Involuntary Mental Health Commitments

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The recent publicity surrounding the Justina Pelletier case has focused attention, not only on the spurious and arbitrary nature of psychiatric diagnoses, but also on the legitimacy and appropriateness of mental health commitments.  It is being widely asserted that these archaic statutes are fundamentally incompatible with current civil rights standards, and the question “should mental health commitments be abolished?” is being raised in a variety of contexts.

Criteria

Here in the US, each state has its own laws and procedures for pursuing a mental health commitment.  Some states allow outpatient commitment as well as inpatient.  There is wording variation from state to state, but in most jurisdictions there is provision to commit a person involuntarily for psychiatric treatment if there is convincing evidence that the person has a “mental illness” and as a result of such “mental illness” is a danger to himself or others, or is gravely disabled.  The term gravely disabled is generally defined along the lines of being unable to care for oneself or provide for one’s basic needs. In recent years some states have expanded these criteria to embrace.

  1. Individuals who have a psychiatric history and are on a “deteriorating course.”
  2. Individuals who are being cared for by a family member, and this care is about to be terminated.

Short-Term Evaluation Hold (72 hours)

Here again, the procedures vary from place to place, but in most cases the mental health center is involved.  Typically the police bring the individual to the mental health center to be evaluated by a mental health professional.  The professional evaluates the individual to determine if the legal criteria are met.  If they are, he fills out the necessary forms, swears to their accuracy in front of a judge, who , if he agrees with the assessment, signs the hold order.  The individual is then taken to the state hospital, or an alternative approved facility, by a police officer.

Three-Month Hold

Before the expiration of the 72-hour hold, the hospital personnel decide whether to allow the individual to convert to voluntary status (which he can do by signing the appropriate forms) or pursue a longer-term commitment.  The latter usually involves a formal hearing conducted in the local courthouse, or more usually, in a room at the state hospital.  A judge presides, and both hospital and client are represented by lawyers.  The hospital calls as witnesses psychiatrists and other staff who have worked with the client.  Clients may also call witnesses, but seldom do.

Discussion

The fundamental premise underlying all mental health commitment legislation is that mental illnesses exist, and that these putative illnesses cause people to think, feel, and behave in a problematic, and sometimes dangerous, manner.

It is my position that this premise is spurious.  I have developed this theme throughout my own website, and the details need not be repeated here.

It is also my position that psychiatric treatments, which almost always mean psycho-pharma drugs, and/or shock treatment, are for the most part unhelpful and disempowering, and usually damaging, especially in the long term!  They generally reduce, at least somewhat, an individual’s level of agitation, aggression, and/or disruption, and this is the essential justification for their use in these situations.  The notion that they are medications and are being used to treat illnesses is false.  The stark reality is that the individuals are being forcibly drugged into quietude, and this is being done under the guise of providing “treatment” for an “illness.”

If the treatments that individuals received at state hospitals and other approved facilities were extremely beneficial, then one might be posed with an ethical dilemma.  To illustrate this, consider the case of a person who has, say, a gangrenous finger, but is refusing treatment.  The treatment would involve losing the finger, but saving his life.  Refusing treatment will result in death.  One could certainly make a case for enforced treatment, especially if his family, friends, etc., were petitioning the courts in this regard.  But in fact, in the US, the general principle is that such an individual is legally entitled to refuse treatment, and die from his illness if he so chooses.

But mental health commitments are entirely different.  Individuals get committed to state hospitals, not because they are sick in any conventional sense of the term, but because they are agitated, and/or aggressive, often as a result of conflict with family members, neighbors, local officials, etc . . .  Usually they are people who have been committed previously, sometimes very frequently, and their social and other abilities have been severely compromised by a history of ingesting psychiatric drugs.  Often their agitation/aggression at the time of the commitment is caused by withdrawal from psychiatric drugs that they had previously taken.  In most cases they have received large quantities of neuroleptic drugs, over extended periods, the devastating side effects of which are all too obvious, and contribute to the perception that they are “different” and need to be locked up.

Because the agitation/aggression is conceptualized as a “symptom” of the putative illness, little or no attempt is made by the police or by the mental health staff to explore the reasons for the agitated, problematic behavior, or what remedies might be available.  The individual is deemed to be “mentally ill,” and it is assumed that attempts at discussion or dialogue would be pointless.  It is also assumed that the individual has zero credibility.

So the kind of ethical dilemma that might exist in the case of the man with the gangrenous finger, doesn’t arise here.  We’re not having to choose between respecting the person’s civil rights vs. saving his life.  We’re choosing between respecting his civil rights vs. forcing him to undergo procedures that will damage him further and will likely cause further deterioration in his relationships with family and other members of the community.

