Ok, I know I just wrote a post about Schizophrenia but I found a perfect episode that addresses some different aspects of Schizophrenia. I just watched Law and Order: SVU second season, episode 6, it was called Noncompliance and you can watch it instantly on Netflix if you have it, if not then it might be in the library?
The episode was about a woman who was killed that worked at a mental hospital for the homeless. There were two men in the show who were portrayed to have Schizophrenia. One, Ben Moreland, was obsessed with the murdered woman and she filed a restraining order against him. He was interestingly a talented artist who suffered from long term side effects of being on antipsychotics such as drooling and shaking. Mark Nash was non-compliant and was diagnosed Paranoid Schizophrenia. He was more violent and drank often. He confessed he had mother issues although he lived with his mother.
It turned out that he was a witness to her murder and then in turn mortally injured the murderer. In order for the case to go through the detectives pressured Nash to take his medication so he could be a credible witness. In order for Nash to go free he had to prove self defense by providing a lucid testimony. The psychiatrist proposed they inject him with antipsychotics that last a month so he would stay hallucination free for his statement. Risks were stated that if he were not in a proper institution he may not be “equipped to handle reality” in addition to the normal side effects. He was given the ultimatum of freedom or jail depending on his medication against his will. After he gave his testimony he committed suicide in the mental hospital with a belt. As an explanation the coroner said that with the medication he lost the voices in his head, he had lost his friends, that made him depressed and he took his own life.
I think this is so tragic and unfair. Why should one person have to bear all that pain and suffering? How does one have a chance for a normal life? Schizophrenia seems to be the most difficult mental disorder thus far because medicated or un-medicated you still face differences that others won’t understand. Some are able to function in society with Schizophrenia but most seem unable to cope with reality with and without proper care.
The head psychologist at the mental hospital for the homeless said, “I absolutely believe that medication and therapy give the best possible relief for Schizophrenia [. . .] but how can a sick mind even recognize that it’s ill?” I think that Mark Nash’s experience is proof that medication isn’t always the answer. He knew that he did not want to take the medication and he was correct. In a medical sense medication and therapy may yield the best results but for many they are not able to handle the side effects of the Schizophrenia medication.
Olivia also expressed her opinion on medicating patients with Schizophrenia. She said she worked with Schizophrenics and knew of a patient who refused to take his meds, killed his father, and then committed suicide. In Olivia’s opinion patients with Schizophrenia should be forced to take their medication for their own good and the safety of others. How do you force someone to take medication against their will? How do you justify that morally and legally?
On Psychology and Neuroscience 
I actually watched this episode of SVU, along with all the others and always find it very interesting that strong opinions, such as Olivia’s are portrayed and very blunt during the show. I suppose it makes the show more interesting and appeases those that have the same feelings, but it gets difficult when the other side is not presented as forcefully. Usually one of the other detectives will have opposing views to make the viewer decide which way to lean.
I find myself in the middle of this predicament, I feel as though if there is a treatment then the person with the disorder should at least try it. With schizophrenia, I could see the problems, as shown in this episode, that if the voices disappear, more chaos is created within the schizophrenic and the treatment does more harm than good. I guess it would be nice to know the statistics behind the good versus the bad in the treatment of schizophrenia to make a more reasonable conclusion.
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Wow, the things they show on television these days! This episode disturbs me for two main reasons:
1. Is drugging Nash with antipsychotics the method of establishing a credible witness? Seeing the consequence of this intense medicating (he committed suicide!), is medication the only option to become a ‘credible human being’?
2. No wonder schizophrenic individuals living in the Western world have more severe symptoms! From the description of this episode it is clear that society develops this negative notion of schizophrenia that deems individuals with its symptoms as incompetent and unfit to lead a successful, healthy life.
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Jessie –
This is a great conversation starter for sure. I understand that on one hand, when dealing with the law, not to mention a murder case, there need to be regulations in terms of the influx of information from witnesses. Yet, I cant help but wonder who is given the right to deem a person “credible.” Furthermore, it seems like in this case, the detectives and lawyers were holding justice for the non-schizophrenic deceased over the life and wellbeing of Nash. Is this an implicit message about worth? Is the life of a schizophrenic somehow worth less than a non-schizophrenic? I have a hard time with this idea, yet it brings me back to a conversation we had in our Bio Basis class about the definition of “normal.” The trouble I have with this debate is that the black and white structure of law is in direct opposition from my thoughts that there is no such thing as worth or normality when assessing human beings.
SVU is the best! Never a dull moment!
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It is interesting to think of alleviation of positive symptoms as a bad thing for schizophrenic patients but eradication of these symptoms that have become reality for these people must indeed be rather depressing.
This Hollywood depiction reminds me a bit of another Hollywood depiction of schizophrenia. In A Beautiful Mind, upon being medicated and learning not to indulge in his minds delusions, John Nash realizes how much he misses talking to one of his delusions, his “college roomate” Charles.
Also in the movie in an attempt to describe what John Nash is going through, his doctor says, “Imagine if you suddenly learned that the people, the places, the moments most important to you were not gone, not dead, but worse, had never been. What kind of hell would that be?”
It would undoubtedly be a very difficult reality to face and is the very reason that schizophrenia cannot be treated with antipsychotics alone but is a process that requires very active participation and a tremendous amount of effort on the schizophrenic individual and their friends and family.
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I agree, there are several things about this episode that are troubling. The violence associated with schizophrenia that leads people to think forcefully medicating people is the only solution is one troubling aspect. Although I understand how some people like the characters in the show might feel like medication is the only solution, people with schizophrenia are still people who should be allowed to have choices about their futures. Another point that this entry brought up in passing is the alarming number of homeless people with mental disorders.
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Jessie,
I found your post particularly interesting because it I have never thought about the possibility of schizo. patients to refuse taking their medication. I had always assumed that all patients must want to relieve their symptoms, relieve their anxiety and hallucinations without hesitation. But clearly, I was wrong. I believe that all schizo. patients should have a legal guardian should to make their decisions as whether take or not take the antipsychotic. You could argue that this takes away the rights of the individual, but if the individual is cognitively impaired, their decisions may not reflect the best course of action. The idea of consent of a legal guardian is not new- people of a young age need their guardian’s consent/signatures as permission, patients with terminal illness in a coma have proxys… ect. Therefore, in schizo patients, it is best for the patient and affiliated parties for the ill patients to have a legal guardian to make decisions. This means, in most cases, the guardians will give permission to administer the drugs as those drugs have been shown to reduce schizo. symptoms.
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Sorry for the grammatical mistakes – I clicked: submit before proof-reading…
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I agree with Lia- it’s scary that drugging him was the way to make him credible for court. Obviously, sometimes such measures are necessary, but it brings us back the question (I think from Solomon?) about whether taking antidepressants creates a new version of self, or whether they constantly mask the true self.
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Loveeeeeeeeeee SVU.
I think that, in this case, SVU portrayed a slightly problematic view of schizophrenia. I have never met an ‘aggressive’ or ‘violent’ schizophrenic. Not that they do not exist, because they certainly do, however they are quite rare. It is a common misconception, and in some cases, I think that even the medication can cause aggression in patients. Some food for thought.
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