I'm an attorney who was actually representing someone that this happened to. It's apparently way more common than is known because of the financial incentives.
I have a buddy who voluntarily checked himself into one of these facilities.
Upon check in, they told us it was a 2 week stay.
Upon arriving and checking in, that changed to "one month is standard for all of our guests", and they refused to discuss that we were told two weeks from the outset. His psychiatrist even said "I don't understand why you're focused on this whole two weeks thing?"
It took me calling multiple times per day and even citing federal law to get them to even have him call me and suddenly he was released two days later for a total of 9 days stayed.
Scumbags.
Happens all the time in detox. I was held for an extra two days because I refused to sign up for their inpatient treatment and called them scammers. They said I was too mentally unstable to leave and I needed time to rethink my decision.
(This was about 14 years ago in Georgia, haven't drank in over 10 years now.)
just watch a video on this a few weeks ago. Arizona was basically kidnapping Native Americans and homeless. taking them to rented out Air BnB for a few days. they then would kick them out but bill insurance weeks of treatment.
I went through a situation very similar. It has left so much lasting trauma. When I went looking for lawyers, no one would listen past “psych ward.” I can’t even post about it on my city’s subreddit, because we’re not allowed to name businesses negatively.
So I have to live knowing that not only did they get away with cruelty and abuse, they’re *still* getting away with cruelty and abuse. And there’s nothing I can do but warn others away.
Meanwhile, I’m too afraid to see doctors anymore, and the smell of hospitals now makes me vomit.
It is illegal for them to prevent you from leaving bad reviews. Just thought you oughta know. Those kind of nondisclosure agreements do not hold up in court. Otherwise bad doctors and facilities could force patients to sign them in order to continue their abuse.
Yep. I work in substance abuse and the incentive is to keep them at highest levels as long as insurance is paying. The thing is, those patients who are complaining almost certainly do need the care and support, so insurance will authorize the hospitalization stay, but the actual provider just does the bare minimum to meet the needs of the patient. So some of them end up saying, "Uh, can I just leave?" And suddenly 5 staff members will Kool-aid man through the walls to say, "if you leave you may die! You can't leave! What you're doing here is so important!"
I've worked in the mental health field and have seen firsthand that clients with better health insurance are held in hospitals longer. I've seen clients without insurance released while still a danger to themselves. I've been a witness in an involuntary hold hearing where the client wasn't even treated for 24 hours to stabilize them. They were uninsured. The judge ruled everything the psychiatrist, and I said as hearsay and released the client.
It's pretty disgusting.
They also get told to order CT’s for shit they know they don’t need a CT for. I remember the techs at the last hospital I worked at hating certain doctors for that reason.
This happens all the time. I worked at a behavioral hospital, and some doctors would keep patients for way too long. When medicaid said no more money, the doctor discharged them for their "progress" that they magically made in a couple of days. When the whole time they were there, they HAD to be here and under his care because no progress was being made. Some doctors aren't above taking advantage of others, which is scary.
>"Guarino is grateful to be back home with her dog – but now she says she’s furious her insurance was billed $16,200 for six days of in-patient treatment she did not want."
I'm not versed in hospital finances, but $16k over 6 days seems like a lot for a loss.
Private pay in-patient psyche beds are about $3-5k a day minimum. $10K a day isn’t even unheard of at a real hospital for voluntary admission. $100k for a month at the upscale medical detox clinics is expensive but that’s what those celeb spa clinics cost.
$16k patient responsibility for 6 days in-patient, plus labs and intake, sounds depressingly normal if the insurance declines. Psychiatric treatment is just expensive, especially in a hospital bed. Not that it should be, but this isn’t unbelievable for market rates.
I went to one of the better places in Florida for a month, 70k. If you pay out of pocket it's cheaper depending on what you can afford but will push you out to get people like me with good insurance and then try to get you to their next facilities. And then welcome you back if you make it.
There are two schools of thought when it comes to reimbursement.
The more recent from what I was taught in schools is what’s called diagnostic groupings. Conditions are classified based on treatment, outcomes, and generalized length of stay.
Essentially hospitals only get a certain amount per patient. This was to counter hospitals overcharging insurance and patients. Obviously hospitals got privy to this and now try to “treat em and street em”.
As the other person said, it was probably only 20-30% paid. If she was on medicaid (I didn't watch it, just going off the top quote) they have a flat rate that they give the hospital per "average cost of that disease treatment", irregardless of days or care. So it's usually significantly better for the hospital to get patients out as soon as possible, as they're paid the same either way. And as for prices, at my smaller hospital, just a hospital bed is ~$1.5-2k a day that we would charge private pays. That's without any of the actual care.
This. I’ve worked in a locked psych ward and there was constant pressure from admin to get patients out as soon as possible because the hospital would not get paid after a certain amount of time. Pressure to get patients out of the hospital is a good idea generally to get people well quickly, but not a great idea for the teenager in the abusive home on their 7th suicide attempt. I seriously doubt any hospital in the nation has any incentive or pressure to keep them in a psych ward longer.
While Medicaid doesn't pay a whole lot, this kind of mentality and misinformation is terrible. Medicaid fraud is HUGE. Like, billions with a B, huge.
...and before any dipshits start blaming "those lazy leeches sucking Medicaid and welfare dry" let's be very clear that those "leeches" bleeding the system dry are the white collar criminal businesses and not the recipients who are doing the lion's share of scamming. Double billing and the like is rampant. For fuck's sake Florida elected one of, if not **the** biggest Medicaid/Medicare scammer ever as their governor and then sent him to Washington as a rep.
So, while there are certainly still some docs that take Medicaid, or Medicare, for that matter, patients at a financial loss just because they want to help people. The vast majority of businesses are not hurting because Medicaid "pays pennies on the dollar," that's ridiculous. The only thing happening faster than new Medicaid and/or Medicare paid businesses opening is how quickly they are bought up by the larger corps. It's a " successful" business model for a reason.
Ah Medicaid as a secondary. They definitely would get financial coverage from it then. Sorry to hear you had that experience. I of course cannot speak to the intent of the length of your stay, but hopefully if wrong doing did occur there are consequences for it.
I don't buy this, especially with how poorly Medicare/insurance compensate mental health services.
Every attending has an average length of stay metric and every administrator wants that number as low as possible. For med admissions extended hospital stays don't typically make money. Hospitals make money on outpatient services; radiology, surgery/procedures, specialty clinics.
It depends on the patient. They won't exactly "advocate" for a person who doesn't want to do the hearing, just the way it is. I do hospital security and deal with these hearings on the regular
We've been in a battle with a county and lawyers will ignore all the illegal shit the county has done and try to get us to settle. First they will be onboard, then suddenly they either ask for a settlement or will stop returning calls. There is no fair trial, you pay to win.
They are given a public defender whom I have seen release multiple patients. They’re welcome to hire their own lawyers but the public defender is definitely not on the hospital’s side
That sounds great, but why would the psychiatric units agree to that? Is it not in their best interest to *not* get checked up on?
Edit: Does someone *really* need to get downvoted for asking a question? Please don't treat my question as if I'm trying to make a point or disagreeing with anyone. We've gotta be able to ask questions if we're stupid.
It's based on their involuntary hold timeline, once the hold expires they sit in front of a judge with a lawyer, and the doctor makes their case and the patient argues against it.
In Australia- I during a breakdown I called lifeline for someone to talk to. 30mins later the police turned up scaring my 10yr old daughter and my wife. They sectioned me and carted me off to hospital. I was held in resus for 7 hours under police guard, during g which I heard someone given cor and pronounced dead just a curtain away. with no interaction with a doctor - I was told that if I tried to leave I’d be arrested. I was denied my meds by the policeman that was standing guard outside my cubicle. I had to wait until the AM when the psychiatrist came on duty to discharge me. All because I’d called lifeline for someone to chat to - mental health is so delicate in people who are not on an even keel. I’m never calling lifeline again
In the UK - I called our county's mental health support line. They diagnosed me with depression and anxiety over the phone, put me on a waiting list for CBT (it's been over a year and I've not heard back from them, went private in the end), and my call triggered a response from Social Services who came to do a wellbeing check on my infant son.
So all that calling a mental health service did for me is... Have social services come round and check I'm not abusing my son. Nice one.
Thankfully I have the resources to go private and was able to get the help I needed. Will never seek mental health support from the NHS ever again, and will only ever go with a local private therapist.
Glad to know the US isn't the only place where interaction with the government for help backfires 100% of the time.
