Good question.
Too bad trying to kill yourself isn't like high blood pressure.....
Too bad there's not a suicide cuff that can be strapped on and pumped up... But, of course there isn't such a thing.
A few things that might give some insight into the intent, if any. Did the person think whatever they did was lethal? If a person took pills and felt that they would die, whether the dose was lethal or not, that might well be an attempt to die.
How did anyone find out? You know, if they took a bunch of pills, how did they end up at the emergency room? Usually, the person calls someone. Is that an attempt to die? No. Of course, the problem is, they may have taken enough pills or what-have-you to cause physical damage. They obviously didn't want to die (they called someone) but their behaviour is so reckless that they may pose a danger to themselves.
Someone who drinks a lot poses a danger....not that they necessarily want to die or kill themselves, but the drinking can dull everything to the point that they don't know what they are doing. They pose a danger to themselves as they may accidentally take an over dose or play with a gun....and so on.
OK wise guy. What in your opinion constitutes an attempt to kill oneself?
An easy example. Fred and Sarah have been married for 20 years. In the 20 years Fred has worked for the same company and his schedule is as predictable as the trains in Singapore. He leaves the same time every morning and returns home the same time every evening.
Give or take a few minutes, he, for the last 20 years has left his home at 8:00AM and give or take a few minutes, he returns home at 5:30PM. As usual, today Fred kissed Sarah goodbye, and left their home at 8:02AM.
As soon as Fred leaves, Sarah grabs a bottle of vodka, and scoops up all of her medication in addition to everything that's in the medicine cabinet, aspirin, Fred's heart medication and so on. Every pill she can find. She puts on the hifi to a classical music station, sits in the middle of the living room floor and starts taking the pills and drinking the vodka. A couple of hours after Fred leaves, Sarah is sprawled in the living room in a coma-like state.
Fred, in the meantime, realizes that he forgot an important presentation that he has to have for an afternoon meeting. He speeds home and finds Sarah unconscious.
Yes, ladies and gentlemen, that is truly an attempt.
Tuesday, July 31, 2007
Monday, July 30, 2007
So and So Tried to Kill Themselves......Is it a Cry for Help? Most Likely Not....
First, you need to define, tried to kill oneself?
Sadly, most of the poor folks who do want to kill themselves, well...they kill themselves. They normally don't call someone. It would also seem that if someone, for whatever reason, has decided that they are going to kill themselves, it may well be impossible to stop them.
Most of what is seen in the emergency rooms and most of what emergency services sees....and other folks in the community, counselors, fire fighters/paramedics, police and so on....at best are gestures. My small dictionary says in part, a gesture is...something said or done for its effect on the attitude of others.
We often say, So and so tried to kill themselves. It's a cry for help. Well, it might be, but it's most likely a cry to manipulate? What are you talking about? Good question.
Normally, the person who makes a gesture wants to bring attention to themselves. They want folks to know that everything isn't going like they'd like. Someone can be extremely depressed and this is their way of letting people know. Some people sadly, learn that a gesture is a way of getting attention and they do it over and over. That they do.
Many folks do it to try to manipulate. There's something in their environment that they want to change. Most likely 60/70% of gestures have a boy friend or girl friend element to it.
So and so just broke up and this is their way of trying to get the person back.
Sometimes the gestures are the equivalent of a magician's misdirection. Yes, the person is trying to move the focus from one place to another. As an example, let's say Fred, on the way home with his pay check, decided to blow it on crack. So, he gets home and his wife or girl friend is rightly...well, mad and so on. Sooooo, attempting to move his wife's ire from his bad behavior, he claims he's suicidal, rushes to an emergency room, lays up on a gurney, and hopes his wife will come by and feel sorry for him. And, so it goes.....
Sadly, most of the poor folks who do want to kill themselves, well...they kill themselves. They normally don't call someone. It would also seem that if someone, for whatever reason, has decided that they are going to kill themselves, it may well be impossible to stop them.
Most of what is seen in the emergency rooms and most of what emergency services sees....and other folks in the community, counselors, fire fighters/paramedics, police and so on....at best are gestures. My small dictionary says in part, a gesture is...something said or done for its effect on the attitude of others.
We often say, So and so tried to kill themselves. It's a cry for help. Well, it might be, but it's most likely a cry to manipulate? What are you talking about? Good question.
