her son involuntarily hospitalized when she felt it was necessary. Seriously? Someone who already thinks you're the enemy, and you do that to them?

3. I guess I have too good of an imagination. I've never been given a psych dx or been forcibly treated, but I can imagine myself in that position. On the one hand, I would hope that if I lost my mind someone would intervene and help me. On the other, I would hope that they would treat me with respect. (I've asked my son what he would do if I started saying odd things and threatening other people. He said he'd just leave me alone. <Sigh!>)

4. Psych meds have serious, serious potential side effects. No one should be forced to assume that risk without being fully informed and allowed to accept or refuse the treatment.

5. I could probably come up with more reasons if I thought about it a while longer.

At this point my son has opted to take an antipsychotic to control his symptoms. Occasionally he hints he'd like to quit them. I've told him I won't allow him to live here if his behavior jepardizes my safety, and I won't retrieve him from jails or hospitals again - if he lands in one of the places due to quitting his meds without medical supervision or abusing drugs or alcohol. Even that feels too coercive to me at times, but at this point IMO he's been wrestling with this monster long enough to avoid behaviors which will make him ill again (I hope!). At any rate I'm a human being who's entitled to some peace too. (Of course, if he becomes ill again despite taking care of himself, I'd help him.)