How Hard Is It to Involuntarily Hospitalize Someone for Psychiatric Problems?

[snot]

Maybe it's not so hard, IF the right people want it to happen?

This morning, the Diane Rehm Show had a panel of experts discussing how and why Jared Laughner failed to receive mental health treatment that might have prevented the shooting spree that recently downed 12 people. They said it's almost impossible to hospitalize someone involuntarily, because you have to prove they're a danger to themselves or others, and that that's almost impossible to do before they've actually committed violence.

Cf. what we've been told re- Adrian Lamo:

Someone had grabbed Lamo’s backpack containing the prescription anti-depressants he’d been on since 2004, the year he pleaded guilty to hacking The New York Times. He wanted his medication back. But when the police arrived at the Safeway parking lot it was Lamo, not the missing backpack, that interested them. Something about his halting, monotone speech, perhaps slowed by his medication, got the officers’ attention.

An ambulance arrived. “After a few moments of conversation, they just kind of exchanged a look and told me to get on the stretcher,” says Lamo.

Thus began Lamo’s journey through California’s mental health system — and self discovery. He was transported to a local emergency room and put under guard, and then transferred to the Woodland Memorial Hospital near Sacramento, where he was placed on a 72-hour involuntary psychiatric hold under a state law allowing the temporary forced hospitalization of those judged dangerous or unable to care for themselves. As the staff evaluated him and adjusted his medication, a judicial officer extended his stay, and three days became nine.

More at http://www.wired.com/threatlevel/2010/05/lamo/ .

Ok, so it was next to impossible to get Laughner hospitalized even though he made whole classrooms of people so nervous that his college expelled him; but Lamo got involuntarily hospitalized because his speech was "halting, monotone . . . perhaps slowed"??

You may want to make note about this, if you've been following the news re- Bradley Manning, Julian Assange, and Wikileaks -- esp. the excellent analyses at FDL re- various discrepancies in Lamo's statements about his dealings with Manning.

More background at:

http://www.boingboing.net/2010/12/29/lamomanning-wikileak.html

http://emptywheel.firedoglake.com/2010/12/31/lamos-two-laptops/?

http://fdlaction.firedoglake.com/tag/wikileaks/

[Warpy]

1. We have an overly narrow definition of "danger to oneself or others"

that means the person has to cause bodily harm or be standing with a weapon in his hand about to do so before the authorities can act. We had a little more latitude in a psych unit at a VA, but not much.

As someone from a family full of bipolars who periodically go off their meds because they miss the highs and then totally wreck their lives, often ending up homeless, I would love to see "danger to oneself" broadened to reflect that. I also know parents of severely ill children who live in terror that the child will harm them or him/herself and there is nothing they can do about it beyond putting the child out on the street at the age of 18.

I also worked in one of the old state mental hospitals before deinstitutionalization closed most of it. Fully a third of the patients didn't need to be there, just normally depressed women whose husbands didn't want them any more. If they could have been evaluated and released per their ability to cope (most could with coaching), that would have been a distinct improvement. They were simply dumped with no resources along with the seriously ill people who needed to be there.

We're living through a perfect storm caused by idealistic but ignorant civil liberties lawyers, stingy conservatives loath to provide services, and people who are allowed to get sicker and sicker because no one in power cares. We're going to see a lot more Jareds out there before anything changes for the better.

Good luck to us all until it does.

[cali]

10. Actually, it varies widely. Mental Health law is made by the states

In Arizona it's actually pretty easy to get someone evaluated and even held for several days.

[AngryOldDem]

2. It's hard.

At least in my experience. People have to present a clear and present danger to themselves and others, and that can be subjective unless the person is really acting out when he or she is being assessed.

You can't detain someone against their will, which is what a psychiatric evaluation would do.

[cali]

11. depends on the state.

[Sancho]

3. I had an experience with this in Florida...

I was in court over a decade ago where several people (including me) asked a court to hold a dangerous teenager. After an evaluation, both a psychologist and psychiatrist testified that the teen was dangerous. The professionals named a diagnosis based on interviews and testing. At the time, the school resource officer also testified that he had to physically arrest that same kid and thought he was dangerous. Several months later, that teen shot and killed someone after breaking in their house.

The judge said he could not hold him! If a person doesn't have a violent record, and if the person "appears sane" and if they deny that they intend to hurt someone - the court here almost always lets them go. The state doesn't want to pay for treatment (neither does the school) if it's residential. Unfortunately, it's too late when these people start shooting!

The kid got a life sentence, but here in Florida we've recently had some appeals that say it's unconstitutional to give a life sentence to kids under certain ages (16 or 18 I think, but I'm not a lawyer). I heard that the kid might get out at some point.

[soryang]

4. A lot of the people in the mentally ill category end up in jail

...because their public defenders plead them out rather than go the forensic route of psychiatric evals and commitment to community residential facilities that the state doesn't want to pay for. Lawyers on government payrolls who repetitively force these costs on the state are discriminated against. Private lawyers will only do what client's can pay for.

[rainlillie]

8. That has been our experience with my cousin.

[cutlassmama]

5. If the person has a record of violence and two police officers deem it so

they can be held for 72-hours pretty easily in my state. If not, it takes on psychiatrist, but he/she has to pay $400.00 to do it. Most don't want to go to that trouble.

[rainlillie]

6. It is extremely difficult to have someone hospitalized..

My aunt has been trying for the last 20 years to have her schizophrenic son hospitalized. I thank you for this post. I think the AZ shooting is bigger than Palin and her lame chart.

[stray cat]

7. For 24 hours not hard but you open yourself to a lawsuit from them

[ProgressiveProfessor]

9. Very difficult for adults