The most reliable data available suggests that millions of Americans from many walks of life have been subjected to psychiatric detentions and treatment against their will, and millions more have experienced unwanted psychiatric coercion under threat of commitment.
Where are all of these people? Especially with the massive growth of social media helping give voice and space to those who were previously blocked out of centralized news media, why don’t we see these millions constantly speaking out and sharing their perspectives on involuntary commitment?
I recently completed Your Consent Is Not Required, a book that investigates people’s experiences of psychiatric detentions and the science, economics, and politics of forced treatment today. Yet, despite so many people being affected—many in ways that they felt were profoundly unjust, unhelpful, and traumatizing—I found that focused, sustained discussions of wide public reach don’t emerge much or trend often in social media. Compared with social media discussions of other civil rights issues currently in the news and affecting millions of Americans, like abortion, sexual harassment, or police violence, involuntary commitment is off the radar.
It’s not that no one ever talks about psychiatric detentions or forced treatment on social media; indeed, there’s been a noticeable uptick over the past few years. But even those people rarely use common, clearly identified terms or hashtags in their posts, pages, or groups that make them easy to find.
On Twitter, as well as on Instagram, TikTok, Facebook, Mastodon and other social media, hashtags often get used to highlight key terms or ideas, and then function as organizing tools—anyone who clicks on the hashtag can instantly connect to other posts and people anywhere discussing the same issue. This can help disparate people find each other and share stories, support, and research, build alliances, educate others, politically organize, and catch the attention of news media. The result can sometimes be extremely potent: #MeToo developed from a unifying hashtag into a social movement and then an indelible national political symbol. #BlackLivesMatter, too. But involuntary commitment doesn’t seem to have even a seed of such a hashtag. Consequently, on those occasions when forced treatment does hit mainstream news and then get discussed in social media, cohesive critiques remain difficult to find and rarely trend.
Why is this happening, and what can be done to change it?
I sought answers from a variety of people who are active in social media, public relations, education, or organizing, and who are also public critics of coercive psychiatry.
Coercion is Nowhere but Everywhere
Searching social media, it’s comparatively much easier to find busy discussions and debates about other issues in the general field of “critical psychiatry”—such as adverse effects of psychotropics, withdrawal problems, and pseudoscientific diagnoses—highlighted with hashtags like #PrescribedHarm, #Tapering, or #Antipsychiatry.
But Adele Framer has noticed the same tendency I have: The underlying themes of power and coercion are nevertheless practically everywhere.
Framer is best known as Altostrata on Twitter and as founder of SurvivingAntidepressants.org, a discussion forum about psychotropic tapering with 18,000 members. SurvivingAntidepressants.org has many topic subcategories with active discussions—but none about coercive treatment. Still, said Framer, “Individuals bring it up all the time.”
Essentially, she explained, while engaging in the forums or on social media, even people who’ve never been forcibly treated frequently express their humiliation, frustration, or anger about having been victims of “sales pitches” from doctors, media, family, and others that misled them with tales of alleged “biochemical imbalances” and corrective “safe and effective” psychotropics with virtually no serious adverse effects or potential withdrawal problems.
“Everyone gets together to persuade the reluctant patient to go on drugs,” said Framer. “It’s very seldom that people will say, ‘I knew what I was getting into.’ The coercion occurs in the doctor’s office. It’s the opposite of providing autonomy; it’s undermining or sabotaging the patient’s own independence and ability to make their own decisions.”
In that sense, people’s criticisms of coercion in psychiatry are frequently implied while discussing countless other mental health topics. Yet, by not focusing and centering discussion more explicitly on the role of coercion—and its ideological and practical connections to formalized forced treatment—countless opportunities are missed to more strongly emphasize this core issue in psychiatry, and critically discuss, educate, and organize in response to it.
At the same time, strikingly, even when involuntary commitment and forced treatment are the main topics at hand, they’re rarely clearly named as such.
For example, in December of 2022, when more aggressive uses of mental health laws against unhoused people in New York made national news, most critical discussions on social media seemed to use #Homelessness and policing-related hashtags like #CareNotCops or #HousingNotHandcuffs. The more targeted hashtags #NoToForcedHospitalization, #InvoluntaryCommitment and #HousingNotHospitals had only a handful of posts—and even fewer before December. #ForcedPsychiatry, #StopForcedPsychiatry, #ForcedTreatment, #Sectioned and #PsychiatricCoercion were also used only rarely or by very small numbers of people.
Similarly, the high-profile detention, control, and forced drugging cases of Britney Spears and Paris Hilton spawned massive discussion hubs. But again, the key popular hashtags #FreeBritney and #BreakingCodeSilence—the latter the name of an organization boosted by Hilton that represents survivors of the troubled teen industry—don’t clearly put at the forefront the general issues of involuntary commitment or forced treatment.
