I agree. A person cannot be involuntarily committed just on the say-so of another; an authorized person must witness that behavior.
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.
A few years ago, I had an incident with a nervous young doctor just after my heart attack. Without going into too many details, she made a minor mistake, and then handled things very badly trying to cover it up with me (lying to my face, refusing to let me talk with my wife, etc). I told her I wanted to talk to a different doctor, and she refused.
This young woman had told me, when I check in to her floor for recovery, that she happened to be the patient advocate for the hospital. In light of this, her behavior was more than a little disconcerting.
Fast forward a few weeks later, and I noticed that my regular doctor was behaving strangely around me, and made a few odd comments. I grew concerned enough that I requested my medical records from around the time of my heart attack.
I discovered that the young doctor had a rather skewed report as to what happened, neglecting to mention any of the things she had done that contributed to our disagreement, only noting that I suddenly grew “belligerent” without noting any reason. I was further shocked when I saw the report given by the first doctor I saw at my clinic after release (my PCP was unavailable), where he questioned my mental health and supported the young doctor’s actions, when nothing of the sort came up during my appointment with him. My PCP’s clinic and the hospital are under the same company, FWIW.
Long story short, I found a new doctor at a separate clinic.
An interesting note: one of my neighbors is a retired psychiatrist. I shared my story with her, and she shared a story with me that had happened to her just a few months after mine. She was at that same hospital for a cardiac situation, and learned that there was a mistake on her record, indicating an allergy to a medication that she did not have. She tried to get this corrected, but her doctor went on an ego trip, as she put it, and made some vague threats about sending her to psych instead of correcting the error. She was pretty upset about the whole thing, saying, “I’m a doctor, and they treat me this way? What happens when a regular person has a problem? What are they supposed to do?”
Having seen just this much of the darker underbelly of the medical profession, what I find surprising is that so many posters here, whom one might presume to be educated and informed, so readily dismiss the idea that someone could be put on a psych hold inappropriately. So many of the safeguards (patient’s rights, patient advocacy, needing a second doctor’s opinion, etc) can be so easily manipulated to cover for incompetency (or, presumably, abuse).
The story is told here.
Nobody has done that. All that some of us have said is that it’s more *likely *that this woman actually does need inpatient treatment. Is it possible she’s being held against her will and doesn’t need inpatient treatment? Yes, of course it is. But it’s more *likely *she needs some help right now.
(Would a coworker you went out to lunch with be your first choice to call if you were being held against your will? Or your second? Or your tenth? She would be pretty far down my list of calls, because I’m capable of rational thought and personal insight enough to know that you don’t burden coworkers with stuff like this. That’s what friends and family are for…and if all her friends and family are unwilling to spring her, that’s pretty telling itself.)
A few things surprise me about your experience—one, that a doctor is allowed to be the patient advocate for a hospital in which she also works. That seems to be a conflict of interests, IME. Where I work, patient advocates are non-clinical, neutral third parties for just that reason—less likely to side with either party (or, in your case, themselves). I’m also surprised, though, that your PCP would be so uncomfortable with a situation in which you might have become belligerent. People in medical crises frequently have emotional/mental reactions as well.
Your neighbors situation, on the other hand, just baffles me. She was trying to correct erroneous med allergy info and the response was vague threats about having her evaluated by psychiatry? That’s a huge leap. Huge. Are you certain it went from 0-60 like that? No other stops along the way?
Exactly. Thinking that this person is likely in need of treatment rather than trapped in an institution with no justification is not the same as saying, “Oh, no one is ever held against their will when there’s no cause.”
My experience as a former LMHC is that fewer people are able to access treatment before it becomes acute, more so than people thrown in the clink when they’re perfectly sane. I had plenty of patients who were suicidal and still sent home from the ER with, “Well, make an appointment with your therapist in the morning and call the crisis team if you’re actually going to OD.” People who desperately need to feel safe for a few days could not get authorization from their insurance to cover any time on a psych unit.
