Somebody called me from a psychiatric instutition saying she's held against her will.

[AHunter3]

@Truman Burbank

Sorry, the point stands. You can’t have both "The motivation for taking the kids is that the kids might be at risk. We (as a culture) might take someone’s kids (temporarily) if we had reason to suspect that the parent was addicted to illegal drugs and was neglecting them. " AND use ‘lacking a crystal ball, I do nothing’.
Either we can
(1) have reasonable suspicions, and act upon them, or we are
(2) incapable of having reasonable suspicion.
You need to pick one. You let the mom go in my hypothetical because you (B) lacked a crystal ball, remember. Later, you said you should have taken the kids, apparently because you (A) saw something in the crystal ball.
After you pick one, then you can argue the nuances of which is the worse action, taking the kids or hospitalizing the mom.

No it doesn’t, Yes I can, and No I don’t.

Who the hell appointed you the arbiter of what is and isn’t a logical and reasonable distinction?

I never said there was no possibility of ever predicting violence in a person. I said people who attempt to make such predictions do a dismal job of it.
Let’s look at the situation with the kids first (for contrast value to be used farther down-post). I would be inclined to authorize temporary removal of the kids based on my belief that the patient is a danger to them. This willingness is predicated on the following beliefs or assumptions, though, and if I have sufficient reason to doubt some or all of these, I’d probably flip my decision and NOT authorize the removal of the kids:

• that the relevant child welfare authority has a safe place to put them, where they will not be at high risk of being traumatized by coercive or abusive individuals as an outcome of having been removed

• that the patient will most likely be reunited with the children without undue invasion of family privacy if there’s no additional suggestion or reason to believe the patient might harm them

• that the patient herself meant that she thought there was some likelihood that she would act on what the voices were telling her to do
Now with regards to holding the patient herself. I’m possibly unusually zealous about incarceration in general. (To me, it seems like our society is jaw-droppingly blasé about it. We actually have activists running around trying to stop capital punishment who don’t appear to have any problem with life imprisonment. If I were ever convicted of the type of crime for which those were possible punishments, I’d want to escape just to go torture and maim those idiots for such a stupid-ass position. I don’t think it should be legal to incarcerate anyone for 5 years or more without at least giving them the option of death instead. Putting people in some kind of cage is incredibly cruel and it should be vanishingly rare). Then, on top of that, there are many associated outcomes, possible side effects of short-term psychiatric incarceration if you will, that I’d consider significant risks were I to act to commit her under the described circumstances:
• she’d be someone on whom an involuntary hold had been secured for anticipated violence and, as such, I don’t think they’d release her simply because 72 hours of observation elapsed during which she did not threaten to kill her children any more. I think she’d be at risk of being held involuntarily for a comparatively long time and her release would be contingent on manifesting signs of “change”, and not as she would necessarily define it for herself.

• I think it extremely likely that she would be pressured to take psychiatric drugs of the class generally described as “antipsychotics”, and/or those described as “antidepressants”; I don’t share the psychiatric profession’s generally high opinion of those; and the right to refuse psychiatric medication without medication compliance being made a requirement for discharge (or even the attainment of “privileges” as an inpatient) is one of the areas in which self-determination is most at risk in an involuntary commitment situation. Even if we stipulate that she’s already taking psych meds, the general experience of pro-treatment mental health “consumers” with involuntary situations indicates that patents tend not to be consulted about which medications they do or do not wish to take.

• it very often creates a revolving-door profile, in which the institutionalized person internalizes a sense of self as belonging in an institutional setting and damaged or sick in the head and incapable of taking care of self, and in which the relevant police and psychiatric personnel view the person as someone already demonstrated to be a person who quite properly needs to be locked up on occasion, hence future involuntary incarcerations are more likely than they would be for someone else all other things being equal

[Truman_Burbank]

What you said was:
“Statistics seem to indicate that people like you & me do a dismal job of predicting dangerousness. I choose to err on the side of not coercing people. It’s sad but that’s what you get when you opt for people’s freedom over people’s safety from themselves. And I do.”

