Original SDMB thread - How can you be committed against your will?


In most of the United States and much of Europe, you can be committed for having, in the opinion of two psychiatrists (one admitting, one concurring), signs of a mental condition that could make you a danger to yourself and/or other people. Furthermore, a police officer can detain you for suspicion of same without arresting you oharging you with any crime and remove you to a psychiatric facility for immediate evaluation. If, in the opinion of the two shrinks, you seem to be a danger to yourself or others, you can be held for up to 30 days before being entitled to a hearing in a mental hygiene court, which in theory means that if they feel they need to keep you longer, they have to prove why in a court of law, but in practice means you appear before a mental hygiene judge, most of whom tend to believe that, by definition, "the psychiatrist would know best".

The flip side of this is that there is limited hospital bed space in the bins, so unless you are actively disturbing someone or worrying someone with your behavior, or actually DO (or threaten to do) something dangerous, you aren't likely to be incarcerated involuntarily. Also, for the same reasons, you will most likely be discharged soon unless you are a major problem inside (e.g., violence against staff members, etc).

In theory, "danger to self" is supposed to mean literal and immediate. In practice, it can be and has been stretched to include everything from going out into the cold underdressed to adopting an unprofitable lifestyle and obtaining a job inappropriate for one's station in life.

The flip side, once again, is that if you are homeless and destitute, you could starve and freeze on the outside of the door to Bellevue and they wouldn't commit you, but if you are, let's say, the wife of the Superintendent of Schools in your district and you begin behaving inappropriately, like perhaps mentioning in public that your husband beats you up or something like that, you could find yourself in an environment with locks on the doors and bars in the windows and without shoestrings, belt, or credibility.

Incarceration invariably fails to help those who need help, aside from immobilizing them somewhat, and post-discharge aftercare is nonexistent for the most part, which would be horrible except that the care that the profession is capable of providing tends to cause permanent brain damage while failing to fix the problems, so that is actually for the best.

These circumstances persist because of very little money being devoted to providing truly nurturant care environments and because the profession and the pharmaceutical industry is heavily invested in a non-working paradigm, the "medical model of mental illness", which data has failed to support over the last 125 years, i.e., they continue to believe in the existence AS DISEASES OF BRAIN OR BRAIN CHEMISTRY of specific ailments called "schizophrenia", "depression" and "bipolar disorder" (aka "manic-depressive psychosis") when by the normal standards of inter-rater reliability and causal etiology and diagnostic acumen, they cannot be said to exist. (What we have instead is a lot of human misery, a few observed patterns that it tends to take, mixed results from a variety of medications, and a hell of a stigma.)

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