Monday, January 09, 2012

Forced Treatment: Does it Help?

Go for it, I know we have many readers who oppose forced treatment.

  In "Opposing View: Forced Care Doesn't Work"  by Joseph A. Rogers in  USA Today discusses the usefulness of forced treatment.  While some would contend that people who are sick may become dangerous, lack insight, or be so sick they can't see themselves as ill, Rogers contends that by forcing people into treatment, they get turned off on the idea of getting care and that a better solution to the problem is to make psychiatric care something patients want to get.    Rogers writes:

Studies have shown that what works is not force but access to effective services. We don't need to change the laws to make it easier to lock people up; existing laws provide for that when warranted. Instead, we need to create and fund effective community-based mental health services that would make it attractive for people to come in and receive care, and that would support them in their recovery.

I don't know if better access to good care is the whole answer, but it's not a bad place to start.

Recent posts on forced treatment:
Jan 9: Forced Treatment: Does it Help? ("make psychiatric care something patients want to get")
Jan 13: I'm Sorry ("I'm sorry that... the mental health system has failed [those who have died due to hiding from 'treatment']")
Jan 14: What We Need (list of 12 things readers are saying they need from the MH system)
Jan 14: Poll: Involuntary Commitment: Would you do it again? (a survey for those who have been committed in the past)


nonononon said...

After my experiences with forced care which ,I will admit, saved my life, I often spoke of what an ideal world would look like. It would not include forced care. Even the juxtaposition of the two words makes me roll my eyes. I plan never to go near a hospital again and that makes it not too likely that I will let people know i am in crisis. i will hide out until I die of something. I would go for help if that help was helpful and did not leave me feeling abused yet saved at the same time. There are good people in the world to talk to. Why do they have to be in hospitals? Why do we have to get so very sick to get the care we need and even then get care that is less than ideal?
I have to stop. My ideas are going to drive me insane if i have to think about this issue at all.

Anonymous said...

Involuntary commitment only confirmed for me that the "doctors" in hospitals have "caring about patients" at the bottom of their to-do lists, right after "keeping my word". I would not ever allow myself to be put back into one of those hellholes. I won't speak to a psych-anything-ist until they can truthfully tell me they would respect my wishes and that's a guarantee no one has been willing to make. When psychiatrists ask why patients don't trust them all I can do is laugh.

Anon 2 said...

I agree with both comments above. The last time I went into the hospital voluntarily, they forced me to stay despite there being no real treatment. They deceived me, manipulated me and condescended to me. So I faked well and lied back at them as best I could until they released me. I vowed to die before ever returning to a psych ward. (I'm not against psychiatry in general, in fact I have a fine therapist. I'm just against the way they treat hospitalized patients. It's incredibly demeaning. They really need an attitude adjustment.)
Sadly, it probably won't happen in my lifetime, but maybe one day pnurses will realize they are not superior to their patients just because we are sick and they are well and pdocs will realize they're not necessarily smarter than every patient.

Liz said...

The need for "forcing people" to get help would be less if there was a better mental health care system to begin with. For example: I was forced to go to a state mental hospital. My hospitalization was approximately five weeks long. The morning they let me go, the psychiatrist asked- would you like to go home today? I replied that I would. I was released. Before I left, they had me call to make an outpatient appointment with a counselor. I did that, but the first available appointment was THREE WEEKS away. If I was so dangerous six weeks before that I had to be forcibly admitted, did I really improve so much in a month that I no longer needed to see someone but once a month? They had me on two or three meds, all of which I ran out of, because despite my pleas, it took FOUR MONTHS for me to get in to see a psychiatrist. It seems to me either the system totally runs your life or throws you out to sea. Comprehensive help is unavailable and balance is utterly absent.

nonononononon said...