Seems to translate to me as: we cannot do an adequate job of predicting dangerousness, therefore I err on the side of not coercing people.
So on what basis did you retroactively remove the children, again? Seemed like you were predicting dangerousness.

[Truman_Burbank]

I mean, just to draw it as clearly as possible, using your own words, if this:
“you & me do a dismal job of predicting dangerousness.”
Then how this?:

@AHunter3

Good catch, both of you. Yeah :smack: get those kids out of there.

[living_in_hell]

@Merejane

Also, I think someone mentioned in an earlier post that there are likely lurkers on this thread who have lost family members to suicide, and who are appalled by AHunter3’s views. For the record, that is true; I am one of those lurkers.

I was far from a lurker in this thread. I have lost 6 friends and two family members to suicide. Oddly, I have never lost a patient whom I have helped to be hospitalized for a higher level of care.

AHunter3 appears to have had a bad experience with the mental health system, and surrounds himself with others who have, as well. Angry mob.

I don’t think any level of logic or reason or experience or compassion will change the mind of AHunter3, as she is clearly not willing to budge.

As for Orr? You’re on your own with that one…

[AHunter3]

@Truman_Burbank

What you said was:
“Statistics seem to indicate that people like you & me do a dismal job of predicting dangerousness. I choose to err on the side of not coercing people. It’s sad but that’s what you get when you opt for people’s freedom over people’s safety from themselves. And I do.”

Seems to translate to me as: we cannot do an adequate job of predicting dangerousness, therefore I err on the side of not coercing people.
So on what basis did you retroactively remove the children, again? Seemed like you were predicting dangerousness.

Don’t be obtuse.

On the day of the company picnic I glance at the sky and it looks to me like it wants to rain. I grab an umbrella. I don’t call the relevant people and cancel the picnic and have the event moved to the cafeteria. The tradeoffs of grabbing an umbrella unnecessarily are sufficiently trivial that I’m not reluctant to do it despite my spotty record as a weather prognosticator. Cancelling the picnic will make lots of folks unhappy, they look forward to the outdoor barbecue.

Don’t try to claim I’m comparing the killing of children with the agony of missing a barbecue. Don’t even go there.

People make different decisions based on different degrees of certainty all the time.

[Truman_Burbank]

If this analogy is the best response you’ve got, I’m content to leave the discussion right here. May others judge our respective contributions as they may. I noticed you did not address my most recent post, juxtaposing your comments. Others may notice that, also.

[kayaker]

@AHunter3

On the day of the company picnic I glance at the sky and it looks to me like it wants to rain.

Rain Alarm for iPhone, iPad, and iPod Touch. Very good rain predictor.

[nearwildheaven]

@Chimera

Things paranoid and delusional people say cannot be taken at face value. That should be blatantly obvious. My ex-wife would go into screaming crying delusional martyrdom binges because of the look on someone’s face (that had nothing to do with her), or her believing they said something they didn’t, or just shit that happened in her dreams or in her own head.

No, you don’t really have the right to your delusions when they impact others.

My mother would do that too. She was one of those people who believed that everyone who saw her (and us, by default) would spend every minute of the rest of the day talking about us, and it was the first time I ever heard anyone say that every time she went to the grocery store, big crowds of people would follow her around and laugh at her the whole time.

I worked at Target for 4 years, and a grocery store for 3 years after that, and never witnessed any such thing.

Knowing what I do now, I wonder if some of it was caused by the birth control pills available at the time. Thing is, most women who get ragey on them recognize it, and do something about it.

[Merejane]

@AHunter3

Don’t try to claim I’m comparing the killing of children with the agony of missing a barbecue. Don’t even go there.

Okay, fine, but isn’t it accurate to say that you are comparing taking a mother’s children away from her to grabbing an umbrella?

