Our insane mental health laws

[LiberalEsto]

Imagine that you have a 20-year-old, 220-pound son living at home. You're a single mom with a younger daughter, and you are not physically strong enough to stand up to him. (This is completely fictional)

Imagine that the son doesn't work, but wanders around all day in his pajama pants. He curses and mumbles to himself. Sometimes he gets angry and pounds on things. He throws glass and cups, not at you or your daughter, but against walls. Everywhere he goes, he leaves a colossal mess. He breaks furniture.

His room is a forbidden zone, but you can hear him tapping away at his computer, sometimes all night. Weird smells come from the room, but you can't go in to investigate. He has no friends, but complains constantly about having many enemies. He hears voices that tell him to do strange things, like disconnect the phone or let water run out of the tub and flood the bathroom. You never know what he will do next.

You and your daughter are terrified of him, and you call the police. But there is NOTHING the police can do, unless he is a danger to himself or others. Unless he waves a knife at you or your daughter, or threatens to kill you, you are out of luck.

Your daughter runs away because she can't stand living in this nightmare. She's picked up and charged as a juvenile for being a runaway. But nobody can or will help you deal with your son, because of our insane mental health laws. Law enforcement officers' hands are tied. You don't dare throw him out,for fear he will attack you. You can't afford to move away or send your daughter to a safe place.

You are trapped.

Even if your son does hit you or threaten you or threaten to kill himself, the most that can be done is that he will be committed for 72 hours. Even then, he,like the Virginia Tech murderer, can find ways to leave the hospital after one day there.

Why on earth are the laws concerning the mentally ill so completely insane? Why do we have to wait for an ill person to actually cause harm, or threaten to harm, when there are multiple, obvious signs of disturbance?

Why are obviously disturbed mentally ill people allowed to wander homeless on the streets and public libraries without receiving help, just because they are not an immediate danger to themselves and others. This is a bloody cop-out.

Why can't the laws be changed to expand criteria for involuntary commitment? And why can't people like this be involuntarily committed for up to 21 days, on a judge's order, following a psychiatric examination and testimony from witnesses?

And by the way,why do universities and colleges hide behind "privacy laws" to avoid notifying family members when a student exhibits signs of severe distress? I believe this policy is completely and utterly wrongheaded, and can (as it did) jeopardize the lives of others.

Why?
Because we're cheap, and lazy, and scared of lawsuits, and we use words like "privacy" and "patient rights" to excuse our society of the obligation to care for the seriously mentally ill and their exhausted families.

Dumping people on the streets and shutting psychiatric hospitals was a dandy way to save money in the 1970s and 80s. The cheapskates came up with nice euphemisms like "community-based care," but very little of such care actually materialized. That's why there are thousands of mentally ill homeless people around, and no clue what to do with them.

As a journalist years ago, I investigated conditions at state-run psychiatric institutions and was subpoenaed by a legislative commission to testify about what I saw. They used this as evidence to shut down the places instead of working to improve them and make them humane.

Our society lets corporations pay their CEOs obscenely high salaries while they lay off thousands of employees. We let oil companies raise gas prices and rake in record profits off our backs.

But attempt to create and operate a sensible, humane network of care and protections for the mentally ill and their families? No. We're too damned cheap.

[Warpy]

1. The problem is that "danger" is interpreted far too tightly

Danger to oneself should be applied to lost souls out on the street who can't fend for themselves properly and who die of exposure all too often.

Danger to others should be the situation you described. Mom should be able to call the cops and get him committed, evaluated, and put on appropriate medication because he really is a constant threat to her well being.

It's not just suicide or assault, folks.

[Joe Chi Minh]

24. It would have to beaid for out of the pork. No bridge to nowhere in Alaska.

Where are your priorities?

[Lindsey]

2. I'm emailing Boxer & Feinstein today and calling....

This was what I talkin' about when all of this happened. I work at a small(pop. about 520)career college and the student privacy is a hugh thing. I've had parents call and have had to explain to them that I can't say anything unless the student authorizes it. The parent will say they are paying for it and I have to say it doesn't matter.

