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If you don't mind me asking, is there anywhere I can read more about this aspect of the system? This comment seems really extreme and it's a perspective I have

If you don't mind me asking, is there anywhere I can read more about this aspect of the system? This comment seems really extreme and it's a perspective I haven't really seen anywhere else.

anm89 5y ago
I'll hunt around but one thing that came to to the top of my head: https://slatestarcodex.com/2018/03/22/navigating-and-or-avoiding-the-inpatient-mental-health-system/ https://slatestarcodex.com/2018/03/22/navigating-and-or-avoi... I don't know if he's considered to be a controversial figure or not generally but he is a real psychiatrist so I'd argue he knows what he is talking about
- Fr0styMatt88 5y ago
  Thank you very much for posting this article, I'm reading it now. This paragraph really resonated with me and with the initial thoughts I had whilst reading your comment; I'm pasting it here as I think it provides a very worthwhile perspective: "And my second excuse is that in the end, this is not an adversarial enterprise. Psychiatrists commit people because they’re scared. They’re scared because they can’t predict what the patient is going to do – and on another level, they’re scared because they might get sued if they don’t follow the rules. If patients who aren’t going to hurt themselves know how to explain that they aren’t going to hurt themselves in a way that reassures their psychiatrist, and in a way that doesn’t leave their psychiatrist legally liable for not committing them, then everybody can be more comfortable and get on with the hard work of actual treatment."
derbOac 5y ago
So speaking as someone who has worked in psychiatry and mental health care, I can say it's basically true. It's not the intent of those working in it, but I think like a lot of things it's sort of what has emerged through the system. I had a colleague, now retired, who was the president of state mental health associations, etc. who made the argument that most suicide treatment programs are really designed to protect practitioners and healthcare providers, not the patients. At the time I understood what he was saying, but didn't really understand it until later. The way it came up with him was more about prediction and risk. He was talking about it because there's basically no way to know if someone is actually imminently suicidal. Most people who talk about it never even make an attempt, and there are lots of people who commit suicide suddenly without saying a word to anyone else ahead of time. My colleague's point was this: if saying X is totally unpredictive of Y in reality, why react so strongly to saying X? The reason is because it's not really about preventing Y -- you can't -- it's because it legally and morally absolves you of responsibility. I feel weird writing this because it sounds so cynical, but its a sad truth about the poor state of care of our fellow human beings in contemporary society.
- everybodyknows 5y ago
  Anyone seeking help with a minor physical disorder from the local urgent care facility here (California) is promptly asked: "Have you had thoughts of harming yourself or anyone else?". Immediate tingling of danger -- but wondered if my suspicions might be little more than the product of a cynical mind. Didn't think so -- but thanks for the confirmation!
- deleted 5y ago
  [deleted]
- ncmncm 5y ago
  I always thought of suicide as incomprehensible, then I encountered it used as a coping mechanism: "It's not so bad, I could always kill myself." (A person who has come to rely on that must not have kids!)
- liminal 5y ago
  >> My colleague's point was this: if saying X is totally unpredictive of Y in reality, why react so strongly to saying X? The reason is because it's not really about preventing Y -- you can't -- it's because it legally and morally absolves you of responsibility. If it's actually unpredictive, then shouldn't committing someone -- taking full control of their life -- make the doctor more responsible for them and not less? Responsible for them not being able to work, pay their bills, etc. and ultimately making their life situation more precarious, thus increasing their mental stress.

If you don't mind me asking, is there anywhere I can read more about this aspect of the system? This comment seems really extreme and it's a perspective I haven't really seen anywhere else.

anm89 5y ago

I'll hunt around but one thing that came to to the top of my head: https://slatestarcodex.com/2018/03/22/navigating-and-or-avoiding-the-inpatient-mental-health-system/ https://slatestarcodex.com/2018/03/22/navigating-and-or-avoi... I don't know if he's considered to be a controversial figure or not generally but he is a real psychiatrist so I'd argue he knows what he is talking about

Fr0styMatt88 5y ago
Thank you very much for posting this article, I'm reading it now. This paragraph really resonated with me and with the initial thoughts I had whilst reading your comment; I'm pasting it here as I think it provides a very worthwhile perspective: "And my second excuse is that in the end, this is not an adversarial enterprise. Psychiatrists commit people because they’re scared. They’re scared because they can’t predict what the patient is going to do – and on another level, they’re scared because they might get sued if they don’t follow the rules. If patients who aren’t going to hurt themselves know how to explain that they aren’t going to hurt themselves in a way that reassures their psychiatrist, and in a way that doesn’t leave their psychiatrist legally liable for not committing them, then everybody can be more comfortable and get on with the hard work of actual treatment."

derbOac 5y ago

So speaking as someone who has worked in psychiatry and mental health care, I can say it's basically true. It's not the intent of those working in it, but I think like a lot of things it's sort of what has emerged through the system. I had a colleague, now retired, who was the president of state mental health associations, etc. who made the argument that most suicide treatment programs are really designed to protect practitioners and healthcare providers, not the patients. At the time I understood what he was saying, but didn't really understand it until later. The way it came up with him was more about prediction and risk. He was talking about it because there's basically no way to know if someone is actually imminently suicidal. Most people who talk about it never even make an attempt, and there are lots of people who commit suicide suddenly without saying a word to anyone else ahead of time. My colleague's point was this: if saying X is totally unpredictive of Y in reality, why react so strongly to saying X? The reason is because it's not really about preventing Y -- you can't -- it's because it legally and morally absolves you of responsibility. I feel weird writing this because it sounds so cynical, but its a sad truth about the poor state of care of our fellow human beings in contemporary society.

everybodyknows 5y ago
Anyone seeking help with a minor physical disorder from the local urgent care facility here (California) is promptly asked: "Have you had thoughts of harming yourself or anyone else?". Immediate tingling of danger -- but wondered if my suspicions might be little more than the product of a cynical mind. Didn't think so -- but thanks for the confirmation!
deleted 5y ago
[deleted]
ncmncm 5y ago
I always thought of suicide as incomprehensible, then I encountered it used as a coping mechanism: "It's not so bad, I could always kill myself." (A person who has come to rely on that must not have kids!)
liminal 5y ago
>> My colleague's point was this: if saying X is totally unpredictive of Y in reality, why react so strongly to saying X? The reason is because it's not really about preventing Y -- you can't -- it's because it legally and morally absolves you of responsibility. If it's actually unpredictive, then shouldn't committing someone -- taking full control of their life -- make the doctor more responsible for them and not less? Responsible for them not being able to work, pay their bills, etc. and ultimately making their life situation more precarious, thus increasing their mental stress.