“Kangaroo” Courts

The Fifth Amendment to the US Constitution states:

“…nor shall any person…be deprived of life, liberty, or property without due process of law…”

The Fourteenth Amendment states:

“…nor shall any State deprive any person of life, liberty, or property without due process of law…”

In practice, the procedures outlined above for the 72-hour hold and for the 3-month committal are considered to be due process of law.  Strictly speaking this is true, because they reflect the law as enacted by the particular state legislature.

The more fundamental question, however, is:  do these procedures provide adequate protection for the civil rights of the individual who is being committed?  In my view, the answer to this question is no, for the following reasons.

  1. In practice, the 72-hour hold is decided by the mental health worker, often a fairly junior intake worker, who in many cases has been trained to think of involuntary commitment as the only reasonable response to a crisis.  Even in cases where a judge’s signature is required, it is extremely rare to find a judge who will attempt to second-guess the mental health professional.  The unspoken ethos here is that “crazy” people are fundamentally different from “ordinary” people; that they can only be understood by trained professionals; and that interference from non-professionals is likely to be counterproductive.  This ethos, incidentally, is actively promoted by organized psychiatry.  Indeed, I would suggest that it constitutes one of the fundamental pillars of psychiatric “treatment.”  It is also false.  People who are “crazy,” or despondent, or agitated are not fundamentally different from “ordinary” people.  Their craziness, despondency, and/or agitation are usually understandable if one is willing to listen attentively and respectfully and patiently.
  2. In practice the judge’s signature tends to be a rubber stamp, and there is no attorney present to argue for the client.  There is usually not even a requirement that the client be present at the initial meeting between the mental health worker and the judge.
  3. Although danger to self or others or grave disability is usually required by the statute, in practice a 72-hour hold can be obtained in situations that don’t actually rise to this standard.  In most cases, if a client has come off his “meds,” and is agitated, a 72-hour hold will be granted even if his agitation is for some legitimate reason and is perfectly understandable, and even if he poses no particular threat to self or others.  The tacit, and incidentally false, assumption is that his agitation/aggression will inevitably escalate unless he is sent to the state hospital for “stabilization.”
  4. Once the 72-hour hold has been activated, the process is very difficult to reverse.  The client is taken to the state hospital and is often “persuaded” to convert to voluntary status.  The persuasion usually entails the threat that if he doesn’t convert, he will be committed.  I suggest that this kind of tactic makes a mockery of the term “voluntary.”
  5. If the client refuses to convert to voluntary status, he can be brought before a formal mental health hearing.
  6. This is an improvement over the 72-hour hold procedure, but in my view, the individual’s rights are not adequately protected.  As mentioned earlier, the hearing is often (perhaps usually) held in the hospital. This confers clear advantage to the psychiatrists.  They can call all the witnesses they want.  They’re on the payroll and just a few steps away.  The client is at a marked disadvantage, in that any witnesses he might want to call are likely to be in his home area (usually hours away), and at work.  The client is often unfamiliar with the procedure, and has had little opportunity to prepare his case.  Usually he gets to meet his defending attorney for only a few minutes prior to the hearing, and, in some cases, his cognitive ability has been compromised by prior “treatments.”  I recently received an email from a woman who has been through this kind of proceeding.  She pointed out that:“…having a patient address her involuntary status at a Review Panel while drugged and wearing hospital pajamas does tend to work against her.  If you’ve decided that someone’s incompetent, that’s pretty much what you’ll see.”
  7. If the client expresses the belief that he is not ill, and that he doesn’t need treatment, this will be interpreted (and sworn to by the psychiatrists) as convincing evidence that he is ill, and that he does need treatment.  Imagine, in a criminal trial, if a plea of not guilty were routinely construed as evidence of guilt!
  8. There is usually a great reluctance on the part of the defending attorney to challenge the psychiatrists and other professional witnesses, and in most cases the hearing endorses the psychiatrists’ recommendation – which is usually:  keep him here until we say it’s OK to let him go.
  9. Eventually, even the most heavily-drugged client realizes that the only way he’s going to get out of the hospital is to cooperate with the psychiatrists and staff.  This entails saying things like:  “I was a fool to go off my medication;” “I realize now that you people are just trying to help me;” “I’m my own worst enemy;” “I need to stay here until you people say it’s OK for me to go.”  If he can keep this up for a week or so, he’ll probably be released.

So to get back to the original question:  should this kind of practice cease? The answer is obviously yes.  The recent Justina Pelletier case has drawn much-needed attention to the abuses inherent in the psychiatric commitment system.  In particular, this case has highlighted the fact that psychiatry is a closed system that routinely rejects, marginalizes, and even pathologizes any attempt to challenge or even question its pronouncements.  Such a system has no place in a democratic, transparent society.

The Way Forward

The most significant step forward at this juncture would be the removal of the concept and term “mental illness” from all statutes.  The term has no explanatory significance, and no clear meaning.  In the area of civil commitment, it serves merely as justification of enforced drugging for individuals who are agitated or aggressive or otherwise disruptive.  It also serves as justification for denying these individuals some very basic civil rights.

