Original SDMB thread - Psychology, the law, and being committed


This is why the psychiatric inmates' liberation movement wants "mental health" commitment to refer back to the more general laws for declaring someone incompetent.

There are decent safeguards built in to prevent Creepazoid Pennybags from having Rich Uncle Pennybags declared incompetent just because he wants control of his uncle's estate.

There is no reason and no excuse for a shadow process to exist for treating someone as incapable of making their own treatment decisions solely because they are alleged to suffer from a "mental illness". If I am schizophrenic (and the doctors did say that I am, which is pretty much the functional definition of it if you see what I mean), but cannot be shown to be incompetent through the workings of a regular competency hearing, then my schizophrenia, and my decisions about treatment or lack thereof, are my business and no one else's. (Similarly, if I enjoy the mental condition I'm in and turn down offers of psychiatric treatment and then go on to commit crimes, I should be subject to the same laws and punishments that would be applicable to a non-schizophrenic committing the same crimes).

Commitment hearings in NY basically work like this: a special mental hygiene court that only hears cases of this nature is convened, often right on the grounds of the psychiatric hospital; the psychiatrist's testimony carries the weight of expert opinion, and, since the hearing is occurring at all, that means the psychiatrist is going to say that the subject of the hearing is mentally ill and lacks insight into his or her condition (and is therefore/and/or) is a danger to him/herself and/or others. The subject of the hearing gets to explain, as a nonexpert whose testimony is not impartial and is already impugned as psychotic babbling, why he or she does too have insight into his/her condition and does not need or want psychiatric treatment (a difficult maneuver when "lack of insight" is defined as "doesn't understand the need for treatment").

Volunteers from Mental Hygiene Legal Services are appointed to represent the subject but many are undertrained and often do not take an adversarial role (i.e., do not argue and present evidence supporting the subject's right to refuse forced treatment). A strategically savvy subject with the wherewithal to pull it off will have obtained an independent psychiatrist's opinion (therefore coming in with a dissenting expert opinion) or, lacking the connections/money to do that, will request independent evaluation in a separate psychiatric setting rather than using the observations of the doctor or other doctors at the same facility to support the doctor's position.

Some judges are good and fair, many are rubber-stamp weilders, and more than a few are dedicated to the principle that it is the court's responsibility to keep all lunatics locked up for the protection of the community.

In NY, if anyone other than a police officer draws the attention of a psychiatrist to your questionable behavior and the psychiatrist decides that you may be in need of treatment whether you agree or not, the psychiatrist can have you taken by the police to a psychiatric facility where an admitting psychiatrist will supply the second concurring psychiatric opinion (usually automatically, though it isn't supposed to be), and then they can hold you for 72 hours' observation before designating you as "involuntary". Only after you have been deemed "involuntary" is a commitment hearing scheduled, so it doesn't occur immediately.

If, on the other hand, a police officer observes your behavior and decides that you are nutty and dangerous (to self or others), you can be taken and held in a psychiatric facility for 30 days before they are obliged to convene a hearing.

The psychiatric facility is not obliged to present you in the courtroom in an undrugged state or in street clothes, so at your commitment hearing you may be in hospital robes and slippers or even in a straitjacket, and if, in the hours prior to your hearing, a psychiatrist or staff nurse thought medication was called for, your brain may be full of Prolixin or Haldol.

The judge is not obligated to speak to you or allow you to speak in your own hearing, and some do not.


See my next post on this same thread


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