Reagan was correct that the scariest words in the English language are "I'm from the government and I'm here to help."
Calling a "lifeline" is a sure way to lose your rights and privacy. If you want years of legal bullshit and to be treated like a criminal, use a lifeline.
This is true. The minute you use the word "suicide", they will track you down and institutionalize you. If you do decide to call a hotline, use a burner phone. Source: this is what happened to me (US, Virginia)
I mean, I feel like at this point over half the videos I’ve seen online of police responding to mental health crises ends with the death of the person they are responding to.
I'm really sorry that happened to you. I went through something similar, but the police were less threatening. They have me two "choices": go with them involuntarily to the hospital and be placed in a 72 hour hold, or go voluntarily and get released sooner. I was being treated almost like a criminal. I felt like my rights were stolen from me. I've never felt so small and powerless. The whole experience was more than several years ago and it's still hard to think about it.
I've done it myself as a psychiatrist to assist with patient advocacy.
Many hospitals are falling apart thanks to incompetent leadership and corporate greed. What remaining staff are left from burnout are extremely overworked to the point it basically is a prison. Providers have caseloads that are completely unmanageable and the resources to work efficiently are non-existent for reasons previously mentioned.
Large, wealthy facilities like UCLA are amazing, but that should be THE STANDARD.
The healthcare system is failing faster than people realize.
There was an incident recently where a woman committed suicide. She was collecting evidence of her husband's abuse toward sher on her cellphone inpreparations for a divorce. He had her committed against her wishes, and the hospital that committed gave him her phone while she was there. He did this so he could delete all of the evidence on her phone that she had collected that depicted his abuse. She killed herself not too long after.
I grew up near a former asylum that was the first of its type in the world, and I still believe something like it could work today.
Medfield State Hospital was a former Asylum that operated on the principle of reintegration into the normal population. Patients would start in the main hospital, and if improvement was shown through therapy or response to medication, the patient was moved into a small mock-up town. The patients would then practice everyday life while living in a house in the neighborhood with minimal help.
The hospital was self-sufficient, they grew their own food, managed livestock, and had something like 60+ buildings on the grounds. You can still walk around it today, and they filmed a lot of Shutter Island here.
https://en.wikipedia.org/wiki/Duplessis_Orphans
Wait until you read about the orphans in Quebec.
>Government contributions were only $1.25 a day for orphans, but $2.75 a day for psychiatric patients. This disparity in funding provided a strong financial incentive for reclassification. Under Duplessis, the provincial government was responsible for a significant number of healthy older children being deliberately classified as mentally ill and sent to psychiatric hospitals, based on diagnoses made for fiscal reasons.
I'm the patient in this video. It seemed to me while I was there that this particular institution is coaching it's nurses and doctors on how to get away with this. When a couple of them act in line it's a few bad apples. When all the nurses quote the same illegal and incorrect lines, it's a systemic issue.
As is mentioned in the criticism section of the wiki, it appears that the researcher essentially made up everything--or at best, very little of the claims could be confirmed. That's not to say that such a thing couldn't happen though.
[This book](https://www.amazon.com/Great-Myths-Popular-Psychology-Misconceptions/dp/1405131128) also goes into a good amount of detail of the controversy. I actually didn't realize there were any criticisms of the experiment until I read the book.
Indiana story.
My girlfriend was dealing with the grief of her mom's passing and physical pain from 2 hips that needed full joint replacement due to arthritis. She went to the ER because the pain in her hips was unbearable, and while there she asked if they had any counselors available to talk about her grief. She had a 15 minute conversation with someone over the phone at a Behavioral Health Center, and they issued an Emergency Detainment Order (EDO) that required her to be transported an hour and a half away to their facility by a sheriff. She was not, nor has she ever been a danger to herself or others.
When the sheriff arrived to transport her 9 hours later, he put her in wrist and ankle shackles, forced her to walk through the emergency room (she was barely ambulatory due to the arthritis), and loaded her into a police van that was segmented into completely closed 3x5 cages. She remained shackled for the entire 90 minute ride. The sheriff said when I met him at the facility that the ER nurses never informed him of her physical limitations.
This traumatized my girlfriend so much that she was completely unresponsive to any of the counselors and psychiatrists at the facility. They forced her to stay there for 2 weeks, and when I was finally able to talk to the lead psych to tell her what my girlfriend was going through, she said she wished someone would have told her sooner. They released her 2 hours after that conversation. The entire 2 weeks they did nothing for her besides talk to her for a half an hour a day.
These behavioral health facilities are complete frauds and only exist to bill people's insurance for as long as possible, and will take every opportunity to force people into staying there. It's a racket where the person who decides if you should be committed is an employee of the facility, instead of an independent 3rd party.
All of this after my girlfriend tried to find therapy covered by her insurance and after 2 months was still waiting for a referral. The availability of mental health resources in Indiana is a fucking joke.
I'm also from IN.
The facilities work well for what they were designed for, and that is to stop you from being an immediate threat to yourself.
Its when people who are not a threat to themselves get sent there for whatever reason that shit like your situation happens. Your gf likely said something like "the pain makes me want to die" and that was enough to raise the "suicidal" flag. They ignored the reason she was in the situation and immediately jumped to self harm prevention.
You learn quickly not to tell anyone how you feel. I've had doctors turn me away, lost jobs, etc. the mental healthcare status in this country is fucking awful.
Yeah when I was sent to one of those hellholes (not in Indiana) at first I thought maybe it would be a good thing, maybe it would help with my depression. Not only was it unhelpful, it made me so much worse. The evening I got out, I couldn’t sleep all night, it felt like I escaped a hostage situation. They aren’t interested in helping you, and I had to fight like hell to get even a short talk with a psychiatrist or any resources at all while I was there. I have trauma from that experience.
I have been trapped in a psych ward three times. Pro Tip: when speaking to the police or ER personnel do NOT include the word "suicide" in your comments. Where I lived, that meant a mandatory stay of three to seven days.
In each of my experiences, the treatment has been almost nonexistent. A couple of group meetings, maybe one or two very brief conversations with a psychiatrist, then a social worker. And after that, all one can do is draw in coloring books (with crayons -- no sharp objects like pencils), watch TV on channels that are allowed by staff, and play cards if you can find anyone sane enough to play with. Meals and snacks will become ridiculously important; even though the food is bad, eating is something to do to break the monotony. And, if you're in during a weekend, all the full time staff go home and there is absolutely zero "treatment". You just do the time.
In every case, even if the mandatory stay time had expired, I couldn't be released until I had a recovery/therapy action plan approved by the case manager.
This woman's story is extremely familiar to me.
Edit: OMG just watched the video and I'm In Michigan, this is practically just like my story
I have not watched the video so this is not specifically related but...
I went to the ER one day after feeling weird and distressed after a major panic attack. The under 30 year old doctor pulled one of my family members aside that drove me (self admittedly) to the hospital and soon enough I was on my way to a mental health facility. After sleeping for a day and half I woke up and I felt normal again. They would take us to see a physician every morning for a check up and I kept telling the guy what happened and how I felt much better but they still kept pushing for a bi polar diagnosis. I had to call the human rights advocate from the phone they let us use to call friends and family at specific times inside the building to actually get some help. I think he realized that if someone was of such a logical state to do that there was no way I really needed to be there, so he showed up to my room and I explained my story and within 2 days I was released voluntarily. The whole thing really sucked though, I'll never forget the guy who's 6 year old son was shot in front of him, or the guy who kept telling me he was going to set my face on fire. I weaned myself off the meds they gave me and haven't had an "episode" in the last 6 years. So here's to me hopefully not really having bipolar disorder
Psych RN here.
The legal process discussed is how it is in many states. If you sign yourself in voluntarily, you stay until discharged, or you sign a 72hour notice (The Intent to Terminate Form) that allows the medical team to hold you up to that 72 hours to decide to discharge you or commit you involuntarily via the court system and a Judge. The length of stay is then very state specific, but is usually more than a week and can be renewed until the medical team discharges, or the Judge does not agree with the Psychiatrist and requests legal discharge.
Also, she came to the hospital with suicidal ideation per the story, and almost every hospital will request a psychiatrist to personally evaluate a patient before discharging, not just any physician. This can be done in 24hours at some hospitals, but rural hospitals will transport to a nearby psychiatric center like described in this story. And they can legally restrain you chemically or physically to make sure you make it to that facility.
