I’m skimming this thread because my head can’t take all the wow.
A friend in library school got a call from a friend of his in library school (who I was fortunate not to have been very close with) very late one night to let him know that he’d been put in Dorothea Dix and to please let all his professors know he’d get in touch when he could.
Oy. It’s the exceedingly rare quadruple negative.
Let’s see. If these are supposed to cancel each other out, are you saying that a competent person who has not broken a law should not be incarcerated or an incompetent person who has not broken a law should not be incarcerated? Involuntarily of course. Then again maybe they should be.
Think about it.
So then, you agree with my idea that Zsofia should get herself committed to the same facility & investigate from the inside, right?
I think the chances are extremely high the husband was told by his committed wife that she had called Zsofia. If I was in his shoes I might well call the work friend she contacted to reassure them she is being taken care of.
The part you seem to be leaving out is that this type of behavior is often a precursor to violent or self harming behavior. If someone is behaving like a complete loon, especially if the behavior is out of character, I think it’s perfectly ethical for a friend of relative to ask that they be detained and evaluated. Not to do so would IMO be grossly irresponsible.
Possible. But I wouldn’t just assume that.
One thing that has also changed - and which works in the opposite directions - is that the definitions of mental health disorders have ben expanded greatly over the years, to the point where a lot of experts believe that normal behaviour and feelings are being classified as abnormal disorders. There is a lot of controversy over this issue at this time, due to the publication of the DSM-5 which has been heavily criticized on these grounds. (Some people seem to be blaming the drug manufacturers as having an incentive to push this line, but if you ask me, everyone in the mental health field has the same incentive, and they’re all in on it.)
In any event, the point is that the broader variety of things classified as mental health disorders and the lower threshhold for such a diagnosis these days, makes the possiblity of inappropriate incarceration much more feasible than it would otherwise be, and would tend to counteract the effects of whatever rules a nd regulations may have gone into effect since that time.
"In any event, the point is that the broader variety of things classified as mental health disorders and the lower threshhold for such a diagnosis these days, makes the possiblity of inappropriate incarceration much more feasible than it would otherwise be, and would tend to counteract the effects of whatever rules a nd regulations may have gone into effect since that time. "
Not really relevent. Interesting as a side conversation, but has nothing to do with increasing the liklihood of involuntary committment. None of it has the effect of ‘lowering the bar’ for an involuntary hold.
Do you care to explain that further or is that a Pronouncement From on High?
Because I personally think that it has a lot to do with the liklihood of involuntary committment. And all of it would seem to me to have the effect of ‘lowering the bar’ for an involuntary hold.
I’m not in any way a mental health professional, but I don’t believe that the (legal or medical) standards for involuntary commitment are merely ‘person has a condition recognized in the DSM’; there certainly needs to be something along the lines of ‘is a danger to themselves or others’.
So, when an irrational need to correct others on the internet is added to the DSM, that doesn’t mean I can be involuntarily committed; I need to be doing something dangerous because of my correction obsession.
:smack:
OK, point taken.
That’s undoubtedly true.
But if Condition X is associated with being a possible danger to oneself or others and you’ve been diagnosed with Condition X, then you are more likely to be judged a potential danger to yourself or others. So if the criteria for diagnosing Condition X are broadened, and the threshholds are lowered, that it’s more likely that someone will be unjustly incarcerated.
Depression in particular comes to mind, both as something which has been subject to this broadening criteria and which could be thought to result in a person being a danger to themselves or others. But that’s just one example.
Zsofia, my husband gets these calls almost every day from his bipolar mother. The story is always a little different, but she is usually pregnant, frequently with twins, always detained against her will by either the evil doctors or Nazis, we need to get the word out, call the police immediately. She has been in and out of institutions for 35 years, and when the delusions start, it is never easy to get her committed. She becomes violent and mean, but nothing can be done until she actually attacks someone (she has never to my knowledge harmed herself.) Then they can hold her for a few days, then there has to be a competency hearing, the last of which she refused to put clothes on for, and then they can keep her until she’s stable again. Certainly my sister in law’s life would be much simpler if she could just have her committed when the crazy starts, rather than after my MIL has made a huge mess of her life, again. I think it’s extremely unlikely that your co-worker does not need to be hospitalized.
It’s definitely the original standard that a person is supposed to be a danger to self or others, and not just crazy. Many venues now include “gravely disabled”, which is an expansion of the circumstances underwhich involuntary confinement can be imposed, but you’re both right, it’s not tantamount to “because I think you need treatment”.
Officially.
I have compellingly good reason to believe that in practice people are often held for what amounts to “because I think you need treatment”, but I’d also like to learn. Truman Burbank, if you wouldn’t mind elaborating, to whom would you as the person initiating the commitment need to provide supporting evidence, and with whom would it “not fly” were that evidence to be found insufficient?
You’re right, I’m not a mental health professional, I’m an escaped schizophrenic and activist in the psych patients’ rights movement, and yes, of course, I have the expected slanted perspectives of one who comes to the issue from that background.
