6 ms·

it became hard for Psychs to institutionalize people who need help. The prospect of a society in which any psychologist can, on a whim, circumvent due process

• kolbe 10y ago
  i agree that liberty is more important in this case, but it is important to acknowledge that the cost of liberty is the well-being of thousands (maybe millions) of mentally-ill would would otherwise be treatable.
• DanBC 10y ago
  >> it became hard for Psychs to institutionalize people who need help. > The prospect of a society in which any psychologist can, You've mixed up psychologist and psychiatrist. It's easy to find ways that psychiatrists can detain people against their will, and force them to undergo medical treatment against their will, that don't rely on a single doctor and that have strong protections against abuse. Something like two doctors - one of which knows the patient, plus an approved MH professional who's role is to protect the legal rights of the patient, plus free advocacy during all stages of detention to protect the legal rights, with powers of a close relative to ask for the detained person to be released; with a default position that people have capacity to make decisions about themselves, and that any limitations of capacity are limited to a single domain (I might not be able to say what happens to my money, but you should not use that to assume my capacity chose my medication is limited); with a recognition from all involved that this is a significant interference with my human rights and that we only tolerate this because it's in my best interests.
  • tptacek 10y ago
    Same problem with psychiatrists. The psychiatrists associated with large-scale direct intake at hospitals are also extremely overworked and often not particularly sophisticated (psychiatrists who keep up with research and are effective practitioners can make more money outside the hospital system). In the very worst case, which is unfortunately common, you have chains like UHS operating mental health hospitals in numerous states with what appear to be quotas. You don't have to drive yourself to a UHS hospital to end up in one. Most hospitals, even the very good ones, don't do on-site psych; in many of them, if you show up for any psych reason, you'll be held and then transported to an affiliated mental health hospital. So, yes, there are very significant due process concerns with acute mental health care.
• CalChris 10y ago
  Psychologist no. But psychiatrist yes. Actually there's a few others who have that authority as well. Involuntary commitment, 72 hour hold. Police can do this and some mental health professionals. http://www.disabilityrightsca.org/pubs/502401.pdf http://www.disabilityrightsca.org/pubs/502401.pdf
• anigbrowl 10y ago
  I feel you're committing the fallacy of the excluded middle here. The current standard in which a person needs to present a danger to themselves or others also results in everyone within the mental health system being treated like they're one step away from being violent criminals, resulting in significant additional stigmatization. My best friend went through a mental health crisis earlier this spring and was involuntarily hospitalized for several weeks in virtually carceral conditions.
• cjensen 10y ago
  Like I said above "There needs to be strong oversight to prevent abuse". That pretty much rules out whims. We have people who talk to themselves and freeze to death in the Winter. I disagree when you say "it is better this way." There are real risks in allowing institutionalization; on the other hand, innocent people are dying from treatable mental health issues. Surely there is some middle position to be had?