9 ms·

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

by 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.
  - limeblack 9y ago
    > 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. Yes. Once admitted you have something no matter how convincing you are. Never talked to someone who walked out having not be diagnosed with something.
    - KGIII 9y ago
      I'm not sure this is really on-topic, but I'll share it anyhow. I think it adds to your statement with personal experience. Warning: This may be a bit long and hastily written. For reasons, I once doubted my sanity. To make a long story short, I used to use an obscene amount of drugs. I'm an addict in recovery, sort of - I take prescribed Suboxone. I didn't use because I didn't feel well, I used because I wanted to feel even better. I was never a stereotypical addict, I was a functioning addict. I had no major trauma, no abuse history, or any history of mental illness. I used because I liked being high. I wasn't escaping anything. My life was fine. I just liked getting high. My drug of choice was opiates, they helped me sleep and not think all the time. In fact, I have a Ph.D. in Applied Mathematics - from MIT. I have plenty of money, healthy relationships, and no real criminal record, or at least convictions. So, after rehab, I doubted my sanity. I doubted whether or not I was sane. I mean, what sort of sane person wants to shut their brain down and get high? What sane person knows the risks of addiction but still chooses to inject themselves with untested drugs purchased from shady people? So, I went to the shrink and we had a few sessions. I did my best to be absolutely honest with them. Even during the peak of my drug use, I was completely honest with my physicians. They are tasked with saving my life, I shouldn't lie to them. I did the same thing with the head doctor. Finally, he sets me up for advanced and expensive training. It was three eight hour days, one of which was spent taking this giant test called something like the MMPI. It is one of those tests where you fill in the ovals and it's thousands of questions long. Two of the days were spent talking to people and doing some writing. They didn't feel obligated to hook me up to any of the machines. It took a bit for the results to come back and it turns out, I'm not even remotely insane. I kind of hoped I was, because then I'd have a reason for some of my choices. Nope... I'm probably more close to clinically sane than the people who administered the tests. Except, and this is the important part, they won't tell you that you're sane. This isn't verbatime, but it went something like this, "You show no signs of your life being negatively impacted by any diagnosable mental illness. You exhibit no significant traits of any clinically diagnosable disability as defined in the DSM-V." It was something like that. So, even after all those tests, and apparently being pretty damned sane, they still wouldn't call me sane - only that I wasn't able to be diagnosed with anything on the list and that my life wasn't being harmed by any uncontrolable brain functions. That's as close to sane as they appear to admit. The initial head doc hadn't done the tests, but had sent me out for them. We both got a good chuckle at the responses. He then recommended I visit a therapist once a week and offered me some sleeping pills. At the very least, they do seem inclined to keep you in their care. They won't say you're sane, either. Even when they couldn't pinpoint an issue, they still wouldn't say I was sane. The closest they came was saying that I'd no signs of my life being harmed because of a mental process I couldn't control. Go figure?

by KGIII 9y ago

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.
- limeblack 9y ago
  > 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. Yes. Once admitted you have something no matter how convincing you are. Never talked to someone who walked out having not be diagnosed with something.
  - KGIII 9y ago
    I'm not sure this is really on-topic, but I'll share it anyhow. I think it adds to your statement with personal experience. Warning: This may be a bit long and hastily written. For reasons, I once doubted my sanity. To make a long story short, I used to use an obscene amount of drugs. I'm an addict in recovery, sort of - I take prescribed Suboxone. I didn't use because I didn't feel well, I used because I wanted to feel even better. I was never a stereotypical addict, I was a functioning addict. I had no major trauma, no abuse history, or any history of mental illness. I used because I liked being high. I wasn't escaping anything. My life was fine. I just liked getting high. My drug of choice was opiates, they helped me sleep and not think all the time. In fact, I have a Ph.D. in Applied Mathematics - from MIT. I have plenty of money, healthy relationships, and no real criminal record, or at least convictions. So, after rehab, I doubted my sanity. I doubted whether or not I was sane. I mean, what sort of sane person wants to shut their brain down and get high? What sane person knows the risks of addiction but still chooses to inject themselves with untested drugs purchased from shady people? So, I went to the shrink and we had a few sessions. I did my best to be absolutely honest with them. Even during the peak of my drug use, I was completely honest with my physicians. They are tasked with saving my life, I shouldn't lie to them. I did the same thing with the head doctor. Finally, he sets me up for advanced and expensive training. It was three eight hour days, one of which was spent taking this giant test called something like the MMPI. It is one of those tests where you fill in the ovals and it's thousands of questions long. Two of the days were spent talking to people and doing some writing. They didn't feel obligated to hook me up to any of the machines. It took a bit for the results to come back and it turns out, I'm not even remotely insane. I kind of hoped I was, because then I'd have a reason for some of my choices. Nope... I'm probably more close to clinically sane than the people who administered the tests. Except, and this is the important part, they won't tell you that you're sane. This isn't verbatime, but it went something like this, "You show no signs of your life being negatively impacted by any diagnosable mental illness. You exhibit no significant traits of any clinically diagnosable disability as defined in the DSM-V." It was something like that. So, even after all those tests, and apparently being pretty damned sane, they still wouldn't call me sane - only that I wasn't able to be diagnosed with anything on the list and that my life wasn't being harmed by any uncontrolable brain functions. That's as close to sane as they appear to admit. The initial head doc hadn't done the tests, but had sent me out for them. We both got a good chuckle at the responses. He then recommended I visit a therapist once a week and offered me some sleeping pills. At the very least, they do seem inclined to keep you in their care. They won't say you're sane, either. Even when they couldn't pinpoint an issue, they still wouldn't say I was sane. The closest they came was saying that I'd no signs of my life being harmed because of a mental process I couldn't control. Go figure?