Washington State Supreme Court Declares ‘Psychiatric Boarding’ Illegal

Rob Wipond
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Washington’s Supreme Court has unanimously declared it illegal under state law to forcibly detain psychiatric patients in hospital emergency rooms when there’s a lack of available treatment beds in psychiatric wards, reports The News Tribune. The Tribune says such “psychiatric boarding” has “pretty much exploded” across the state in the past seven years, with 3,421 mental patients detained in emergency departments in 2013. “The ruling noted that the state’s civil commitment system has been ‘regularly overwhelmed’ since the Legislature enacted the Involuntary Treatment Act in 1979.”

“The central idea: No vacancy is no excuse,” reports the Tribune. “In the absence of a specific medical need, the state cannot detain people against their will solely to ease overcrowding without providing treatment.”

“I’m feeling pretty good today,” Chris Jennings, a legal representative for mental patients told the Tribune. “I think they got it exactly right.”

“This latest decision by the court means people in need of treatment cannot be detained and may end up on the streets,” said Victoria Roberts, a deputy director for the government’s mental-health agency in a statement.

Supreme Court strikes down ‘psychiatric boarding’ of mentally ill (The News Tribune, August 7, 2014)

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Rob Wipond
Rob Wipond is a Victoria, British Columbia-based freelance journalist who has been writing on mental health issues for fifteen years. His research has particularly focused on the interfaces between psychiatry, the justice system, and civil rights. His articles have been nominated for three Canadian National Magazine Awards, six Western Magazine Awards, and four Jack Webster Awards for journalism. He can be contacted through his website.

15 COMMENTS

  1. If my experience of involuntary commitment is normal, and from what I’ve read from people here it is, then mental wards can make room for the people most in crisis by, for instance, releasing people who disagree with their assessment but are not a danger to themselves or others— even when the V.A. or Medicaid or Medicare is paying for them.

    What to do, what to do? Need? Or hubris and greed? That’s a tough one, I suppose.

  2. Surely, we, as a society should be asking ourselves WHY as The Néws Tribune reports “psychiatric boarding” has”pretty much exploded” across the state the past 7 yrs, with 3,421 pts with MH problems held in ERs in 2013???? I know the answers are clear as the nose on our face.

    My 23 y/o son in Oct, 2009 developed altered reality, literally overnight, was rejected by the first psych hosp the police dropped him off at because his bride of two months called 911 on his sudden bizarre, delusional behavior. Unfortunately, my son’s rapid onset of altered behavior was so beyond frightening to myself and his dad once we found our son in the wee hours of the night completely out of his mind as the psych hosp had called a taxi to haul him off- where ?? We convinced our son to get in our family car, where he tried to jumped out on the 101 fwy and was IMO suffering a breakdown. And my son’s admission” I know you don’t think I do drugs but I’ve been using marijuana but it’s just a herb, harmless” I believed would help the ” experts” (at the next psych hosp we found) to investigate could this be the trigger behind his brain unraveling ( especially given he was such a well-adjusted, socially stable young guy with many successes already in life). Did any one bother to isolate the recent traumas he was dealt. NOPE!!!! Despite THC was (+) on his toxicology report, it was just label and massively over-drug, ignore how a mind-altering drug( especially the skunk varieties abundant to produce extreme highs though most young users are unaware how this drug has genetically morphed) the ” experts” refuted the cannabis-psychosis link.

    To quote one of our most articulate MIA bloggers, Jonah (BeyondLabeling):

    from Sandy Steinberg’s ” Anti-Psychiaty” article:
    And, as far as the sorts of ‘madness’ that winds up being ‘treated’ in most psychiatric “hospitals” goes, I think that, probably, the majority of ‘cases’ are drug and alcohol related; they could be healed rather quickly, if only those individuals were led to realize the harms being caused them by their drug(s) of choice.

  3. Something not often mentioned on this forum is that perfectly sane, normal people are detained by police and involuntarily committed on various agendas: to punish “gang” members, to humiliate those who talk back to them, and to get rid of anyone on the street they don’t want to see for a few days.

    These people experience the greatest trauma and horror in those emergency lock ups, not to mention the extreme physical danger inherent in the “pool” they are being dropped into, while never having asked for any psychiatric help and probably despising it beforehand.

    Where are the attorneys to take these cases? Where are the courts which won’t–regularly, like clockwork–absolve the police and crisis teams who deprive normal individuals of their liberty? Usually the only defendant left is the admitting psychiatrist, who may be not as much to blame as the police who use i.c. as a “tool” against anyone as they see fit.