There is only one word in the term that describes what it is. Forced is accurate if you are referring to involuntary hospitalizations. There is nothing caring about it. There is no care received. Care does not mean being fed meds that you do not want but that keep you docile until they are ready to let you go and yes Liz, they do let you go out into the sea without a dinghy. Once a person has been medicated to the point that their personality disappears along with all feeling it becomes possible for them to say to the doctor, I feel fine and I am ready to go home. This really means get me out of this place. Once you are out and get off the massive doses of drugs, you realize that you do need some sort of help but it is not available to you. They claim that suicide is a cry for help. They have never found a way to help. They system was set up to control and it does that well. Someone came along and said oh wait, doctors help people so they redefined the system as a some from of care, which sounds nice but it far from the truth. Perhaps doctors do want to help people but they get swept up in a system, too. Few take the time to analyze that system and fewer bother to take any measures to change it. What is the incentive when we are all so well controlled by the drugs? Outside of hospital, I take some of the drugs at lower doses. I am not anti medication. I take them so I can manage on a daily basis. Inside the hospital, the goal has never been for me to manage but for me to be managed.That is a achieved by knocking the stuffing out of me. That is achieved by taking away my phone so that I cannot call a friend when i feel awful and need someone to talk to. God knows, I might commit phone suicide. I might actually be able to tell someone on the outside what was going on.
I love how it works out that no matter what you do on the inside, it is a sign of terrible disturbance and must be medicated stat while a higher level of flet disturbance on the outside does not get you access to any sort of treatment or care unless, as Liz said, you are able to wait on it for a month. On the 53rd day, i could not have shoelaces. On day 54, I could walk into a hardware store and buy rope.

rob lindeman said...

"Forced care" is a contradiction in terms.

Viewed through an historical lens, involuntary commitment is essentially identical to the "compassionate" treatment of the mentally-ill that occurred in the mad-houses Europe in past centuries. It is of a piece with Benjamin Rush's spinning chair, hydrotherapy, electroshock (before the days of muscle relaxants!), and lobotomy.

Shrinks ought not to forget their sorry history (don't worry, this pediatrician can quote the history of cave-dweller-pediatrics, chapter and verse)

More difficult, but nonetheless necessary, shrinks ought to see their history mirrored in their current practice (coerced medication, involuntary commitment)

wv = plati; with "primi and segundi", columns on a italianesque lunch/dinner menu

Anonymous said...

I am the person with a bipolar and delusional brother. I was volunteering at my local NAMI with the newsletter and met a very nice woman who informed me that she had bipolar and had a psychotic break with the exact symptoms of my brother. She was forced into hospitalization and was grateful for it. She told me no amount of therapy/logic/family support would have helped her through her delusions. Only the forced meds helped her gain clarity.

nonononon said...

Last Anon,

I have bipolar and have had psychotic episodes. These episodes did not come out of the clear blue sky. I was in a steady slide to the bottom. if there were safe feeling , respectful, humane places to go to get help BEFORE we got so bad that 911 has to be called, there would be far fewer of us in hospital beds.

Sunny CA said...

I am "with" nonononon and the first anon. who had bad experiences with forced care, and I would generalize it to all in-patient psych care. I would rather die than go through a second psych hopitalization. I was on the receiving end of cruelty from the aides and some nurses and demeaning treatment from all. The kind people were very few. A calm, low-key very kind woman from a church came in a few times during my stay and she was the only kind and normal person I spoke to while hospitalized. It was she who led me to attend church for the first time in years after my release. The psychiatrist I was assigned was always angry with me and did not take my insurance so each 10 minute meeting cost me $280 cash without reimbursement. I refused to swallow medications so groups of about 5 of "them" would "jump" me and tackle me to the floor where the nurse would look me in the eye and tell me that she intended to hurt me, then would jab a needle into me. The medication that was shot into me caused me to nearly lose myself in a fog, making it hard to think, hard to speak, hard to focus. Being repeatedly shot up with that horrible drug was torture, quite literally. Ironically, it was the awful effects of that drug that caused me to refuse the oral medications, which were different drugs. It has taken me years to get over the trauma of the physical abuse and chemical abuse and I have to say I am still not over it. The treatment was so abusive, I am not sure I will ever be quite the same.