Normally, the person who makes a gesture wants to bring attention to themselves. They want folks to know that everything isn't going like they'd like. Someone can be extremely depressed and this is their way of letting people know. Some people sadly, learn that a gesture is a way of getting attention and they do it over and over. That they do.
Many folks do it to try to manipulate. There's something in their environment that they want to change. Most likely 60/70% of gestures have a boy friend or girl friend element to it.
So and so just broke up and this is their way of trying to get the person back.
Sometimes the gestures are the equivalent of a magician's misdirection. Yes, the person is trying to move the focus from one place to another. As an example, let's say Fred, on the way home with his pay check, decided to blow it on crack. So, he gets home and his wife or girl friend is rightly...well, mad and so on. Sooooo, attempting to move his wife's ire from his bad behavior, he claims he's suicidal, rushes to an emergency room, lays up on a gurney, and hopes his wife will come by and feel sorry for him. And, so it goes.....
The Statistics for People Who Attempt to Kill Themselves are Most Likely Grossly Inflated
First off, where do they get the figures? Well, I'm not sure but it would seem the only place would be from the triage sheet, or something similar.
Obviously, anyone who makes an attempt to kill themselves or who claim to be suicidal, comes to the emergency room. Normally the first person who they see is a nurse who gathers information: why are you here, any allergies, taking any medications, any health problems, and so on.
So, you might ask, what constitutes a suicide attempt or what does it mean if someone says they're suicidal? On a most likely daily basis, I would imagine that larger hospitals have folks come in with scratches or superficial cuts in the wrist area who claim, they tried to kill themselves. Is it reasonable to assume that they did try to kill themselves? Nope, with a few exceptions.
If someone actually plans to kill themselves and have never cut on themselves before, it's possible that the pain that's caused when they start to cut, stops them. Yes, it's possible that they want to be dead....and merely stopped because of the pain. There are few folks who fit in this category....few. However, when someone in this category can be identified, they may well pose an imminent danger to themselves.
Obviously, anyone who makes an attempt to kill themselves or who claim to be suicidal, comes to the emergency room. Normally the first person who they see is a nurse who gathers information: why are you here, any allergies, taking any medications, any health problems, and so on.
So, you might ask, what constitutes a suicide attempt or what does it mean if someone says they're suicidal? On a most likely daily basis, I would imagine that larger hospitals have folks come in with scratches or superficial cuts in the wrist area who claim, they tried to kill themselves. Is it reasonable to assume that they did try to kill themselves? Nope, with a few exceptions.
If someone actually plans to kill themselves and have never cut on themselves before, it's possible that the pain that's caused when they start to cut, stops them. Yes, it's possible that they want to be dead....and merely stopped because of the pain. There are few folks who fit in this category....few. However, when someone in this category can be identified, they may well pose an imminent danger to themselves.
Sunday, July 29, 2007
Saturday, July 28, 2007
Drinking Too Much....Disease or Bad Behavior.....?
There are many people who consider alcoholism or drinking too much to be a disease. There are also many people who consider problem drinking to be caused by behavior and poor judgment.
There are also some folks who state that alcoholics are weak willed; sort of the morally bankrupt of our society. In fact, some folks would say it doesn’t hurt to have a few drunks around so we can see how we don’t want to be.
The AA model as well as many experts “in the field” consider people who drink in a manner that labels them alcoholic to be suffering from a disease. I guess before someone calls something a disease they should at least have a definition of what a disease is.
While I am surely not a doctor, nor do I claim to have medical training or medical knowledge, it would seem that a disease is something like cancer, diabetes, heart disease, and so on. These are maladies that we can identify through tests. And, while I’m sure that we can show some causal relationship between, say smoking and lung cancer, in general we think that we have little control over having a disease. That is, we have little or no control over getting or having a disease or getting rid of it once we have it.
Well, we’re all entitled to think what we want, but I’m on the side of saying that alcoholism or problem drinking is behavior: Period. We are alcoholic because of our drinking behavior not because we have a disease that we have no control over that makes us drink.
Now, even if we say that alcoholism is a disease and that once we start drinking we have no control over it...it still starts with our picking up the bottle...and, that folks, is behavior.
One of the major problems of calling our problem drinking a disease is that it makes us not responsible...I mean, do you blame people who have cancer for getting it? No. Do you blame people who have heart disease if it doesn’t go away? Of course not.
Do we blame people who drink more than they should and their drinking causes them problems? Well, if you aren’t, you should. Period!
