Even if the US had adequate mental health coverage, how does one force a mentally ill person

[graywarrior]

into getting treatment? I ask because someone close to me who suffers from bi-polar disorder and possibly schizophrenia refuses to see a psychiatrist or take medication.

[a geek named Bob]

1. call it in as danger to self and others? n/t

[graywarrior]

2. Most of the time this person is stable.

Every other month, he goes off the edge.

[a geek named Bob]

4. up to you... n/t

[Sekhmets Daughter]

19. There really isn't much that can be done

once someone turns 18. Most states have a provision for a temporary involuntary commitment, but it usually involves the individual saying they want to kill themselves or someone else. Here in FL it's the Baker Act. The reason it's so hard these days is that at one time
people were committed wily nily....disgruntled husbands sent their wives to state mental hospitals to get rid of them etc.

[Happyhippychick]

3. You can't unless you can prove they are dangerous. Not easy to do.

[graywarrior]

6. Which begs the question how to handle mental illness and guns.

[Happyhippychick]

15. I agree. No real solution unless we want to strip the mentally ill of their civil rights.

It's easier to get rid of guns.

[graywarrior]

16. I know. Check out this story.

http://itemlive.com/articles/2012/12/19/news/news02.txt


snip

“One start is to address the part of the mentally ill. There must be some discipline: We can’t just say, ‘We need to help these people.’ We have to start separating the mentally ill from so-called normal people,” J. Warren Cassidy said Tuesday.

[tama]

36. In my country we have draft

Guess what many of those do who don't want to go to army or civil service (or in jail) as conscious objector?

[vankuria]

5. That's the problem

you can't force an adult to get treatment, take meds, etc. Unless the person is a danger to himself or others, in which case you'd need a court order, there's not much you can do. And from what I understand, getting a court order is no easy task either. I sympathize with you.

[graywarrior]

9. It's frustrating because if he got treatment, his life would not be so complicated.

[tama]

37. It's his life

Why ruin your own life by getting frustrated by worrying about somebody else's life?

[graywarrior]

39. You're approx the 20th person to say that. lol

Clean my own house first.

[tama]

46. That's what they always say

"Healer heal thyself!" Very frustrating, but when you do, also very pleasing.

[graywarrior]

61. All is suffering is not negative when you really think about it

[southern_belle]

54. and then they only get

72 hours confinement IIRC? It can be extended but I'm not sure how often it is extended?

[Brickbat]

7. It depends on the state, but generally it comes down to demonstrating a danger to self or others,

and the burden of proof is quite high.

[nadinbrzezinski]

8. Court ordered commitment

Which is next to impossible in the United States at the current time.

[unblock]

10. i have a brother worse of than yours. it's very hard.

if the person is a minor, it's easier, though at the end of the day if they want to run off and live on the lam it's hard to prevent that.

if the person is an adult, you're s.o.l. unless they prove themselves to be a threat to themselves or others. that generally means they need to do something that gets them arrested, officially diagnosed, and then a judge & prosecutor who hopefully "get it" and put them in some form of treatment as a condition for staying out of prison.

that's exactly what finally happened with my brother, who announced on a bus that there was a bomb onboard (this was shortly after the movie "speed" had come out), then when the police & emts came he technically assaulted an emt as he resisted treatment at the scene.

it worked for a while, but eventually he decided he'd rather be unmedicated, so he just walked away from his halfway house.

no one in the family has heard from him in years.

[graywarrior]

11. Arrrgghh, that would kill me!

This guy is resistant to everything....self help groups, psychologists, psychiatrists, medication. It's almost like he loves his misery.

[unblock]

75. that a big problem for mental illness in general, and bipolar in particular

when in the hypomanic state, apparently you feel super capable. your mind is racing but not out of control. if you're a functional bipolar, you can actually accomplish a lot very quickly. i suspect that famous bipolar executives like ted turner must be hypomanic most of the time. even if you're completely dysfunctional, you THINK you're accomplishing a lot. bipolar people hate to give that up.

in any event, un-medicated just feels "normal" and eventually they just want to feel normal. or they think they might be cured so they stop the meds. then the bipolar takes over and you're back to square one.

[slackmaster]

12. I can tell you from personal experience, generally you can't force anyone into treatment.

But here's what I did here in California:

I knew the person was suicidal. I also knew that simply calling 911, who would dispatch the police, would be useless unless the police could be shown hard evidence of actual danger, such as a suicide attempt. Otherwise, the person could simply say "I'm fine," and the police could do nothing.

I waited until there was an actual suicide attempt in progress, with missing drugs and a note and boxes of stuff labelled with the names of the person's relatives. Then I called 911.

In 20 minutes the first officer showed up, followed shortly by another officer and a psychiatric nurse. They all looked at the evidence and agreed with me that the person was suicidal.

