This is a really interesting thread!
I’ve no interest in picking a fight with anyone. We all have our own experiences and, for the most part, any discussion of this type of thing will fall more into the anecdotal than the empirical. In keeping with that I’ll share a few anecdotal experiences of my own:
Girlfriend #1) Was in university and holding down a pretty good GPA. She was also actively bulemic. I asked her to seek counselling but she wouldn’t. One day she crashed and was taken to ER and hospitalized. After a few days of IV electrolytes and nutrients she was released and told to go - on her own - to the mental hospital. I accompanied her at her request.
She was interviewed by a psychiatrist with a psych nurse in attendance. She answered questions rationally and coherently and repeatedly said she was willing to get therapy but did not want to be admitted. The psychiatrist pushed some papers over to her and, in a round about way, told her they were commitment papers. She was about to sign them when I asked for a minute alone to talk to her. The Dr and nurse left and I said, “Debbie, you know that these are commitment papers right? If you sign them you’re staying here for awhile.”
She hadn’t understood what the papers meant and the DR had made no effort to determine whether she did before asking her to sign them.
Commitment would have screwed up her semester at university and humiliated her. She didn’t sign, she did seek therapy and she graduated and has a good and productive life with no recurrence of bumelia. But she almost ACCIDENTALY committed herself.
Girlfriend#2) Was in a technical college and under the care of a psychiatrist owing to very real mental health problems. Gradually he prescribed more and heavier drugs in larger doses (at one point she was on 6 different meds simultaneously including Diazapam, Clorazapam, an antipsychotic that can cause permanent tics and twitches, Paxil and I can’t remember the rest). She got to the point where she couldn’t get out of bed, couldn’t care for her child, couldn’t convince herself to make meals etc and had to drop school because she could only force herself to make it there once or twice a week at best.
She voluntarily committed herself to adult in-patient treatment a number of times - sometimes at the behest of her care worker - when she felt her illness had progressed to far.
She gradually started to wonder if the meds were part of the problem and asked her pychiatrist to wean her off the two heaviest. The pychiatrist basicaly said, “Okay, if you don’t trust my judgement we’ll see how you do without them.” Rather than weanning her off of them he refused to write a prescription for them and cut her off cold turkey. Within 5 days she was so batshit nuts that she begged to be put back on them. The pychiatrist lectured her about how she wasn’t qualified make decisions about medication and he hoped that this experience showed her that.
After her 5th voluntary commitment in under a year I suggested that she maybe consider seeing another pychiatrist. She, over massive protests from her current psychiatrist, changed psychaitrists to one that didn’t rely so heavily on medication. The new pychiatrist weanned her off of the three heaviest drugs and gradually cut down the doses of the other three.
She now has full custody of her child and is working as teacher’s aid and has been for about 4 years.
Jodi said that there is no assumption of imcompetence (I hope that is a close enough summation of what you said in an earlier post if not please correct me) and I agree that there is no such codified or overt assumption. There does seem to be, in my experience, an underlying one. I call it the wing-nut test <— not meant to be offensive and if it is I apologize sincerely - it goes like this:
Are rational people generally in psch wards? No.
Is [insert name here] in a psychward? Yes.
Therefore [insert name] musn’t be rational and any statement made by [insert name] must take that into consideration. If [name] were rational then he/she wouldn’t be here; ipso facto they are not rational.
Remeber that Doctor’s are often accused (sometimes fairly sometimes not) of having a God complex. Specialists (like psychiatrists) are more prone to this than GP’s owing to greater education and expertise.
The lawyer arguing for commitment is also highly educated and is likely to defer to the judgement of what they percieve to be another professional’s greater expertise. The Judge is likely to do the same.
The patient however is likely not possesed of advanced education and has already failed the wing-nut test (if they had passed the test then this hearing would not be taking place).
The system is weighted against the patient. Not, in my opinion, because of malice on the part of any party (although sometimes that does exist) but because of a natural human tendency to “trust the expert.”
And I have known people (girlfriend #2 for instance) who asked to be released from voluntary commitment and was greeted with a refusal until the psychiatrist could talk to her - sometimes over a day later - and intense pressure from the psychiatrist to remain. Insistence upon release resulted in forced commitment for non-compliance / combative attitude.
I’ve no doubt that Jodi and others like her honestly believe in what the7y are doing but they have little or no 1st hand experience with the patient side of mental health care outside of files/charts and hearings.
Zeke