This thread has more than once veered into more general territory than that. You, and a few others, have been pretty careful, and I appreciate that. Others have not been so careful (in this thread and others on similar topics). Perhaps in some cases I am reading the arguments against, for instance, AHunter3’s statements too strongly, but several of the comments in this thread come across to me as rather rose-colored when it comes to the supposed checks and balances in place.
I was surprised when she told me, because what you say here is the impression I had about how things were supposed to work. She handed me a bunch of pamphlets on hospital policy, patients’ rights, and domestic abuse, and told me to contact her if I had any problems or questions.
My PCP wasn’t exactly uncomfortable, just saying things that only made sense when I read the partially fabricated report. The young doctor at the hospital clearly was - I suspected at the time that something else was bothering her because I was very calm (medicatedly so, so to speak) up until she blatantly lied to my face, and she was already visibly upset about something.
I gave the short version of the story, of course, but I don’t recall my neighbor giving any more insight into her doctor’s behavior other than to call it an ego trip. I vaguely recall her saying something about having a hard time getting in touch with him because he was so busy, so if they went from 0-60, it’s quite possible that they were both gunning their engines pretty hard first.
I suppose I should be clear here and state that I agree that there is a serious lack of access to proper care and other resources for people that are looking for it. My comments were just in response to other’s statements regarding things like the protections or safeguards that are supposedly in place, rather than in response to the specific patient mentioned in the OP.
Clarifying then, since there seems to be some demand for it - I think it’s far more likely than not to be the case that the OP’s coworker is being treated for very appropriate reasons. Everyone being human, of course, there is also the potential that the coworker is correct and being held for insufficient or nefarious reasons. And is pregnant past the standard age for such things.
I also think that it’s highly possible that if she proceeds in the manner that the coworker directed, it could well end up ruining the coworker’s career and humiliating her in front of friends and family.
As such, if the OP is going to take any action, it should be as carefully-considered and private as she is able to manage, and I think she has been directed to the appropriate resources for such things.
Your mileage may vary, all rights reserved, etc., etc.
G. Orr, I am sorry for your bad experience with a cardiologist. One of my best friends is a lawyer specializing in medical malpractice, and he’s got sufficient work. **All **professions are likely to impacted by human imperfections, both great and small, wouldn’t you agree?
Do you generalize your bad medical experience only to medicine/cardiology/psychiatry, or also to CPAs, car mechanics, and mail carriers, etc?
What do you do for a living, if anything? Are you equally skeptical of your peers in your profession?
Thank you. Actually the young doctor I speak of wasn’t the cardiologist, just a new resident (I was, after I was stable, transferred out of the ICU for observation). My cardiologist was amazing. He was a fucking machine; his bedside manner was perfect and efficient, and his teammates worked as if they were an extension of his will.
I’m not sure how to respond here. Of course all people are impacted by human imperfections - sometimes that can be a beautiful thing, but sometimes it can be depressing or horrifying. I don’t know to what extent I generalize my experience; I do know that I was deeply shocked by how easily, and that it was over such a small thing, that medical professionals would malign a patient in their records. This has definitely impacted how careful I am when dealing with anyone who has that kind of potential impact on my life. Aside from that, I think I’m more skeptical and cynical than the average person in general (but maybe not more than the average 'Doper).
A slightly tangential aside: I had to choose a new cardiologist for my follow-up stuff because the first guy was strictly an interventionist. I decided to sign up for one at the Mayo clinic, because I had heard good things. Oh, my God. Those people are wonderful. I’ve mostly been with HMO’s and such, and I’ve had a variety of experiences with medical professionals. But absolutely everyone at Mayo was incredible - kind, and skilled, and respectful, and highly professional. And, in a slightly cult-like way, everyone seemed to make a point of embodying the Mayo’s mission statement at every turn. Even the freakin’ hot dog vendor outside told a heartwarming story about how privileged he was to serve the best dogs in town to the doctors and nurses who performed miracles each day. The hot dog vendor was skilled at developing therapeutic patient rapport.
