How do you commit someone?

The hubby and I watch intervention occasionally (like now) and we question why these families don’t commit those with addictions, especially those that are severely harming the person? Is it hard to commit a person? Expensive? Not enough room in the wards?

Thanks all.

Not enough room.

I knew someone who wanted to be committed because he had done dangerous (to himself and to others) things while hallucinating from PTSD. We called a lot of places and they were all full. They told us that without even asking what insurance he had, so it wasn’t a financial thing.

He discovered that you can get them to take you in for a few days evaluation if you tell them you tried to commit suicide, but otherwise, no go. Luckily outpatient therapy was enough for him and he’s much better now.

Err, can family members (or anyone, for that matter) involuntarily commit other adults who pose no immediate danger to themselves or others? I sure would hope not, no matter how bad the addiction is.

Can they? Yes. Is it legal? Not really. Involuntary commitment can only occur when the patient is believed to pose a danger to himself or others, and requires that the patient receive a psychiatric evaluation within 3 days. It doesn’t matter whether the person who reports the patient is related or not in most states.

It’s governed by state law; in Florida, for example, by the Baker Act (Florida Mental Health Act of 1971, technically), and by the SCOTUS ruling in O’Connor v. Donaldson (regarding a patient who was committed for 15 years and successfully sued the hospital and staff).

That reminds me of this one guy I met in an institution who meticulously kept this big file folder/envelope, sealed and squiggly-lined, with him wherever he went. He claimed it contained evidence of his maltreatment, wrongful commitment, and involuntary drugging. He would ask every other patient their name (and request a signature, if they would give it) so he could add them to his list of eyewitnesses for the lawsuit once/if he got out.

He struck me as the disturbed genius type, like someone out of the movie Conspiracy Theory or maybe A Scanner Darkly. He seemed at once bright and coherent enough to maintain some semblance of a conversation and also all over the place and paranoid, though I’m not sure how much of that was due to the drugs they put him on. Still, I took notes while talking to him and who knows, maybe a few years later I’ll find his name in the papers.

Scary stuff, if true.

  1. It is extremely difficult.

  2. It varies widely and wildly from state to state and sometimes from county to county.

  3. It depends on available bed space in the location.

Generally speaking if the person can’t be proven to be of harm to themselves or others (even if they are) it’s next to impossible in most places, even if you can prove that they’re delusional or depressed or otherwise severely impaired. (The reason for the bolding/underlining, etc., is because proving it isn’t as easy as you might think; I’ve known mental patients [when I used to work in the field] who could be suicidal or violent but you’d be amazed how sober and rational they could appear for an hour in front of a social worker/counselor/or, God forbid, a probate judge with a high school education and the power to commit.)

Worse is that most places bed space is very limited and often has a waiting list. I used to manage an apartment complex for the severely mentally ill so I’ve been through this several times: it’s not uncommon for a social worker/mental health worker to say “Yes, it’s true, she/he needs to be committed… but there’s not a place for them right now… maybe next Thursday we’ll have something”. Priority is of course given to people who are out of control, so if you have somebody who’s catatonic or just bouncing off the walls but not violent, they go to the back of the line. True story: once I had a female resident who was screaming at the top of her lungs and had pushed a refrigerator off of her apartment balcony (she wasn’t tiny but neither was she a 200 lb. bodybuilder- it took some freaking effort!) and she was given low priority!

Drug/alcohol rehab- same story, except you also have to deal with insurance. If they have private hospitalization insurance then there’s a much better chance than if they need a state supported rehab.

In almost all cases if the person is willing to commit themselves it makes it easier BUT usually they can also leave the hospital or program whenever they wish, which is often five minutes after they get there.

In some cases- when a person is undeniably mentally ill/strung out/etc. and clearly needs hospitalization but can’t get it, sometimes you have to hope they do something that warrants calling the cops so they can be put in jail. It may sound cruel, but it’s better than having them run around loose.

I mentioned probate judges above: in Alabama and in some other states the power to commit is held by the probate judge of a county. In Alabama and in some other states, probate judges are not required to be and often are not lawyers- there are several in Alabama who have G.E.D.s (usually the older ones) and one flat out told me and the organization I work for “I don’t know anything about psychology and I don’t care to learn, I’ll know if the person’s crazy when I see 'em”, and of course this guy who (true story) had been propping open his eyes with toothpicks to stay awake for Jesus’s Second Coming and taking the mirrors off of his walls because the devil was spying on him through them came across as the most rational and alert person in town for the five minutes he was before the judge, then immediately reverted to old tricks of course the second he was out of the judge’s sight; the judge wouldn’t listen to me (the person’s apartment manager/case worker), the social worker, or the psychologist! (Luckily that judge didn’t last long.)

So anyway, tain’t easy if they don’t want to be committed, and tain’t always easy if they do. Part of it’s payback for the Horror Days when it was super easy- the signature of one doctor (literally: a veterinarian could sign or a county clerk who wrote “Dr.” in front of his name often sufficed) or the signatures of 3 witnesses or whatever could send someone away for years. Now it’s the other extreme.