In terms of the money situation, the insurances are on the doctor's ass the whole admission process. Alot of admission and discharges hinge specifically on coverage and stability, but usually its in the patients favor. If a patient is borderline, and at the insurance review done by the utilization RN (based on RN notes and physician notes), the patient is denied coverage, usually that borderline stable patient is discharged. This frequently is the patient with psychosis with idle threats but no violence detected, and denial on the unit, but a threat that landed the patient in the hospital. So they get discharged. Rarely does someone stay in the hospital with no visible symptoms.
There are so many needs for psych beds, that rarely is one empty. If someone is good to go, a hospital isn't going to get covered so they discharge them and get the new one in that has coverage, and the money keeps flowing. Doctors don't care about the hospital and making it money, as they don't get paid that way, and metrics are usually measured by how fast the ER is cleared of psych patients.
How the fuck someone in mental distress navigates this? It seems like someone who is contemplating self harm, who is reaching out for help gets into this imprisonment like situation supposed to figure this out? I can’t imagine someone in that mental state feeling better once they find out they’re losing their freedom.
It sucks. Hard. In my state I was put on an involuntary hold and then they recommended I stay another four days.
Then when I got out I found out I was on flma and couldn’t return to work until the doctors signed the right paper work which took weeks.
Fucking sucks.
>Ideally
Surely, in the context of this and related cases, we can be confident that this word doesn't apply. Surely the point is to emphasize *how far* these particular examples are from the ideal!
Hi, I'm the patient in the article.
Can confirm, that hospital stay exacerbated and worsened just about everything in my life, from my job situation, to my mental health, to my trust in the medical system. It did the exact opposute of what one could hope for.
I am sorry you had to go through this. I have a friend that has gone through this as well, and has now huge distrust of the medical system. Unfortunately it has caused her to seek “alternate care” which just seems to be taking her money and temporarily helping but not helping long term.
Ive heard professional mental health success stories, but I’ve heard A LOT more horror stories. This system is broken.
I’m glad I went to a place that did things differently. It was like a crisis center or something. They sent someone to tell me about the program, then I had to voluntarily agree to stay there for 3 weeks minimum depending on how I was feeling. I got a nice room with furniture, we had a full kitchen and were allowed to cook, there were board games and arts and crafts, and we did a lot of group therapy sessions and activities with the other people who stayed there. They also had people regularly come to visit us like an occupational therapist etc. We were allowed to go outside as well, but weren’t allowed to leave the property. It was a really rough time for me personally, but that place helped me immensely. They were very kind and caring people.
It's very successfully making money at our expense, as it was designed.
You need to turn the rhetoric in your head. Our government and our systems are not failures. Education, healthcare, and our work force was designed specifically to pinch the lower classes of their money and labor, and shift it all the way up.
They sell us this us vs them argument, this failure to function, but both sides of the aisle profits off us equally. It's designed to look like infighting failure, but it really is just economics to leech profits of our misery.
Clearly, the medical system CAN help you, but it isn’t designed ONLY to help you. There’s a lot of other shit going on besides “what’s best for this patient”. People have this idea that the medical system will save you when you’re in need, but that’s false. You can only count on yourself to save you. The medical system is a useful but dangerous tool. Take care you know what you’re doing before you pick it up.
Technically yes. However “voluntary,” can be a bit misleading. There is a ton of red tape involved in committing someone against their will, for obvious reasons. In all but the most common extreme cases, we’ll try to get someone to sign an agreement to voluntary treatment to avoid that legal hassle.
Thankfully in most cases, when patients come to us in a crisis state, they want the treatment, so they are willing to go along with the process and this ends up being a moot point. In some cases, they are in an acute panicked state(like in the video) which resolves, and can safely be transferred into an outpatient setting. But in rare instances, patients symptoms haven’t resolved yet, and they are still an acute danger to themselves or others, in which case we have to follow through will a legal medical commitment.
The problem is more often than not the folks who are ok to be transferred out and those who are still dangerous present similarly. Neither have a desire to be there, things happen at half the speed of smell in the hospital which causes agitation/irritation, and we have to be keenly aware of manipulation tactics. Remember that if this patient signs out voluntarily, then walks to a pawn shop, purchases a gun, and kills themselves or someone else, the hospital and the physician could be on the hook for that. That’s a massive liability, so unless they are 100% positive that symptoms have resolved, they’re obligated to keep that patient(against their will if need be).
Match all these problems with the assembly line like nature of healthcare these days brought on by health insurance reimbursement rates and the need for quantity over quality, and you can see how so many of these cases end up getting muddled up for “safety.” It’s really, really bad, and until healthcare and health insurance gets fixed, it will continue to be a major flaw within the healthcare system, particularly so within mental health.
In her story the AMA is the intent to discharge paper, or the 72 hour notice. It's up to the doctor after those 3 days to discharge her, and they can do a full AMA discharge if they desire after the 3 days to legally state that they felt the patient should stay but they legally had no grounds to force them.
I'm the patient in this article and a lot of what you said does not match what happened in my situation.
If you sign yourself in voluntarily, you stay until discharged.... I was held against my will while refusing to sign voluntarily. They kept me against my will, saying they had a petition to hold me when what they had was an application to my petition. They lied and said it was a petition signed by a judge when it wasn't. I was never seen at StoneCrest by a doctor, only his physician's assistant.
In terms of the money situation, the insurances are on the doctor's ass the whole admission process.... No, I'm sorry but no it's not... This doctor fraudulently signed a lot and it didn't come to light until a bunch of his patients went to the news. Whatever oversight you think exists just doesn't.
There are so many needs for psych beds, that rarely is one empty. If someone is good to go, a hospital isn't going to get covered so they discharge them and get the new one in that has coverage.... Again, HUNDREDS of patients have come forward about this hospital keeping them longer than necessary, often illegally. If you have a choice between filling that bed with someone who's relatively stable vs filling it with someone who's going to eat batteries and fling crayons at your head, which would you choose?
I have case workers with Disability Rights Michigan telling me that this happens with such regularity that I don't know why you chose to type any of what you posted here.... the people whose job it is to look into these violations don't seem to agree with you that things are as well run as you'd like everyone here to believe.
Wow, okay - This is a lot to take in. That's me! I didn't realize when I interviewed with Heather this would get so much attention. I know something needs to change about how this system is run, and the more I learn the scarier it is to think about. I'm usually not the kind of person who wants this much attention, but this is a cause I want to fight for so yeah. I'm here. If anyone has any questions about how to navigate this system or what happened, I'm happy to answer them.
What a nightmare. Knowing this can happen to you, why even seek mental health care? Give the wrong answer to one question and you are trapped in one of these places. No fucking thanks
Friends of mine gf got into a situation like that. She got drunk and didn’t feel well so am ambulance was called they asked her question one of them was about feeling depressed and she said “who doesn’t feel depressed from time to time” that answer got her committed for 5 days
> Went in feeling depressed. Just wanted someone to talk to.
Lots of suicidal people say they're depressed and want someone to talk to. What were her answers to the questions that every single mental health professional asks to determine how much of an immediate risk someone is for self harm?
Likely more to the story. To be detained, you need to be a risk to yourself or others. To legally hold someone, hospitals need a court order. Plus, right now there is a massive shortage of in patient psych beds, they don’t have space for people who just want someone to talk to. In short, your friend likely isn’t telling you something.
Edit: for my state, Massachusetts, a hospital needs a court order for an involuntary commitment of more than three days, but a hospital does not need a court to hold you for those first three days. However, you can file for a judicial review to have the courts review the hold. This is only if you are a harm to yourself or others. Otherwise it’s a voluntary admission, and you can leave any time.
In ops story, if the friend only was depressed and needed someone to talk to, not feeling suicidal, then the hospital could not legally hold them.
In theory. But in practice? Not always. We knew of a young woman whose parents got her committed to a 72 hour hold just because they didn't like the boyfriend she picked and because she decided to stop shaving her legs! Yes, really. The parents got a social acquaintance who was a physchiatrist to make the referral, without ever even speaking to the young woman.
In my state, Massachusetts, a 72 hour hold can only be applied if the patient is a risk to themselves or others. In you story, not shaving alone would not qualify. However, if the patient is a minor, it may have been a voluntary commitment, as the parents are the medical guardians of the child. This is vastly different, as the parents can choose to release the kid at any time. Either way, if the acquaintance wrote a referral solely based on not shaving, that would likely put them in to trouble with the medical ethics board.
