Myth: People with mental illness will not receive treatment voluntarily.

A theory, popular on the Internet, but little supported by evidence, is that the condition called “anosognosia” (“lack of insight”) is the main reason for why mentally ill people refuse hospitalization and medication. According to this theory, they simply don’t understand that treatment is good for them.

Of course, this may be true in some cases – there are some people with various problems who don’t know what’s good for them and do not follow sound medical advice, leading to harmful consequences.

What is not true is that “lack of insight” is widespread among people with severe mental illness and is the primarily cause for refusing psychiatric medications.

TO BE CONTINUED

Myth: Involuntary treatment prevents violence

Facts: (TO BE EDITED)

Tens of thousands of people diagnosed with schizophrenia give their consent to participate in clinical trials of antipsychotic medications,which means that they want help and take medications willingly.

Studies show that most people stop medications because of “intolerable side effects” and/or “inefficacy,” which are the two main reasons for refusing psychiatric drugs: the drug either does not work, or its side effects outweigh benefits.

Wealthy people with serious mental illness willingly seek treatment in unlocked, non-coercive private residential programs. Patients diagnosed with schizophrenia and other serious mental illness go there voluntarily and stay in the facility for the duration of treatment, or for as long as their family can pay.

In a study, patients who met criteria for civil commitment were randomly assigned either to an unlocked peer-run respite, or to a locked-up hospital ward. Those in the respite stayed there willingly and showed better outcomes than those who were hospitalized.

A study of “individuals with a serious mental illness” did not find any single reason for their unwillingness to receive treatment. Preliminary findings published in 2016 are that people may not want treatment, because:

(1) they “feel the treatment is not working”;

(2) they “feel mistrustful, or coerced”;

(3) “treatment may be difficult to get to.”

Since then, other studies confirmed that people often avoid treatment because of their prior bad experiences with mental health services.