I also have an very mentally ill sibling and my two other siblings who live close to her are having a horrible time figuring out what to do with her. We've know for the past few years how the system is almost completely broken ( to put it mildly).

FYI - Tipper Gore's "cause" as First Lady" was going to be adressing the mental health-care crisis.

[ThatsMyBarack]

4. Imagine that!

If * hadn't STOLEN office! :grr:

[rhiannon55]

3. I have a mentally ill daughter,

and I know from personal experience how hard it is to get any real help for her (and our family). It has been a 27 year nightmare with no end in sight. I also know several mentally ill people in my town who sleep in allies and on park benches because no one really gives a damn about them. I would bet that a high percentage of homeless people are mentally ill.

Kicked and recommended.

This issue needs to be addressed. Mental health laws in this country are a joke and a travesty.

[LiberalEsto]

5. My deepest condolences to you

It sounds like you are living a nightmare. I hope a way opens for you to get assistance for yourself and your daughter.

One of my childhood friends is bipolar and has been hospitalized many times after creating absolute havoc. It took a long time to convince her parents - who were initially in denial -- that she desperately needed medical help. Her parents have passed away, and the only thing between her and the streets is a live-in boyfriend who has struggled to care for her for at least a decade.

Another dear, longtime friend has a 27-year-old mentally ill daughter who has a 5 year old autistic son. My friends are getting on in years and I dread what might happen once they aren't around to help.

There is no safety net for the mentally ill in our country, nor is there help for their families, nor is there protection for society.

[truedelphi]

10. My prayers are for you. What a tough row to hoe.

Close friends also are in this situation - to have a child that would be so beautiful if not so destructive, and to have these hellish laws thwart a well-intentioned family from getting the help needed.

[truedelphi]

11. Message moved by Delphi - submitted in wrong place

[bleedingheart]

6. because no one cares until it happens to them.

and that has always and will always be the case...

Hell my community is trying to defund its own library to save $30 a household in a middle to upper class neighborhood...

You think these people want to pay for proper mental healthcare? Nope...

As each year passes my faith in humankind diminishes...

[TahitiNut]

7. Who among us is in perfect mental health?

In my life, I've probably met a handful of people whose emotional and mental health seemed to be without the multitude of pathologies in which we swim. Codependency, low self-esteem, overcompensation, projection, bigotry, antisocial attitudes, and a plethora of neuroses seem to be today's 'mormal'. It's like our physical health. Who's not obese, cold- or flu-ridden, withut sinus infections, withut dental caries or gum disease, without warts or fungus infections, and a multitude of maladies we regard as 'normal'?

I'm not complaining, mind you ... I embrace my fellow nuts and fruits. :silly:

[kineneb]

8. dealing with similar issue now

Our goddaughter("Iz") suffers from manic depression (bipolar), on disability and turned 18 in Nov.

-her father killed himself almost 3 years ago
-her mother died from liver cancer in Jan.
-apparently Iz stopped taking her meds shortly after she turned 18
-her grandparents took her in after her mother died, charged her room and board, and when they couldn't get along with her, threw her out
-In March, we took her in and are now getting her assistance through local County Mental Health
- she will not be able to live with us either, because she requires more care than we are able to give, so we await the MH people placing her in a better situation (probably a board and care group home)

We are lucky that she is not violent, but mostly depressed. Also, she had lived with us for 3 months when she was much younger. We had to get in her face and establish (again) that we were the bosses, and that as long as she lives in our house, she must follow our rules.

You can lead a horse to water, but you cannot make him drink.

[EFerrari]

9. Exactly, LiberalEsto. K&R

:yourock: :yourock: :yourock: :yourock: :yourock:

[truedelphi]

12. I am wondering - are these laws state by state?

I am wondering - are these laws state by state?
Edited on Thu Apr-19-07 09:05 AM by truedelphi
I was watching a Court TV murder mystery, and the mentally ill woman that later went on to kill her husband was incarcerated by the husband after a serious attempt at suicide. She stayed ninety days or so in a facility in Texas.

