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> people who have been found not guilty by reason of insanity or who have been arrested but found incompetent to stand trial — are involuntarily confined to ps

> people who have been found not guilty by reason of insanity or who have been arrested but found incompetent to stand trial — are involuntarily confined to psychiatric hospitals. Here, "psychiatric hospital" literally means "prison with carpets". There are locked doors instead of bars, and caretakers instead of guards, but it's a prison all the same. My brother had a mental breakdown (not violent or criminal, but threatening enough to himself for police to be involved), and ended up in the state "hospital" for quite a while. I almost wish it was a prison instead, because at least prison is honest about what it is. These "hospitals" may be necessary for some, but as soon as you walk inside, you take a deep dive into the uncanny valley, and you yourself begin to question your own sanity. I won't even try to imagine what it would be like to be thrown inside with no trial, and told that you can't leave unless you prove to your accusers that you are adequately "normal" The worst thing about the situation is that my brother didn't believe or understand he was ill, and the state gave him every reason to be angry, and reject the situation, rather than come to terms with it. Thankfully now, he is in an assisted living facility, is allowed to leave, and can feel more like a human being, but while he is very normal, functional, etc. he can't just go find work and go live his life. There doesn't seem to be an end game, and that alone is its own prison.

limeblack 9y ago
My frustration with "mental health" is that many things like bipolar, schizophrenia and depression(even ADHD sometimes) are often viewed as incurable while also having no true litmus test. This talks about some of the issues https://www.youtube.com/watch?v=wuhJ-GkRRQc https://www.youtube.com/watch?v=wuhJ-GkRRQc Not to mention the fact homosexuality used to be a mental illness. Prisoners are definitely no better considering then you have a criminal record for a while typically.
cm2012 9y ago
Agreed. Years ago, my wife made a suicide attempt that I stopped. We agreed together to go to the psych hospital after for evaluation. It was a mistake. They forcibly kept her for 3 days. She has a huge anxiety about being trapped places since she was neglected and abandoned as a kid. It didn't prevent her from hurting herself any more than she would have, and made things much worse afterwords because it was traumatic. You have absolutely no control or agency once you're inside. I would never bring her back under any circumstances.
- KGIII 9y ago
  I believe the law, varies by State, usually mandates a minimal of 72 hours of observation in a psychiatric facility when there has been an attempt, or credible threat, reported. Additionally, some classes of people are mandated reporters. If they fail to report the threat, or attempt, they will lose their license and, I think, can face both civil and criminal charges. Again, some variation depending on jurisdiction. Teachers, health care professionals, day care workers, police, etc. are all mandated reporters. They must, by law, report an attempt or threat. An attempt, by law, means a minimum of 72 hours of involuntary commitment. After which, a judge can be called in to extend the stay. I had a sister who was mentally ill. For my last two years in the Marines, I was a transportation officer at a detention facility (brig), where I was a mandated reporter and sometimes had to work with people who had developed their mental illness during their enlistment or had somehow managed to pass the psych eval and managed to enlist. There were a suprisingly large number of them. So, I've had some exposure to the system and the missus used to work in the field. For a while, I volunteered to help some of them out. I used to take some fishing, hiking, and to do things like archery practice. I was a mandated reporter during that, and had to take a number of classes on mental health. If you're curious, I stopped because I don't have the heart for it. It isn't that I don't have a heart for the mentally ill, it's that I don't have the heart for the system in which they are stuck. I don't like being powerless and I was unable to effect change.
  - cm2012 9y ago
    Yeah, I got the impression it was because of some rules or fear of lawsuits. The result is the same though - I would never recommend checking in unless you have no other choice. If you do talk to a psychologist, know when to lie.
    - KGIII 9y ago
      As bad as it is, or as bad as it can be - as not everyone has bad experiences, I'm not sure I can recommend being dishonest with a mental health care provider during a time of crisis. Unfortunately, the system is designed to deal with a broad spectrum of people with myriad complexities. They do tend to take a very hard line approach and to assume the worst. They also have reason to not always trust the patient. It's tricky with mental health. In many ways, it's a damned if you do and damned if you don't situation. This is more true during the initial observation period and one of the reasons many facilities do isolation for the first 24 hours, even for voluntary commitments. It should be noted that voluntary commitments can rapidly and more easily become involuntary commitments. After all, the patient has already admitted that they are unwell. Nope, I have no idea how to fix this mess.
fish_fan 9y ago
