What is your stance on people with mental illness, that are a danger to themselves and others, refusing to take their medication?

First, I think this speaks directly to the fundamental failures of both a medical system focused on profit, and the diseases of consumerist society that externalizes is agency and happiness into commercialized dependencies (on technology, pharmaceuticals, titillating self-distractions, self-medicating behaviors, etc.). Not only can we lay the epidemic levels of unhappiness at the feet of these causes, but also the horrific mishandling and counterproductive treatment of both serious and debilitating genetic or epigenetic psychological disorders (bipolar disorder, various personality disorders, schizophrenia, etc.) and what we could describe as more environmentally exacerbated or triggered conditions (PTSD, depression, anxiety, etc.). For-profit medicine and a culture of commoditized well-being have been disastrous amplifiers of mental illness in the modern world. To understand these impacts, check out:

1) Reviewing the Evidence for Mental Illness Being Epigenetic,

2) Epigenetics, Stress, and Their Potential Impact on Brain Network Function: A Focus on the Schizophrenia Diatheses, and

3) Consumerism and Well-Being in India and the UK: Identity Projection and Emotion Regulation as Underlying Psychological Processes.

So part of the answer to this question is addressing those underlying amplifiers: if we attenuate or eliminate these causal factors, there will be less mental illness in society — both in terms of stress-induced phenotypical expression of genetic disease, and crippling cognitive behavioral responses to stress. The principles of what is basically a preventative approach to mental illness have been demonstrated by a number of success stories. Check out 'Care BnB'- the town where mentally ill people lodge with locals and Soteria (psychiatric treatment) - Wikipedia, both of which essentially replace a transactional, commercialized model of treatment with a relational, community-centric one.

In addition, in my own L e v e l - 7 proposals, access to mental health resources is treated the same way as access to physical health resources: it’s integral to civil society and part of a “Universal Social Backbone” available to everyone without cost.

This is similar to a left-libertarian approach to criminality in society: by reducing the incentives to criminal activity, diffusing and reversing dysfunctional cultural norms that promote violence and coercion (including, and perhaps most especially, the concept of private property — see Private Property as Violence: Why Proprietarian Systems are Incompatible with the Non-Aggression Principle), and strengthening community-centric civil society at the same time, we may not be able to eliminate criminal behavior altogether, but we can greatly reduce it to the point where enduring interpersonal relationships and strong expectations of prosociality have a greater regulatory effect than policing ever could.

That said, the issues of personal agency and selfhood are also at the center of this question. I lean in the direction of personal agency trumping societal or institutional impositions of will. At the same time, I have a right-libertarian friend who was institutionalized and medicated under a 5150 (involuntary psychiatric commitment here in California), after planning and nearly executing his own suicide. I helped him through that time and afterward, and he has been thriving ever since and has been very grateful that others intervened as they did. He had been on the wrong medication (another consequence of a profit-driven medical system) that worsened his depression, but during his 5150 stay he received much more competent assessment and a much better treatment plan. Even as a lifelong libertarian, he has no problem with his involuntary commitment, because he knows he was not in his right mind at that time. In such cases, sanity is a more critical standard than agency, even (by most accounts) according to the perspective of the personal deemed “insane.”

My 2 cents.


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