Commitment is essentially a form of imprisonment.  But it goes beyond ordinary imprisonment, in that it entails the forced administration of neurotoxic chemicals and electrically-induced seizures.  What happens in practice is that the individual takes the drugs under duress in the facility, then semi-voluntarily in the community for a few weeks or even months.  He then stops taking them, or tapers himself off, until the next bout of agitation or aggressiveness.  This precipitates another trip to the state hospital, and this revolving-door travesty continues until he is too brain-damaged to live in the community.  He then goes to a nursing home, where his “medication” is dutifully administered every day, until he succumbs to a premature death. 

If “mental illness” commitments were abolished, there would be a need for a non-psychiatric crisis response team in each county/jurisdiction.  How such a team would be structured and organized is a huge topic, beyond the scope of the present article.  From a practical perspective, it needs to be noted that any non-psychiatric crisis response system will be resisted vigorously by vested interests and will not happen overnight.  What we should focus on in the meantime are those parts of the present system that are particularly unjust or particularly destructive.  These include:

  1. Doing away with the 72-hour hold and replacing it with a formal hearing with mandatory legal representation in front of a judge.
  2. Providing training to lawyers concerning the spuriousness of psychiatric concepts and the destructiveness of psychiatric treatments.  This training should be geared towards empowering them to challenge mental health testimony in commitment hearings with the same force and vigor that they do in criminal proceedings.  In particular, they should be knowledgeable, or have ready access to knowledge, of the adverse effects of the various psychiatric drugs in common use, and the abysmally poor long-term outcomes for individuals who have been repeatedly committed over a period of years.
  3. Recruitment and training of non-psychiatric “talk-down” teams in every county.  These could be part of the sheriff’s department or, preferably, separate departments in their own right.
  4. Continuing to expose psychiatry as the spurious, destructive, and pharmaceutically-corrupted activity that it is.  The major need in this matter is to expose the damage that psychiatry routinely perpetrates against those entrusted to its care, and the impact that this has on life expectancy.
  5. Encouraging mental health centers to hire psychiatric survivors, especially those who don’t support the bio-medical model.  A requirement of survivor representation on governing boards would also be helpful.
  6. Requiring mental health centers to seriously review drug dosages on all clients monthly, and either reduce these dosages or explain why this can’t be done.
  7. Requiring mental health centers to provide active training in social skills to all clients who have ever been committed to a psychiatric hospital.

* * * * *

This blog first appeared on Philip Hickey’s website,
Behaviorism and Mental Health

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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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33 COMMENTS

  1. Thanks, Dr. Hickey for your very clear and informative ideas. I really like the idea of getting rid of the term “mental illness”. With the expansion of DSM diagnoses it seems that every human problem is now a “mental illness” and every person a potential customer for the drug companies. The trend towards committing people like Justina Pelletier, who quite clearly was not a threat to anyone, is very disturbing. Thank you for speaking out against these abuses. Hopefully, if enough professionals like yourself begin to challenge what is happening, psychiatry will begin to change.

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  2. “The fundamental premise underlying all mental health commitment legislation is that mental illnesses exist, and that these putative illnesses cause people to think, feel, and behave in a problematic, and sometimes dangerous, manner.”

    Spurious or not, the idea of this legislation–and in all of what the mental health world dishes out– is to cause fear. Fear-mongering is an extremely powerful tool which is used to create suspicion and paranoia, which is rampant in our society, in general, thanks to the slant that the media gives everything, and we buy into it, hook line and sinker.

    Personally, I do believe that ‘mental illness’ is a valid concept, but I feel that these semantics and perspectives are beside the point. Create fear in a population, and then you got ’em. Leads to chaos, conflict, and illusions, which makes people extremely vulnerable and feeling powerless. The mental health world, just like the government, does not want people to know their own power, as this would really kill their agenda of control and manipulation. Divide and conquer is the game they play with us.

    I believe this is what needs to heal in all of us, individually and collectively. Otherwise, we are vulnerable to deceit and intimidation, because we are not in touch with our truth and inner being. And certainly, we have strayed far from this, as a collective.

    Those who can overcome their chronic fear, who know their inner being, and have a sense of self will not succumb to fear mongering, and therefore, can ground in their own personal reality, without doubting their own voice of well-being. At least, that’s been my experience.

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    • Oh, and btw, even though I do believe that mental illness does exist, and rampantly around us, I do not at all buy into DSM diagnoses or the idea that the brain is ‘broken.’ I also feel that it is neither a disorder or anything chronic. When we operate from chronic negativity or overly suspicious minds–which happens when our heart wounds go unaddressed–then our thought processes become muddled and we cannot focus on point. When I say mental illness, this is to what I refer. There are relatively easy ways to address this and remedy all of it, but it is a process, and in all of my extensive experience and dealings with the mental health world, I have failed to see this addressed adequately.

