Well let me go ahead and step in and tell you how very very incorrect many of your assumptions are
MY NOTE: The following is not true of EVERY single US State...but a good deal of them. I will be speaking for region 6, 10, and 11 and most of the
I'll bullet point them if you life
1. Institutions rarely require mechanical restraints. There are multiple methods we try well before taking someone down or hitting them with
Haldol/Geodon/Zypexa...You can't believe how many people we are capable of talking down without even laying so much as a finger
2. The 'law' requiring a patient to be admitted psychiatrically is correct in much less of the cases than you think. We admit people voluntarily so
many more times than involuntarily. When a patient is admitted voluntarily they have many rights including the right to request immediate discharge.
In fact, in many cases, if the patient is not directly in line with the four potentials, we cannot legally keep them
The four potentials are the reasons we can hospitalize someone
Suicidal WITH intent/plan/attempt to end their life
Homicidal WITH a specific target/plan/intent
Psychosis beyond the baseline of the patient
Inability to care for self...and by this I mean someone hasn't eaten, slept or bathed in weeks not just missed a meal
In fact, it is quite hard to admit someone against their will. Another fun fact ((for Illinois and other states)) If a patient is deemed dangerous
enough to admit involuntarily AND has an open warrant, pending case or open felony or misdemeanor, we CANNOT by law admit that person against their
will because criminal law supercedes civil law
3. Defining "better" is very simple...when they no longer meet the four potentials for imminent risk...period...
4. A patient is NEVER held indefinately unless they are specifically sent to a ward for criminal insanity. Even in a state hospital, the most intense
admission we can make, the best I have ever had someone stay was 3 months...a long time yes, but that was because they persistently represented an
extreme danger....not indefinite
5. the 'book' as in the DSM...is NOT the reason we hospitalize ANYONE EVER. Millions of people come to the hospital and their psychiatrists and
therapist with every diagnosis in the book but they are not BY LAW allowed to be hospitalized without meeting the potentials. An active diagnosis of
schizophrenia is not a admittable permission. I see many people daily who are profoundly bipolar, schizophrenic and depressed and they do not get
hospitalized unless they are an imminent risk...period
Fun fact...people who have actually attempted suicide have been released from an emergency room without psychiatric admission due to the legal
standards for imminent risk
6. The 72 hold per police is in fact legal in some states but not here. A police petition is actually reasonably worthless to me. The only thing it
means in this region is that a absolute best he can be held 24 hours or until a licensed professional such as myself releases him
Also, no offense, 95% of the police petitions I see are absolute garbage or illegal due to failure to properly fill them out. And when they are
properly filled, they are almost always very, very weak narratives. Weak narratives get shut down immediately here. I work on training police to file
strong petitions...they suck at it...again no offense to any officers here
1. If you have been brought to this facility on the basis of this petition alone, you will not be immediately admitted, but
will be detained for examination. You must be examined by a qualified professional within 24 hours or be released.
7. Patients are allowed to refuse any and all medications unless they are actively harming themselves, others, or are actively and acutely psychotic.
In fact, 'fast-tracking' happens a lot. Fast tracking is sending a patient to a psychiatric admission where he immediately states that he refuses to
take any non-emergency medications and refuses to continue medical care once released. At that point, if said patient is not actively dangerous, he is
often fast tracked. I have on countless occasions hospitalized a patient to have him be released in under one hour
8. "Talking to ones self
Being overtly emotional
Not believing in what is "rational" - whatever that may be
Out of touch with "reality" - whatever that may be "
None of these are admissible unless the patient is well beyond baseline and well into the danger zone. I have patients that talk to themselves the
entire time I try to interview them but if it is not abnormal for him or if it does not represent extreme danger then the patient is released.
"Overly emotional" is absolute BS. Unless they are despondent to the point that they tell me they will end their life today, they cannot be forced
to a floor. Rationality/reality is subjective and any good therapist/psychiatrist/MD will see/know the difference.
9. Absolutely 100% incorrect...those who are not 'normal' ((which is super offensive IMO)) are not hospitalized and held. Normal is not your
decision, my decision even as a professional, or anyone's really. It is all, 100% about imminent risk...nothing more
10. Rosinitiate is partially correct...admissions/floors are honestly relatively worthless because many times the second people are released, and
usually in VERY short order, they throw their scripts right in the street. ATS a candidate for admission? please...these folks are normal as sunshine
in Florida...I imagine now there are several people you have met or run into that endure hefty mental illnesses that you don't even know about...why?
Because they are normal. These people are NOT defective. They just hurt...and we do all we can to ease the hurt.
11. The average person is intolerant...or in my opinion ignorant, rude and offensive. OH NO A PERSON IS TALKING TO HIMSELF!!! Call the police! He's
gonna shoot up a store! BULL...CRAP...think of the many shootings we have here. Even if we could psotively attribute every single one to mental
illness, how many tens of millions of people does that leave who are mentally ill that live their lives and move on just fine?
12. JimNasium - I will of course absolutely not speak for California. In our region, any mentally capable adult can file a petition to have a person
assessed by a professional. A doctor, police, a therapist and even a friend of a patient can make a petition and when it is signed, that patient is
now required to be evaluated. So no, here, the police are not even close to the only people who can. The only issue is that no petition in this region
can be filed on any minor child.
any person 18 years of age or older may present a petition to the facility director of a mental health facility in the county where the respondent
resides or is present.