You don’t think that’s the worst analogy ever?

[living_in_hell]

@Merejane

Also, I think someone mentioned in an earlier post that there are likely lurkers on this thread who have lost family members to suicide, and who are appalled by AHunter3’s views. For the record, that is true; I am one of those lurkers.

I may have missed that part, but I DID catch the Orr G comment around my insensitivity as a heartless professional who is so flip about involuntary hospitalization… :rolleyes: I have had 2 family members and SIX friends take their lives. But apparently, I am just a cruel mental health worker who doesn’t get it.

[Truman_Burbank]

Well, Hell, I don’t know about you, but I went into the field because I hate people and figured it was an easy road to wealth.

[Orr_G]

@pendgwen

Have there been abuses of the involuntary commitment process in the past? Of course. Do those abuses continue today despite stricter rules and oversight? No system is perfect so I’m sure it happens occasionally. Although considering how much trouble I’ve had getting an inpatient bed for an actively suicidal patient who desperately wants help I can’t believe it happens very often. Are there people whose mental illness renders them too dangerous to allow them to wander around with the rest of us? Absolutely.

I just wanted to mention that I thought pendgwen’s comment here was quite reasonable and well stated, and goes a long way in mitigating the sense that one can get in these threads that professionals deny even the possibility that abuse (or incompetence, or simple error, for that matter) can take place in involuntary commitment.

@living_in_hell

I may have missed that part, but I DID catch the Orr G comment around my insensitivity as a heartless professional who is so flip about involuntary hospitalization… :rolleyes:

I made no such comment in this thread.

@Truman_Burbank

Well, Hell, I don’t know about you, but I went into the field because I hate people and figured it was an easy road to wealth.

You should realize that the only posters in this thread who’ve painted you and living_in_hell in that fashion are, well, you and living_in_hell.

[Truman_Burbank]

Orr, please review posts #24 and everything Beagles contributed onward;
your post #62, Hunter’s posts #75 and 84 especially (describing himself as an ‘escaped’ schizophrenic is absolutely loaded with connotation, don’t you think?); Annie’s contribution in #133.
Living in Hell noted your language in posts #175, 191, followed by your post 192 where you opine we are taking this all much too personally.
By now I hope you would have given up your strawman that professionals in the field absolutely deny mistakes can occur, of course they can.
Sometimes surgeons take out the wrong kidney, or amputate the wrong leg.
Should we outlaw surgery on seriously injured trauma patients until they regain consciousness?
There have been a good half-dozen, at least, professionals and patients in this thread trying to fight your ignorance about specific misgivings you have expressed about involuntary commitment. I’m not sure it’s made much of a dent. I suspect this thread is about played out.
I just respectfully disagree with Hunter’s position. In my hypothetical, he would have let the mother go. I wouldn’t have. I think he’s overly zealous in his position and a whole lot of people would die if we adopted his position of 'involuntary commitment, just don’t do it - ever".
BTW, Beagles, if you are still following, of course they confiscated her guitar. Think about what a great offensive weapon that would make in the hands of violent patient, and what an opportunity for suicide it would present for others. How would you feel if one of the pts strangled himself with your G string?

[Orr_G]

@Truman_Burbank

Orr, please review posts #24 and everything Beagles contributed onward;
your post #62, Hunter’s posts #75 and 84 especially (describing himself as an ‘escaped’ schizophrenic is absolutely loaded with connotation, don’t you think?); Annie’s contribution in #133.
Living in Hell noted your language in posts #175, 191, followed by your pos 192 where you opine we are taking this all much too personally.

You listed a lot of posts. I’ll grant that Beagles’ posts are less than magnanimous towards psychiatric professionals. I’d forgotten about those, and I should have taken them into account. Please allow me to retroactively insert “aside from Beagles” into my previous comment.