  4. My daughter who never had a history of psychiatric illness or any criminal activity whatsoever, experienced a cannabis related psychos, which scared and confused me so I took her to the ER. When she tried to run away from the ER and I was busy filling out paperwork, they put her in five point restraints which terrorized and completely unhinged her; they then gave her enough tranquilizer for an elephant. When her dad rushed to the scene from work, he immediately questioned the use of restraints. When the same nurse who tied the restraints on my daughter, then unloosed them, freeing my daughter in response to my husband’s protests, my daughter then punched the nurse in the face. She was charged with assault and that is how her ‘mental illness’ became criminalized; that put her in the corrections (forensic) system as well as the civil commitment system. ER’s are no place for people with psychosis. The staff are not trained to handle people in altered states with competence and compassion. They use force and they project their fear, burn-out, and anger onto patients with bizarre behavior, making their patients much worse. We need to eliminate ER’s as the default place where people in altered states are taken to and build a network of crisis management, respite homes, and Soteria houses.

    • “ER’s are no place for people with psychosis. The staff are not trained to handle people in altered states with competence and compassion. They use force and they project their fear, burn-out, and anger onto patients with bizarre behavior, making their patients much worse. We need to eliminate ER’s as the default place where people in altered states are taken to and build a network of crisis management, respite homes, and Soteria houses.”

      madmom,

      I completely agree with that statement, and my heart goes out to you and your family, as every further detail you’ve come to offer here, in your MIA comments, of your daughter’s ongoing ordeals, so strongly indicates, that your daughter’s plight has been caused mainly by iatrogenic effects.

      But, her ordeals began as you’d found her behavior troubling, after she’d been smoking marijuana.

      You seem to be saying, that she punched a nurse in the face immediately after being forcibly drugged with neuroleptics. In my view, no one should ever be drugged that way. No one should be forcibly drugged.

      And, imo, no one who has, perhaps, had a bad reaction to pot should be drugged at all, with neuroleptics. (Surely, that forced drugging she received was with neuroleptics.)

      Imho, a good lawyer would have argued, that the punch, from your daughter, which landed in the face of that nurse, never would have been thrown had the nurse and others working with the nurse, in the ER, followed their own established procedures.

      The practice of forcibly drugging people is barbaric. Once that barbarity has occurred, it can only be the responsibility of those who commit that barbarity, to keep the victim of that barbarity mechanically restrained.

      Your husband, upon seeing his daughter in mechanical restraints, very understandably objected to his daughter being mechanically restrained (that’s an entirely natural response, on his part), but he could not have understood the potential dangers of releasing her immediately from those restraints. The ER staff should have well understood those dangers.

      She was released from the mechanical restraints, threw a punch and was subsequently charged with assault.

      Was she found guilty of assault? (From what you’re describing, I believe she should not have been found guilty.) That she was charged with assault means, I believe, that she received a trial, yes?

      Of course, you needn’t offer more details here than you feel comfortable offering, but I am wondering whether she received a trial, and, if so, what was the precise verdict she received (you seem to be indicating that she was found guilty of assaulting that nurse, but was there no argument from her lawyer, that your daughter had been forcibly drugged and thus was experiencing a form of diminished capacity that was truly no fault of her own?); and, what sort of sentencing did she receive (I’m seriously wondering)?

      Frankly, I know almost nothing about criminal law, yet I imagine, had I been her lawyer, I would have emphasized, that: your daughter tried to leave the ER, and they would not allow her to leave.

      I would have argued, that they (the ER staff) were thus kidnapping her; but, moreover, they had forcibly drugged her, and hospital procedures demand that a forcibly drugged person be kept in mechanical restraints for a given period of time; and, those procedures were violated by staff…

      Also, before any trial began, I might ask you privately, in confidence: what was your daughter’s demeanor before she was forcibly drugged? I.e., prior to her being trapped in the ER and prior to her being forcibly drugged, had she been threatening anyone in that ER with physical violence?

      (Of course, if she had not been threatening anyone there, then we can conclude, fairly reasonably, that it was her ‘treatment’ that had compelled her to become momentarily combative.)

      For whatever it may be worth, briefly, here I’ll share, a bit of my own experience, of having been forcibly drugged, in an ER, at age 21.5 (nearly three decades ago).

      The forced drugging was preceded by my being essentially trapped there.

      That is to say, like your daughter, I wanted to leave and tried to walk out…

      I thought I would be successful doing so; but, just as I got through the doorway, my exit was thwarted by a large ‘security guard’ who led me back in, by the arm.

      I had not been in any way at all threatening to anyone there, nor had I even exhibited any anger; only, I had been somewhat nervous (naturally) …but was attempting to remain humored.

      And, except for my having attempted to walk out, I was cooperating entirely… even as I was escorted into a small side-room and encouraged to lay down, with a Chaplain seated beside me, holding my hand.