In California, even serious suicide attempts only get an individual one to three days in a facility.

Then they are released to family and the family has to be ever vigilant.

It really sucks.

[johnnie]

13. I understand what you are saying and agree to a point

My question is *why* are so many people mentally ill? Just reading through these threads the last few days and seeing "I was diagnosed with..", "My brother, sister, child, father, mother, aunt, uncle, friend and so on....." is quite scary. Everyone either has been diagnosed, knows someone who has or knows or knew someone who wasn't and was let down by the system.

The anti-depressant industry is a multi-billion dollar a year industry in the United States, top selling books are the self-help type books and every other person is seeing an analyst. I am in no way saying that mental disease does not exist, but I think we need more studies in prevention. Why are there so many people with mental illness in this country? Are other countries seeing the same thing? Is there a obvious rise in the cases of mental illness? Is there something wrong with our diet, air, water or something else?

I agree with you that right now our system is not working very well, but I think we also need to start discussing prevention too. Is it normal to have so many people with a mental disease?

[Mend]

18. when I first became a doctor thirty years ago, fully one-half of the

hospital beds were occupied by the mentally ill. They (those government people who don't want to spend money on social issues) took away the beds, the hospitals, the half-way houses, the insurance money, and left the mentally ill to either cope on their own, rely on their families, or die.

[tomp]

bingo! nt

[tomp]

30. self-delete

[nannah]

14. the "fictional" story above is replicated in real life over and over;

you painted a sadly accurate picture of life with a psychotic, adult child. families cope as best they can. it is crippling.

by trying to make everything in life competitive and profit making, we have ignored issues that can't be turned to a ready cash flow. what we are reaping now is the logical end product of the unsustainable, comptetive, winner take all world in which we live.

[kiahzero]

15. For a lot of it, there isn't a viable alternative.

The mentally ill are still people, and they still have constitutional rights.

[LiberalEsto]

16. And so do their families

but nobody is protecting or helping the families, or society.

The people at Virginia Tech had the right to life, liberty and the pursuit of happiness.

But their rights were smashed to smithereens by someone who had the constitutional right to buy a gun and the constitutional right to evade being committed for psychiatric evaluation for, say, 10 to 21 days upon having a judicial hearing.

Constitutional rights are great, but sometimes one has to weigh rights against reality. The Constitution does not guarantee the right to make life a nightmare for others.

[kiahzero]

20. That's a right against individuals.

What you're arguing is that the government would have the right to detain someone at any time without committing a crime. Tell me - how do you feel about Guantanamo? Because that's what you're affirming here.

[LiberalEsto]

25. How do you feel about Virginia Tech?

Because that's what you're affirming here.

[kiahzero]

27. I think the instant background check failed.

His purchase of weapons was a violation of federal law, but the gun dealer didn't know because the system failed somehow.

[pitohui]

33. i feel gitmo happens more often than v-tech

i think we have to err on the side of civil liberty or this is not america

if we lock up everyone some paranoid ass thinks is "too quiet" or some moronic excuse for an english teacher thinks writes fiction "too disturbing" this country is not going to be worth living in for many millions of people

[hfojvt]

17. I can tell you one other reason

Because many of us would rather not be involuntarily committed at the drop of a hat. Who is gonna decide? Are my dysfunctional parents gonna be able to commit me if they feel like it? What about an ex-girlfriend?
What about somebody who does not like my bumpersticker? (This reminded me, because my friend with the mental health issues who was selling anti-bush bumperstickers. I got a couple from him that said "Really support our troops. Don't let them die or kill for oil". He claims his mental health issues started when he had to live on the streets, said much of the town was against him. Paranoid, right? But we went to Pizza Hut once and I noticed that the town's mayor was just glaring at him the whole time.)

Bang. In you go, involuntarily committed for 21 days. Very profitable for the mental institutions too, if they can keep you there. They get paid $600 a day for each patient. (I got this number from a street person who has mental health issues, and said they would have kept him if his uncle had not intervened.) Then what happens when you get out? In a small town, everybody's gonna know you went in, and they will have nothing better to talk about. Kids and teenagers will harrass and taunt you on the streets. You will lose friends, employment prospects, etc., etc. Might as well leave town and start over, but if you apply for another job, you need to put that on your application or they will find it in a background check.