They took her to the county psychiatric hospital for a 72-hour hold as allowed by Section 5150 of the California Welfare and Institutions Code.

It took her 10 days to figure out the right combination of verbal utterances, feigned facial expressions, and gestures to get herself released. The doctors referred her to outpatient treatment with a psychiatrist, gave her a prescription, information about various free crisis intervention services available, and a free cell phone.

She didn't take the medication, didn't call any friends or family, and didn't show up for her first appointment with the psychiatrist. The psychiatrist's office sent the police to her home to do a welfare check. She told them "I'm fine," and they could do nothing.

Seven weeks later she killed herself.

[jody]

17. Damn it slackmaster, given your experience it seems like a lose-lose situation in many cases. Other

locations have no support like you describe.

[slackmaster]

18. Despite heroic efforts by the police and medical professionals and myself, the only person...

...that my actions saved was me.

Although the death has been a terrible burden on me for nearly a year now, I know with certainty that I did everything any person could and more, and that her death was not my fault.

Not in my house, not with my drugs, not with my gun, not on my watch.

[Sekhmets Daughter]

21. And that's all you can ever demand of yourself.

Your efforts were heroic. You tried your best, but a determined suicide will eventually succeed.

[jody]

25. So sorry for you. I have several friends from Vietnam, one an Aussie Squadron Leader, commit suicide

I tremble whenever I hear about another veteran committing suicide because they're my buddies and I grieve for those who loved them.

[graywarrior]

20. That's frightening.

[slackmaster]

26. Yes it is. I'm in a cold sweat right now from thinking about it. I was in therapy for 4 months.

The nightmares I had after learning of her death were some of the most terrifying and bizarre things I've ever experienced.

Please consider this, while people are so occupied with discussing firearm issues:

I collect firearms. I have a federal license that makes collecting easier. I have more than 50 working firearms in my home, but they are all locked up in a safe.

I also have multiple prescriptions for potentially dangerous drugs, such as Vicodin. I always have supplies of those, but I keep them locked up in the same safe as my gun collection.

The deceased person lived for four months in my house while she was trying to get back on her feet after a job loss. She rifled through my medication, searched through all of my stuff for weapons, dropped numerous hints that she was considering killing herself. But I denied her the means to do so easily.

People who own firearms should always keep them secured. I've preached that message since my first days here on DU. I'm a "white hat" gun owner.

But there are still people on this board who hate me and bully me just because I own guns.

[graywarrior]

31. The solution to the gun/mental health issue won't be easy.

Where I grew up, we were surrounded by guns throughout the neighborhood. It was part of the norm. Not seeking mental help was part of the norm. We as a country are gonna have to make some very uncomfortable changes and I don't think a lot of people are capable of those changes.

[jody]

40. "hate me and bully me"! I'm an old man and held many responsible positions in govt., education, and

business.

My experience has led me to conclude, that the more more morally correct a person becomes, the more they become a target for all groups who claim to have the one and only answer to moral questions.

I've read most of your posts on DU and marveled at your composure under villainous attack populated with scurrilous comments.

Don't let the SOB's wear you down, you have many, I mean many-many, people who respect and admire you.

Jody

[graywarrior]

62. !!!!

Thank you so much!

[riderinthestorm]

57. Adam Lanza had EASY access to guns. That's the difference.

Wherever he was on the mental health scale, the difference between your story where your friend only killed herself, and Adam Lanza who killed 26, is easy access to the weaponry to commit a mass slaughter.

I am so sorry for your terrible time. I hope you are doing better now...you DID do everything right. Please know that.

[slackmaster]

77. Thank you for your kind words

[Odin2005]

48. Oh gosh!

[monmouth3]

13. What about using Baker acted...n/t

[jody]

14. Is legal system the only way? nt

[SoCalDem]

22. They lie...and the person goes in for 72 hours and emerges pissed off

at the people who put them there..and they withdraw more than ever...or maybe if they have weapons........

[graywarrior]

24. I know, even when he sees his primary care doctor, he's pissed for a few days after.

[slackmaster]

27. Yes, my friend who I had "5150'd" absolutely hated my guts when she got out

But she sure wanted a cigarette badly.

[cbayer]

23. The laws and mechanisms vary from state to state, but, in general

one must be a danger to self, others or gravely disabled (unable to care for their basic needs). When people are stable, it is very, very difficult to force treatment unless they have a court order due to previous episodes.

It's a fine line between preserving someone's civil liberties and forcing them into treatment.

[slackmaster]

28. They only have to be stable enough to tell the police "I'm fine" and maintain for a few minutes

Then they can go back to being psychotic.

[cbayer]

30. Not true everywhere. In many places, EMT's or police can bring someone into

the emergency room for evaluation with little difficulty. They then have to be evaluated by a physician, who is much less likely to just let them out on an "I'm fine".

