Enforced Therapy - Works as well as enforced health care

A patient walks into a doctor's office because his boss tells him he has to go and get checked out for blurred vision. It's affecting his work performance. The patient is told by the doctor that he is diabetic and must go on insulin and quit drinking. The patient refuses to do either one. Can the doctor force him to quit drinking and take insulin? Can his boss? The answer is no. The patient still has the right to refuse treatment. Can his boss fire him? Only if his health condition prevents him from doing his job and when he has been offered resources and assistance to correct the problem.

This therapist walks into a home because she has been told to do a mental health evaluation on an 18 year-old boy. His evaluation and subsequent services if indicated, will be paid for by your tax dollars. In this case, the boy is on parole and the court has ordered therapy. I do the evaluation and the young man denies any symptoms indicating mental illness or suicidal or homicidal intent. I ask him if he wants therapy and his reply is: "Fuck no. I want to get me a job and get the fuck outta here. I mean no offense ma'am, but I don't need no fuckin' therapy."

Can I force him? If the court orders him to therapy as part of his parole requirements, I suppose THEY can force him and I become a part of that because I have been assigned the case. Will he engage in therapy and benefit from it? Probably not. I can have a conversation with him about his past and his family of origin, I can dig for problems and probably find some if he chooses to share with me, and I can probably identify some areas where he could use a little soul work, but the bottom line is, if he chooses to shut down, it's game over. He will have a bitter taste in his mouth for a long time about "therapy," and if he ever does need it, he probably won't seek it out because his first experience with it was force fed.

Your tax dollars might as well be flushed down the latrine. And if you total up the amount of money spent on cases just like these, it adds up to millions of dollars.

The solution? The state and county government budgets should be adjusted such that providing mental health services are offered only to those who seek it out. It can be offered to anyone by Child Welfare Departments, Juvenile Justice and other branches of human services, but ultimately, it should be the client's choice to accept it. Same as health care. And that is the ONLY instance in which I think mental health care should have parity with physical health care.