Meanwhile, any more directly explicit hashtags that could potentially be dominated by other users, frequently are. #Committed has been taken over by people testifying to their dedication to football, baseball, religion, and marriage. #InformedConsent is overrun with discussions of Covid-19, vaccines, and other medical issues. #Abolition shows that there are a lot of different things people want to abolish. Even discussions tagging California’s #FiftyOneFifty detention law are more cluttered with chatting about the Van Halen album.
Amid all this, it can start to seem like even the people who are publicly protesting against involuntary commitment in social media may not want to be easily identified as such.
Wary of Bigotry
Michael Simonson has talked with many people who, like him, at times feel reluctant to speak out about their own experiences of getting detained under mental health laws. “People are embarrassed to talk about it because, by definition, it means they were allegedly not just mentally ill, but dangerously mentally ill.” Many diagnostic labels alone, he added, already come with implied connotations that a person is purportedly less reliable or credible.
Simonson is a communications and public relations professional who occasionally does journalism for Mad in America and other outlets, and also experienced forced treatment. “Between the time I was committed and the time I started writing about it, that was a thirteen-year gap. Despite the fact that it was a traumatizing, life-altering event that shaped my life.” Even now, Simonson said, he feels “nervous” about the idea of using a hashtag that could more readily identify him as someone who has been committed.
Daniel Brummitt also believes that caution, wariness and fear are among the main reasons that psychiatric survivors, for their part, don’t speak out more against forced treatment.
Brummitt was first forcibly medicated as a child, but is now thirty-eight and has been off all psychotropics for fifteen years. Due in part to his diverse background in independent publishing, fashion, and the arts, Brummitt has nearly 30,000 followers on Twitter—as many as Mad in America has, and certainly a large number for a clearly self-identified survivor and activist against psychiatric force.
Brummitt’s personal account and another one he manages have been issuing posts with the hashtag #PsychiatricCoercion for years—yet very few others have joined in. The core problem, he told me, is that people who are pro-force often attack critics, and such attacks can be especially painful for those still struggling to recover from harms.
“They’re very scared to talk about things online,” said Brummitt. He said even some psychiatrists have become notorious in the social-media community for saying “really nasty things” to psychiatric survivors. “I’m very fortunate to not have any permanent damage. But I can definitely put myself in someone’s shoes who has been, and it’s horrible to be treated that way by a doctor. It’s like a surgeon messes your body up, and then laughs at you because your legs don’t work.”
Expressing one’s anger openly can cause other blowback, too. Brummitt once tweeted a framed picture of a generic building on fire with the Pfizer logo beside it. Police subpoenaed Twitter, and the FBI then visited him.
— Anti-Mental Health (@mh_reform) November 11, 2021
For Jill Kesti, the fear of getting visited by authorities is still more ever-present.
Kesti has been in and out of involuntary treatment across two decades. “I’ve been very harmed. I’m on a lot of drugs, neurotoxins. And my physical body is falling apart,” she said.
Kesti manages a Facebook page, the Coalition to End Forced Psychiatric Drugging, that seems to be one of very few popular, open groups on Facebook targeted specifically at forced treatment. Kesti has created and posted thousands of images, memes, quotations, and links to articles and research that challenge common ways of thinking about psychiatric force and related social issues. She uses hashtags to link series of posts into de facto organized bodies of thematic commentary and research. Yet, even with 5,400 page likes and 5,800 followers, virtually no discussions occur on the page or below her posts.
“I get a lot of people texting me privately,” said Kesti. “But in general, people stay away… People are afraid to have their name out there on the page, with their history, with the horrible things that have happened to them.”
This privacy can be crucial for one’s sense of safety, said Kesti. “For somebody to speak out, they’re speaking out against the judge and against the lawyer and against the psychiatrist in the hospital that’s putting the orders out there, so it creates more of a fear of authority. There’s that fear that if you speak out, you’re going to be reprimanded, punished by being put back on a court order.”
Vesper Moore, an Indigenous activist, trainer, and psychiatric survivor, agreed. “There’s an inherent fear about talking about it, because you end up speaking out against public and private institutions.” Furthermore, Moore said, having been psychiatrically incarcerated carries a link in the public mind with violence or danger—so it can be risky, especially for people of color, to be associated with such an image.
It’s possible there could be “safety in numbers” if more survivors were regularly speaking out—especially if lots of diverse allies joined them—to help shift the public dialogue. However, others pointed out that feelings of embarrassment and a wariness of talking frankly about involuntary commitment occur also in health workers, critical practitioners, and across our culture.