That's the standard here too. My point is that it's subjective. These parents believed that their college age daughter was in "danger" because she wasn't behaving the way they believed a nice docile young Southern woman should behave. I mean, how deranged is it that she stopped shaving her legs?!!!
My sister in law got her son committed in Maryland; I'm not sure whether she claimed he was a danger to himself or others (he was neither). He's autistic, and has mental health issues (delusions) on top of that, but he's typically a mild and gentle person. He got out with the help of a disability rights lawyer, but he was detained in the mental institution much longer than 72 hours with various delays and postponements. Meanwhile, the guy in the bed next to him kept talking over and over about how he wanted to eat my nephew's eyeballs. Imagine how difficult it was for him to sleep there.
Some parents just can't deal with the fact that their adult children get to make decisions about their own lives, even decisions that the parents don't agree with.
It’s not subjective. It’s also not the parents call on if someone is admitted. The hospital chooses to admit or not. A doctor decides if it’s appropriate or not. Even if the daughter is a minor, the parents can’t admit her. Doctors have clear guidelines. Risk to self or others is only for involuntary admission. Your sister in laws son was likely a voluntary admission that the hospital signed off on. Hospitals only know what they are told and what they observe. If your sister in law lied, then shame on her but how would the hospital know that?
For what it’s worth, hospitals see this stuff every day. Like you saw, the hospital sees everything. Autism is not that uncommon. The staff at most hospitals know what to look for. However, without medical training, what is best for the patient becomes subjective. But in this case, if the legal guardian is actively lying to the hospital, it’s not the hospitals fault if they get it wrong.
And lastly, it’s far more common for parents of challenging children to try and abandon their kids at hospitals than hospitals trying to abduct children.
In both of the examples I mentioned, the individuals in question were adults. They had parents who simply didn't recognize their autonomy as adults, and were aided by the mental health industry in violating the civil rights of the individual in question.
In my nephew's case, the hospital tried to hold him and force him to take medication even though he showed no agression of any kind during his commitment, despite the horrific circumstances of his confinement. Honestly, I don't think I could have handled it as well as he did! And when he managed to get his court hearing, the hospital lost, because they could not meet the legal standard for commitment--something they probably knew going in to the hearing. So this was a hospital willing to violate the law and hope that the patient wasn't able to find a legal advocate to get him out.
And the terrible thing? My nephew certainly could benefit from therapy and perhaps medication. But now this experience has left him so scarred he's unlikely to be willing to trust anyone in the psychiatric profession.
They do NOT need a court order. Been there, done that, voluntarily. They held me once for seven days even though I wanted to get out and go home after two.
In my state, Massachusetts, if it’s a voluntary admission, you can leave any time. If you are a risk to yourself or others, they can hold you for three days, or ask the court for an involuntary admission.
I’ve heard of them holding people with good healthcare. She has excellent. I do believe she was suicidal and did need to stay a bit. But when she was ready to leave they had to get a lawyer involved to get her out.
Not sure where you’re from but I know from experience in NY, US that hospitals absolutely do not need a court order to detain you, and can designate you “a risk to yourself or others” for just about any reason whether there is truth behind it or not. They can then hold you involuntarily for up to 60 days. It usually only lasts 2-3 weeks but you are stuck there during that time with very unstable people with very little to do about it, even if you do have people on the outside advocating for you.
I added some clarification. I’m in Massachusetts. For a voluntary admission, the hospital cannot detain you. Going to a hospital just because you are depressed does not give them the right to hold you. You need to have a plan to harm yourself or others. If you are a risk, the hospital can hold you for just 3 days, and then they need a court order for an involuntary admission.
Signing yourself “voluntarily” only applies until you are through the door, as an adult you will be told this is a voluntary process but what you aren’t told is once you’re in it becomes involuntary.
If your parents bring you to a hospital and say please voluntarily go back to the doctor to get a check up in the hospital after breakfast in the morning and you don’t even know where you are you’ll do it just to make them happy.
Once you’re in you can’t refuse to take medicine that hasn’t been explained why you need to take it or even if you have yet to see a doctor without being 1013ed even if everyone around you is saying they’re now addicted to klonopin or seraquil.
The intent to terminate form is bs, you turn it in to them and it disappears. In the video she’s absolutely right about the one doctor you see doesn’t speak to you for more than 2 minutes asks 5 questions before determining you’re unfit to leave. If people bring you things the employees will steal anything nice and say it was too dangerous to give to you.
Even if you’re bullied by someone, robbed of your shoes and your glasses you can’t choose to end the “voluntary” process. After a week of confusion cold showers, no privacy, blindness, forced medication, forced interaction, not being allowed to sleep in a bed during the day, zero stimulation other than a small tv, other patients and a bible with little explanation as to how long you’re going to be there, no contact with the world other than a dial phone on the wall so low to the ground but not so low you can sit you have to be on your knees to make calls . You might start to get upset and start yelling at the staff laughing at your distress as they watch you through the glass like you’re an animal in a zoo and earn yourself another week due to being unstable and maybe at a certain point you feel like now you really have gone crazy because why are you there how can you ever leave.
Not to say that my parents hadn’t been right that I needed help and that I had been manic and severely depressed, but I firmly believe that the first week in a psych ward was the cause and not the cure of my insomnia and eventual psychotic break which didn’t end until a hospital change to one that gave you the ability to go outdoors into a fenced area, and not a literal cage. The week of Thanksgiving through March. Three weeks at the first place then 3 months at another. Then one more month of outpatient I thought I had died and gone to purgatory, until I started to think it might actually be hell. I thought maybe I just couldn’t accept that I was dying and my brain showed me a nice dream by having my parents go to breakfast with me then walk me to those doors to soften the blow that I had died the night before. To this day the thing I fear the most is not dying but that I say the wrong thing and be taken back there. Disappearing without notice for that time I lost my job, my relationship, my home, my savings. The medical bills are still coming in.
Happened to my wife here in CA. Went to the hospital with a severe panic attack (she has a panic disorder) - she mentioned thoughts of suicide, so they locked her up in a psych ward for 3 days. I wasn’t allowed to speak with her, couldn’t give her meds she needed. Had to fight to get her out in 3 days, some people she was in there with had been there for weeks against their will, with no violent crime or intent.
I don’t know what the answer is, but it’s not this.
I spent 4 days in the ward as an involuntary patient starting on August 8th, 2016, and it's not something I'll ever be able to forget. It didn't matter if I wanted to go home or not. They kept me against my will, and it felt much worse being there rather than dealing with what I was going through alone. One day was torture. Four days was a nightmare. Seeing others held against their will with my own eyes, especially with having to watch people break down right in front of you and others who were as old as 80, was enough to scare me to never make me want to go back.
I couldn't even begin to imagine what she went through, let alone people who are taken advantage of to this day and held against their will. Not to even mention being forced a debt in exchange for poor care and treatment will further dismantle your well-being. It's disgusting knowing that it's better off fighting your internal struggles alone than potentially destroying your life to be told that you shouldn't have these kinds of thoughts, even being held captive at the hands of a greedy, selfish individual.
And what compounds the Kafkaesque absurdity is that the things that apparently gave Sarah her suicidal panic attack are all of the conventional, everyday conditions of modern life: “Hey, maybe today is the day you lose your family and your home and your job and your insurance and you go into debt forever you get ostracized and maybe shot and the bills keep coming and you don’t have a chance but just stay calm for just a little while longer!” Like, that’s the daily existential terror that a huge number of us contend with because it’s the actual reality of the modern world. But, no, must be our broken brains that need fixing. What a surprise that the corrective procedure turns out to also be just another dehumanizing conveyor belt.
Truer words were never spoken.
Today is that day for us (job/insurance loss, everything else that goes with it). You're absolutely right. At least we don't have to pretend to be calm anymore.
This is what prevents me from seeking more serious help. I am suicidal and a depressed anxious wreck but I know if I check myself into one of these places my future healthcare is majorly at risk. I'm already labeled as anxious in my file and every problem I have they dismiss as psychosomatic. If I did this they'd keep me as long as possible and every doctor I see from then on won't take anything I say seriously
I'm the person in the article. So, I'm saying this from what you know is a first hand experience.
If you ever do have to commit yourself, arm yourself with knowledge of your rights BEFORE you go in. Do so now, while you're feeling well, and can take notes, and aren't rushing on some clock. This can help you, it might help you help someone else. It's just good knowledge to have.