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      • While I find your work very interesting, humane, and insightful, I’m not sure we agree about the illness thing, Dr. Hickey. I looked up illness on dictionary.com, and it defines it like this:

        1. Poor health resulting from disease of body or mind
        2. A disease
        3. Evil; wickedness

        Again, I’m not saying that anything is chronic, I don’t even believe in chronic physical illness. I feel that chronic illnesses are fabrications to keep some people in fear and feelings of powerlessness and helplessness, while keeping others rolling in money. I believe that our society has degenerated to this degree, which is why the world is as it is now, and why suffering has been so rampant and perpetual.

        This is not my website that I’m posting below, but it is representational of much of what I learned after defecting from the mental health world, and in which I trained to heal myself. This is also what I teach others now. I believe we are our own healers, once we learn how to focus in a way that is most appropriate to our well-being. That is a matter of understanding the vibration of energy, and practicing radical self-responsibility.

        http://www.energyandvibration.com

        But I do believe that chronic rage and fear puts our minds and bodies at dis-ease, causing us myriad health issues, and that this ripples out into society, creating social ills, which, in turn, comes back to the individuals. It is a vicious cycle, which is why discussions around this have become loopy and stuck. At this point, I strongly feel that it is simply a matter of quieting our minds, feeling our hearts, and doing the healing work, individually. Certainly, support is beneficial, if we can find the right kind of support by those who understand vibration and energy. But it’s not absolutely necessary. Ultimately, we are in our own hands, and minds.

        I do not feel we are born this way, but most certainly, we learn this in our earliest environments, mainly referring to family. We are the end result of generations of hardships and suffering, control and manipulation–and abuse–that has translated into a complete separation of our intuitively loving and confident true selves. We are stuck in systems of perpetrator/victim/enabler that is only a downward spiral in humanity. This is what I experienced with myself, which I eventually remedied in a complex way over the years. I continue to observe these patterns and dynamics in others, in epidemic proportion. I am always extending a hand of support, but it can be challenging to accept it, because healing does mean letting go of old habitual beliefs that have been so deeply engrained in all of us. This is a rigorous process, and one has to be ready to face the unknown. This is where good support comes in handy, simply to encourage and cheer on, as well as to help heal fears, doubts and worries with authentic reassurance, neutrally, without ego, and from experience.

        Not everyone can accept what I say, here, at present, but it is where I landed after all of my debacles in the mental health world, and in advocacy. The issues have become so political, that we seem to have forgotten that health and well-being is really what we’re after. And I am so grateful that my path led me to know this truth, because as I’ve said before on here, it has transformed my health and my life.

        I was most definitely ‘ill’ at points in my life, and I was never in denial of it. Now I am well, and I celebrate it. I taught my partner all of this, as he was part of my oppressive environment which caused me to become very ill and disabled–which he owns fully–and as a result, he healed his fear and heart wounds, as well.

        As far as the 3rd definition goes, isn’t ‘evil’ what we are all talking about on here? Haven’t we all witnessed and/or experienced what feels like ‘evil’ from psychiatry and the mental health systems? Isn’t this what the global community is screaming about, in general, that they wish would end, once and for all, that has caused the world to be in such fear, rage, violence, and chaos? I don’t think it’s a stretch to say that it makes us sick.

        It’s hard to recognize illness when we have been surrounded by it and entrenched in it all our lives, until we separate from it. The irony now is that those who are well and happy are not so easily accepted, and who, in turn, may look and sound kind of weird and ‘off.’ And our fear of being thought of as weird, keeps us good and sick, simply to appease others and not be an ‘outsider.’

        It takes a lot of courage and fortitude to heal, and to be happy and loving, in this sick and cynical world. But I think it’s well worthwhile, because it leads to a lot of wonderful things. I have learned this well in my journey, and I’m so glad I did.

        Sometimes I wonder if I really fit into this community, even though my experiences have been strikingly similar and I share generously all that I have done to make myself well, while encouraging others to find their own healing. Still, it seems to simply rub some people the wrong way. Now that is what I find to be very interesting.

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  3. I think this is a very good article and a good review of the problem. Some minor points, though.

    In California, as a result of a federal court case Doe v. Gallinot, we have a system in place where there are automatic hearings after 72 hours, and the inmate has representation from (usually nonlawyer) advocates. At its best, with zealous advocates and honest hearing officers, this cuts down greatly on the endless incarceration this article describes. Unfortunately, there are also a lot of counties where the advocacy is a bad joke, and the hearing officer acts as a rubber stamp for the “hospital.”