We Hide It From Ourselves
“A lot of psychiatric nurses would say, ‘I hate holding people down and injecting them.’” And though they’ll usually still do it, said Johnstone, “they have a tremendous amount of shame.”
Lucy Johnstone is a clinical psychologist, and one of a number of critical experts based in the UK with relatively large social media followings. Critical perspectives appear to be more prominent and accepted in the UK than in North America; nevertheless, Johnstone said she and others have been “massively attacked on Twitter” for simply challenging psychiatry’s diagnostic framework. Online debates have also led to seven formal complaints being lodged against Johnstone to her regulatory body. (All were dismissed.)
With regard to the relative lack of sustained, critical public discussions about involuntary commitment as a systemic practice—even in the wake of several damning TV documentaries last year about UK psychiatric hospitals—Johnstone compared the situation to how mainstream society tends to dehumanize or regard as “lesser” certain minority groups, prisoners, or refugees. A little dehumanizing can go a long way towards making it easier to ignore certain groups and the conditions into which they’re forced. “The public has bought into this narrative about crazy dangerous people who go around with axes killing people. So, I think there’s something rather dark and murky and unexplored about the whole idea of doing something that may not be justified.”
Indeed, Simonson said a major reason that he himself doesn’t write or tweet more about other people’s experiences of forced treatment is because our society has made it so difficult to explore this dark area. “It’s literally behind closed doors. It’s not just that people who are involuntarily treated are locked away, but medical records prevent you from accessing the data… It’s a battle to get into court hearings… It’s so blocked off.”
This darkness and dearth of data is something I repeatedly ran into during the research for Your Consent Is Not Required, and it’s also an issue that UCLA social welfare professor and author David Cohen has exposed through stalwart efforts to simply find out how many people nationally are getting psychiatrically detained.
In conversation, Cohen suggested that the lack of social media discussions mirror a similar lack of sustained research and discussion throughout the scientific and academic literature and our culture as a whole.
Since the death of psychiatrist-philosopher Thomas Szasz a decade ago—a scholar who made it his lifelong work to attack the principles and practices of forced psychiatric treatment—Cohen said no comparable, prominent intellectual has “taken the mantle” of constantly, doggedly, and deeply attacking the scientific, philosophical, and political underpinnings of involuntary treatment. “Szasz stayed with it. He never gave it up. Because it was his strong belief that it was like forced religious conversion; a crime against humanity,” said Cohen.
And Cohen believes the lack of sustained, thoughtful dialogue about force—even among many people who might readily critique other aspects of psychiatry, let alone among the broader public—is neither incidental nor accidental.
Cohen frequently describes coercion as a kind of conceptual sociopolitical glue for modern psychiatry and psychiatric practices. That is, using psychiatric force against people cannot truly be justified by contemporary science or Western ethical principles. However, Cohen argues, the widespread shoddy science and dubious, harmful treatments can be criticized until the cows come home, but are ultimately still held together and socially accepted mainly because they justify using force against certain, non-criminal types of people—a power society generally wants to reserve for itself.
“The desire to coerce others makes the theories of psychiatric science acceptable, even though the theories are so full of holes that they can’t be accepted,” said Cohen. “It gives everything the sense that we can trust psychiatrists to do this thing which is otherwise distasteful to our democratic norms, our rules of law, our sanctity of the individual, and our respect for privacy.”
And maintaining this illusion requires that society never look too closely or discuss too thoughtfully, said Cohen, but instead to obfuscate reality with the kind of “bigotry and ignorance” against “the dangerous mentally ill” that Johnstone also described.
Can this systemic, culture-wide darkness be brought more into the light? And if so, what role can social media play?
The Good that Can Be Done—and How
As Maggie Leppert shows, focused and sustained social media discussions of force can, at the very least, start to bring survivors and other critics of involuntary commitment together.
The twenty-five-year-old Leppert, The Booksmart Bimbo on Instagram, puts out a stream of visual memes, brief satirical videos, and critical stories about psychiatry and her experiences of coercive treatment and withdrawal from psychotropics. Over the past year, she’s gathered 4,300 followers.
Leppert said that, among many in her generation, there’s a “woke-ification” associated with psychiatry where treatments are seen as inherently virtuous. “There’s a lot of this attitude that, if you don’t go to therapy, if you don’t take medication, then you’re stigmatizing therapy, and that’s irresponsible, and you’re going to hurt other people,” said Leppert.
In spite of that—or because of it—right from the start, Leppert received many public comments and private messages such as, “You made me feel like I wasn’t alone,” “I didn’t know that I was right to feel like I was mistreated,” and “I don’t feel safe sharing my story publicly, but I want to share it with you.”