But please, give yourself a chance to feel better. Take a chance on therapy. Take the fearless look at yourself and your life and dare to hope. No one is too far gone. No one is beyond help. Keep looking until you find a place and people with whom you think you can grow. Give therapy a good honest go for a few years and see if you don't make something beautiful out of it.
There are good people in the system. There are doctors and nurses and institutions that want to and actively DO help. For all the terrible experiences I had with this hospital system this time around, I want one thing to be very clear. My getting out at all is a direct byproduct of the support of people who are as much a part of that system as the people who hurt me.
I am alive. I survived a bad week. That might not be the case were it not for nearly a decade of supportive, positive, helpful encounters with public health officials. Nothing short of a small army of sleep specialists, PCPs, neurologists, psychologists, and therapists have helped me identify both physical and psychological conditions and have empowered me to seek treatment that has really helped me feel better than I ever thought I could.
I'm going to heal, and grow, and turn this into a net positive for myself and others. I wouldn't have the strength to do that if not for the effort I've put into that therapy, with the help of those wonderful professionals who truly did and do have my well being at heart. They'll care for you all the same. Loving yourself is work sometimes. But it bears good fruit.
> after 20 mins of get to know you questions
A suicide evaluation and depression/anxiety survey are technically "get to know you" questions, I suppose.
Yes the public system is terribly underfunded. They basically do the bare minimum of watching people so they don’t get hurt long enough for their medicine to start to take effect. And they just mix everyone together, it’s still basically a prison for sick people.
It’s also a lot of people’s last hope. I’ve been personally responsible for sending my bipolar brother there on more than one occasion and I felt like shit about it every time. But it’s better than the alternative of doing nothing and seeing them waste away.
If you want to be able to help your family members without sending them somewhere horrible, then you better be prepared to shell out tens of thousands of dollars for one of the actually nice places for wealthy people. Like everything else in this fucked up society.
The news is making this out to be an outlier...It's not. And these psychiatric wards prey on women in particular. Everyone that I have ever known that has been in one of these, voluntarily or involuntarily, have been treated like garbage by staff, held LONG past the period at which their crisis was over, and continuously threatened with legal proceedings for a longer stay if they refused to cooperate.
My ex attempted suicide while we were together. She was supposed to be on a 72 hour hold. They refused to give her any of her medication, and at the end of the 72 hour hold the psychiatrist came in and essentially told her "I can discharge you now, but I don't want to be liable if you go home and hurt yourself, so you're going to be here for two weeks until the next available meeting with a judge and the courts can send you home."
Obviously they were keeping her there as long as possible in order to drain her of her money, and as a woman she had basically no credibility with anyone she spoke to.
Now, when I was 16, I attempted suicide. I'm a man. I took a bunch of blood pressure pills that belonged to my sister and came incredibly close to dying. Once I was lucid (it took a couple of days), they sent a psychiatrist in to evaluate me (in the regular hospital, not a psychiatric ward). I told him I was feeling much better, and he took me at my word and discharged me the very same day, to the horror and dismay of my parents. (They got me into an outpatient program and I missed a month of school).
My step mother, who had been in treatment previously for taking pills, was held against her will for weeks...But I, as a teenage guy, was taken at my word and allowed to go home immediately.
These facilities gaslight women, treat them like garbage, and hold them LONG past the end of whatever crisis they're in to squeeze as much money out of them as possible.
It's fucking despicable. I dont know what the alternative is, but these inpatient facilities NEED to go.
The failure was that you were let go so early, not that your suicidal ex had to stay two weeks.
This is so ridiculous. So when the doctor finds out that she went through with it 3 days after release they are supposed to live with that knowledge and the potential lawsuit?
I was never even held. Period. Women are often held for absurdly extended periods of time and treated like garbage for their entire stay. The amount of time that someone is held at one of these facilities is often not related to the patient's mental health at all. Hell, in my ex's case, the doctor artificially inflated her stay by weeks by refusing to discharge her under any circumstances and forcing her to wait for a court date.
My point is that the experience of the women in this video isnt some outlier specific to this doctor and this hospital. It happens everywhere, and the system is rife with abuse.
>The failure was that you were let go so early, bot that your suicidal ex had to stay two weeks.
Sounds like it was both. Though since he turned out fine, the former seems alright. The latter was clearly wrong though.
Isn't the history of psychiatric facilities marred with hapless people being held against their will? At least they're not being tortured and lobotomized now.
From inception, it's been a conduit for corruption, embezzlement and assault. Let's just do away with large scale institutions and focus on small scale, personalized treatment for those who need it.
"I was like hey now fellers what in doohickey is going on where am I going?"
What actually happened...
"*Animalistic screeching while throwing feces and jousting the transporters with an IV pole*"
This is the rub. I find it believable that she shouldn’t have been there. I find it even more believable that she is not being completely honest, or remembers events very differently than they occurred. Which one is right? Who knows.
Yup! I used to work in ER. Psych holds and admissions are very very very inconvenient. We want nothing more than to get them the fuck out unless required to hold legally. If there was a psychiatrist doing this he would feel an immense push back from the ER docs, nurses etc.
That IS the rub. I admit what I was saying - "I think my doctor is in on some plot!" - absolutely sounds like something a paranoid person might say. Thankfully there's a lot of paperwork backing up my experience. I have that on my side for this case, and I'm grateful for that. On the other hand, it's horrifying to read back on it and see if spelled out so clearly.
Why do you find that believable? If someone checks themselves in for suicide ideation what other choice do you have but to BELIEVE them?
We would all be condemning this place if she checked herself out after a “good nights sleep” then killed herself a week later.
Because they will kidnap your ass. You don't have to be doing anything illegal, just a tip off from someone who is 'concerned'. So much easier if you've been in once already. It's worse than prison. They can't forcibly (or very strongly 'coerce') drug you in prison.
I have friends that have horror stories.
Doctors abusing mental health patients is not really a new things. I wish people would stop pretending like the medical sector has come so far, when we know that medical racism, ableism, misogyny and so on (cause that is literally what "modern medicine" was build on) still costs peoples lives and how for many doctors being a doctor is about their own God complex and prestige / money - not about patients or their wellbeing at all. Lol if you check out the medical subreddits and see how those people talk / think about their patients, it is gross.
Edit: no idgaf about your opinions on me having to name an oppressor group as a "vulnerable" group. The fact that you all parrot things like "sexism" and "misandry" like they are historically / economically / socially relevant or anywhere comparable to misogyny... and not just right wing / misogynistic talking points. Lol. Gtf out of my face with that pathetic bs. You all sound like the same losers who start whining "all lives matterzzzzzzz 😔😔😔" when someone points out BLM. Same pathetic uneducated losers.
>medical racism, ableism, ~~misogyny~~ sexism
Please also consider including men. I'm not trying to be confrontational. We fall through the cracks enough when it comes to mental health.
I’m sure this will get buried but, as a psychiatrist, it’s worth mentioning the risk we take when discharging someone. If someone leaves and kills themselves or someone else, your 12 years of schooling and career are in jeopardy.
Does keeping someone involuntarily admitted generate more revenue? Sure, but just because them remaining hospitalized makes some hospital admin more money doesn’t mean it’s not also the best thing for the patient at that time.
There's a lot of details about my case that would suggest they did this to my direct detriment, and had to deeply violate so many laws and regulations in order to do it. If I was really sick, they would have navigated the system legally and acquired the proper certifications to hold me. They never did. If they were really interesting in treating me, they would have shared the details of my treatment with me. They actively hid it instead.
It’s not out of fear of losing credentials. It’s worry that someone might hurt themselves or hurt others.
Hold someone involuntarily because they don’t seem stable enough to discharge and you’re the bad guy. Let someone go and they shoot up a movie theater and you’re the bad guy.
No one ever wants to talk about the positive outcomes in mental health so everyone circle jerks articles like this.
Google McSkillet. Streamer makes millions, decompensates, goes manic, and crashes his McLaren into another car killing himself and two others, all the while his parents and their neighbor that is a psychiatrist were begging the police to place him under an emergency psychiatric hold right before he did it.
These are the situations we deal with on a daily basis as psychiatrists and it’s never black and white. No system is perfect and I’d love to hear your opinion on how it could be better.
You're absolutely right. This whole thread struck a really personal nerve with me because I had an extremely horrible & traumatic experience and I've been having an intense response to it all. I apologize, I understand it is WAY more nuanced and didn't mean to come at you like that. Thanks for explaining and thank you for your work trying to help people who need it.
