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> One almost-exception: voluntary treatment involving the mother (mostly by the mother) has only a slight negative effect. Father does not seem to matter if the

> One almost-exception: voluntary treatment involving the mother (mostly by the mother) has only a slight negative effect. Father does not seem to matter if they're part of treatment. Still does not have a positive effect though. (Absense of a father has a strong negative effect though. I would love to see studies on if you see the same with mothers where the father is the primary caregiver) Can you clarify #4? What "treatment" are you referring to? Chemical dependency? Treatment in child services?

candiodari 8y ago
Any psychiatric treatment. The exact name and even mechanism varies a lot depending on location. For children, there's almost always legal threats behind them though, especially where child services is involved. The dirty secret of psychiatry is that it almost never works. By the standard of placebo, "will this treatment work better than giving people a tictac 'that should help'" 90% of psychiatric treatments are ineffective. Better in the study means "reducing the chance of a future treatment being necessary" (doesn't include one other option that probably should be tracked: suicide) On children, the stats are worse, and there you generally see a worsening of symptoms given treatment. Right now psychologists are trying to build a case that child psychiatric treatments at least do not make things worse (because there is a famous study showing that it does). When it comes to forced treatment, there is no real doubt: it makes things much worse. The outcome everyone wants to see is that treatment helps, but it just isn't what the data shows. And of course, there are plenty of examples of forced treatment causing complete disasters, for example the famous French case of Solenn Poivre d'Arvor. TLDR: Girl gets anorexia, gets admitted to youth services. Girl jumps under metro after escaping what is effectively a prison, part of youth services. She committed suicide so "she could be saved in a little bottle, to be kept by her father, not thrown in the sea" (roughly translated, it was in French of course). The reason it's so famous is what happened next. Her dad was a news anchor, who convinced then-president Chirac (and a lot of other rich French people, Chirac's wife organizing a lot with the mother of this kid) to build a new youth care facility with the following rules: 1) everybody, under any circumstances, is free to leave. They will not inform the police or youth services unless asked. 2) under no circumstances will ever anyone's name or dossier be discussed or passed to any other part of youth services (one wonders just what French youth services pulled to make the mother of that kid demand such rules and convince a LOT of people, including the wife of the president, to make them official rules of the institution) It is a pretty building called "Maison de Solenn" that tries to improve treatment of anorexia disorders in France. It is also an incredible and very, very public total failure of youth services, but the truth is this (youth services forced treatment) happens in something like 70% of the cases of suicide in France. https://histoire.inserm.fr/les-lieux/la-maison-de-solenn https://histoire.inserm.fr/les-lieux/la-maison-de-solenn
- tomcam 8y ago
  Wait, so Maison de Solenn, the new facility, is also a failure?
  - candiodari 8y ago
    That's a good question, it certainly seems to have some effect but I'm not sure it's there yet. 1) it hasn't achieved the goals it set out for (firstly changing French youth care, secondly achieving significant progress in treatment of anorexia). But it's certainly trying. It's certainly getting the attention of policymakers from youth care, they're just totally unwilling to change. It's also hosting conventions for researchers into anorexia. 2) perhaps one could say that it has a small measure of success on the first goal: it hasn't changed any other institutions but it seems to be trusted by French youth tribunals, despite its rules. Tribunals will assign kids that would otherwise be incarcerated to this, and they're free as a result. As for outcomes I'm not sure. Despite their rules, this institution seems to have managed to avoid fucking up bigtime (which cannot be said for child services as a whole).

candiodari 8y ago

Any psychiatric treatment. The exact name and even mechanism varies a lot depending on location. For children, there's almost always legal threats behind them though, especially where child services is involved. The dirty secret of psychiatry is that it almost never works. By the standard of placebo, "will this treatment work better than giving people a tictac 'that should help'" 90% of psychiatric treatments are ineffective. Better in the study means "reducing the chance of a future treatment being necessary" (doesn't include one other option that probably should be tracked: suicide) On children, the stats are worse, and there you generally see a worsening of symptoms given treatment. Right now psychologists are trying to build a case that child psychiatric treatments at least do not make things worse (because there is a famous study showing that it does). When it comes to forced treatment, there is no real doubt: it makes things much worse. The outcome everyone wants to see is that treatment helps, but it just isn't what the data shows. And of course, there are plenty of examples of forced treatment causing complete disasters, for example the famous French case of Solenn Poivre d'Arvor. TLDR: Girl gets anorexia, gets admitted to youth services. Girl jumps under metro after escaping what is effectively a prison, part of youth services. She committed suicide so "she could be saved in a little bottle, to be kept by her father, not thrown in the sea" (roughly translated, it was in French of course). The reason it's so famous is what happened next. Her dad was a news anchor, who convinced then-president Chirac (and a lot of other rich French people, Chirac's wife organizing a lot with the mother of this kid) to build a new youth care facility with the following rules: 1) everybody, under any circumstances, is free to leave. They will not inform the police or youth services unless asked. 2) under no circumstances will ever anyone's name or dossier be discussed or passed to any other part of youth services (one wonders just what French youth services pulled to make the mother of that kid demand such rules and convince a LOT of people, including the wife of the president, to make them official rules of the institution) It is a pretty building called "Maison de Solenn" that tries to improve treatment of anorexia disorders in France. It is also an incredible and very, very public total failure of youth services, but the truth is this (youth services forced treatment) happens in something like 70% of the cases of suicide in France. https://histoire.inserm.fr/les-lieux/la-maison-de-solenn https://histoire.inserm.fr/les-lieux/la-maison-de-solenn

tomcam 8y ago
Wait, so Maison de Solenn, the new facility, is also a failure?
- candiodari 8y ago
  That's a good question, it certainly seems to have some effect but I'm not sure it's there yet. 1) it hasn't achieved the goals it set out for (firstly changing French youth care, secondly achieving significant progress in treatment of anorexia). But it's certainly trying. It's certainly getting the attention of policymakers from youth care, they're just totally unwilling to change. It's also hosting conventions for researchers into anorexia. 2) perhaps one could say that it has a small measure of success on the first goal: it hasn't changed any other institutions but it seems to be trusted by French youth tribunals, despite its rules. Tribunals will assign kids that would otherwise be incarcerated to this, and they're free as a result. As for outcomes I'm not sure. Despite their rules, this institution seems to have managed to avoid fucking up bigtime (which cannot be said for child services as a whole).