A Remarkable Feat: A Psychiatric Patient Changed the Law on Restraints

It is extremely rare that anyone succeeds in changing the horrible laws we have in all countries about forced treatment with psychiatric drugs and belt restraints. I shall therefore tell a story from Denmark. It is so unusual that his obituary was written by a journalist and published in a national newspaper.

Silas Dam killed himself this summer, only 24 years old. But in his short lifetime, he made a contribution that will benefit many psychiatric patients in Denmark. He entered a settlement with the Ministry of Health in December 2021, which obliged the government to amend the Psychiatry Act, so that the rights for psychiatric patients subjected to belt fixation were improved. Silas also got the ministry to commit to making an effort to improve the treatment of people with autism.

Silas had autism and came into contact with the psychiatric system at a very young age. He was admitted to hospital several times and spoke openly about his experiences with the aim of improving the treatment that people with autism receive when they meet the psychiatric system.

He argued that people with autism were mistreated and greatly harmed when they—voluntarily or forcibly—were treated with strong neuroleptics that made them feel worse. He pointed out that people with autism can have anxiety attacks and panic attacks, which may require sedative medication, but they generally do not become psychotic and therefore do not need to be treated with neuroleptics.

Silas experienced himself the harms of forced medication and restraints with belts. At the beginning of 2019, he was subjected to belt fixation at a psychiatric ward. He considered it unjustified, and although it was approved by both the district court and the high court, he brought the case to the European Court of Human Rights in Strasbourg with the help of a lawyer.

For another Danish patient, the Court had ruled that the belt fixation he had experienced was in violation of the Human Rights Convention’s prohibition against inhumane treatment, as it continued even though the patient was completely calm.

Silas’ case was very similar, and to avoid another defeat at the Court in Strasbourg, the Ministry of Health offered him a settlement with a compensation of DKK 90,000. But the money was not important for Silas. He wanted the settlement to benefit other patients and demanded that the Ministry of Health acknowledge that the belt fixation was a violation of human rights, which documented serious problems in the psychiatric wards.

Silas also demanded that the Psychiatry Act be amended so that the permanent guards who keep an eye on belt-fixated patients were required to make notes about the patient’s condition several times every hour. And he insisted that the government should ask the National Board of Health to draw up an action plan for autism.

After a lengthy negotiation, the Ministry of Health accepted Silas’ demands. The Psychiatry Act was amended, and guards must now make a note every 15 minutes about whether a belt-fixated patient shows signs of danger or not. If the patient is calm, he or she must be released from the belts.

In Iceland, seclusion and restraint were abolished in 1932 and never used again. That year, psychiatrist Helgi Tómasson took the shackles, straightjackets and other physical restraints that existed in the mental hospital, Kleppur, and burnt them in a furnace—all except one set, which he sent to the Parliament where it is still on display. This should be done in all countries.

For his efforts, Silas received a very prestigious award, the Kafka award, which is given to a person who has made a special effort to strengthen the legal position of weak social groups in society.

Silas lived in a youth home for the last period of his life. He was proud to receive this honor but was stigmatised by his experiences and sometimes found it difficult to thrive. He therefore chose to end his life. In a farewell letter, he apologised to his parents and relatives and explained why it had to end that way for him. The note read: “Psychiatry killed me, belt fixation killed me, forced medication killed me.” He added: “Share my story.”

Silas’ mother contacted me in October and wrote: “I witnessed what the psychiatric drugs did to him. He described it carefully. I hope that you will want to hear about the side effects and possibly use the information in your lectures. I do not think his case, despite his passing, is over yet.” In another email, his mother explained:

“Silas fought with everything he had in him right to the end. During the belt fixation, he was forcibly medicated with both Abilify and Stesolid [diazepam] at the same time. In addition to the horror of having a towel stuffed in his mouth, he described that the medication made him drowsy, everything spun around, like standing on a merry-go-round where you have no option of getting off. He was given additional forced medication, which meant that he could not remember his mother, father or siblings for six months. The memory gradually returned and he started a battle so that others would not have to go through what he had gone through. Psychiatry could not recognize an autistic anxious meltdown and therefore forcibly medicated him, without entering a dialogue, with psychosis medication. However, the medicine had done irreparable damage. He couldn’t sleep or get his head straight. The way to get off the carousel turned tragic. My son has told of another inpatient who was so wrecked by medication that he trudged on the floor all day drooling and couldn’t even hold his cutlery when he had to eat.”

Silas was killed by psychiatry. I have described on Mad in America that Tuva Andersson, whose problem was anxiety, was also killed by psychiatry. Millions of people have been killed by psychiatry, many of them through forced treatment. Why do we accept this?

In 2014, the United Nations Special Rapporteur Dainius Pūras, who is a psychiatrist, called upon all nations to make forced treatment illegal, but not a single country has done anything. Recently, the UN Office of the High Commissioner on Human Rights declared his work “groundbreaking,” but leading psychiatric organisations have been very hostile and disdainful. A common linguistic strategy was to represent the special rapporteur, and, by association, the United Nations, as unscientific and biased while current practice in psychiatry was presented as intrinsically scientific and ethical.

The reactions to Pūras’ reports by psychiatric organisations have been analysed in an instructive article. They included the usual falsehoods, e.g. that antipsychotics emptied the asylums and made it possible for people to live normal lives, and that “pharmacological treatments have been shown to reduce the risk for suicide” (avoiding mentioning which drugs they were), with no references, only vague statements like “an extensive body of data.” The correct, so-called assumption that psychiatry is guilty of human rights violations was called “absolutely slanderous as it attacks an entire professional community without distinction and—what is more—is absolutely not evidence-based.”

The reactions were full of strategic ignorance, in which the psychiatric organisations appeared to be completely ignorant of any evidence that psychiatric drugs do harm—a tactic enabling denial of liability. There was also a lot of conceptual “bullshitting” in which “rituals of politeness are foregone entirely, and we are faced with the raw assertion of power or authority in brusque gestures and commanding tones” with false statements like, “Advances in neuroscience are occurring at a remarkable pace.” Not unless one by remarkable pace means close to a standstill, as far as value for patients is concerned.

Sorry for being blunt but this must be said: The psychiatric profession continues to kill their patients in huge numbers and get insulted when the United Nations tries to stop it. This is a profession beyond repair. It should be closed down. Immediately, as an emergency.