    The three standards (danger to self or others, or grave disability) come from the 1975 Donaldson case, where the U.S Supreme Court ruled unanimously that “the state cannot hold, without more, someone who is a danger to no one and can survive safely in freedom.” These were the California standards adopted here in 1968, though the USSC did not so identify them.

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  4. Glad to see that despite its “professional” focus there is a growing consensus at MIA that the notion of “mental illness” should be done away with, along with involuntary “treatment.” Also glad the point is made about “mental illness” terminology being used to justify drugs and shock.

    My only slight philosophical quibble is that as long as we accept that the current system will be in place for some time to come, the more likely we will be to try to “reform” something that must be abolished. To paraphrase Szasz, the notion of concentration camps being reformed would be seen as ridiculous; the same reasoning should be applied to psychiatry. Still I understand the need to think tactically without compromising ourselves.

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    • oldhead,

      I know. You’re making a good point. It’s very easy to deceive ourselves that we’re trying to reform the system from within when actually we’re condoning by our presence. I struggle with this balance all the time. On the other side is the fact that we are up against a multi-billion dollar industry – a tough nut to crack by any standards.

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  5. I was subjected to an involuntary hold several years ago. It wasn’t necessary because I told my psychiatrist I would sign voluntary papers (this was behind closed doors) because I eventually knew my predicament to be futile since they were in charge. I was experiencing a reaction to medication I probably should never have been prescribed since I had documented adverse effects to the same class of drug. None of this mattered. I had had an argument with my husband, “I” called the police on him, and all he had to say was “she’s a patient of so and so” and I was hoisted off to the ER for an evaluation. ( I believe I’ve relayed this whole story before on your website somewhere.) Well, I was even wearing an adverse drug alert on my wrist indicating previous reactions to the same class of drug. Not only was the possibility of adverse drug reaction NOT considered while I was in house (the doctor…my doctor…just happened to be clinical director, mind you), but the medication (an addictive Rx) was continued and other drugs that I was also adversely affected by were given me. I believe it was a little over two weeks or there about. I had been forced into a court hearing that was unnecessary (I think they just wanted to get that “on the books” for the record) and I really couldn’t say much because I didn’t have the mind to speak after being continuously drugged. In fact, I literally slid off my chair during the consult with a court appointed attorney and wasn’t even aware of what was happening. I couldn’t make sense of any of it because I was so over medicated. The proper course of action would seem to have warranted an investigation into the meds and possibly weaning me from them, but they chose to more or less “make me fit” their diagnosis. Then it was almost as if it were a good rub in the face, because the adversity to the same class of drug was listed right there on my discharge summary when I was finally released with Rx for the same class of med. I was pretty delusional when I left, but just pretended because I wanted to be released before I died or worse. But they didn’t know this, and simply noted that it was safe for me to go home. I was released and I’ve never been back for counseling to that facility and I have developed increased fear of all doctors so much so that I avoid them all now. I already had White Coat Syndrome and the “forced” medication/involuntary hospitalization changed my mind about psychiatry and modern medicine as it is practiced locally. It wasn’t “fair” It wasn’t even ‘safe’ for them to treat me as they did. I weaned myself off of the addictive substance because I no longer trusted them. Looking back, I believe all of it was basically to perhaps save their own behinds from possible litigation because perhaps they were aware of the medication mistake and feared I’d sue them. In fact, I should have but it is such a long road back through withdrawal to right thinking that there wasn’t enough time. None of my complaining in the world seemed to matter. Once “they have you” they have you and you are powerless. That was what I experienced and that is why I don’t see any doctors to this day. The doctor is still in his position despite the fact I complained to the State Medical Board and the local board over the mental health facility. They simply either do not care, or they are cheats for their own gain. Thank you for letting me share.

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  6. Thank you again for speaking the truth about appalling civil rights violations of human beings by the medical community, Dr. Hickey. I completely agree with you, oldhead, “the notion of concentration camps being reformed would be seen as ridiculous, the same should be applied to psychiatry.”

    And Cory, I’m so sorry about what happened to you, but completely understand it because my story was similar. I suffered from a sleep walking talking issue, likely due to being weaned off inappropriately mandated drugs (given to cover up a “bad fix” on a broken bone), which are known to cause drug withdrawal induced super sensitivity issues.

    The only people in the world I was potentially “dangerous” to, were former doctors who were paranoid of possible malpractice suits due to their obvious malpractice. Co-workers of theirs medically unnecessarily shipped me to a different county (that had no legal right, according to the court documents, to hold me against my will) to a Dr. V R Kuchipudi. Kuchipudi has now been arrested by the FBI for having many patients medically unnecessarily shipped long distances to him, “snowing” many patients, and ordering unneeded tracheotomies, resulting in many patient deaths – merely for profit.

