The hospital rep brought Kristina into the hearing room, a windowless cubicle so crowded there was barely room for them to get to the chairs. Kristina was eleven, a tiny little thing with big eyes and a serious and appealing face. She sat in the only available chair, right next to the hospital rep, and moved her body as far away as she could.

The hearing officer started her spiel. “Kristina, today we’re going to talk about whether you’re well enough to leave the hospital. First the hospital will say why they think you should be here, and then you and your advocate will be able to talk too. OK?”

“OK,” the girl said in a small voice.

The hospital rep said, “Kristina is participating today in this hearing because it’s part of her therapy and she wants to get well. Isn’t that right, Kristina?”

“Yes,” Kristina said in an even smaller voice. I knew when I had talked with her yesterday that she did not want to be there, but the hospital had pressured her to be here and sit and listen. She looks very drugged today, I thought.

The hospital rep started her presentation. “Raped by her alcoholic father…” I had heard this kind of story too many times before, and only half listened, as I watched the little girl shift in her chair. She drew her knees up and looked into the room without expression, hurting and with no one to comfort her. I wanted to pick her up in my arms and carry her out of there, but I was trapped.

“Ran away from three foster homes…fights with staff at group home…” Kristina looked around the room as if planning her escape. She looked right past me, knowing I was betraying her as much as anyone else in her life. I had tried to talk with her the day before, but I couldn’t reach her. And what good would it have done?

“Oppositional defiant disorder…ADHD…possible bipolar…” Then a recitation of the five drugs they had her on.

Kristina stared into space. I wanted to hold her.

“All right, Ted. Is there anything you have to say?”

“Nothing that’s been presented here goes to whether she’s gravely disabled…” I went on, but I knew it was a waste of time.

“Well, where would she go if I released her today?”

“That’s the hospital’s responsibility. She’s eleven years old, she certainly can’t find a place to stay on her own…”

“Well, I’m finding probable cause that she’s gravely disabled. Kristina, I’m ruling that the hospital can keep you here for up to fourteen more days. And you should cooperate with the therapy here and take your meds, OK?”

Knowing that her ordeal was nearly over, Kristina didn’t bother to answer this time. She ran out of the room, brushing past me. I felt emotionally drained, and it was only the first hearing.

I thought about her that night before I fell asleep.

“Open up that goddamn door! If you don’t open it for us, we’ll break it down!” They had found me again…I was walking around in New York, trying to pretend I was normal. I didn’t have my car, where was my car? Someone had stolen it and I had to walk around by myself. I had hidden from them for years but they had found me out again.

The clock radio went off, summoning me to work. The announcer was telling me the news, about very important things that were being done by very important people.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. Much, much appreciation and respect. I’m so glad you’re writing here, Ted! Your heart is amazing and the world has much to learn from it.

    I found myself leaving you a note in a comment on a fb post made re: a book on electroshock and children and figured I’d just put it here:

    “:( Just the words “electroshock and children” make me tearful. Ted C. – if you happen to come across this comment, please know that you and your young friends remembered are in my heart right.this.very.minute.”

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  2. I want to give more context to this post.

    This is a report of a commitment hearing here in the San Francisco Bay Area, where I represented an eleven-year-old, one of many I did that day.

    California has mandatory commitment hearings, which take place automatically, after the original 72-hour hold, without a request from the patient. They’re called “Gallinot” hearings, after a federal court case, Doe vs. Gallinot. The court held that requiring the patient to have to obtain a lawyer and go to court to challenge their detention through a writ of habeas corpus, given the difficulty of doing that while being held on a psychiatric ward, was a violation of due process of law.

    The hearings take place on the wards, not in court, and are very informal. The patient is represented by a patients’ rights advocate, who need not be a lawyer, although some are. The decision to hold or release the person is made by a hearing officer, a lawyer, who is appointed by the local courts. The standard of proof is very low, “probable cause,” and the grounds for commitment are danger to self or others, or “grave disability,” meaning the person is unable to take care of their needs for food, clothing, and shelter. For minors, grave disability is defined as being unable to utilize the elements of food, clothing, or shelter, a very vague standard.

    The adequacy of these hearings varies widely. Some counties provide good representation, in others the patients’ rights programs are a (bad) joke. Some hearing officers are conscientious, others refuse to follow the law and never release anyone.

    At the time of this hearing, I was a patients’ rights advocate with Mental Health Consumer Concerns, a consumer/survivor-run nonprofit that had contracts with three counties to provide patients’ rights services.

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