[slackmaster]

42. Thanks for that. My actions in the case outlined here were taylored to San Diego, and the victim.

The police are very busy, so it's difficult to get them to come to a domestic situation unless there is strong evidence of danger. It's a very bad idea to make them think you're wasting their time.

The victim had Borderline Personality Disorder, and I knew that unless I could make a good case for having her taken in she'd tell the police that we were fighting and I was just trying to set her up. And in domestic situations, it's usually the man who gets hauled away.

[TheBlackAdder]

60. Florida had a thing where physicians were 5250ing elderly with no family to fund their clinics.

Doctors were just going around randomly institutionalizing elderly seniors who had no family.

These seniors were being placed into the doctor's own care facility so the doctor was able to fund his business on the backs of the state and federal systems. The 'patients' would then be released after 2 weeks of 'observation' and another 'patient' would then get 5250'd.

[Sen. Walter Sobchak]

29. Saddly these issues cross two of our most sacred cows

The right to be armed to the teeth with enough firepower to down helicopter gunships AND the right to be completely fucking unhinged and threatening.

[graywarrior]

33. The original American Horror Story

[Sen. Walter Sobchak]

50. Someone needs to make an editorial cartoon

depicting a heavily armed young man being escorted to the entrance of a school, a camouflaged NRA nutter on one side and a ponytailed moron in an ACLU sweatshirt on the other.

Because that is pretty much where we're at.

[graywarrior]

51. You nailed that one!

[HooptieWagon]

32. If you can't get them Baker acted, at least talk to police and get a paper trail started.

And if you are in fear of the person, its pretty easy to get a restraining order. For 48 hours or so its just on your word. Then the person has to appear before the judge to explain why they aren't a threat to you. It doesn't take much evidence for the judge to continue the restraining order permanently.

[tama]

34. You don't force people

unless they are clear danger to others.

Bi-polars not only suffer but also enjoy greatly, and the various out of norm "schizophrenic" experiences can be also very important and life changing "spiritual" experiences for many. In indigenous cultures similar set of symptoms and experiences are often considered signs of shaman disease.

Each individual is of course unique and so it's impossible to give any specific advise about someone you don't know, but "mental disorder" can be and often is healthy reaction to society suffering from collective insanity.

[graywarrior]

47. Very interesting comment.

Thank you!

[tama]

53. If you ask good psychiatrists

they would say pretty much the same. I believe you genuinely care for your friend and wish him well. But from what you say, he clearly feels that the standard system is not for him - and many "bi-polars" genuinely prefer their strong wave pattern to dull straight line - experience junkie is a good characterization. What everybody likes and needs is acceptance and love - for what you are as you are, even when you don't share exactly the same experience world and can't comprehend everything about someone other. I've given more than enough of trouble and worry to my close ones, but also heard them say this simple and beautiful truth to me: Thank you for being.

[graywarrior]

55. Absolutely!

I'm practicing unconditional love for this guy. I spend most of my time with him listening without judgement. He told another friend of ours that of everyone, he trusts me the most.

[tama]

63. <3

I have a friend who has a long history with the medical system, and it also helps to feel less lonely when you meet others with similar experiences and are able to share them - "mutual support group" . But when he goes deep into his personal labyrinth of symbols I just don't give that stuff any attention. No positive of negative feedback, just not interested. Unconditional love and non-judgemental listening does not mean you have to agree and hum hum with everything and reward all and everything with attention.

Best advice I've been given and can give is just to feel your body, let your body feel itself as it feels - to know yourself, as Socrates advised.

[graywarrior]

66. You rock!

[GreenPartyVoter]

70. Bipolar person chiming in here. Just wanted to point out that

while we may be excitement junkies at times, it's not necessarily a good thing. Mania is when our judgement becomes impaired, which is how we manage to go home with someone else when we are married, or mortgage the house to buy a yacht we can't afford when we don't live anywhere near water.

Also, being off of meds is a gamble because you don't know if you are even going to get the escstatic high, or rather a towering rage, or start pacing the floor trying to pull your hair out, or crying with anxiety and paranoia that something awful is going to happen, or if God is going to start channeling new Bible verses to you, or be convinced that you are the stupidest, worst person in the world and it would be better off without you.

I absolutely agree that everyone needs acceptance and love, but there are times when that's not even close to enough to get them through, because it can only affect their brain chemistry just so much. I was loved plenty as a kid and young adult, but it didn't stop my own brain from putting me (and others) through hell.

Unfortunately it's hard to convince someone to seek medical care for a number of reasons. Me, I am mostly compliant with the meds, but I am terrible about the rest of it like diet, exercise, and a regular sleeping schedule. (I just don't feeeeeel like it. *whine whine*)

I hope that you can continue to be a source of support and strength for your friend, but don't let him drain you or take advantage of you.