I have committed myself twice, once for being suicidal and once for life-ruining anxiety. It did not help in the way I expected. You are essentially not allowed to express confidence in your own health because your caretakers will assume you’re overeager and take it as evidence you need more time in the hospital. Don’t get it twisted, though, your stay length is entirely determined by convincing health insurance companies that any time there will reduce recidivism. The smart people “play” healthy, not admitting ongoing doubts and concerns. Why? Because you go to the hospital to make rapid medication changes. The therapy offered is often insufficient, both in terms of one-one-one therapy and simply what you can cover during your stay. Overstaying is enough to make anyone clinically depressed. It can also cost a lot; while it is illegal to fire for mental health leaves, it is not uncommon to get let go for “unrelated reasons”, to prevent paying for future stays, or simply because they’re uncomfortable supporting their employees to this extent. Mental health hospitals are aimed at maximizing the number of beds in use, ensuring everyone is at least as medicated as the doctor thinks they can handle, and pumping insurance companies for money. If you are considering one, use it to prevent crises, not to expect any kind of therapy suited for long-term help. The simply do not have the available attention, funding, or even reliable pharmaceutical research to make a dent in the latter. To be honest, I have high hopes for psychedelics to make fruitful, therapeutic use in a short stay. As it is I’ve lost faith in the pharmaceutical industry to demonstrate the pills they make are effective, let alone not harmful to the general population. 3/5ths of the mental health prescriptions I’ve been given have been pulled from the market, linked to high suicide rates, or linked to other serious medical issues (no shit, Risperdal made me lactate as a male.) ...and of course, the absolute worst part is seeing people you know will never function in society, many rimes without family. I suppose better the asylum than the street, but we will likely always need long-term mental health care in publicly funded facilities.
- cm2012 9y ago
  Agreed on all points. The system demands that you learn to play the game quickly, lie about certain things, etc.
- ThrustVectoring 9y ago
  Ironically, a great way to get out of psychiatric commitment is to cancel or threaten to cancel your health insurance.
dsego 9y ago
My brother also had a psychotic episode last year, was on injections of risperidone for some months, now only zyprexa, back to univsersity, almost normal, except for bipolar/borderline behaviors and a tendency towards creating drama. People don't understand that when someone is in a psychotic state, they don't live in the same reality. It's not a question of free will or choice, or control. People see distorted faces, visions, hear things and the worst part are not these hallucinations, but delusions, strong beliefs (he thought the family conspired against him, that he was raped as a child and even that he was transgender) and anosognosia, which means they aren't aware of it. At the same time my father also started "traveling in time", not sleeping, convinced that there was some cosmic truth behind these events. He also ended up in a psych ward, but now it seems he might be having some kind of atrophy. But seeing your father restrained to a bed in front of you is not pleasant, hardest thing I had to do in my life. And now I don't even know if we made the right choice, those drugs, haldol and leponex, I mean, even after months of not taking them, he still walks like a zombie, shuffling gate, jaw dropped, open mouth, no affect whatsoever. He's not the same man and I don't know if he will ever recover.
- wolco 9y ago
  There is a lot to parse. Thoses drugs are dangerous and do not cure a patient usually leaving them in a worse state mentally. When you are the one forced to make these decisions its tough because there are no easy answers. I find the traveling through time reference interesting. I remember the line from slaughter house 5. What cosmic truth was he approaching?
  - dsego 9y ago
    I forget the details, but my brother filled his head with ideas about non-linear time, spiritual plane, lacrimosa (?), and some other nonsense he had discovered in his crazy state of mind, very philosophical new-age stuff. My father is also that type who believes in esotericism, things like pendulums, bioenergy and radiesthesia. So this really affected him. And I guess he had had some internal conflicts about his marriage and life for some time (also treating depression for twenty years) and then started decompensating. Poor man would spin around, trying to turn back time, or convince us of some powers, or how my brother was almost son of god. Nothing he and my brother were saying made sense, but to them it was like they really uncovered some deeper meaning.
mi3law 9y ago
Hi Thomas. Thank you for sharing your story. I'm sorry about your brother. I'm going through a similar situation with someone very dear to me, and I'm wondering what will happen to them. Would you have time for a quick chat or phone call? My email is in my profile; please email me if you see this.
- angmarsbane 9y ago
  NAMI (National Alliance on Mental Illness) has free classes and support groups for friends or family members of people suffering with mental illness. It helped my Mom and me immensely when our family member had a psychotic break. I highly recommend them if you can make the time.