    According to my medical records, since I wouldn’t sign the voluntary commitment papers, my signature was forged. So I’m not certain changing the laws would stop such medical abuses, especially since it’s so easy to take away people’s rights based upon illegitimate “mental illnesses.”
    “The notion of concentration camps needing to be reformed would be seen as ridiculous, the same should be applied to” all forced treatment. No doctor should have a right to hold anyone against their will. Such power only leads to abuse.

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  7. As I’ve repeated many times on this site, the articles such as this one, the many authors and all the MIA bloggers have educated me beyond. After the horrific death of my 25 y/o son over two yrs ago, I made a promise the night my husband and I drove up to where our son insisted he move away to hoping “to start anew” after all that life had thrown at him in a quick span of time, I would unearth every stone to find out what took this beautiful young man from us. A life that had always been filled with so much promise, a life rich with multiple friends, a wife, a successful career- most of it vanished overnight when a ” sea of stressors” hit my son. Only by stepping back and realizing how “NLEs” (neg life exp borrowed from Maria Bradshaw’s CASPER Foundation brochure) push young souls into escaping do I understand why my son chose to indulge in cannabis( + some other “recreational” substances) but THC was what showed up on his toxicology reports twice (over 18 months) when his mind drifted out of reality. I realize, too late, the coding criteria, per the DSM IV ( in 2009 and 2011) used should have invalidated the mood disorder assigned my son, twice. But not understanding the MH BUSINESS model which is just coerce into a locked unit, label, massively drug into a drug stuporous state, warehouse and then ” dump” once my son’s PPO ins refused further authorization, how would the public know? As I’ve combed thru my son’s medical records, despite he entered solely for the drug rehab program I researched, and only reluctantly with incredible persuasion by his family did he enter despite all arrangements set up myself with the Adm Coordinator ( including thousands of dollars upfront we handed over for this program) my son within 24 hrs was coerced into their locked unit.
    To blogger Ted-in CA- the records prove my son was never under any hold!! My son’s locked unit ” stay” is listed as “VOLUNTARY ” despite the documentation thru-out his stay he begs to return to the Open Unit that he entered with family beside him. My son (as I’ve read every page) begs them” I won’t survive what you’re doing to me” “call my mom she’ll know how to help me” yet each night we visited no-one helped us, and my son’s reality was gone. He hardly acknowledged us, as his mind which had begun to spin out before entering was now progressive inside those locked walls pushed into full blown psychosis, so badly even some of the other caged souls were afraid of our son. Each night we begged for answers, how could his mind be lost? Why was he placed in this locked when it was pre-arranged only for drug rehab? Why wasn’t the adm p-doc returning the multiple calls we made each day ( two of us were listed in my son’s HIPAA).
    How in CA can a young man who begs daily to stop being drugged by multiple neuroleptics, actually pulled the smoke alarm in attempt to escape- and the consequences he received make me want to expose this facility (a chain facility actually)- and hold every staff member, the p-doc, the admin, and CEO to the highest court in the land. What no one admitted to us each night we visited and saw how progressively worse our son was from how he entered ( plus I kept voice msgs he left on our landline which prove what he endured inside ) is that he could have walked out because there was NO hold, legally!!!! It was their dirty little secret, coerced into entering – they told my son this building had a pool table since the unit he began in was on such lush grounds – only it was the locked unit instead. Then started drugging him with these multiple neuroleptics, and a brain that was already under assault from the “recreational” drug he had been using threw him into full blown psychosis. And they kept my kid close to two weeks, locked up, drugged into a stuporous state until the ins refused further authorization. Never did they provide drug rehab, not even educating the family that had coughed up all the extra money, no discharge planning, no psychological treatment to unmask those “NLEs” my son was hit with. Just coerce, label, massively over-medicate, provide worthless services, convince instead of the truth- his mind spun out because the effects a drug w/psychoactive properties can do to certain, young brains- instead drill him, and his parents to accept this terrible, severe MI diagnosis!!!
    How can this be the U.S.? How can ” the system” allow facilities to get away with what my son’s medical records reveal ( and yes I have sought out professionals for counsel that see the distorted lies and egregious mistreatment my son was subjected to). There are more secrets revealed as I’ve read each pg that this facility purposely withheld knowing they were going to ” dump” my son out from their locked unit. The psychologist my son was under the care of before this hosp admission agrees had the truth these records speak be known it would have changed how we supported my son moving away, once the effects of all the chemicals his brain was assaulted with finally cleared and his mental health recovered. But surely, after all my son endured, and the records speak volumes to me, he felt hopeless and powerless by the brainwashing and intimidation he was subjected to. A family that believed drug rehab was the answer (yet it was never realized) from a facility allowed to cause such harm to a young human being. And a beautiful young man whom the world once was his oyster ( as his psychologist would say) exited 7 months after he was ” dumped” from a ruthless industry that engulfs its victims. Maybe, my son realized what I’ve finally admitted, this is a cruel, heartless society. I hope, in my son’s memory, I can make a difference by exposing the truth.