[graywarrior]

71. What a great post, GreenPartyVoter!

[GreenPartyVoter]

72. Thanks. :^) I just thought it might help to hear from someone who has the DX.

[graywarrior]

74. For sure!

[randome]

35. Even treatment is not the only solution to the mentally ill.

Someone needs to stay engaged with them pretty much all the time. I feel for you if you have that burden to carry but that's the way it is.

It takes a village to raise a child. It takes one to keep some from going off the deep end, too.

[tama]

38. And when the village

is suffering from collective suicidal psychosis and the village idiot and the little boy who yelled that emperor is naked are considered having "mental disorder" by the Village People?

[jody]

41. Tama, you've pegged it. Almost makes me hope the Mayan 12/21/12 prediction is correct. nt

[tama]

43. By the look of the world, it is

Ie. what the Mayans themselves say that the end of a cycle and beginning of new means. Not the end of world but deep changes - which don't happen miraculously in one day, but as nature is sticky and slow to change (from our perspective) the process of change has been going for a while and will continue to do so.

[graywarrior]

64. Indeed!

[Odin2005]

44. It's very hard to get somebody commited nowadays because it was horribly abused...

...in the past. A lot of women, especially, would be forced into a mental facility because they rejected the accepted gender norms, because sexist doctors dismissed a woman's health concerns as "hysteria", or even just because their husbands wanted to get rid of them. People who would now be diagnosed with Asperger's would be committed with Schizophrenia because they took the "do you hear voices" question literally.

I don't know what the solution is.

[graywarrior]

49. Yes and if a person is a paranoid schizophrenic (like someone else I know) they

think the doctors are in on it.

[Comrade_McKenzie]

45. I am in favor of compulsory annual mental health exams for school kids...

And gun owners.

[MotherPetrie]

52. Bottom line: You can't. Been there, done that, with a family member.

Extremely frustrating and heartbreaking process that did not end well despite our best efforts.

[Fire Walk With Me]

56. "Force" is the key word.

May anyone who forces another, who is not a threat to themselves or others, to do anything, receive that karma in return and more until they GET IT. "Do what we say or else" is tea party, is republican. Aren't we better than that, if something is not harming us?

[randome]

58. I think the point is that we don't know who is a threat to themselves or others...

...until they harm themselves or others.

It's a dilemma. There is no single solution but mental health resources is a start.

Eliminating the stigma of mental illness would help.

[tama]

67. Eliminate the stigma by acceptance

that as member of insane society you also are insane. Then we can be happily crazy all together - and keep on healing and getting better.

[randome]

73. That really doesn't help.

[riderinthestorm]

59. You can't. So the solution is to make mass slaughter virtually impossible for them

if they are leaning in that direction.

Since you can't force a mentally ill person into treatment, we MUST get our easy access to guns under control FIRST.

Without easy access, the chances of mass slaughter are greatly reduced.

[easttexaslefty]

65. It's a complicated issue.

I was "committed" for a suicide attempt after my son's suicide. I am uninsured. Where I was sent was a hell hole and I don't say that lightly. I have stories that would curdle your blood.
I would have said anything to get out of there.

[graywarrior]

68. I used to do art therapy in a MA asylum.

American Horror Story reminds me of that place. Truly horrifying!

[arthritisR_US]

69. You can call it in but if they passed a MSE and

did not admit to wanting to harm themselves or others there is not much you can do.

[tblue]

76. I heard 85% of us need help

and only half of those ever get any. I don't have an answer to your question. Treatment must be readily available and schools and families educated about signs of trouble. But for those who want it, treatment also takes time. It takes time to get an appointment and time for therapies to work. In the mean time, anything can happen. I say take away the fucking guns! At least start! Try!

[JDPriestly]

78. You could see a lawyer about getting the person committed to an institution.

That is one possibility.

You may or may not have enough grounds to take some sort of legal action to get some help for the person.

We don't want to have people placed in psychiatric care just because they are inconvenient, but there are times when it is best to make sure a person gets help. Maybe a pastor could assist you. Maybe you could find a social worker. Depends on the community. Don't be too passive. Do something and do it in a way that shows respect for the adult in the person you are trying to help. That is my advice.

Mental hospitals used to be dismal places. I don't know what they are like now. But I understand that a lot of them have been closed. In some cases, that is a very sad thing. In others, it is good.

I have a dear friend who has had terrible psychiatric problems. I see her a couple of times a week. Only recently have she and her doctor found the "right" medication, one that gives her a lot of good days. Even though she still has tough days, I am just so happy for her. I always give her a hug and let her know that I am happy that she is more present and with us now than she was before. It is a simple thing, but she knows I really mean it, and that makes her feel happy too.

It is important, in my uninformed opinion, to let a person with psychiatric problems know that you see their humanity through the self-centeredness and fear that psychiatric problems may inflict on them. That's my opinion for what it is worth. I hope you find the right answer for you.