Posted by Caper on July 8, 2004, at 6:33:46
In reply to Friend needs hospitalization - what to do?, posted by katia on July 4, 2004, at 15:33:33
Hi Katia,
I have a little personal experience with involuntary psych hospital admissions. The way it works where I live is: the standard for involuntary admission is that you are a danger to yourself or others, or that you lack the ability to care for yourself. (I'm in the U.S., so if you're not most of this won't apply and sorry in advance.)
In this state, to start the commitment process, you go to a magistrate and swear out an affidavit, giving your reasons for your concerns about your friend or relative. It doesn't seem to take much for the magistrate to sign off on what's called an Emergency Custody Order (ECO). Then what happens is (and this is the part that's so hard when you're trying to get help for someone), well what happens in my state is they send police. The person is then handcuffed and possibly shackled at the legs as well, put in the back of a police car and driven to a hospital, where he waits for a mental health person to evaluate him. On an ECO they're only allowed to hold him for a few hours, unless the mental health person decides he meets the criteria for involuntary admission.
If that happens, next comes a TDO, temporary detention order. That means he's held up to 72 hours in a psych hospital, and before that time is up he'll have a hearing with a judge. The judge listens to the patient's side, and the treating doctor(s) side and the nurses and staff evaluations too. Then the judge usually takes the staff recommendation and that decides if the patient can leave.
If the person is not considered well enough to leave, the judge usually offers a "choice" of committing oneself "voluntarily" for a certain number of days, or being committed involuntary for a longer time. (You can imagine what option most people take.)
I've experienced involuntary commitment from both sides. A relative of mine was completely out of control, banging his head against the wall until it bled, telling us exactly where he was going to go get a gun and kill himself, etc. But, when we got the ECO, he was calm and cooperative and basically talked his way right out of it. So then he was home in a few hours and very angry about the whole thing. (Plus a little smug that he talked his way out of it- lied about his suicidal gestures, impulses, etc., and knew he'd gotten away with it.) Your friend sounds like he might not be able to fool them though, if you got him ECO'd. I say that because mania's harder to hide, plus manics don't think they are manic so they don't even try to hide it.
My other experiences were my own. I'll try not to go into the details too much, but it seemed to me that I got TDO'd twice because I already had a psych history dating back to 1995. My relative had none. Neither time I was TDO'd was I suicidal, but I was emotional and I suppose they were just being cautious.
So, to sum up- it's not pleasant for the person who is being committed, but if a person does not need to be there, the docs figure it out pretty fast and then he(or she) gets released. If the person truly _does_ need to be there, then at least you know he is safe and being taken care of.
I'm not sure what else to add really. My TDO's were by doctors, so my family and friends didn't have to deal with my anger about it later since it was not any of them who instigated it.
My relative? He got over it fairly quickly. My theory is he got over it so quickly because he knew everything we said to the magistrate was true and that he _was_ out of control and suicidal at the time.
The only other thing I can think of to say is follow your instincts but try to remember you can't control this. You do what you can and what you think is best and that's all you can do. I know it's easier said than done, when you care for someone, but.....you're already doing more than most people would do I think. Mental illness is hard to face up to.
As far as getting the process started, I'd call the local magistrate and if you can't reach him or her, call the Emergency Room and they'll direct you. I'm not sure if you have to be related to him to be the one to go the magistrate. I'd guess no, but that it would help if you had a family member of his as well.
I hope this helps a little and that it's not too late to be of any help, since you posted this several days ago I see.
Best of luck to you in figuring out this dilemma.
Caper
> Hi everyone,
> A friend of mine is experiencing his first true manic episode after a lifetime of depression and drug abuse. He's 33. He's been manic for about two months now and has been fired from his corporate job and kicked out of his house because his roommate called 911 after he felt threatened by him. He was gambling so much and owed money that guys came after him with a dog and he got mangled up and had to call 911. He's aunt felt threatened on a visit and had to leave for her physical safety. He claims he's number 1 at everything and will prove it through fighting and also claims he has had a spiritual awakening. He's gone completely nuts and won't take meds. He was on zyprexa at 20mg for ONE week and it didn't do much for him and the doctor wanted to up it. But he wanted to prove to everyone that he wasn't manic and since 20mg didn't do anything for him, he thought he didn't need help. He's family is close to me and I wish they would involuntarily hospitalize him before any thing even more serious happens to him. Does anyone have experience with this? How do you go about doing it? He's completely opposed to meds and getting help. i called him to see how he was doing and he proposed dinner and seducing me. Needless to say I didn't return that phone call. He won't take the help that everyone is extending to him.
>
> How does one hospitalize someone so manic? He's beligerent and won't cooperate.
> Please - responses are welcome.
> Katia
poster:Caper
thread:363071
URL: http://www.dr-bob.org/babble/20040704/msgs/363946.html