As Ted Bundy and the Boston Strangler showed, some of the craziest people are very good at seeming normal. What you describe seems to me like an easy way to stigmatize the already outcast.

[LiberalEsto]

19. We do need safeguards

"Why can't the laws be changed to expand criteria for involuntary commitment? And why can't people like this be involuntarily committed for up to 21 days, on a judge's order, following a psychiatric examination and testimony from witnesses?"

I never said someone should be committed because their dysfunctional parents say so, or because someone doesn't like a person's bumper sticker.

I never said we just need to lock people up.

We need a system where an individual's right to freedom is weighed by a combination of judges, physicians and witnesses. And I don't mean we need to lock people up and throw away the key. Why not a 10 or 21 day commitment?

Things are severely out of balance. We need to protect the rights of others too.

[hfojvt]

21. because the stigma of the ten days, or even the accusation

would be trial by media. Witnesses can lie, have their own agenda and problems, as can judges and psychiatrists. Remember the scenes from "Good Will Hunting" when he talks to several therapists? Imagine the power, and the potential for abuse with those 3 or 4 psychiatrists with the power to commit anybody. Maybe I am just reliving an episode of the "Rockford Files" when Jim got drugged and put into a mental institution. Keep him drugged, and he always seems crazy.

I don't trust their profession any more than Tom Cruise does. I have known too many people who it seemed were getting as much messed up from their meds as they were getting helped.

I am just saying. Most people who know me, do not consider me 'normal'. I think I am a mild Aspie, but does that make me dangerous, mentally ill any more than the steady stream of people who have felt the need to pick on me?

[TexasLawyer]

22. Re the Virginia Tech shooting--

I just posted this re the debate on gun control laws:

I think the bigger debate should be about the state of mental health care in this country. This guy obviously needed mental help-- perhaps a long-term stay somewhere where he would not harm himself or others-- and oversight by mental health professionals-- but didn't get it.

I have mentally ill children myself, and my insurance covers very little of my expenses for them. Nothing seems to warrant long-term care, including their jumping out of moving cars, suicide attempts, holding chef's knives in family members' faces, etc... All of which have happened in my household and all of which have elicited a big "ho hum" by my insurer and by public service providers.

Public services for the mentally ill, especially long-term inpatient treatment, is practically non-existent.

[ourbluenation]

23. but do you force someone into a long term stay against their will?

and if so, who decides and on what grounds? I'm a relatively sane person, but if someone tried to have me committed I'd go ballistic and would "appear" out of control. I see a lot of problems with this. Dont know what the answer is. I have a friend who's brother is mentally ill. They have tried to set him up in an apartment several times but he prefers the streets. He won't stay on his meds.

[LiberalEsto]

26. As I wrote earlier

"We need a system where an individual's right to freedom is weighed by a combination of judges, physicians and witnesses. And I don't mean we need to lock people up and throw away the key. Why not a 10 or 21 day commitment?"

[pitohui]

34. good, i vote you are committed for 21 days first

since you say "why not?" and this is fine for everybody else, it should be fine for you too

jeesus, seriously, what's wrong w. people?

you go in for 21 days and get back to us, okay?

[JVS]

35. I agree. Her ideas are clearly an indicator of insanity. Lock her up.

[LiberalEsto]

41. Please let's have a civil discussion

about the issue.

If all you can say in reply to what I hope was a calm, reasonable opinion is "Lock her up," then perhaps you should consider switching to another web site. I welcome civil feedback from people who raise legitimate objections.

But I also notice that those posters who have direct experience of family members with mental illness generally agree with me.

