>He was a college graduate from a middle-class family. But on Christmas Eve three decades earlier, the Archangel Michael had come to him in a vision and demande

>He was a college graduate from a middle-class family. But on Christmas Eve three decades earlier, the Archangel Michael had come to him in a vision and demanded that he spread God’s word. Suppose it's false. Given that it's false, are his actions acceptable conduct for a person? Really what is unacceptable is going without treatment for obvious full-blown AIDS. >I run a program for young people experiencing psychosis for the first time. Every day I confront my impulse to coerce people into care. This spring, one of our participants, whom I will call Mark, once again went off his medications. He had been on track to finish his first semester of community college and was looking for part-time work when his father showed up after years of absence. Soon he was smoking weed daily with his father, had dropped out of school and was refusing to take his medications. Over the next few months he became increasingly psychotic, stopped sleeping and started rhyming all his sentences. Then the sentences gave way to incoherent word pairings that psychiatrists call “clanging.” Soon he was nearly mute and rail-thin. But he still refused medication. You're lying. Not to me, and not to Mike, but to yourself and to society. Nobody wants to help Mike be himself or be happy. That's Mike's job. The modern paradigm of psychiatry says "take your medications so that you can be happy", but what we obviously mean is "take your medications so that you can work". Here's the thing: he'll be just as happy smoking weed and babbling as he is at college. Or, to be more honest, we have no good evidence that he won't be. Here's the thing: how on Earth is Mark supposed to work if nobody cares that he does? The society around him has stated quite clearly that it isn't worth going to a bunch of effort to get him to work -- he's not being medicated in order for him to work -- his work isn't necessary or a duty, according to everyone who tells him anything about anything -- yet the actual standard being applied is "does this guy pass his classes?". The truth is that that sounds awful. But the deeper truth is that the psychiatrist and the family and the legal system as a whole have collectively chosen the non-awful fantasy of "mental health" rather than the awful reality of "crazy people are useless". And then we wonder why the patient wants to make the same kind of choice!