“That transformed the way I took the page,” said Leppert. “Instead of mostly educational, it became more of a place for validation. I really wanted to make it a safe space where people could feel their experiences were reflected and respected.”
She believes her efforts have been helped by Instagram’s algorithm, as it tends to connect like-minded people. “You could call it an echo chamber, but I don’t really think it’s that. I think it’s circling within spaces of people who are open to hearing these kinds of conversations.”
In a Washington Post op-ed, Sara Kenigsberg described how her experience of involuntary treatment “torments” her still, but then hopefully compared our current cultural situation to the beginnings of the #MeToo movement. She wrote, “I want those who have stories similar to mine to speak—so long as they’re willing and able… I hope by coming forward, I make clear that not just my voice, but all our voices deserve to be heard, our trauma recognized, and our insight taken seriously.”
Kenigsberg is a media producer with 32,000 Twitter followers. She has worked on nationally prominent advocacy and political campaigns and is now also a board member of the Bazelon Center for Mental Health Law.
“If we had #InvoluntaryCommitment trending on Twitter, that would be great,” said Kenigsberg. But for any unifying, galvanizing phrases and hashtags to emerge, Kenigsberg noted that it helps enormously to have established, influential groups regularly promoting them. “You need an organizer. If you look at #BlackLivesMatter, you had people that were organizing a movement.”
Currently, though, it seems that the relatively small number of groups and organizations that strongly and clearly critique the culture of psychiatric force do not tend to have busy or large social media presences, while larger ones—such as Human Rights Watch or some state Disability Rights network organizations—do not focus on the issue very sharply or very often.
Kenigsberg also suggested that educators and activists using social media could more regularly connect the issue of involuntary commitment with broader disability rights and human rights groups and hashtags, with movements for criminal justice and police reform, and in conversations about bodily autonomy. And she encouraged adding hashtags that promote clear ideas for change, such as #HomesNotHospitals or #CareNotCoercion.
I wrote a story published in @washingtonpost today. “The stigma of what I went through torments me, but it’s hard to stay silent as people, including our president, tie mental illness to mass shootings — and call for others to endure what I went through.” https://t.co/1G0ynSSu0R
— Sara Pearl (@skenigsberg) August 7, 2019
Vesper Moore similarly noted that, for example, #MentalWellness gets billions of hits on some social media, while #PsychSurvivor more typically gets a few thousand. By posting something that uses both hashtags, one can “subvert” the conventional discussions of mental wellness. And many diagnostic labels have been turned into enormously popular hashtags where people embrace “self-diagnosing” as “liberatory practice,” said Moore. Those same hashtags can be used to reach and educate. “They don’t understand the history of psych labels, and some of the harms that have come up—how these labels have destroyed lives and institutionalized people en masse.”
Another key factor to be navigated, though, said Moore, is how critics of the dominant mental health system take many different positions using different terms on practically every major issue, not only on involuntary commitment—such as reform, abolition, recovery with or without medications, mad pride, antipsychiatry, or viewing hospitals as places of care versus incarceration, etc. “I actually think it’s liberatory, in the way where we find language for ourselves. I think of madness as a way of subverting and defying the norms of mental health and what we understand as mental health in our society.” Unfortunately, Moore conceded, this “polyphony” of voices makes establishing universally used hashtags challenging.
In any case, such hashtags could definitely help survivors, educators, researchers, organizers, activists, and reporters alike find each other—along with others of like mind, and those looking to learn. Everyone I interviewed expressed excitement about the prospect of creating some shared hashtags for involuntary commitment.
“I’m grateful for you for doing this article and bringing it to the fore,” said Kesti. “I believe in hashtags. I believe in the power of technology.”
Framer pointed to how SurvivingAntidepressants.org and similar online groups focused on psychotropic withdrawal have now also inspired more than half a dozen scientific studies and papers and been included in numerous news stories. “Patients are educating each other with the assistance of social media. Patients are taking the initiative to challenge the medical paradigm,” she said.
A more robust social media presence for people and organizations questioning and challenging psychiatric force would seem especially important now, in a cultural climate of increasing authoritarian attitudes, and in which the uses of coercive hospitalizations and drugging are rapidly expanding, not only for policing the streets but for managing disruption, protest, and distress in schools, long-term care facilities, prisons, workplaces and elsewhere.
Of course, creating popular, influential hashtags on social media requires a community of participants acting together to collectively build and maintain. Can talking about it spark change? For his part, Brummitt doesn’t believe it would take a lot to get something good going. “If you have a small army of one hundred people pushing the same hashtag over and over again, it’s going to create a shift in public perception.”