Anonymous said...

Having community-based access to mental health services is all good and well, but sometimes it's still not enough. Being in a large city in Canada, I have all the access I could possibly need both on the government's side and numerous non-profit options for things the government doesn't cover, and yet still hospitalization is a necessity at times.

When I'm really doing awful, If I'm going to get care it's going to have to be forced. If I need hospitalization, I'll have to be dragged there kicking and screaming. Why? What's so bad about hospital that I refuse to go? It's what you feel after the fact.

Guilt, shame, worthlessness, confusion... you feel smaller coming out than you did going in, and in some ways that makes you feel worse. I feel such fear over ending up in hospital that I actually lie to any person with the capacity to send me there, even when I know that the hospital is exactly where I need to be at that time. There's this little mental wall with marks counting the number of times I've ruined someone else's day/week/month/life by ending up in hospital, and another row for how many times I've "wasted" a bed that could be better put to use by somebody else (oh how rational, I know).

As quickly as you're placed into the hospital, you're thrust back out with substandard support to deal with the trauma and stigmatization that comes with having been in the hospital, an issue that in my opinion should be dealt with before you're discharged and followed through on in the weeks after treatment. This includes self-stigmatization and stigmatization and manipulation imposed upon the individual by family, friends and coworkers (try having a mother who, ever since your first hospitalization, when you get into an argument, later disrupts your shower to ask if "you're going to slit your wrists while I'm gone" despite such a thing never having occurred). Who's there to help me afterwards?

You have psychiatrist that keeps your meds in order, you get either a therapist or social worker whose sole interest is getting you back into the functioning world of work, bill paying and grocery shopping, but nobody sits down with the client and, if necessary, the family to talk about what the client needs on an emotional level following their hospital stay, to help them deal with the inevitable tension and conflict that's come to exist, before, during, and/or after their stay.

It would be wonderful if, when needed, I could voluntarily place myself in hospital. But, I know what happens once the hospital stay ends, and until that's sorted it'll be involuntary committal all the way.

Anonymous said...

I committed no crime, yet was treated like a criminal. I would never again put myself under the care of someone who has the authority to do that to me. Hospitalization was not life saving, it was depressing and scary. It only compounded the despair I felt. What they did was verbally and physically abusive. They should have their butts thrown in jail.

Luckily, not all people who work in the mental health care field support forced treatment or that would have been the end of mental health care for me.

I haven't been hospitalized since 2002 but continue to be haunted by those experiences.

Anonymous said...

Canadian Anon, if you have such great access to services then why do those services not do the job they ought to. All of what you described does not happen is exactly the sort of support that could keep you out of hospital.

Anonymous said...

Because I screw up. And at the same time, we're still working to find a medication that helps and doesn't result in bad side-effects.

There are issues with the system, and then there are issues with the person in the system. You can make the system as great as you like, but the person's own hangups and disordered thought processes can be a hindrance to making the system work as you'd hoped it would. Have you never met a person with Bipolar Disorder who suddenly decides they'll be fine without medication only to become severely depressed or manic? A schizophrenic who insists their medication is actually poison? A person with depression suffering from Prozac Poopout (and who, due to their still-negative thinking because they haven't completed CBT yet blames this on themselves, is embarrassed by their apparent flaw, and feels it might be better just to end it all)?

I had medication that worked. It pooped out, I felt like it was all my fault, became suicidal, ended up in the hospital. They put me on medication, I got out and couldn't tolerate the side effects any longer, so we started working to find an alternative. While working to find an alternative, I dipped back down into a severe depression, and a short hospital stay was necessary because I was feeling suicidal and have a tendency to make impulsive decisions. A few months ago, while trying another medication, I went manic and had to be hospitalized while they tinkered with my meds. Got out, gained a massive amount of weight thanks to the meds, and have been working with my psychiatrist ever since to find a new option. Except, while trying to find that option I'm once again finding myself in a depressive episode, and if I were honest with my psychiatrist about the thoughts that go along with it I'd be in the hospital again. He can't make any med work overnight, pills aren't miracles they still take time to get right.