It hasn't been that long ago that we called people who drank too much, bums, drunks, dead beats, and so on. I’m not suggesting that we use these terms for everyone who has a problem with alcoholic but we have sort of made it more legitimate by referring to those behaviors as substance abuse problems. Hmm. Uncle Harry, who drinks a fifth a day and beats his wife isn’t a drunk...he’s, yep folks, he’s a substance abuser who’s suffering from a disease.
Before going further one thing should be clarified. There are people who suffer from organic diseases that for all practical purposes virtually makes it impossible for them to use sound judgment. That is, the way they are effected renders them incapable of using sound judgment or doing any type of problem solving. There are many people in our society who suffer from organic disease who just don’t have the capacity to understand the consequences of their behavior. That said, I will follow up that these people are in the minority. An extremely small minority. And, if you’re one who is in this minority you surely wouldn’t be reading this.
There is also a population of seriously mentally ill people who are also incapable of understanding the consequences of their behavior. And, their judgment is more particularly impaired when they stop their psychiatric medications or mix alcohol with the medications. Here again, if you’re seriously mentally ill, I doubt that you’d be reading this.
And, herein lies one of the problems with calling problem drinking a disease...these are just hapless victims of a terrible degenerative disease who basically have no control over their situation. Yeah, that’s what many people who call themselves alcoholics would have us believe; and, want us to believe.
Anyway, don’t get too hung up on the disease vs. behavior argument about drinking unless you’re trying to excuse yours or others boozing. All you have to do is assume responsibility for your behavior, drinking and otherwise, and you are headed in the right direction.
There are also some folks who state that alcoholics are weak willed; sort of the morally bankrupt of our society. In fact, some folks would say it doesn’t hurt to have a few drunks around so we can see how we don’t want to be.
The AA model as well as many experts “in the field” consider people who drink in a manner that labels them alcoholic to be suffering from a disease. I guess before someone calls something a disease they should at least have a definition of what a disease is.
While I am surely not a doctor, nor do I claim to have medical training or medical knowledge, it would seem that a disease is something like cancer, diabetes, heart disease, and so on. These are maladies that we can identify through tests. And, while I’m sure that we can show some causal relationship between, say smoking and lung cancer, in general we think that we have little control over having a disease. That is, we have little or no control over getting or having a disease or getting rid of it once we have it.
Well, we’re all entitled to think what we want, but I’m on the side of saying that alcoholism or problem drinking is behavior: Period. We are alcoholic because of our drinking behavior not because we have a disease that we have no control over that makes us drink.
Now, even if we say that alcoholism is a disease and that once we start drinking we have no control over it...it still starts with our picking up the bottle...and, that folks, is behavior.
One of the major problems of calling our problem drinking a disease is that it makes us not responsible...I mean, do you blame people who have cancer for getting it? No. Do you blame people who have heart disease if it doesn’t go away? Of course not.
Do we blame people who drink more than they should and their drinking causes them problems? Well, if you aren’t, you should. Period!
It hasn't been that long ago that we called people who drank too much, bums, drunks, dead beats, and so on. I’m not suggesting that we use these terms for everyone who has a problem with alcoholic but we have sort of made it more legitimate by referring to those behaviors as substance abuse problems. Hmm. Uncle Harry, who drinks a fifth a day and beats his wife isn’t a drunk...he’s, yep folks, he’s a substance abuser who’s suffering from a disease.
Before going further one thing should be clarified. There are people who suffer from organic diseases that for all practical purposes virtually makes it impossible for them to use sound judgment. That is, the way they are effected renders them incapable of using sound judgment or doing any type of problem solving. There are many people in our society who suffer from organic disease who just don’t have the capacity to understand the consequences of their behavior. That said, I will follow up that these people are in the minority. An extremely small minority. And, if you’re one who is in this minority you surely wouldn’t be reading this.
There is also a population of seriously mentally ill people who are also incapable of understanding the consequences of their behavior. And, their judgment is more particularly impaired when they stop their psychiatric medications or mix alcohol with the medications. Here again, if you’re seriously mentally ill, I doubt that you’d be reading this.
And, herein lies one of the problems with calling problem drinking a disease...these are just hapless victims of a terrible degenerative disease who basically have no control over their situation. Yeah, that’s what many people who call themselves alcoholics would have us believe; and, want us to believe.
