When Treatment Becomes Fate: My Article in Psychiatric Services
- Michael Elwan
- Jun 11
- 2 min read
This month, my article When Treatment Becomes Fate was published in Psychiatric Services, the journal of the American Psychiatric Association. It reflects on a conversation I had with a psychiatrist when I was 16, about my mother.
I was a careful teenager. I believed that if I explained things accurately enough, help would follow. The psychiatrist listened, and then told me, with certainty, that my mother would either remain in hospital or take medication for the rest of her life. What stays with me is not what he said. It is what he never asked: how she was coping, how I was, what medication could and could not do, what recovery might look like.
What When Treatment Becomes Fate is about
Years later, my mother died by suicide, and the certainty I had been holding could not explain what had happened. The article begins there, in the gap between what a clinical frame can name and what a family is left to carry. Diagnosis, medication and hospitalisation can be lifesaving. When they arrive without education, without relational care, without attention to a person's history and circumstances, responsibility settles quietly on families, often without anyone recognising it.
What lived experience in psychiatry asks of clinicians
The article in Psychiatric Services is one of the few places where lived experience in psychiatry is published alongside clinical research, creating space for dialogue between clinical and lived/living experience perspectives. Lived experience in psychiatry offers the context clinical care needs if families are to be partners in treatment rather than silent carriers of it. The clinicians I most respect already work this way; the article is, in part, a description of why it matters when they do.
Read the full article through Psychiatric Services:
What I needed at 16 was not less expertise. It was a wider frame: someone to say that treatment might help but would not solve everything, that recovery is uneven, and that families should not carry this alone.
If these are questions your service or team is sitting with, it is the kind of work I take on through the work I do at LEXs.
If this raises anything for you, support is available. Lifeline 13 11 14.