Now, I can talk to my therapist about this, he can help me through it, but I'm too scared of ending up in the hospital. So, I don't talk to him about it. I could tell my psychiatrist about it, because obviously whatever we have me on isn't doing anything, but I'm too scared of ending up in the hospital. I could call a crisis line, but I'm scared of the phone and besides, what if they deem me unsafe and in need of hospitalization?

So I, as a patient, am not honest. Because of my hangups. Which I don't talk about with the therapist or the psychiatrist when I'm this depressed because they might try to hospitalize me.

The system itself works fine but I, and many others I'm sure, make mistakes or let our thoughts get the best of us, or aren't as honest as we should be because we're embarrassed or scared.

Where the system could improve is on post-hospital procedure. It's great that they help get a person back on their feet, but what they don't do - at least not the Canadian system - is ensure that issues of stigmatization within the individual's circles do not prove to be a barrier to that individual accepting hospitalization in the future *before* things get nasty versus being forced once things reach the tipping point. For example, if I weren't worried about how my mother would respond, I could have asked to have myself placed in a non-profit short-stay treatment centre when the suicidal thoughts reached the point where they were constant. This is not the hospital, simply a treatment centre where, if I so desire, I could spend the entire day out and about with no restrictions and the food doesn't suck, they're simply tweaking my meds in a safe environment and opening the doors for instant support if I find my thoughts are becoming overwhelmingly worse (and it's free!). But, if I do is my mother going to make another comment about me slitting my wrists? How many more comments is she going to make? How is it going to affect our relationship this time?

Anonymous said...

I asked, you answered. I am in your very same system and I find much that could be improved to keep people out of the hospital. Of course I have heard of a bipolar person who decided to stop meds. As for poop out and mania made worse by med tinkering (no matter who was doing the tinkernig, have you been reading my medical chart? It seems as though you have.)
I am sorry that you are too frightened to speak to your mother about options. I am much to old to have a mother to worry about but in this very same system, with a psychiatrist to go to for meds, there is nowhere to go when I KNOW that I am heading downhill, on an accelerating path. I don't agree that the system is fine and that you are to blame as a patient. I do know that the hospital can be necessary at times BUT I do strongly believe that we could stop many episodes in their tracks with the appropriate support in the community. What that support would look like is a topic that would take up a whole book but it would certainly help with the post hospital period of which you wrote. In my view, the support needed post hospital is not so different from the support that could obviate the need to be hospitalized and the hospital would be needed less frequently.

rob lindeman said...

Are any shrinks reading these comments? Is Clink reading? I don't know how a shrink could read these searing testimonies and then shrug and say "well, sometimes it's necessary"

Anonymous said...

Sister of DD man responding:

I have read Robert Whitaker’s “Anatomy of an Epidemic.” I have attended a conference with him as a speaker. I also listened to a functional (and I believe unmedicated) schizophrenic counselor who was cognizant of his issues and started a support group for bipolar and schizophrenics. This man was able to understand his illness and understand that the voices were NOT real. However, some people with mental illness are not helped solely with counseling and family support, and even Mr. Whitaker agreed that there are times where medication is needed. I am pro-mandatory hospitalization for people like my brother who suffer from anosognosia or lack of insight. He refuses to take anti-psychotics since he cannot see that he is ill. I have spent, on-and-off, the last five years of my life trying to understand and help my once semi-functional brother. As he descended into his non-bizarre delusional disorder, the people who knew him for years probably fed the illness because his delusions sounded rational due the life he was leading. They honestly believed that the black helicopter flying overhead was due to his presence. Even I initially believed him, until he told me that television newscasters and newspapers were reporting on corruption with the FBI and excess surveillance due to the letters he has sent them. He watches Senate hearings and thinks right now they are addressing his case. Even nighttime comedians were letting him know through their jokes that they were on his side. That was MY reality check. Thank goodness, due to NAMI and their Family-to-Family class, I learned a lot. I could not live when him when I realized that I was taking antidepressants and attending counseling in order to cope living with him! I was able to get him on Section 8 housing, food stamps, and free county counseling. The isolation is killing my brother and I feel that my support only made the situation worse, since it has prevented him from completely snapping and getting his much-needed hospitalization. At NAMI we learn that even if we get them into the hospital, many patients are able to act sane enough to get discharged that same evening. Therefore, I think the laws need to change. Instead of hospital requirements of being just at risk to themselves (which translates to suicidal only) and others, the law needs to include some kind of self-awareness. And granted, humane treatment of patients should also be mandated.