Hunter’s posts were pretty even-handed given his passion for his argument. He did not paint any professionals as hateful and greedy in this thread.

Annie recounted her personal experience, and did not describe anyone as evil or greedy (although she might feel that the “out for revenge person” might be, but that was someone outside the system entirely).

I fail to see where I’ve painted anyone in particular, or any group, as greedy and evil. I did once use the phrase “mustache-twisting”, which was of course tongue-in-cheek and meant to be a sardonic nod to the possibility that the coworker’s claims were true and her situation was due to abuse rather than perceived need.

You were the one who said, in post #151,

@Truman_Burbank

Oops, resident, sorry I didn’t read more closely. Sometimes in these mental health threads I get as frustrated as an epidemiologist talking to antivaxxers, but it is probably my error for taking it personally.

So, in post #192, I was following your lead with that comment.

If one were to read only your posts, one might think you make a strong statement, but your arguments are often not convincing.

@Truman_Burbank

By now I hope you would have given up your strawman that professionals in the field absolutely deny mistakes can occur, of course they can.

I’m glad that you acknowledge that mistakes can happen. Simple acknowledgments like that can strongly change the tone of the thread without weakening one’s argument.

I still feel that these threads have typically come across as though many of the posters (professionals and otherwise) find the idea to be implausible or ridiculous. Perhaps part of it is that I’m picking up on some defensiveness, perhaps I’m picking up on some proactive reaction against the more voluble Anti-Psychiatry types, or perhaps I’m conflating a bit between posters’ reactions to the specific situation under discussion and how they might respond in a more general discussion. In any case, the specific acknowledgments I’ve seen in this thread address my concern on that point.

@Truman_Burbank

There have been a good half-dozen, at least, professionals and patients in this thread trying to fight your ignorance about specific misgivings you have expressed about involuntary commitment. I’m not sure it’s made much of a dent.

I’ve definitely learned a bit from participating in this thread. Some posts have been very useful, other posts have perhaps done more damage to their own argument than have been helpful - admittedly, on both sides (although, frankly, there are a number of positions stakes out in this thread, so the number of sides depends on how you parse them).

[AHunter3]

A lot of caring people get lured to the profession.

I think there’s a lot of burnout, especially among the compassionate. It must be at least as bad as social work, to be trying to help people and constantly be colliding with the legal, medical, and structural limitations that make it so hard to prevent calamities and be supportive in the ways that would make the most difference, and to see so many people falling through the rather large cracks.
I can’t provide you with a really long litany of praise for specific people in the mental health profession who did well by me, but I’ll mention…

• the shrink at Vista Sandia Psych Hospital in Albuquerque — I hadn’t been a true threat to anyone, nor had I intended to commit myself (the paper I signed contained text indicating that I agreed to treatment, not that I agreed to relinquish the right to leave or thought I needed locking up; I thought I was agreeing to talk to the psychiatrist long enough to reassure them that I was OK in the head, i.e., 30 minutes or less), but he didn’t know that and I’d already caused some degree of commotion on the locked ward by the time he saw me. But he listened to me and asked good questions and then agreed that he saw no reason to put me on psych meds.

• several of the nurses and aides there, who dared to say they thought the mutual-support “patient people” self-help group we set up on the ward was a good idea, even after head nurse Richard F____ began yelling at us that it constituted “personal contact” and said we were interfering with each other’s therapy

• my assigned primary counselor at Deer Park Hospital in Houston who broke the white wall of uniform official opinion and told me flat-out “You need to get out of here. Dr B____ has a huge ego stake in this and just wants to win, you’ve made him very angry. Play the game until you get some privileges back and then get the hell out of this place”
Anyway, you may or may not appreciate hearing it, but there are also a lot of people with an appetite for direct power over other people who get attracted to the profession. People with more than a streak of emotional sadism who like to thwart other people and make them angry when they can’t do anything about it. Sadly, there’s probably less burnout among them, although I’d like to think some of them get tossed out as bad apples for ethics violations sooner or later.