      In fact, as he held my hand, suddenly, I was entirely calm — until, just moments later, in came the psych-techs, to do their dirty deed.

      Within moments, the Chaplain was stepping aside, and I was being attacked with their hypodermic needle.

      I screamed “NO!” …and very shortly afterward, I was to become absolutely infuriated.

      I mean, that experience triggered such incredible anger within me — to an extent, that I had never been previously, in my entire life, to that point, ever experienced.

      It took a quite while — in retrospect, I’m guessing it was roughly 15 minutes — for the drugging to take complete hold of me, such that I’d eventually go unconscious.

      And, really, I was so totally enraged by that ‘treatment’ before going totally unconscious, I can only now begin to imagine how I might have attempted to fight back, had they come to unstrap me prior to that time (i.e., prior to going completely unconscious).

      Surely, I would have done anything I possibly could have done, to get those people to back off entirely, so I could hopefully run, making my escape.

      Being a guy, I wouldn’t have punched the nurse if the nurse was a female, but if the nurse was a male, and I’d felt that throwing a punch could have helped me to get away, then probably I would have thrown a punch…

      Respectfully,

      Jonah

      • P.S. — Please…

        No one should read my comment (above, to madmom) as suggesting, that I might somehow believe that it could be a wise move, to punch anyone, in an ER. (I absolutely do not believe that would ever be the wise thing to do.)

        In case I was, perhaps, not entirely clear, here I explain my above comment more fully:

        My comment to madmom was simply aiming to convey, that I do know, from first hand experience, that: becoming trapped and then getting forcibly drugged, in an ER, can very readily generate a sudden rage in the victim (a.k.a., “the patient”) who has received such drugging.

        I know, that person can be in relatively good humor and can even be calm — until being forcibly drugged; at that point, there can be a rage that comes on quite fast, overtaking literally every nerve cell, in that person’s body; and, it can be a rage which shall in no way dissipate before that person has actually gone deeply into an unconscious state (as the full effects of the so-called “antipsychotic” drug finally takes over).

        And, s/he may not necessarily enter that deeply unconscious state, until at least fifteen minutes (or, perhaps, until even more time than that) has passed.

        Now, of course, I am not an ‘expert’ on such matters; simply, that was my own experience (my all-too-unforgettable, nightmarish experience) of being introduced to to the ways of ER psychiatry, nearly three decades ago…

        But, I can’t help but assume that many people who are trapped and forcibly drugged wind up similarly enraged.

        Probably, almost any fairly seasoned ER staff person has notices such effects…

        Hence, I would think, it should come as no surprise whatsoever, to an ER staff, that any “patient” of theirs, who has been forcibly drugged in their ER would, if released from mechanical restraints too soon after that drugging, attempt to take a swing at somebody.

        That’s all I was attempting to say, in my comment to madmom, above.

        Respectfully,

        Jonah

        • Lets’ put it differently – when someone tries to forcibly drug you, restrain you etc. they are morally responsible for getting punched in the face. The person starting the violence is responsible. It’s a rule of self defence. If the victim cannot walk away they have every right to defend themselves. One can of course say it’s not smart because it can make your situation worse but having lived the abuse – sometimes fighting back is the only way to preserve your dignity.

        • One more thing to add – the psychiatry behaves like Israeli government on that: complaining that the Palestinians dare to defend themselves instead of just laying down and taking it and making it sounds like they’re the ones who are defending themselves. Well, who’s occupying whom? Who is locking someone up and forcing drugs on him? In this sick world when you’re a victim you’re supposed to be calm and non-violent and hope that at some point the abuse is going to become too outrageous than someone may complain and stop the abuser.
          https://i.embed.ly/1/display/resize?key=1e6a1a1efdb011df84894040444cdc60&url=http%3A%2F%2Fpbs.twimg.com%2Fmedia%2FBsKGfSyCIAES1MD.jpg
          It goes on on the international level, in domestic abuse, in psychiatric torture… the list goes on.

  5. Madmom- in case you didn’t read the article on the alternative healing centers in Brazil, we moms can only stop and wonder “if only”…. Neither from what I’ve read about your daughter, or my son, had any hint of abnormal behavior (anything but!) until they unfortunately used recreational drugs (cannabis fueled a destructive alteration on their reality). Had our families been living in Brazil, I wager to believe your daughter would not be incarcerated in some mental hellhole and my son would be alive and thriving as he fully had all his life until he met his fate with the warped MH wastelands in this country. I’m sure our families both now live in purgatory with all we’ve endured. Just I’m still holding out for a miracle your daughter will be released and somehow, some way the right “healer” will find a way to reach her.
    https://www.madinamerica.com/2014/08/managing-spiritual-emergency-spiritist-psychiatric-hospitals-community-centers-brazil/