Do patients who hear voices have the right to refuse psychiatric medicine? A growing movement says yes

LONDON —  The voices came often: three men, mocking her. Telling her she was stupid. Urging her to kill herself.  Psychiatrists diagnosed her with schizophrenia.

But Rachel Waddingham now rejects that diagnosis.

After more than a decade of taking medications and cycling in and out of mental hospitals, Waddingham has embraced a new way of thinking about her voices. She no longer tries to banish them with drugs, but accepts them as a part of herself. She now considers them a reflection of her feelings and experiences, signals that help her understand when and why she feels overwhelmed —  rather than authorities whose commands she should follow.

This approach underlies a controversial international movement that raises fundamental questions about what it means to be mentally ill. The question at the heart of the debate: Do patients who hear voices — and suffer other symptoms that psychiatrists would consider severe —  have the right to direct their treatment, even if that means rejecting conventional therapies, such as psychiatric medication?

Some mainstream psychiatrists have