[AHunter3]

PS:

Hunter’s posts #75 and 84 especially (describing himself as an ‘escaped’ schizophrenic is absolutely loaded with connotation, don’t you think?

Not connotation, denotation. Escaped, as in “I had to remove the locking mechism of a door with a purloined table knife and then slide out between chains and run for it in order to leave the facility”.

[Truman_Burbank]

"I’m glad that you acknowledge that mistakes can happen. Simple acknowledgments like that can strongly change the tone of the thread without weakening one’s argument. "

@Truman_Burbank

"
(snip)

There are lots of instances of abuse in medicine and psychiatry, of course, but some of the contributions in this thread sound more like a Scientology disinformation campaign than anything real. (snip)

My Post 121: There is an important and profound discussion to be had between individual rights to be let alone, vs the state’s obligation (if any) to protect people from the effects of their untreated mental illness. At some point, there’s sure to be areas of fuzziness to be discovered and explored.

My Post 129: Nothing in life is foolproof. Granted.

My Post 139: I think we’re moving towards general agreement, as no-one here is saying it could never happen.

Enough. More than enough.

[NeverKnownNormal]

I suppose you can be happy, AHunter3, to know that one really can walk around absolutely free, to harass and annoy at will. I wouldn’t mind if it were someone talking to their own personal deity, or walking their imaginary dog, but yesterday a certain person walked into my child’s school and demanded to take my eldest daughter to an imaginary dentist appointment. The school knows not to release my kids into her custody, but she’s still free to try again, and again, apparently. I gave a police report, and was told that if I had a PFA, and she violated that,* then* she could be charged. Which is wonderful and terrifying. I’ve tried twice to get a PFA, denied both times. And I have to “let” her kidnap my kid before I can do anything?:dubious: :eek:

Incidentally, there has been some sort of nastiness roughly every week since May 2012, but nobody wants to touch this with a ten-foot vaccinated crowbar. Legal Aid in 2012 was openly, rudely dismissive. Online Legal Aid a couple of months ago claimed that without physical abuse, there’s no basis for a Protection From Stalking order. Of two lawyers that I’ve called last Friday, nobody has called me back (not that I’m surprised–I wouldn’t want into this if I had a choice.) so it appears that a mental illness diagnosis is a de facto free pass. Freedom!:rolleyes:

[Orr_G]

@Truman_Burbank

"I’m glad that you acknowledge that mistakes can happen. Simple acknowledgments like that can strongly change the tone of the thread without weakening one’s argument. "

My Post 121: There is an important and profound discussion to be had between individual rights to be let alone, vs the state’s obligation (if any) to protect people from the effects of their untreated mental illness. At some point, there’s sure to be areas of fuzziness to be discovered and explored.

My Post 129: Nothing in life is foolproof. Granted.

My Post 139: I think we’re moving towards general agreement, as no-one here is saying it could never happen.

Enough. More than enough.

Ahh, posts younger than 150. Those were the days, eh?

From my post 142:

@Orr_G

All of these posts where people seem to be so sure that the system wouldn’t be abused or even occasionally handled with incompetence have me concerned.

Why in the world would you think I’m talking about your posts? Especially considering that there were a number of people posting on either side of the issue before I even made my post?

And later, when speaking on the topic, I used phrases like, “in these threads”, while often including words like “some” or “many”. I probably should have stuck with referring to expressing surprise at the zero beta error posts, rather than eliding to my sense of “these threads” in general, but what are ya gonna do?

@Truman_Burbank

By now I hope you would have given up your strawman that professionals in the field absolutely deny mistakes can occur, of course they can.

Speaking of strawmen…

[Truman_Burbank]

• and when you read poster after poster, many of whom are professionals in the field, dismiss, ridicule, and deride the very possibility of what these people have actually experienced in their lives, well, that is fucking hellish - Orr, Post #186.