limeblack 9y ago

My frustration with "mental health" is that many things like bipolar, schizophrenia and depression(even ADHD sometimes) are often viewed as incurable while also having no true litmus test. This talks about some of the issues https://www.youtube.com/watch?v=wuhJ-GkRRQc https://www.youtube.com/watch?v=wuhJ-GkRRQc Not to mention the fact homosexuality used to be a mental illness. Prisoners are definitely no better considering then you have a criminal record for a while typically.

cm2012 9y ago

Agreed. Years ago, my wife made a suicide attempt that I stopped. We agreed together to go to the psych hospital after for evaluation. It was a mistake. They forcibly kept her for 3 days. She has a huge anxiety about being trapped places since she was neglected and abandoned as a kid. It didn't prevent her from hurting herself any more than she would have, and made things much worse afterwords because it was traumatic. You have absolutely no control or agency once you're inside. I would never bring her back under any circumstances.

KGIII 9y ago
I believe the law, varies by State, usually mandates a minimal of 72 hours of observation in a psychiatric facility when there has been an attempt, or credible threat, reported. Additionally, some classes of people are mandated reporters. If they fail to report the threat, or attempt, they will lose their license and, I think, can face both civil and criminal charges. Again, some variation depending on jurisdiction. Teachers, health care professionals, day care workers, police, etc. are all mandated reporters. They must, by law, report an attempt or threat. An attempt, by law, means a minimum of 72 hours of involuntary commitment. After which, a judge can be called in to extend the stay. I had a sister who was mentally ill. For my last two years in the Marines, I was a transportation officer at a detention facility (brig), where I was a mandated reporter and sometimes had to work with people who had developed their mental illness during their enlistment or had somehow managed to pass the psych eval and managed to enlist. There were a suprisingly large number of them. So, I've had some exposure to the system and the missus used to work in the field. For a while, I volunteered to help some of them out. I used to take some fishing, hiking, and to do things like archery practice. I was a mandated reporter during that, and had to take a number of classes on mental health. If you're curious, I stopped because I don't have the heart for it. It isn't that I don't have a heart for the mentally ill, it's that I don't have the heart for the system in which they are stuck. I don't like being powerless and I was unable to effect change.
- cm2012 9y ago
  Yeah, I got the impression it was because of some rules or fear of lawsuits. The result is the same though - I would never recommend checking in unless you have no other choice. If you do talk to a psychologist, know when to lie.
  - KGIII 9y ago
    As bad as it is, or as bad as it can be - as not everyone has bad experiences, I'm not sure I can recommend being dishonest with a mental health care provider during a time of crisis. Unfortunately, the system is designed to deal with a broad spectrum of people with myriad complexities. They do tend to take a very hard line approach and to assume the worst. They also have reason to not always trust the patient. It's tricky with mental health. In many ways, it's a damned if you do and damned if you don't situation. This is more true during the initial observation period and one of the reasons many facilities do isolation for the first 24 hours, even for voluntary commitments. It should be noted that voluntary commitments can rapidly and more easily become involuntary commitments. After all, the patient has already admitted that they are unwell. Nope, I have no idea how to fix this mess.