So, I can be pretty cynical, because I have high standards, especially for people who hold other people’s lives in their hands, and I’ve read a lot, and experienced some, of how badly some people live up to those standards. But I know that I’m not being entirely unreasonable, because I’ve encountered people who have excelled and exceeded those standards.
I have no peers. 
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. People are gonna think what they’re gonna think. We’re much more likely to be given un-needed dental work than hospitalized involuntarily inappropriately, I would confidently wager. No profit motive, for one.
I’m sure you are ‘peerless’, but I’m also sure if we examined your profession (assuming you have/had one) some people would have negative stories or WAGs they’d be happy to share. If you didn’t have a profession, we’d have opinions about SOBs who were born rich…
Not a huge deal - it was a parenthetical remark about exagerating “a bit”.
You said “Rosenhan’s study took place in a facility where subjects (confederates) had already been placed with bogus diagnoses and histories”.
Here are the actual details:
The term “bogus diagnoses and histories” suggests that these people provided (bogus) disagnoses previously done by other mental health professionals, and (false) documentation of prior psychotic episodes. Neither of these happened. It would have been more accurate to say “bogus symptoms”.
Again, I agree with the general distinction between a case in which there is otherwise reason to believe the person has some psychosis and cases where there is not. And on that divide, I think having family members testifying to a history of alleged psychotic behaviour falls on the “reason present” side of the divide. So I thought it was worth noting that the basis for the mistaken diagnoses in the Rosenhan situation was not as extensive as might have been suggested from your words.
Again, not a big deal.
You are absolutely right, I had mis-remembered the details of how they went about the admitting process. Thanks for reminder. How could I have forgotten “thunk?”:smack:
If anything the correction underscores how much more stringent we are now about inpatient treatment criteria. These days that presentation wouldn’t likely get you admitted unless you were private pay. I don’t any managed care reviewer is going to authorize an inpt admission for “thunk”.
Thanks for the correction. That was such a cool experiment. I apologize for doing it any harm in the retelling.
Highly.
I have worked in the human services field over 21 years and completed over 1,500 psychiatric assessments.
You are spreading a lot if misinformation and basically, you sound like a brat. And that is me being diplomatic.
I’m thoroughly convinced by your detailed, well-informed, and equanimous analysis.
Well, you’re not biased.
Perhaps living_in_hell is biased, but I for one would like to hear from the opposite bias, as it were. living_in_hell, would you mind giving the typical (insomuch as anything can be typical) evaluation/hold/intake scenario from your point of view?
Possibly they are, but AHunter3 stakes a position where regardless of whatever supreme levels of batshit public insanity someone acts out with they should be nigh untouchable by psychiatric authorities short of doing violence to others. This is IMO an unreasonable and dangerous standard for dealing with mentally ill people, and I can see how someone who deals with seriously mentally ill people day in and day out might be aggravated by this position.
Well, these 72 hour hold wards do a brisk business I understand, yet they release almost everyone after 72 hours. How truly, genuinely insane could these people be? Isn’t it just as possible that the vast majority of loony bin holds are in fact not insane, and apparently not in immediate danger after all? Does sitting around for 72 hours cure you? Really, that easy? Oh, I’m sure they send them off with info about therapy groups, etc. But still, were they really crazy and suddenly got better?
Re “brisk business” I am curious about this whole “There’s money in it somewhere” hypothesis that a lot of people seem to assume is a motivator for institutionalizing people arbitrarily. It seems to me that in this era of insurance companies looking over everything with fine tooth comb to ferret out waste and state and county resources being very pinched there is not some big incentive to institutionalize people unnecessarily. It’s very expensive and if a state or private entity develops an (expensive) track record for doing this unnecessarily or arbitrarily they are going to get looked at very closely.
Where’s the incentive to institutionalize willy-nilly if the people financing it are not in favor of excessive (or even moderate) use of these resources?