Visions Journal

Marianna

Reprinted from the Involuntary Treatment: Tensions and choices issue of Visions Journal, 2025, 21 (2), pp. 27-28

I have the unique perspective of being involuntarily treated and then working with people who are going through the same thing. For me, I will never be the same person I was before being committed. Each time it happened I felt pieces of me break off, and what was left for me to put together again was in shambles.

The last time I was certified, I spent the first month so severely sedated I have zero recollection of that time. I have no memories about what I did to fill my day. I don’t remember anyone telling me to shower or to brush my teeth. After six weeks, I was discharged and taken off all but one medication that my brain had become dependent on.

For me, that is when things got serious. I'll never forget the withdrawals I went through, thinking that I absolutely could not make it through another day feeling how I did. The injustice I felt and witnessed lit a fire within me. I said that I would be back on the units one day, but not as a patient. And I was, returning to provide a service on the unit. It wasn't easy. I often reflect on how hard it's been to be triggered and professional at the same time.

Unheard

The experience of involuntary psychiatric treatment can be described as terrifying and unjust. It can be particularly frightening for those who have interactions with the police. I was kicked into a car by one officer, and another one made callous comments about needing to "pull out a cage for this one." Both times, the police refused to disclose where they were taking me, and I was not aware of the destination.

Once inside the system, the trauma continues. Many patients comment that they feel animals are treated better. A power imbalance is re-enforced. Once admitted, medication is weaponized. I was told by a nurse, "If you keep talking, they will put you on more pills." This leaves a person unheard and harmed.

The environment within involuntary psychiatric treatment facilities is often anything but healing. People often describe the spaces as cold, sterile and distinctly non-therapeutic. They lack the warmth and human connection necessary for recovery. The primary function of the medical staff appears to be ensuring medication compliance, rather than providing the emotional support or guidance needed to navigate a crisis.

Patients are left to use their own resources and expected to process the profound trauma of being certified and institutionalized, with little to no help. There is a lack of support on the unit. Racism and discrimination are very real there, making the ward an even more hostile and isolating place for some. Patients feel deeply the institutional focus on control, rather than care. Ultimately, prioritizing containment leaves patients to suffer in an environment that reinforces their trauma instead of alleviating it.

Old ideas

Involuntary psychiatric treatment is governed by outdated laws. The Mental Health Act remains largely unchanged since the 1960s. This legal void, coupled with a lack of regulation on practices like solitary confinement and use of restraints, allows for immense unchecked power. The very language used to define the criteria for the need of involuntary status, such as "control" and "supervision," reflects a system more focused on containment and institutionalization, rather than healing and patient dignity.

This power imbalance often leads to an environment where patient rights are not upheld, and where patients are often punished for exercising them. For instance, individuals applying for a review panel (an option to reassess their detainment) are sometimes pressured to cancel it based on false promises of an earlier discharge. While the Canadian Charter of Rights and Freedoms guarantees the right to know the reasons for detention, this is often ignored in practice. Compounding these issues is the fact that directives for care, created by a person prior to hospitalization to describe how to handle their crises, are not legally binding.

Unique distress

The lived experience of those who have been subjected to the mental health system reveals a reality that is often more terrifying and dehumanizing than clinical frameworks suggest. Involuntary treatment is designed to stabilize the individual, prevent irreversible harm and restore them to a state where they can once again make rational choices.

Yet, personal accounts often challenge this ideal. Some patients find themselves in a worse condition after being discharged than when they were first admitted—that was my experience. Detainment is distressing, both for the person experiencing it and for those who love them. However, it is one of those things that is hard to fully understand unless you have gone through it. It doesn’t mean someone can’t understand parts of it. But to know it wholly is to go through it yourself.

To people who are living this reality, I want to validate your feelings of injustice. I hear you. I see you. We will see systemic change. Keep speaking your truth.