Anyway, don’t get too hung up on the disease vs. behavior argument about drinking unless you’re trying to excuse yours or others boozing. All you have to do is assume responsibility for your behavior, drinking and otherwise, and you are headed in the right direction.
Tuesday, July 24, 2007
Saturday, July 21, 2007
Why are the Mentally Ill in Jail and Criminals in Psychiatric Hospitals?
OK, calm down and take a deep breath. First to the mentally ill in jails.
more to come
more to come
The Project...The Grand Plan
A few years ago, just as the bed shortage reached critical mass, someone decided that the answer to the bed shortage was yes, partially close down the State's hospitals. Hmmm. The thinking was that, Hey, we reduce the number of beds at the state level and send that money to the communities. The communities could then purchase their beds locally. The mentally ill could stay close to their communities and therefor be close to friends and relatives. Additionally, it would make discharge planning easier, the services these folks would receive would be local.
I think though there were most likely good intentions here, possibly one thing wasn't factored it, so to speak. At the time this change was made, there was a bed shortage...that's right, everyone was having a difficult time finding beds for the people who needed inpatient treatment....so, let's close some state beds...you buy your own. Well, let's see...there are no beds....we're going to close down some of the beds at the state hospitals....and, we'll buy the beds, where? No comment.
I think though there were most likely good intentions here, possibly one thing wasn't factored it, so to speak. At the time this change was made, there was a bed shortage...that's right, everyone was having a difficult time finding beds for the people who needed inpatient treatment....so, let's close some state beds...you buy your own. Well, let's see...there are no beds....we're going to close down some of the beds at the state hospitals....and, we'll buy the beds, where? No comment.
Thursday, July 19, 2007
There's a Psychiatric Bed Shortage...Why Is That?
Hmmm. I'm not sure if there's an easy answer to this one.... Let's see. For reasons that I can't fathom, several hospitals in our area have closed. Yep, shut the doors and that's that. If you assume that most parts of the country have an ongoing increase in the population, you would expect an increase in the population of the mentally ill who may need hospitalization.
So, we have fewer beds and more people needing beds. Hey, ain't gotta be no brain surgeon to figure that one out.
See the other posts about what can be done and what the communities are doing.....
Also, see the post about who needs to be in a psychiatric hospital... And, the post about what it takes to get admitted to a psychiatric hospital.
So, we have fewer beds and more people needing beds. Hey, ain't gotta be no brain surgeon to figure that one out.
See the other posts about what can be done and what the communities are doing.....
Also, see the post about who needs to be in a psychiatric hospital... And, the post about what it takes to get admitted to a psychiatric hospital.
Are There any Problems out There?
Funny you should ask. Yes, there are a few.
There is an extreme shortage of inpatient psychiatric beds. Yes, it's an ongoing problem, having the mentally ill who need to be hospitalized...and no beds or no one willing to accept them.
If a doctor requires medical clearance and the person isn't in an emergency room and doesn't want to go, that is a problem. Surely, if you can force a person against their will to go to a psychiatric hospital, can't you force them to go to an ER? Nope.....
Most likely well over 95% of the police officers and paramedics are quite accommodating in assisting with patients who need hospitalization; however the few who aren't are a pain in the butt. Often times an officer will say, You got papers? (meaning TDO)...implying that they can't act without the papers.
Will cover the above in more detail.
There is an extreme shortage of inpatient psychiatric beds. Yes, it's an ongoing problem, having the mentally ill who need to be hospitalized...and no beds or no one willing to accept them.
If a doctor requires medical clearance and the person isn't in an emergency room and doesn't want to go, that is a problem. Surely, if you can force a person against their will to go to a psychiatric hospital, can't you force them to go to an ER? Nope.....
Most likely well over 95% of the police officers and paramedics are quite accommodating in assisting with patients who need hospitalization; however the few who aren't are a pain in the butt. Often times an officer will say, You got papers? (meaning TDO)...implying that they can't act without the papers.
Will cover the above in more detail.
I Don't Buy This no Bed Business! Surely You Can Send These Folks to the State Hospital....
That's a good question...you'd think so, wouldn't you? After all, isn't the State supposed to provide treatment for those who have no insurance or have no other hospital to go to?
more to come.......
more to come.......
OK, This is the One. Yep, Joseph Heller is Turning Over in his Grave.....