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  8. Thankyou for this informative article Dr Hickey.

    I’ve been wondering about this process of commitment and the right to silence. What evidence would the mental health workers, or psychiatrists have for commitment if a suspected person was silent. The evidence comes mainly from what a person says.

    I know that if I’m ever in the situation again I will be saying absolutely nothing to these people. The last time i spoke with a mental health worker they simply “verballed” a statement as evidence for detention. The agitation caused by the unlawful detention was then used as further evidence of the need to detain.

    Any legitimate complaints that people have are dealt with by weaponising the complaints process, and subjecting people to legal and administrative abuses. And of course one can hardly expect any honesty and integrity in an investigative process conducted by the beneficiaries of an alleged crime.

    It is a disgusting process but not understood until the jackboot is on your head, and of course by this time it is too late.

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      • Just one of the many “exploits” being used to “help” us all the way to detention and forced drugging oldhead.

        I hope one of the authors here takes up this issue of what your rights really are. I think the confusion surrounding this issue is not spoken about by mental health workers and psychiatrists precisely because they know the exploit.

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  9. boans,

    Thanks for coming in. I don’t really know how silence would be interpreted in these situations. Probably as an indication of hostility and paranoia! The best policy is to try to stay out of those situations entirely, though I realize that this isn’t always easy.

    Best wishes.

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    • Better to remain silent and be thought hostile and paranoid, than open ones mouth and prove it lol.

      It seems to me that the only real access a mental health worker has to the state of a persons mind is via there words and actions. Cut off the words and they can not access the evidence.
      They may detain anyway, but why give them everything they need.

      Certainly it would bring the detention into question if it was done solely on the basis of “observed behaviour”

      And if they do detain, bring action for unlawful detention when released.

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      • Just as an example, my loved one has called mental health services and expressed concerns about my mental health.

        You attend as a mental health worker, but can not detain me based on communicated matters alone. I say i am exercising my right to silence and sit quietly without saying another word. What grounds do you have for detaining me?

        I understand that there are those who would not be able to maintain sitting still or silent. The ‘ruse’ relies on the assumption that the mental health worker is your friend and is there to help. Simply not true, they are attempting to gather the evidence required to detain.

        Any detention under these conditions would be unlawful.

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  10. What the public doesn’t get is that inpatient abuse is not reserved just for those people defined by the undefined term “severely mentally ill” just combine a nervous breakdown with a little drinking and a “history of mental illness” (taking any of there pills) and the psychiatric nightmare can easily happen to anyone. It often starts with the agitation caused by the unlawful detention being used as further evidence of the need to detain. Then add in refusal of there lobotamy pills like Haldol or Trileptal like I did and the nightmare goes from bad to worse ! They threatened to inject drugs into my body with force with a scary needle. Putting things in another persons body against there will is RAPE !

    Of course my reaction to the threat of being raped with drugs was used as proof I needed to be raped with drugs, my chart said “speech is rapid” of course my speech was rapid , someone just threatened me with a violence to put chemicals in my body that was functioning properly that would affect MY heart rate, MY thinking ability, MY breathing patterns, MY kidneys, MY liver, MY muscle function… MY BODY , I OWN IT.

    A psychiatric drug rape is a violation just like a sexual rape, it’s inside you.

    What the hell is wrong with these “mental health” people ? I told them I am into health and fitness, I am not taking all these pills that only damage my health and feel zombie like . What part of NO don’t these sadistic barbarians get when there victims say it ?

    And just like rapists psychiatry just loves victim blaming, Victim blaming occurs when the victim of a crime or any wrongful act is held entirely or partially responsible for the harm that befell them. I was my fault for not wanting there toxic treatment or thinking I ‘need it’. I am fine now without the toxic treatment’s for my so called “psychiatric disease” they were pushing but no apology letter for the misdiagnosis is coming any time soon.

    The best thing to do if your having a nervous breakdown or drinking or what ever is to avoid “treatment” at all costs. They even lied on my medical records and stated I was “suicidal”. Give me a break, I wasn’t born yesterday, I would never say that to a mental health worker ever .

    The conflict of interest is glaring, the people charging $1,000 a day per bed are the same people who get to decide who ‘needs’ there toxic treatments against there will. Of course it’s corrupt.

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      • Ya it can, the diagnosis they put on my chart was “bipolar mixed” the psychiatric label for angry. Ya being told to get naked and squat and cough during intake by this guy who acted like a corrections officer made me angry right from the start. I said F U to the squat and cough request and was told “things can get rough around here”. My reaction to that and the injection threat that came from the doctor later for the “med” refusal were all symptoms of a “psychiatric disease” , give me a f-ing break. Everything this place called “treatment” was a violation or an assault on a persons dignity.

        I watched over and over as people with no insurance were out the door wile others with insurance usually with parents who believed all the medical model psychiatric bullcrap kept being told they are “not ready” to go home.