[pitohui]

46. asking you to have empathy IS a civil discussion

anyone who calls to take away the freedom of another should be willing to undergo the same restrictions

you are willing to have some incarcerated on suspicion for 10 to 21 days, it is only right and fair that you go first and experience what this does to your life, to your ability to get a job or insurance, and to your lifelong financial future, which will almost certainly be one of poverty

until you have "been there," don't suggest this for others just because you think they are odd and you want them controlled

it is wrong and it is unamerican

[LiberalEsto]

39. Please read my post #38

because I have some direct experience with this issue.

Please note that I never said people should just be locked up.

I said people should be carefully evaluated by judges and doctors.

And if I were mentally ill enough to require hospitalization, I certainly hope my family would do what was necessary to get me treatment so i can recover.

[Occulus]

42. Employers will use it to deny jpbs

Guaranteed. Landlords' insurance companies will tart telling their policyholders they have to start doing mental health screening of prospective tenants.

That's only two I can think of at the moment- I just woke up- but I've said on another thread I'm sure I could come up with an even dozen terrible unintended consequences to such a set of laws. In our society, even a 10-day stint in a mental health ward could/would be enough to deny a person all sorts of things from all sorts of sources for years.

In other words, the stigma is alive and well and you would not believe how many people would be willing to treat people known to be mentally ill as "lessers"- even if it's someone who outwardly seems perfectly "normal".

People on this thread are frustrated by the privacy rights of the mantally ill, but I don't think they're conidering the unintended consequences of such laws- consequences suffered by the very people they are very laudably willing and eager to help. It's a problem I can't seem to be abe to guess a solution for- how do you kill a social stigma?

[LiberalEsto]

44. There's already a social stigma

privacy laws notwithstanding.

Perhaps we need to pass laws prohibiting such discrimination.

[pitohui]

45. they could not even buy private health insurance around here, maybe never again

10-21 day stints in a mental ward would be a very easy way to guarantee long-term financial destruction of the life of some enemy you disliked or alternately some family member or spouse you wanted to forever be able to control

the reality is that even this brief a stint would change the person's options and opportunities forever, and not for the better

i don't want my life destroyed because some fuckwit or control freak thinks i am odd, and i am not willing to live in a society where it is routine to lock people up for 2 or 3 weeks because someone thinks (or pretends to think) someone else is odd

unfortunately i don't want to hire people who might have a mental illness either, don't want em on my company health plan, don't want the legal liability if they ever do go postal, so once someone is put in that category of "might be" fishy, i see the employers and insurers point of view of they can't afford to take a chance

there is reason it is hard to commit people these days, it's because it was terribly abused when it was easy

[MLFerrell]

28. Our commitment laws are stringent for reason: to prevent abuse.

How easy it would be for a family member with a grudge to "invent" a troubling history of "mental illness" in order to get someone committed?

VERY easy. The laws concerning involuntary committal may seem too lenient, but personally, I'm glad. There's simply too much potential for nefarious individuals to use alleged mental instability as a means of exacting revenge.

[tomp]

29. we have to be very careful about the rights of the person...

...in question. i think we should have an intermediate step between committment for evaluation/treatment and complete freedom to do whatever one wants. how about a family is allowed to request a mandatory counseling session with professionals--just a sit down to try to work things out, step by step, with eventual commitment in only the most recalcitrant people. people need help, to start.

[pitohui]

31. you never heard of a restraining order and tough love?

your son is of age, you are not required to house him, if you love your daughter, you throw him out and get a restraining order so he don't come back, the rest is up to him

you are not required to let any adult who is not your spouse live in your house, period

next question?

instead of taking responsibility for securing your home, you want to change the law so that anyone at any time can have a person accused of being mentally ill and locked up w.out recourse for years or decades, we had that for most of the 20th century

it was righteously abused

one of the most awful cases, it turned out a woman was locked up, as mentally ill, until age 84 when they discovered that she wasn't ill and speaking an imaginary language but was in fact from the ukraine and speaking her own language, but her entire life was stolen and she couldn't get it back

jesus, next question? 72 hours is enough for a jealous boyfriend or evil abusive spouse to steal from you, in the olden times they could steal your whole life by accusing you of being mentally ill

[LiberalEsto]

38. Did you really read what I wrote?

It was a FICTIONAL example, based on stories I've heard from people I know, from cops I know, and from articles I've read about families dealing with mental illness.