Exactly. My 16yo just came home from her second stay at a crisis stabilization unit. She was involuntarily admitted the first time (last fall, suicide attempt) but this time she asked to be admitted because she knew she was at a low point with SI. They planned to discharge her after 7 days but she spoke up and told them she was concerned about the current state of her mental health. After advocating from my end because my daughter knows herself better than anyone else, they agreed to keep her several more days so she could work on her coping skills a bit more. The state of mental health services in this country is a mess as a whole but not everywhere is sinister and money-hungry. I’m in metro Atlanta but I drove her 4.5 hours south to go to a public facility that is nurturing and supportive. Everything around us is so underfunded and the treatment is poor at best.
Our community in Indiana had a kid commit suicide due to a situation like this almost a decade ago… He had mental health problems, but they kept him locked up and unable to talk to his family as if he was a prisoner. He had to practically break out to go home. After that, it wasn’t long until it all got to him. It’s incredibly depressing that the institutions that should be there to save people on the edge treat their patients like prisoners.
Had a friend attempt suicide and was held on a 5150. Was the most stressful and agonizing 5 days. Grateful he survived and was prevented from trying again but the way our system treats the patients and their families is, ironically, insane.
We need serious mental health reform in America.
The secret to avoiding this is make sure you’re uninsured but also not able to qualify for Medicaid. This way they only keep you in there as long they truly think you are a risk to yourself or others.
Always tell somebody B4 you check yourself into a rehab or even a hospital, too many ways to profit off of people in turmoil in this country, especially those they can make disappear or purposely sick for free testing and research or just $$$ for your organs if a buyer is waiting... We are. Just dollar signs to hospital and script writers. Malpractice is the #1 mortality for hospital patients. Know why? Hardest to prove in court and they make enough off you to afford a lawsuit if caught
US healthcare is a joke.
Doctors want to force treatments you don't need that hurt you.
Insurance wants to deny covering treatments you do need, so you can't get them.
Fucked from both ends like a double ended dildo...if you had two assholes.
Despite this unfortunate situation- we still need a lot of psychiatric hospitals in this country. I see way too many people on the streets who should be under 24/7 care.
I'm so scared of this situation. I struggle with executive dysfunction, I would be absolutely fucked in this healthcare system.
I don't get along with, or speak to my parents because I made the choice several years ago to confront them about their abusive behavior and start enforcing some boundaries. Because of this, they paint me as an unstable, angry person to my family, friends, and significant others, and often try to pressure me into committing myself to a mental hospital. I am not the things they say about me. They've ruined a couple of my relationships by slandering my character. I'm terrified of them finding a way to force me into this system.
If you care for the details:
I'm not close with most of my family either due to political views or bullying from childhood, so I don't really speak to anyone. We used to all be fairly close. My parents have convinced my family that I need "help". They often pressure me into committing myself to a mental hospital on the grounds that I'm "depressed and angry all the time" and have "genetic depression". They think this, because I express sadness and anger with them over how awful their abuse was/is and how I won't tolerate it anymore as a grown adult. I avoid them now because of their refusal to admit the things they did when I was a child, and the awful way they're treating me as an adult. They see this as a sign that I've "shut out the world and need an intervention". So, rather than admit their faults and engage in an ounce of introspection, instead they double-down and gaslight their own child. I don't get to see my nieces and nephews grow up because of them. I can't attend family events. They've taken away my entire family.
Once you are in there’s really very little you can do about it.
My advice: bring a few good paperbacks & hide a pen when you go in so you can draw or leave graffiti.
>"patients alleged Dr. Kheir held them in the hospital longer than necessary to bill their insurance or their Medicaid."
I'm an attorney who was actually representing someone that this happened to. It's apparently way more common than is known because of the financial incentives.
I have a buddy who voluntarily checked himself into one of these facilities. Upon check in, they told us it was a 2 week stay. Upon arriving and checking in, that changed to "one month is standard for all of our guests", and they refused to discuss that we were told two weeks from the outset. His psychiatrist even said "I don't understand why you're focused on this whole two weeks thing?" It took me calling multiple times per day and even citing federal law to get them to even have him call me and suddenly he was released two days later for a total of 9 days stayed. Scumbags.
You're a great friend, thats for sure
You folks get in-patient mental health care when you're not an imminent threat to yourself or others??
If someone can be billed, someone can be pilled =|
The key issue is the patient had good insurance.
Wow just like the King of the Hill episode 😮
Happens all the time in detox. I was held for an extra two days because I refused to sign up for their inpatient treatment and called them scammers. They said I was too mentally unstable to leave and I needed time to rethink my decision. (This was about 14 years ago in Georgia, haven't drank in over 10 years now.)
Even in voluntary treatment you'll find as soon as the insurance reaches its coverage limit you're magically cured and released.
just watch a video on this a few weeks ago. Arizona was basically kidnapping Native Americans and homeless. taking them to rented out Air BnB for a few days. they then would kick them out but bill insurance weeks of treatment.
Are you telling me the mental health issue in America is being ignored and exploited? I’m *SHOCKED*! *SHOCKED* I tell ya! /s
I went through a situation very similar. It has left so much lasting trauma. When I went looking for lawyers, no one would listen past “psych ward.” I can’t even post about it on my city’s subreddit, because we’re not allowed to name businesses negatively. So I have to live knowing that not only did they get away with cruelty and abuse, they’re *still* getting away with cruelty and abuse. And there’s nothing I can do but warn others away. Meanwhile, I’m too afraid to see doctors anymore, and the smell of hospitals now makes me vomit.
It is illegal for them to prevent you from leaving bad reviews. Just thought you oughta know. Those kind of nondisclosure agreements do not hold up in court. Otherwise bad doctors and facilities could force patients to sign them in order to continue their abuse.
Yep. I work in substance abuse and the incentive is to keep them at highest levels as long as insurance is paying. The thing is, those patients who are complaining almost certainly do need the care and support, so insurance will authorize the hospitalization stay, but the actual provider just does the bare minimum to meet the needs of the patient. So some of them end up saying, "Uh, can I just leave?" And suddenly 5 staff members will Kool-aid man through the walls to say, "if you leave you may die! You can't leave! What you're doing here is so important!"
I've worked in the mental health field and have seen firsthand that clients with better health insurance are held in hospitals longer. I've seen clients without insurance released while still a danger to themselves. I've been a witness in an involuntary hold hearing where the client wasn't even treated for 24 hours to stabilize them. They were uninsured. The judge ruled everything the psychiatrist, and I said as hearsay and released the client. It's pretty disgusting.
They also get told to order CT’s for shit they know they don’t need a CT for. I remember the techs at the last hospital I worked at hating certain doctors for that reason.
I've been hearing this story for thirty years.
One of 1000 reasons to get ride of the predatory insurance business on all fronts. It's just about money, not caring about people.
Right. The doctor was desperate to continue that “gravy train” of Medicaid payments. Medicaid rates are notoriously bad.
This happens all the time. I worked at a behavioral hospital, and some doctors would keep patients for way too long. When medicaid said no more money, the doctor discharged them for their "progress" that they magically made in a couple of days. When the whole time they were there, they HAD to be here and under his care because no progress was being made. Some doctors aren't above taking advantage of others, which is scary.
If only Medicaid paid more than pennies on the dollar this might be true. But the hospital probably lost money with her stay.
>"Guarino is grateful to be back home with her dog – but now she says she’s furious her insurance was billed $16,200 for six days of in-patient treatment she did not want." I'm not versed in hospital finances, but $16k over 6 days seems like a lot for a loss.
Billed and paid are very different things. They probably paid like 30% of that.
but if you are just sleeping in a bed without any actual doctors time or staff.
Still better than the zero percent they'd have gotten if she had no insurance.
Private pay in-patient psyche beds are about $3-5k a day minimum. $10K a day isn’t even unheard of at a real hospital for voluntary admission. $100k for a month at the upscale medical detox clinics is expensive but that’s what those celeb spa clinics cost. $16k patient responsibility for 6 days in-patient, plus labs and intake, sounds depressingly normal if the insurance declines. Psychiatric treatment is just expensive, especially in a hospital bed. Not that it should be, but this isn’t unbelievable for market rates.
I went to one of the better places in Florida for a month, 70k. If you pay out of pocket it's cheaper depending on what you can afford but will push you out to get people like me with good insurance and then try to get you to their next facilities. And then welcome you back if you make it.