Here’s my understanding of how things work in practice: one psychiatrist initiates the involuntary hold. A reason is given but need not be tied to specific behavior: that is, it could look a lot like “I observed the patient Joe Blow to be agitated, expressing confused ideation, indicated a delusional belief that his father in law was trying to poison him, and indicated a plan to leave the campus despite the dangerous neighborhood at 3 am and could not describe a clear plan of where he intended to go. Family members describe a pattern in which patient Joe Blow becomes excited and agitated and disappears for several days not taking proper care of himself and expending his resources before being found days later incoherent and unbathed, consistent with bipolar disorder cyclic mood swings. I believe this person to be at risk and incapable of taking adequate care of himself based on current observations and reported history”
A second psychiatrist has to confirm the commitment. This takes place, usually, at the psychiatric facility to which the involuntary patient is transported by the police. The confirming psychiatrist is supposed to interact with the patient independently but in practice reads the notes from the first psychiatrist. I understand it to be vanishingly rare for the second required psychiatrist’s participation to consist of a negation of the first psychiatrist’s intention to commit. Many people who have been the patient in these situations have said that the corroborating shrink didn’t talk with them in person at all. Be that as it may (or may not) actually be, the corroborating shrink’s assessment is an observation of a person who has been hauled involuntarily to a locked ward and if you see what I mean they’re not likely to be at their most composed.
I didn’t know there were any disinterested 3rd parties to whom the rationale for commitment had to be presented, with whom “I thought he needed it” or equivalent would “not fly”. There is?
How wrong or how badly misconstrued would you consider my description of the process to be?
"then you are more likely to be judged a potential danger to yourself or others. " (bolding mine)
No, what Quercus said. It does not necessarily follow.
Hunter, I’ll try to get back in a little bit to respond to your post as fully as I can.
As someone with a diagnosis of depression who has never been committed, voluntarily or involuntarily - I think you’d have to be pretty suicidal to get yourself committed. I’ve had breakdowns in therapists offices and doctors offices. Said I had current suicidal ideation, but was able to control it. And as long as I said “I know that this is nuts, and I’m able to control it” they let me walk out the door. I’ve scored so high on the “how are you feeling today” depression test that they give me if I walk in for a pap smear that I wonder if I’d actually have to grab a scalpel in order to have them call the guys in the white coats - because you can’t score higher. Again - as long as I say “I recognize this is bad and that is why I’m hear” - they let me walk - usually with an upgrade to my prescription. (If I said “give them a call and admit me” they probably would, but I don’t want admittance on my records - I wouldn’t be able to get a gun :))
Renee’s story pretty much confirms my experience - crazy isn’t enough. Thoughts aren’t enough - danger to yourself or others involves action.
I’m also noticing this has turned into a bit of a hijack, if someone wants to start a thread in GD about mental health, involuntary committments, and/or medications that might be cool. I’ll start one later if I get time if people would be interested, right now I only have time for drive-by postings (I’m at work, busily not committing people). 
Whatever you do, do NOT rent the Mexican film “Maria de mi corazon” (1979) for your next work function. Or watch it at all.
The key question is what would happen if your immediate family decided to have you committed.
I’m obviously not claiming simultaneously that 1) 25% of the population would be diagnosed as having a mental disorder and 2) that everyone diagnosed with a mental disorder gets involuntarily committed.
What I have been saying throughout is that due to the prevalence of mental health disorder diagnoses, if circumstances are otherwise ripe for an involuntary committal (most notably, an inability to get along with immediate family), then I don’t have that much confidence that the mental health professionals in charge will thwart it.
From past personal experience, I’ll second what Dangerosa said in terms of depression. Even saying stuff like, “I think about suicide but don’t want to do it” or saying that you sometimes/often feel like everyone would be better off without you around isn’t grounds to try to detain or hospitalize.
Contrast that with the story from my old grad school advisor (in psychology), who felt some situational depression back in grad school in the mid-60s, asked the student counseling center therapist about the latest antidepressant and got a nearly frantic, intense cross-examination about suicidal thoughts and the like.
“an inability to get along with immediate family”
Where did you get the idea that’s criteria for involuntary committment? If it were, your 25% observation would probably be conservative.
Again, in general (I’m sure specific language varies from state to state), the criteria are: **danger to self **(specific suicidal plan/intention, or so psychotic may end there life due to the psychosis, eg “I can fly like a bird”), danger to others (eg the neighbor is poisoning my food, so I’m gonna shoot him), or **gravely disabled as a result of mental disability **(eg so disrupted by psychosis that cannot plan and excute rudimentary strategies to obtain food, clothing, shelter).
If I’m screaming at my kids to clean up their G-D rooms, that’s not committment criteria (for me OR the kid).
The checks/balances are roughly thus: if I write a ‘hold’ on a person, I’m stating in a legal document that it is my professional opinion that the person meets one or more of the criteria above. (In my state police and sheriffs can also write holds). This is not an instant ticket to involuntary admission, it is the step that gets them to the facilty for further evaluation. At the facility, they are evaluated again, by another licensed professional, and there is a consult with a psychiatrist with admitting privileges somewhere near that point. If the MD agrees, then the pt. is admitted (generally for up to 72 hours). Longer terms of invuluntary treatment require going to court and making your case before a judge who has generally, I would imagine, seen lots of these cases, and pts can also speak for themselves and/or have advocates with them.
Practically speaking, there is often another layer of “protection” - the hospitals now also have oversight from the insurance/managed care companies - if they were pulling people off the streets without criteria the managed care company would probably deny reimbursement.
I hope this isn’t a hijack but I thought it might help the OP feel reassured that her coworker probably is in the right place