Anonymous said...

So Dinah,

Do you ever have to deal with your patients in practice who are in crisis and need more than a quick med change or an extra session? What do you do when a patient is seriously suicidal or do you only not see that "type" in your private practice? Do you ever send people to the hospital, by force if necessary ie tell the family to call 911?

Anonymous said...

Fellow Canadian:

I'm not sure what province you're in, but I'm in BC. I was given a list of family doctors accepting patients, and set up with a psychiatrist and psychologist through the CMHA (I dumped both for outside options, as my new family doctor had a psychiatrist on staff and I wanted more expanded therapy options than simply getting back into the working world). I accessed a local university's outpatient psychology program (there's two that I know of: UBC and SFU). The university clinics run on a sliding scale, so if you're low-income they will base the fee on your income; depending on which university you go through the lowest fee is $10 or $20 per session.

When my stability's in question, I see the psychiatrist every 2 weeks, my doctor every 2 weeks in between sessions with the psychiatrist, and my therapist weekly. If between any of these I feel I'm getting worse, I can contact my therapist through the university, or my family doctor if it's a med-problem. If any one of them takes a holiday, my family doctor sees me more frequently to ensure I don't slip through a crack while they're gone. When my therapist goes out of town they give me an emergency contact number for a person that will provide sessions as needed.

So my calendar looks a lot like this:
January 03: psychiatrist
January 05: therapist
January 11: doctor
January 12: therapist
No matter what, somebody always has an eye on me, and if I'm willing to be honest I have all the doors open waiting for me to walk in.

If you haven't already, contacting your local Canadian Mental Health Association is a good place to start getting access to the services you need (the hospital, if doing their job right, should be immediately booking an initial appointment for you via the CMHA).
While working on that, look up your local universities to see which ones offer therapy. The CMHA does provide access to group therapy, but if you want/need a one-on-one experience, universities are the place to go.
If you don't have a family doctor, find one right away; walk-in clinics are really bad resources when dealing with mental illness.

Lastly, your local health authority's website should have a "find a service" section. Choose "Mental Health" in the drop-down selection box and you can find a list of services you can access, which should provide you with options similar to my local short-stay treatment centre. You can bring up accessing these various supports with your doctor or psychiatrist, and they can refer you to the programs. One of these will be a short-stay treatment centre of some sort, which when you know you're bad but not quite hospital-bad serves as the perfect in-between. There should also be a mental health after-hours crisis line listed, whom provide both clinical and emotional support and referrals.

Hopefully that helps you get access to what you feel you need to keep yourself safe :)

Anonymous said...

Canuck in B.C.

Sounds like you have your bases all covered.
My only advice for you is to make sure you stay in B.C. Things don't work like that where I am.

Anonymous said...

Sister of DD,

The problem with anosognosia is that it's completely subjective. Lack of insight is often defined as simply disagreeing with the psychiatrist's treatment plan. If you don't agree, you must lack insight. I was oriented X 4 and it didn't keep me from forced treatment. In the psych ward, I didn't get up from the dinner table as directed because I was dizzy from all the crap they had me on. They surrounded me in what they like to call "a show of force" and even though I told them to stop, they grabbed me by my arms and forcibly dragged me back to my room and tossed me on the bed. I was threatening no one, but I didn't do what they said (and inpatient staff get really testy when that happens). I wouldn't treat a dog the way I was treated. Of course, they can get by with doing stuff like this because what am I going to do about it? It's not like they document when they do that.