OK. Listen carefully. A mentally ill person is seen on the street at the request of the police department. OK. Just for the sake of this illustration we will assume that this person is seriously mentally ill and needs immediate hospitalization. Hmmm. That sounds simple enough. OK..... still with me. OK. Call hospital A, B, C and there are no beds. Call hospital D. Yes, they have a jillion beds. However, they request medical clearance. Hey, nothing wrong with that. They want the person to go to the emergency room, have lab tests and such to make sure they have no serious illnesses that would make them not a candidate for a stand alone hospital.
Hmmmm.
OK. Listen carefully. It is possible to get a Temporary Detention Order...that has at the bottom a check that says, a direct quote from the order, "For medical evaluation or treatment as may be required by a physician at the temporary detention facility."
OK. That seems to make everything, OK. Well, it doesn't as the hospital says, Hey, get them medically cleared and we'll see whether or not we'll admit them. Hmmm.-
Hmmmm. Let's see. If the hospital says, Yes, we'll accept with medical clearance the mentally ill person can be taken to an emergency room to have whatever tests are required. If the person is medically compromised so to speak, they will be admitted medically and that's that. They will not go to the psychiatric hospital.
However, if the hospital will not accept them subject to medical clearance...nothing can be done. If the mentally ill person states they won't go to the ER, the police have no legal way of taking them...and, ultimately, they will be released to the street. That's a pretty good system, hey...
Hmmmm.
OK. Listen carefully. It is possible to get a Temporary Detention Order...that has at the bottom a check that says, a direct quote from the order, "For medical evaluation or treatment as may be required by a physician at the temporary detention facility."
OK. That seems to make everything, OK. Well, it doesn't as the hospital says, Hey, get them medically cleared and we'll see whether or not we'll admit them. Hmmm.-
Hmmmm. Let's see. If the hospital says, Yes, we'll accept with medical clearance the mentally ill person can be taken to an emergency room to have whatever tests are required. If the person is medically compromised so to speak, they will be admitted medically and that's that. They will not go to the psychiatric hospital.
However, if the hospital will not accept them subject to medical clearance...nothing can be done. If the mentally ill person states they won't go to the ER, the police have no legal way of taking them...and, ultimately, they will be released to the street. That's a pretty good system, hey...
Want to Know What Might be a Secret About Stand Alone Hospitals?
OK, folks. Just between you and me. There may not be no doctors in a stand alone hospital..... Hmmm. Ok, don't panic. Let me explain.
No doctors, what the heck are you talking about???
Calm down.
Yes, the doctors come in the morning and make their rounds. Yep, see the patients and so on....write orders and such. But, they are pretty much outta there by noon.
Well, who in the heck is left if there are no doctors? Hey, relax. There are some nurses.
If there is a medical emergency the person is sent to the closest emergency room.
Hey, just because they ain't got doctors there 24/7 doesn't mean you shouldn't go there. Just thought you might like to know.
No doctors, what the heck are you talking about???
Calm down.
Yes, the doctors come in the morning and make their rounds. Yep, see the patients and so on....write orders and such. But, they are pretty much outta there by noon.
Well, who in the heck is left if there are no doctors? Hey, relax. There are some nurses.
If there is a medical emergency the person is sent to the closest emergency room.
Hey, just because they ain't got doctors there 24/7 doesn't mean you shouldn't go there. Just thought you might like to know.
Are all Psychiatric Hospitals the Same? Well, Yes and No.....
Think you can say that there are two types of psychiatric hospitals. There are the medical surgical hospitals that have a psychiatric wing. You know, these are the hospitals with emergency rooms and they operate on people.
Then there are the stand alone hospitals. The private hospitals. Yep, these are the ones that have no affiliation, so to speak, with the full-service medical surgical hospitals.
Then there are the stand alone hospitals. The private hospitals. Yep, these are the ones that have no affiliation, so to speak, with the full-service medical surgical hospitals.
When a Hospital Says They Don't Have a Bed... What does That Mean?
Hmmm. Good question.
(1) There is a patient in every bed that's in the hospital.
(2) There are empty beds but no staff to cover them. What the heck does that mean? Well, there has to be a certain ratio between staff and patients....sooooo, if a hospital is low on staff, they will not be able to admit more patients even though they have empty beds.
(3) This is a good one. We have lots of staff, in fact, they are falling all over each other....and we have a thousand beds....but, we have no doctors to admit. Where are the doctors? Not sure...on vacation maybe....don't feel like taking anymore patients...who knows. Isn't there anyone in charge at hospitals? You know, someone who runs the day-to-day operation of the hospital? You would think so.... Why doesn't that person hire more doctors? That would seem logical, wouldn't it? Hey, sometimes we just can't look for logic, can we?