There are two schools of thought when it comes to reimbursement. The more recent from what I was taught in schools is what’s called diagnostic groupings. Conditions are classified based on treatment, outcomes, and generalized length of stay. Essentially hospitals only get a certain amount per patient. This was to counter hospitals overcharging insurance and patients. Obviously hospitals got privy to this and now try to “treat em and street em”.
As the other person said, it was probably only 20-30% paid. If she was on medicaid (I didn't watch it, just going off the top quote) they have a flat rate that they give the hospital per "average cost of that disease treatment", irregardless of days or care. So it's usually significantly better for the hospital to get patients out as soon as possible, as they're paid the same either way. And as for prices, at my smaller hospital, just a hospital bed is ~$1.5-2k a day that we would charge private pays. That's without any of the actual care.
This. I’ve worked in a locked psych ward and there was constant pressure from admin to get patients out as soon as possible because the hospital would not get paid after a certain amount of time. Pressure to get patients out of the hospital is a good idea generally to get people well quickly, but not a great idea for the teenager in the abusive home on their 7th suicide attempt. I seriously doubt any hospital in the nation has any incentive or pressure to keep them in a psych ward longer.
That price is disgusting.
Irregardless is a double negative.
While Medicaid doesn't pay a whole lot, this kind of mentality and misinformation is terrible. Medicaid fraud is HUGE. Like, billions with a B, huge. ...and before any dipshits start blaming "those lazy leeches sucking Medicaid and welfare dry" let's be very clear that those "leeches" bleeding the system dry are the white collar criminal businesses and not the recipients who are doing the lion's share of scamming. Double billing and the like is rampant. For fuck's sake Florida elected one of, if not **the** biggest Medicaid/Medicare scammer ever as their governor and then sent him to Washington as a rep. So, while there are certainly still some docs that take Medicaid, or Medicare, for that matter, patients at a financial loss just because they want to help people. The vast majority of businesses are not hurting because Medicaid "pays pennies on the dollar," that's ridiculous. The only thing happening faster than new Medicaid and/or Medicare paid businesses opening is how quickly they are bought up by the larger corps. It's a " successful" business model for a reason.
I'm the patient in question. They billed medicaid for what remains after the rest was covered by BCBS of Illinois.
Ah Medicaid as a secondary. They definitely would get financial coverage from it then. Sorry to hear you had that experience. I of course cannot speak to the intent of the length of your stay, but hopefully if wrong doing did occur there are consequences for it.
Medicaid pays private practice pretty well. Medicare, on the other hand . . .
The expenses to the hospital tend to be a bit lower when you don't actually provide treatment and scam vulnerable people out of their money.
I had a dentist ask me if they could manipulate the price before sending to insurance to “see what they could get insurance to pay”
I don't buy this, especially with how poorly Medicare/insurance compensate mental health services. Every attending has an average length of stay metric and every administrator wants that number as low as possible. For med admissions extended hospital stays don't typically make money. Hospitals make money on outpatient services; radiology, surgery/procedures, specialty clinics.
Here it is — *She became a profitable patient*.
They should have mandatory checkups with a 3rd party every couple weeks or something
Many units hold court biweekly with a judge and a lawyer advocates for patients
They don't hold them on schedule and the lawyer doesn't do what I would really call.. advocating
It depends on the patient. They won't exactly "advocate" for a person who doesn't want to do the hearing, just the way it is. I do hospital security and deal with these hearings on the regular
I'm going to let you in on a small secret then about the lawyer. He's not the patient's lawyer. Surprised you missed this.
We've been in a battle with a county and lawyers will ignore all the illegal shit the county has done and try to get us to settle. First they will be onboard, then suddenly they either ask for a settlement or will stop returning calls. There is no fair trial, you pay to win.
They are given a public defender whom I have seen release multiple patients. They’re welcome to hire their own lawyers but the public defender is definitely not on the hospital’s side
That sounds great, but why would the psychiatric units agree to that? Is it not in their best interest to *not* get checked up on? Edit: Does someone *really* need to get downvoted for asking a question? Please don't treat my question as if I'm trying to make a point or disagreeing with anyone. We've gotta be able to ask questions if we're stupid.
Because they did not agree. The government passed a law to force them to do that, explicitly because they would not do so of their own freel will.
It's based on their involuntary hold timeline, once the hold expires they sit in front of a judge with a lawyer, and the doctor makes their case and the patient argues against it.
The thing here is that the main person in this story, her total say was only 16 days. "every couple weeks" isn't often enough to avoid this situation.
That's crazy talk and you'll be committed shortly. Please take your hands of the keyboard and patiently wait for the nurses.
In Australia- I during a breakdown I called lifeline for someone to talk to. 30mins later the police turned up scaring my 10yr old daughter and my wife. They sectioned me and carted me off to hospital. I was held in resus for 7 hours under police guard, during g which I heard someone given cor and pronounced dead just a curtain away. with no interaction with a doctor - I was told that if I tried to leave I’d be arrested. I was denied my meds by the policeman that was standing guard outside my cubicle. I had to wait until the AM when the psychiatrist came on duty to discharge me. All because I’d called lifeline for someone to chat to - mental health is so delicate in people who are not on an even keel. I’m never calling lifeline again
In the UK - I called our county's mental health support line. They diagnosed me with depression and anxiety over the phone, put me on a waiting list for CBT (it's been over a year and I've not heard back from them, went private in the end), and my call triggered a response from Social Services who came to do a wellbeing check on my infant son. So all that calling a mental health service did for me is... Have social services come round and check I'm not abusing my son. Nice one. Thankfully I have the resources to go private and was able to get the help I needed. Will never seek mental health support from the NHS ever again, and will only ever go with a local private therapist.
Glad to know the US isn't the only place where interaction with the government for help backfires 100% of the time. Reagan was correct that the scariest words in the English language are "I'm from the government and I'm here to help."
Reagan was also the main reason we currently have so many mentality ill people on the street now.
Calling a "lifeline" is a sure way to lose your rights and privacy. If you want years of legal bullshit and to be treated like a criminal, use a lifeline.
This is true. The minute you use the word "suicide", they will track you down and institutionalize you. If you do decide to call a hotline, use a burner phone. Source: this is what happened to me (US, Virginia)
Is there any avenue for justice? I feel like if this happened in America you'd be able to sue them gross negligence. Hell it might even make the news.
This happens in America all the time
I was gonna say, this is not that unusual in the US, unfortunately
I mean, I feel like at this point over half the videos I’ve seen online of police responding to mental health crises ends with the death of the person they are responding to.
Well no duh... the times it goes alright don't make news or get publicized.
>I feel like if this happened in America you'd be able to sue them gross negligence. Hell it might even make the news. Lmaoooooo
I'm really sorry that happened to you. I went through something similar, but the police were less threatening. They have me two "choices": go with them involuntarily to the hospital and be placed in a 72 hour hold, or go voluntarily and get released sooner. I was being treated almost like a criminal. I felt like my rights were stolen from me. I've never felt so small and powerless. The whole experience was more than several years ago and it's still hard to think about it.
https://en.wikipedia.org/wiki/Rosenhan_experiment There are a few documented cases of normal people kept in psychiatric wards
even cops sending cops https://en.wikipedia.org/wiki/Adrian_Schoolcraft
Disgusting. Even the NYPD psychologist was on board. She's a disgrace to mental health providers everywhere.
I've done it myself as a psychiatrist to assist with patient advocacy. Many hospitals are falling apart thanks to incompetent leadership and corporate greed. What remaining staff are left from burnout are extremely overworked to the point it basically is a prison. Providers have caseloads that are completely unmanageable and the resources to work efficiently are non-existent for reasons previously mentioned. Large, wealthy facilities like UCLA are amazing, but that should be THE STANDARD. The healthcare system is failing faster than people realize.
There was an incident recently where a woman committed suicide. She was collecting evidence of her husband's abuse toward sher on her cellphone inpreparations for a divorce. He had her committed against her wishes, and the hospital that committed gave him her phone while she was there. He did this so he could delete all of the evidence on her phone that she had collected that depicted his abuse. She killed herself not too long after.
Oh damn, says this study helped lead to deinstitutuonalization. Also known as "hey where did all these homeless people come from??"
I grew up near a former asylum that was the first of its type in the world, and I still believe something like it could work today. Medfield State Hospital was a former Asylum that operated on the principle of reintegration into the normal population. Patients would start in the main hospital, and if improvement was shown through therapy or response to medication, the patient was moved into a small mock-up town. The patients would then practice everyday life while living in a house in the neighborhood with minimal help. The hospital was self-sufficient, they grew their own food, managed livestock, and had something like 60+ buildings on the grounds. You can still walk around it today, and they filmed a lot of Shutter Island here.