The vast majority of people in psych hospitals (when I was there) were oriented and not hallucinating. And, so we get to be haunted by these memories because we knew exactly what was being done to us against our will.

Personally, I don't understand why anyone would seek further care after being treated like that. If I had a family member trying to get me more forced treatment, I would move to another state.

I have a family member who has been diagnosed with schizophrenia. She has never hurt anyone. I do not support forced treatment for her, either. Because, I know what it feels like.

Anonymous said...

nononon said, "On the 53rd day, i could not have shoelaces. On day 54, I could walk into a hardware store and buy rope."

I had to laugh at that, because it is so true. Within 24 hours I was supposedly so dangerous that I was forced to strip, put in a closet with a metal door, had my belongings taken and catalogued, theatened that if I did not sign in voluntarily they would sign me in involuntarily, watched every 15 minutes, to less than 24 hours later being released in a crappy part of town with no transportation home.

After I told them it was incredibly dangerous for a young woman to be wandering around in that part of the city, they finally relented and gave me a bus ticket with no assistance and no instructions. I didn't exactly live in the kind of city where public transportation was a big thing. I wasn't sure where my stop was, so I got off at the wrong place. Thee only way for me to get to my home at that point was to walk across a freeway. So, that's exactly what I did.

Biggest waste of money, not to mention the danger they put me in by dumping me out in a bad part of town, and then having to walk across a freeway.

You would think that if patients were brought in by threat/force, someone would have a clue and say, I bet they don't have transportation home. But, they don't think about that. When you're released, you're pretty much on your own. Common sense is nowhere to be found in that system.

Anonymous said...

I will never understand the hospital system. One day i was sectioned because of an anxiety attack. Apparently people with bipolar are not allowed to have anxiety attacks and when they do, the correct response is forced restraint so they cannot leave the hospital. I mean actual physical or chemical restraints. On another occasion, I was actually quite calm given that I had overdosed and was unconscious. As soon as they determined that I could breathe on my own they released me onto the streets because i swore that I was not going to OD again. I did not have money to get home because I had been rushed to Emerg and no one thought I would be needing bus fare for a good while. so an anxiety attack kept me locked up longer than an intentional overdose. Here is part of the reality: the ER is staffed with new grads, some are not even done med school yet. There are a fair number who do not speak English and if that is what you speak, too bad for you. Another chunk do not give a hoot about psych patients and find it is way easier to put you on a hold than to actually examine you. That is actually not even legal but they do it anyway and slough off the job of talking to you for more than 15 seconds to a shrink who needs to be called from the other side of the city to come see you and say you are okay to go home. Once a psych patient, always a psych patient even if you go in for a broken leg. They will decide that you threw yourself down the stairs and put you on a hold just in case you did even if all that happened was a slip on the ice.You might get some haldol shot up your backside in which case you will barely notice the time passing by.

Alexis said...

Rob, the problem with your question is that many of the stories are about care that didn't help them. That doesn't answer the theoretical question about whether it's ethical to force someone into treatment. All it does is say that forcing someone into bad care is futile; you're left asking "If the care helped, would it be okay to force you into it?"

It's been suggested that if care were better, patients would seek it voluntarily. That's true for some people, but not all. I have a friend right now who desperately needs help. She could have access to amazing care, and she wouldn't seek it, because she believes she does not have a problem--even though she's endangering herself and her children. (CPS has been involved.) Instead, she cuts off anyone who attempts to tell her that her behavior is dangerous. And she just quit taking her meds.

Anonymous said...