Let's see. I own a Chevrolet dealership. I'm looking out over the lot. People are streaming in wanting to buy a car....and, there aren't enough salesmen to wait on them. People are streaming in and then leaving going to other dealerships to buy cars. And, I'm just going to sit there? Sure. You bet I'd get some salesmen in there....right away.
Obviously, the hospitals operate in a little different way.....
(1) There is a patient in every bed that's in the hospital.
(2) There are empty beds but no staff to cover them. What the heck does that mean? Well, there has to be a certain ratio between staff and patients....sooooo, if a hospital is low on staff, they will not be able to admit more patients even though they have empty beds.
(3) This is a good one. We have lots of staff, in fact, they are falling all over each other....and we have a thousand beds....but, we have no doctors to admit. Where are the doctors? Not sure...on vacation maybe....don't feel like taking anymore patients...who knows. Isn't there anyone in charge at hospitals? You know, someone who runs the day-to-day operation of the hospital? You would think so.... Why doesn't that person hire more doctors? That would seem logical, wouldn't it? Hey, sometimes we just can't look for logic, can we?
Let's see. I own a Chevrolet dealership. I'm looking out over the lot. People are streaming in wanting to buy a car....and, there aren't enough salesmen to wait on them. People are streaming in and then leaving going to other dealerships to buy cars. And, I'm just going to sit there? Sure. You bet I'd get some salesmen in there....right away.
Obviously, the hospitals operate in a little different way.....
Wednesday, July 18, 2007
Who Needs to be in a Psychiatric Hospital? This is Different from Who is Actually in Them......
My opinion. Who needs to be in a psychiatric hospital?
The seriously mentally ill who have decompensated. Yes, these are the folks who have possibly stopped taking their medication and are exhibiting psychotic symptoms. They could be hearing voices, seeing things, delusional, and so on. Folks are seen on a regular basis who are receiving messages, sometimes through the radio and the TV...people who know that the FBI and CIA are after them, people who think they are God, and so on.
Though, sadly, there are many folks out there who have what we generally call fixed delusions; that is, delusions that just seem to never leave; for many mentally ill people the symptoms exacerbate themselves when they stop taking their medication.
These folks need hospitalization so that their medication can be regulated and possibly adjusted, modified or changed, in the hopes of having their symptoms diminish so that they'll be able to function outside of the hospital environment.
Anyone else who needs to be in a psychiatric hospital? Yes.
Sadly, some folks become so depressed, so emotionally devastated, that they are no longer able to function. Often times they have stopped bathing, stopped eating, and not unusually, never getting out of bed....sleep all the time...never sleep....and so on. Then there are the folks who may have had an event in their life: death of a spouse, or family member...or possibly an ongoing battle with depression.....separation from a loved-one or spouse, loss of a job, the threat of becoming homeless...and so on.
These folks also may benefit from being in a hospital, in the hopes of getting them going again.
The seriously mentally ill who have decompensated. Yes, these are the folks who have possibly stopped taking their medication and are exhibiting psychotic symptoms. They could be hearing voices, seeing things, delusional, and so on. Folks are seen on a regular basis who are receiving messages, sometimes through the radio and the TV...people who know that the FBI and CIA are after them, people who think they are God, and so on.
Though, sadly, there are many folks out there who have what we generally call fixed delusions; that is, delusions that just seem to never leave; for many mentally ill people the symptoms exacerbate themselves when they stop taking their medication.
These folks need hospitalization so that their medication can be regulated and possibly adjusted, modified or changed, in the hopes of having their symptoms diminish so that they'll be able to function outside of the hospital environment.
Anyone else who needs to be in a psychiatric hospital? Yes.
Sadly, some folks become so depressed, so emotionally devastated, that they are no longer able to function. Often times they have stopped bathing, stopped eating, and not unusually, never getting out of bed....sleep all the time...never sleep....and so on. Then there are the folks who may have had an event in their life: death of a spouse, or family member...or possibly an ongoing battle with depression.....separation from a loved-one or spouse, loss of a job, the threat of becoming homeless...and so on.
These folks also may benefit from being in a hospital, in the hopes of getting them going again.
Where Can a Person be Evaluated?
