In 1997, Indiana became the first state in America to require that mental health providers get the informed consent of clients before treatment begins. Indiana Senate Bill 309 is hardly a radical concept; it simply takes the principles of the Nuremberg Code and applies them to the mental health industry by requiring that mental health providers inform clients of the risks, benefits, and alternatives to a proposed treatment before treatment begins and get the client's informed consent.

What decent human being could possibly oppose this legislation? Why should any mental health client ever be subjected to a potentially hazardous treatment such as hypnosis without first being informed of the known risks, benefits, and alternatives and being given an opportunity to decide whether he or she actually wishes to undergo the treatment? Why should mental health providers ever be free to experiment with clients' minds without warning them of the risks?

Human experiments in academic and corporate research settings are already strictly controlled by rules for the ethical use of human subjects. Human subjects must be informed in advance of the potential risks, benefits, and alternatives to the experiment and informed of their right to participate, not participate, or terminate participation at any time after the experiment begins. It would be unethical for a psychologist or any other researcher to perform an experiment on a human without getting the person's informed consent first.

Ironically, what would be unethical and absolutely prohibited in a research setting goes on every day in therapy rooms around the country: mental health providers use dangerous and experimental procedures such as hypnosis, relaxation techniques which may induce hypnotic trance, and "guided imagery" without first notifying the client of the known risks and alternatives to these procedures and getting the client's informed consent. Mental health researchers are strictly controlled by ethics guidelines, but mental health providers are free to use and abuse their clients as unwitting guinea pigs for the latest therapeutic fad without telling them whether a technique has been tested for safety and effectiveness or informing them of any known risks.

The result is grotesque abuse and exploitation of vulnerable, unwitting, uninformed clients by irresponsible or incompetent mental health providers. For example, one psychiatrist showed children handcuffs and a real gun as part of their "therapy." Until the Informed Consent in Mental Health Practices Act is passed into law nationwide, other mental health providers are still free to show children handcuffs and guns as part of their "therapy" without warning them and their guardians of the risks and getting their informed consent! While showing handcuffs and guns to children may be rare, using hypnosis and potentially hypnotic trance-inducing "relaxation techniques" on children and adults without warning them of the known risks is common--and even more dangerous!

Every mental health provider in America should support the Informed Consent in Mental Health Practices Act. If a mental health provider objects to the Act, ask him or her the following questions:

• Do you always advise your clients of the known risks, benefits, and alternatives to a treatment before treatment begins?
• If so:
• Why do you believe that other mental health providers should not be required to adhere to the same ethical standards?
• Why do you think it is ever ethically acceptable to use a treatment on a human being without informing them of the risks, benefits, and alternatives first?
• If it is unethical to use a treatment on a human being without informing them of the risks, benefits, and alternatives first, why shouldn't it be illegal as well? Why should mental health providers be legally free to abuse, exploit, and experiment with their clients?
• If not:
• What right do you have to play God?
• What right do you have to treat your clients like animals instead of thinking human beings with human rights?
• Do you have a lawyer? If not, you should get one, because you deserve to be sued, and inevitably you will be.
• Are you aware of the form of malpractice known as "memory recovery therapy"?
• If not:
• Why not? You are required by your licensing board to stay abreast of currrent theory and practice.
• If so:
• How do you believe the mental health industry should be reformed to make sure that such abuses never happen in the future? Why should reforms not include a guarantee that clients will always be informed of risks, benefits, and alternatives and given the chance to grant their informed consent? Why should the human rights of mental health consumers not be guaranteed by law?

• Why do you believe that the citizens of our state should be less well protected from mental health fraud and malpractice than the citizens of Indiana?
• Why do you believe that mental health providers should be allowed to use dangerous techniques like hypnosis without first warning clients of the risks and getting their informed consent?
• Do you care about patient safety and human rights or not? If you do, you must introduce the legislation. If you don't introduce this legislation, you are allowing mental health providers to legally use dangerous techniques such as hypnosis on their clients without informing them of this risks. If you don't think that's right, why aren't you doing something to prohibit it?

However, the Informed Consent in Mental Health Practices Act  is only a first step. More needs to be done. In particular, we must establish the principle that just as medicines are tested for safety and effectiveness before they are used on patients, therapies should also be tested for safety and effectiveness before they are used on clients. Why should the mental health industry be any less careful of patient safety than the pharmaceutical industry? Why should the standards of care in mental health be any lower than the standards of care in the rest of medicine? Why should any therapy be rushed into use in therapy rooms across America without bothering to first check whether it's safe, let alone effective? Why should mental health providers roll dice with their clients' lives?

The  Truth and Responsibility in Mental Health Practices Act is comprehensive model legislation to require that mental therapies, like medicines and surgical procedures, be tested for safety and effectiveness before they are rushed into use on vulnerable clients and before mental health providers can get rich by charging insurers and taxpayers for the latest fad, be it "memory recovery therapy" or "primal therapy" or lobotomies. The Truth and Responsibility in Mental Health Practices Act will transform the mental health industry from the unruly, anarchic cesspool of amateurism and faddism it is today into a true profession which bases its practices on research findings rather than whim and consistently protects its clients from exploitation and harm. Read this Introduction, the Barden Letter to Congress, and this list of Frequently Asked Questions to learn more.

The Informed Consent in Mental Health Practices Act simply guarantees the human right of individual mental health consumers to be informed about the known risks of any treatments they are subjected to. The Truth and Responsibility in Mental Health Practices Act reforms the mental health industry as a whole by establishing a firewall of testing for safety and effectiveness to stop the fads like lobotomies and "memory recovery therapy" which sweep the industry every decade or two and providing a powerful financial incentive for the industry to at last do its homework and find out which therapies do and don't work. Either is an improvement over today's status quo in which therapies are not tested and clients are not informed.

Write your state and federal elected officials and DEMAND that they act now to stop the waste of taxpayer dollars on crazy, untested therapies and to stop the abuse and exploitation of the mentally ill by the therapists they turn to for help. Remember, your family could be next.

top of page