fish_fan 9y ago

I have committed myself twice, once for being suicidal and once for life-ruining anxiety. It did not help in the way I expected. You are essentially not allowed to express confidence in your own health because your caretakers will assume you’re overeager and take it as evidence you need more time in the hospital. Don’t get it twisted, though, your stay length is entirely determined by convincing health insurance companies that any time there will reduce recidivism. The smart people “play” healthy, not admitting ongoing doubts and concerns. Why? Because you go to the hospital to make rapid medication changes. The therapy offered is often insufficient, both in terms of one-one-one therapy and simply what you can cover during your stay. Overstaying is enough to make anyone clinically depressed. It can also cost a lot; while it is illegal to fire for mental health leaves, it is not uncommon to get let go for “unrelated reasons”, to prevent paying for future stays, or simply because they’re uncomfortable supporting their employees to this extent. Mental health hospitals are aimed at maximizing the number of beds in use, ensuring everyone is at least as medicated as the doctor thinks they can handle, and pumping insurance companies for money. If you are considering one, use it to prevent crises, not to expect any kind of therapy suited for long-term help. The simply do not have the available attention, funding, or even reliable pharmaceutical research to make a dent in the latter. To be honest, I have high hopes for psychedelics to make fruitful, therapeutic use in a short stay. As it is I’ve lost faith in the pharmaceutical industry to demonstrate the pills they make are effective, let alone not harmful to the general population. 3/5ths of the mental health prescriptions I’ve been given have been pulled from the market, linked to high suicide rates, or linked to other serious medical issues (no shit, Risperdal made me lactate as a male.) ...and of course, the absolute worst part is seeing people you know will never function in society, many rimes without family. I suppose better the asylum than the street, but we will likely always need long-term mental health care in publicly funded facilities.

cm2012 9y ago
Agreed on all points. The system demands that you learn to play the game quickly, lie about certain things, etc.
ThrustVectoring 9y ago
Ironically, a great way to get out of psychiatric commitment is to cancel or threaten to cancel your health insurance.

dsego 9y ago

My brother also had a psychotic episode last year, was on injections of risperidone for some months, now only zyprexa, back to univsersity, almost normal, except for bipolar/borderline behaviors and a tendency towards creating drama. People don't understand that when someone is in a psychotic state, they don't live in the same reality. It's not a question of free will or choice, or control. People see distorted faces, visions, hear things and the worst part are not these hallucinations, but delusions, strong beliefs (he thought the family conspired against him, that he was raped as a child and even that he was transgender) and anosognosia, which means they aren't aware of it. At the same time my father also started "traveling in time", not sleeping, convinced that there was some cosmic truth behind these events. He also ended up in a psych ward, but now it seems he might be having some kind of atrophy. But seeing your father restrained to a bed in front of you is not pleasant, hardest thing I had to do in my life. And now I don't even know if we made the right choice, those drugs, haldol and leponex, I mean, even after months of not taking them, he still walks like a zombie, shuffling gate, jaw dropped, open mouth, no affect whatsoever. He's not the same man and I don't know if he will ever recover.

wolco 9y ago
There is a lot to parse. Thoses drugs are dangerous and do not cure a patient usually leaving them in a worse state mentally. When you are the one forced to make these decisions its tough because there are no easy answers. I find the traveling through time reference interesting. I remember the line from slaughter house 5. What cosmic truth was he approaching?
- dsego 9y ago
  I forget the details, but my brother filled his head with ideas about non-linear time, spiritual plane, lacrimosa (?), and some other nonsense he had discovered in his crazy state of mind, very philosophical new-age stuff. My father is also that type who believes in esotericism, things like pendulums, bioenergy and radiesthesia. So this really affected him. And I guess he had had some internal conflicts about his marriage and life for some time (also treating depression for twenty years) and then started decompensating. Poor man would spin around, trying to turn back time, or convince us of some powers, or how my brother was almost son of god. Nothing he and my brother were saying made sense, but to them it was like they really uncovered some deeper meaning.

mi3law 9y ago

Hi Thomas. Thank you for sharing your story. I'm sorry about your brother. I'm going through a similar situation with someone very dear to me, and I'm wondering what will happen to them. Would you have time for a quick chat or phone call? My email is in my profile; please email me if you see this.

angmarsbane 9y ago
NAMI (National Alliance on Mental Illness) has free classes and support groups for friends or family members of people suffering with mental illness. It helped my Mom and me immensely when our family member had a psychotic break. I highly recommend them if you can make the time.