Just about anywhere. Typically will be at their residence, "on the street" usually at the request of the police, hospitals, jail (rarely), schools, juvenile detention, halfway houses, adult residential facilities, emergency rooms, nursing homes, churches.... Where won't a person be evaluated? Sort of case-by-case decision; however, just about unheard of to go to a person's place of business unless the request is by the employer.
How Does a Hospital Accept a Person Who is Being Detained?
Good question. As with anyone who is going to be inpatient in a hospital there must be an accepting physician. This is a doctor who is willing to accept the responsibility for the patient and to call treatment orders to the nursing staff.
How does the doctor decide whether or not he wants to assume this responsibility?
Though there may be some variations, the normal procedure is for the evaluator to call the hospital and describe the case to one of the staff: could be a nurse or a counselor. That person in turn calls the doctor and presents the information. The doctor can refuse, accept, or ask for more tests or information. For example, let's say there's a history of heart disease or diabetes, the doctor may request at a minimum blood sugar and vitals. The doctor may ask for anything they want (more on this later).
How does the doctor decide whether or not he wants to assume this responsibility?
Though there may be some variations, the normal procedure is for the evaluator to call the hospital and describe the case to one of the staff: could be a nurse or a counselor. That person in turn calls the doctor and presents the information. The doctor can refuse, accept, or ask for more tests or information. For example, let's say there's a history of heart disease or diabetes, the doctor may request at a minimum blood sugar and vitals. The doctor may ask for anything they want (more on this later).
Can a Police Officer Take a Person into Custody Just Because They are "Crazy"?
Yes. The code basically states, That any law enforcement officer, based on their own observations or the reliable reports of others, feels as though the person needs to be evaluated for emergency hospitalization, they may be taken into custody and held for not more than four hours. This is known as an Emergency Custody Order, even though a paper order hasn't been issued.
Within the four hours, the person must be evaluated and if the person is going to be TDO'd to a hospital, it must be done within the four hours.
Within the four hours, the person must be evaluated and if the person is going to be TDO'd to a hospital, it must be done within the four hours.
Involuntary Psychiatric Hospitalization....
What happens if someone needs psychiatric treatment, and they are either unaware of the need, refusing treatment, or not able to make an informed decision?
All states have a method or way of having someone admitted against their will. And, this is one area that Virginia does well. Some states allow any medical doctor to sign someone in...other states extend that to licensed social workers and other licensed counselors.
In Virgina, a person must be evaluated by a representative of the community services board. Each board has an emergency services unit that is responsible for performing the evaluations. Interestingly, none are medical doctors; in fact, some who were grandfathered in have bachelor degrees. About 12 years or so ago the Commonwealth established a certification system. Now an evaluator is required to have a masters degree and go through a not difficult certification process.
Why is this system better than most? Even though these folks are aware of the potential liability in what they do, they are not driven by it. Medical doctors are always aware of the potential to be sued for their actions or lack of acting. The emergency services' worker often time acts as an advocate for the person who everyone is saying needs to be detained. Their job is to look for the least restrictive alternative to detaining someone.
Routinely emergency room doctors and psychiatrists ask for patients to be screened. Their motivations are usually wanting someone else to be the one who makes the decision as to whether or not a person will be allowed to go home.
The typical request is sort of like this, "I don't feel comfortable with discharging them."
All states have a method or way of having someone admitted against their will. And, this is one area that Virginia does well. Some states allow any medical doctor to sign someone in...other states extend that to licensed social workers and other licensed counselors.
In Virgina, a person must be evaluated by a representative of the community services board. Each board has an emergency services unit that is responsible for performing the evaluations. Interestingly, none are medical doctors; in fact, some who were grandfathered in have bachelor degrees. About 12 years or so ago the Commonwealth established a certification system. Now an evaluator is required to have a masters degree and go through a not difficult certification process.
Why is this system better than most? Even though these folks are aware of the potential liability in what they do, they are not driven by it. Medical doctors are always aware of the potential to be sued for their actions or lack of acting. The emergency services' worker often time acts as an advocate for the person who everyone is saying needs to be detained. Their job is to look for the least restrictive alternative to detaining someone.
Routinely emergency room doctors and psychiatrists ask for patients to be screened. Their motivations are usually wanting someone else to be the one who makes the decision as to whether or not a person will be allowed to go home.
The typical request is sort of like this, "I don't feel comfortable with discharging them."
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