        This was a Universal Health Services operation, UHS, Inc. (NYSE: UHS) is a Fortune 500 company based in King of Prussia, Pennsylvania. UHS company is one of the largest hospital management companies in the nation, operating behavioral health facilities.

        Universal Health Services, (UHS, Inc.) in the news. UHS, Inc. is frequently in the news for substandard care, abuse, and fraud.

        Read more http://failuretocare.com/

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  11. It’s a very slippery slope once you fall into their hands. You can be surprised and things can start moving real fast like you fell into a funnel and landed in the bin. Once it’s happened you think you’ve been forewarned and it’s easier to avoid but its really much slipperier invalid again into the void .By the third time well your just constantly circling the drain.Maybe you need to morph into your grand escape.

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  13. As usual Phil, a great post. But I do have issues about commitment.. i.e control of others. What should we do in certain (or even uncertain) circumstances?

    I would like to say that there are medical conditions (not psychiatric) which need to be taken into account. A person may become very confused and disorientated due to delirium http://en.wikipedia.org/wiki/Delirium, or organic brain disease, http://en.wikipedia.org/wiki/Organic_brain_syndrome, or even through accidently (or by design), ingesting deliriants or other hallucinogenic drugs. Booze and pills may not mix. Also it is well known that some, especially young people, become suicidal after taking SSRIs. And people who cry for help may just make a bad decision.

    A young person has just started a course on prozac for depression. He feels suicidal and wants to jump off a cliff. Should I restrain him? If yes.. for how long?

    These medical conditions must be tested for. And coercion may be necessary to allow these tests to be done. Thankfully, I have never been faced with such an ehtical dilemma. I do think that psychiatry just clouds these issues and actually interferes with true medical practise. But there’s the rub! Cheers………..

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  14. On August 30, 2014, I feel into a sound sleep, having slept poorly the night before. I was staying at a vegan/fasting center i n Santa Rosa, California. I had gone to the center un the hope of improving my severe rheumatoid arthritis. I suddenly awoke to strange men behaving in a frightening way, telling me I had to go to the emergency room. Why? My dangerous sleep was reported by my mother who was 2000 miles away. She had called and supposedly I answered the phone, speaking gibberish. Although she has knowledge of the fact that I sometimes walk and talk in my sleep, she invented a silly story about me falling earlier in the week, suffering a concussion, and rolling on the floor crying out, “I want my baby! I want my baby!” I have no baby.
    I resisted going to the hospital, since there was no reason at all for it. The paramedics probably felt they were being firm with me when they removed me by brute force, covering me with bruises, hitting my head on furniture, and giving me whiplash and a back injury from the extreme shaking to wake me from my sleep. I was then back to walking with crutches, which I had succeeding in greatly reducing the need for by a 26 day water fast at the clinic. The paramedics claimed that I had fallen as evidenced by their allegation that they found me asleep on the floor. When I sleep walk I am not alert, and probably was not sure where the bed was since I was away from home, and simply laid down and slept harmlessly on the floor. In addition, they dumped the soup on me that had been prepared to help me resume normal eating.
    I was taken without any witness from the clinic, with no clothing, no shoes, no cell phone, no id, no credit card or money. At the emergency room, where I was seen faster than I’ve been seen in years, I insisted on leaving. The nurse stated that that was impossible because I was wearing no clothes, no shoes, and had no means of communication or money or credit card.
    The hospital kept me most of the night, desperately trying to tie my “condition” to drug us, I think. When this proved impossible, since I was taking no drugs, I was released and put in a taxi, but only after I signed papers agreeing to pay them for doing this to me.
    I was kidnapped for ransom.

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  15. PS to my above story I had the presence of mind not to name my mother or any one else as next of kin. I would only have considered my late husband as a safe person to list as next of kin. This would never have happened if I hadn’t been recently widowed.
    I learned subsequently that my mother’s plan was to commute the 2000 miles to the hospital, where she thought her report would have been sufficient to get me committed, collect me, force me to live with her. She labored under the assumption that as my mother she would automatically be named my guardian and conservator.
    I am not a poor person. My dear husband left me fairly well heeled. Was this part of my mother’s motive? To gain access to my funds? I really don’t know, but I wouldn’t entirely rule it out. I believe that her true motivation was that, unlike what she has said to others, that I could not escape her, that she realized I was perfectly capable of going whithersoever I wished. She was lonely and wanted me to come back. I would like to point out that very wealthy people have lost the right to handle their own finances due to this outrageous practice. From there one could see their life savings looted, all for falling asleep in an untimely manner. My fabulous mother is the last person I would feel comfortable about being my guardian/conservator. THIS IS ALL ABOUT MONEY Any American can lose all their assets, be kidnapped, drugged, humiliated, and beaten, on any pretext.

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