I know you were speaking to Rob, but I will answer my opinion. I don't believe it's ethical to force someone into treatment. Particularly someone who is oriented. I worked in a stroke unit and the vast majority of people were there because they did not follow medical advice. Would it be ethical to force them to take their antihypertensive meds to prevent a stroke? Couldn't we argue that they lacked insight or surely they would have taken their medication to prevent lying paralyzed in the bed? Why is psych care so different? I feel the same way about forced psych treatment when I was supposedly so ill that I needed it as I do now. Nothing has changed except that I don't see people who would do that to me.

Also, I'm not sure where this amazing care is that you speak of. I have always had insurance and the psych hospitals still sucked.

Can't blame your friend for not seeking care. I have experienced the psych hospital and I wouldn't sign up for that either. I bet if psych hospitals treated patients like regular hospitals treat regular patients with the same respect and same rights, then more people would stay.

rob lindeman said...


I agree with anon above.

The ethics here hinge not on whether the intervention helps the individual (whatever that means), but whether the individual wanted the intervention. Free societies let individual's words speak for themselves. They don't let so-called experts in mental illness speak for them.

wv = sectonet; lesser-known brass instrument, beloved by third-graders, discarded by fourth grade

Liz said...

I'm thankful to everyone else for sharing their stories. There are a lot of issues being thrown about. The major one, for me, is that individuals with mental illness are often stripped of their human rights.

After a forced psych admission two and a half years ago, I was angry and cut myself in the psych ward(an admittedly stupid thing to do). When I was found, I was restrained for nearly TWO FULL DAYS with straps around my ankles, wrists, and waist (they tapered off over the last eight hours or so). I cried and begged to be released nearly the entire time.

I understand their need to keep me safe (for their own sake, not mine), but I had family that would have sat with me for that period of time to watch me- family that initially didn't even know I was strapped down. There WERE other options, besides strapping me. This was PURELY punishment.

After I was released from restraints, the psychiatrist told me I needed to "grow up and learn some new coping skills." (DUH.) and he also told me that if I ever was hospitalized again, I'd be in restraints, and probably transferred to be locked with the criminally insane.

Without meeting with me or speaking to my family, I was sent to court. I might have considered a long term placement- just not the one they wanted to send me to, but NO ONE ASKED me, my husband, my mother, or my siblings. My family and I spoke with my lawyer and the judge, who decided that I did not need to be long-term hospitalized.

I was discharged straight from court without any outpatient instructions at all-- their temper tantrum for the courts not agreeing with them that I needed long-term inpatient care.

The next time I was hospitalized it was due to a suicide attempt in a nearby state-- just in case I survived and ended up in the psych ward (thank God I did), I wanted to make sure it wasn't in that ass-hole's hospital.

I was lucky-- the other hospital still sucked, but it had doctors that gave a shit. I was still forced to stay, and I still hated it. but at least this time, I was referred for outpatient therapy that actually made a difference.

Forcing someone into the hospital is terrible. But if you are going to do it, the least you can do is treat them with respect and dignity, do something helpful for them when they are there, work with and educate their family, and send them with an effective, workable discharge plan.

Here's another issue-- There was a time when I actually tried to go to the hospital myself, when I felt horribly suicidal. This was quite some time ago- I was an adult, but barely. I told the psychiatrist I was feeling suicidal; he responded, "What do you want me to do, tie your hands behind your back?" I went home and that night took eighty or so various anti-depressants, and ended up in the ICU, and THEN the psych ward.

If you don't want help, they are all about forcing you into it. If you do, you are definitely being manipulative in the eyes of the mental health care system.

Anonymous said...


You might want to check this link out:

As an FYI, the site is run by a colleague of yours, Dan Fisher. For those of you not familiar with his story, he became a psychiatrist after being diagnosed with schizophrenia in his early 20s.

And for those you who think he was misdiagnosed, in listening to him being interviewed, it doesn't sound like he was. But of course, I am not an expert.

Even if he was misdiagnosed, to overcome a label like that to become a psychiatrist is still incredible.


Anonymous said...

Sorry, I just realized I posted in the wrong thread. I mean this for Clink's blog entry.

Can someone please move it at their earliest convenience?