Let me tell you a TRUE story. In 1972,when I was 19, I came home from my sophomore year of college to find my mother exhibiting many symptoms of paranoid schizophrenia. I had just finished an abnormal psychology class in which we did field work with patients at a state psychiatric hospital, so I recognized what was happening. I was frightened and alarmed.

My father was deeply depressed and in complete denial and unwilling to do anything for Mom. I called my professor, who guided me through what I had to do to get her evaluated and treated. I raised hell with my father until he consented to take her to a mental health clinic for evaluation.

The doctor at the clinic agreed that she had paranoid schizophrenic symptoms. They urged my father to have her hospitalized and treated. Mom was taken to a local hospital with a pretty good psychiatric treatment program.

Within a couple of days, the doctors there found out that she had kidney failure, and that her symptoms were due to the toxins that were accumulating due to her kidneys' inability to process and excrete them. She was placed on dialysis and a low-protein diet, and her mental symptoms gradually cleared up.

I SAVED HER LIFE by insisting that she be evaluated and hospitalized for treatment. If I had not acted, she would have died of kidney failure in a matter of days or weeks. Thank heaven for her smart doctors at St. Joseph's Hospital in Paterson, NJ.

For years I helped the family of a close lifelong friend who is severely bipolar, and who has had to be hospitalized numerous times. Hospital treatment has saved her life many times over.

I have volunteered at psychiatric facilities, and later, as a newspaper reporter, investigated one state psychiatric hospital for its woefully bad patient care. I myself have suffered severe depression and been successfully treated for it, although never hospitalized.

Would you deny treatment to someone who has cancer? People who are mentally ill, or who have symptoms of mental illness due to other physical illness, deserve treatment. Hiding behind "civil liberties" to avoid taking responsibility for treating them is a cop-out.

[pitohui]

47. now i will tell you a true story

my friend's dad was diagnosed with clinical depression and locked in a mental institution for several months in the 1960s

my friend's dad did NOT have clinical depression, he had colon cancer which went untreated while they kept him in a wrong hospital over a period of months treating a mental illness that he didn't even have!

by the time they corrected the diagnosis and set him free, it was too late, he died

i am not willing to trust the old time system where being sad and quiet was enough to lock someone up for months, years, or even life as depressed person causing a "danger to themselves and others"

if you are with that system, fine, seek it for yourself and yours

do NOT seek it for me and mine or to make this a rigid law

more people will be destroyed than will be saved

people worked very hard to end these long involuntary stays for a reason, they destroy lives and futures

[piedmont]

32. Having dealt with the mental health care system, I WOULD NOT TRUST IT...

enough to give it more power to lock people away for any length of time.

[blogslut]

36. The same goes for VOLUNTARY commitment

Even when a person recognizes they are a danger. Unless they lie, unless they tell the facility that they intend to do harm to them self or others, they will not get the help. And then, they only get about four days of 24/hr treatment (when uninsured - the insured get as long as their coverage covers). After that, they're back on the street, with a month of meds and a promise that they will return for counseling.

[JVS]

37. Way to fearmonger against the mentally ill!

[WinkyDink]

40. No need to qualify it with "mental".

[insane_cratic_gal]

43. Your not even touching the insurance issues

and how crappy the coverage is! I think my own insurance covers about 90 days out of year for mental help. After that you pay out of pocket.

I work in an ER, I see it everyday. People desperate to help their loved ones, but their hands are tied unless that patient states anything about hurting themselves, or they are a cutter.

when they 302 (involuntary commitment) the insurance refuses to pay. leaving the family and patient with a bill.

It's just a nightmare all around.

[mdmc]

48. the 20 year old son could legally be evicted

If he refused hospitalization, the mom could have him evicted from her home. The laws don't need to be changed. Mom needs to stop being a victim. There are no easy answers.

I agree regarding de-institutionalization. I agree that politicians have damaged our collective mental health. It is very much a shame that America is too damn cheap to deal with mental illness.