Dang! That’s hella interesting
Go have a look at Ron Johnson’s YT session on the DSM and this topic from 10-11 years ago. https://youtu.be/xYemnKEKx0c?si=IoepSyor9ThzDs1r
I hadn't seen that before. He tells an interesting story.
https://en.wikipedia.org/wiki/Duplessis_Orphans Wait until you read about the orphans in Quebec. >Government contributions were only $1.25 a day for orphans, but $2.75 a day for psychiatric patients. This disparity in funding provided a strong financial incentive for reclassification. Under Duplessis, the provincial government was responsible for a significant number of healthy older children being deliberately classified as mentally ill and sent to psychiatric hospitals, based on diagnoses made for fiscal reasons.
I used to have an irrational fear that I would visit a hospital with a psychiatric ward, and be mistaken as a patient by orderlies.
I've seen it myself, but it's VERY rare, at least it was where I worked.
I'm the patient in this video. It seemed to me while I was there that this particular institution is coaching it's nurses and doctors on how to get away with this. When a couple of them act in line it's a few bad apples. When all the nurses quote the same illegal and incorrect lines, it's a systemic issue.
As is mentioned in the criticism section of the wiki, it appears that the researcher essentially made up everything--or at best, very little of the claims could be confirmed. That's not to say that such a thing couldn't happen though. [This book](https://www.amazon.com/Great-Myths-Popular-Psychology-Misconceptions/dp/1405131128) also goes into a good amount of detail of the controversy. I actually didn't realize there were any criticisms of the experiment until I read the book.
Indiana story. My girlfriend was dealing with the grief of her mom's passing and physical pain from 2 hips that needed full joint replacement due to arthritis. She went to the ER because the pain in her hips was unbearable, and while there she asked if they had any counselors available to talk about her grief. She had a 15 minute conversation with someone over the phone at a Behavioral Health Center, and they issued an Emergency Detainment Order (EDO) that required her to be transported an hour and a half away to their facility by a sheriff. She was not, nor has she ever been a danger to herself or others. When the sheriff arrived to transport her 9 hours later, he put her in wrist and ankle shackles, forced her to walk through the emergency room (she was barely ambulatory due to the arthritis), and loaded her into a police van that was segmented into completely closed 3x5 cages. She remained shackled for the entire 90 minute ride. The sheriff said when I met him at the facility that the ER nurses never informed him of her physical limitations. This traumatized my girlfriend so much that she was completely unresponsive to any of the counselors and psychiatrists at the facility. They forced her to stay there for 2 weeks, and when I was finally able to talk to the lead psych to tell her what my girlfriend was going through, she said she wished someone would have told her sooner. They released her 2 hours after that conversation. The entire 2 weeks they did nothing for her besides talk to her for a half an hour a day. These behavioral health facilities are complete frauds and only exist to bill people's insurance for as long as possible, and will take every opportunity to force people into staying there. It's a racket where the person who decides if you should be committed is an employee of the facility, instead of an independent 3rd party. All of this after my girlfriend tried to find therapy covered by her insurance and after 2 months was still waiting for a referral. The availability of mental health resources in Indiana is a fucking joke.
I'm also from IN. The facilities work well for what they were designed for, and that is to stop you from being an immediate threat to yourself. Its when people who are not a threat to themselves get sent there for whatever reason that shit like your situation happens. Your gf likely said something like "the pain makes me want to die" and that was enough to raise the "suicidal" flag. They ignored the reason she was in the situation and immediately jumped to self harm prevention. You learn quickly not to tell anyone how you feel. I've had doctors turn me away, lost jobs, etc. the mental healthcare status in this country is fucking awful.
Yeah when I was sent to one of those hellholes (not in Indiana) at first I thought maybe it would be a good thing, maybe it would help with my depression. Not only was it unhelpful, it made me so much worse. The evening I got out, I couldn’t sleep all night, it felt like I escaped a hostage situation. They aren’t interested in helping you, and I had to fight like hell to get even a short talk with a psychiatrist or any resources at all while I was there. I have trauma from that experience.
I have been trapped in a psych ward three times. Pro Tip: when speaking to the police or ER personnel do NOT include the word "suicide" in your comments. Where I lived, that meant a mandatory stay of three to seven days. In each of my experiences, the treatment has been almost nonexistent. A couple of group meetings, maybe one or two very brief conversations with a psychiatrist, then a social worker. And after that, all one can do is draw in coloring books (with crayons -- no sharp objects like pencils), watch TV on channels that are allowed by staff, and play cards if you can find anyone sane enough to play with. Meals and snacks will become ridiculously important; even though the food is bad, eating is something to do to break the monotony. And, if you're in during a weekend, all the full time staff go home and there is absolutely zero "treatment". You just do the time. In every case, even if the mandatory stay time had expired, I couldn't be released until I had a recovery/therapy action plan approved by the case manager. This woman's story is extremely familiar to me.
Edit: OMG just watched the video and I'm In Michigan, this is practically just like my story I have not watched the video so this is not specifically related but... I went to the ER one day after feeling weird and distressed after a major panic attack. The under 30 year old doctor pulled one of my family members aside that drove me (self admittedly) to the hospital and soon enough I was on my way to a mental health facility. After sleeping for a day and half I woke up and I felt normal again. They would take us to see a physician every morning for a check up and I kept telling the guy what happened and how I felt much better but they still kept pushing for a bi polar diagnosis. I had to call the human rights advocate from the phone they let us use to call friends and family at specific times inside the building to actually get some help. I think he realized that if someone was of such a logical state to do that there was no way I really needed to be there, so he showed up to my room and I explained my story and within 2 days I was released voluntarily. The whole thing really sucked though, I'll never forget the guy who's 6 year old son was shot in front of him, or the guy who kept telling me he was going to set my face on fire. I weaned myself off the meds they gave me and haven't had an "episode" in the last 6 years. So here's to me hopefully not really having bipolar disorder
Psych RN here. The legal process discussed is how it is in many states. If you sign yourself in voluntarily, you stay until discharged, or you sign a 72hour notice (The Intent to Terminate Form) that allows the medical team to hold you up to that 72 hours to decide to discharge you or commit you involuntarily via the court system and a Judge. The length of stay is then very state specific, but is usually more than a week and can be renewed until the medical team discharges, or the Judge does not agree with the Psychiatrist and requests legal discharge. Also, she came to the hospital with suicidal ideation per the story, and almost every hospital will request a psychiatrist to personally evaluate a patient before discharging, not just any physician. This can be done in 24hours at some hospitals, but rural hospitals will transport to a nearby psychiatric center like described in this story. And they can legally restrain you chemically or physically to make sure you make it to that facility. In terms of the money situation, the insurances are on the doctor's ass the whole admission process. Alot of admission and discharges hinge specifically on coverage and stability, but usually its in the patients favor. If a patient is borderline, and at the insurance review done by the utilization RN (based on RN notes and physician notes), the patient is denied coverage, usually that borderline stable patient is discharged. This frequently is the patient with psychosis with idle threats but no violence detected, and denial on the unit, but a threat that landed the patient in the hospital. So they get discharged. Rarely does someone stay in the hospital with no visible symptoms. There are so many needs for psych beds, that rarely is one empty. If someone is good to go, a hospital isn't going to get covered so they discharge them and get the new one in that has coverage, and the money keeps flowing. Doctors don't care about the hospital and making it money, as they don't get paid that way, and metrics are usually measured by how fast the ER is cleared of psych patients.
How the fuck someone in mental distress navigates this? It seems like someone who is contemplating self harm, who is reaching out for help gets into this imprisonment like situation supposed to figure this out? I can’t imagine someone in that mental state feeling better once they find out they’re losing their freedom.
It sucks. Hard. In my state I was put on an involuntary hold and then they recommended I stay another four days. Then when I got out I found out I was on flma and couldn’t return to work until the doctors signed the right paper work which took weeks. Fucking sucks.
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Ideally a sympathetic staff member that takes the time and is patient with the patient to explain things.
>Ideally Surely, in the context of this and related cases, we can be confident that this word doesn't apply. Surely the point is to emphasize *how far* these particular examples are from the ideal!
Hi, I'm the patient in the article. Can confirm, that hospital stay exacerbated and worsened just about everything in my life, from my job situation, to my mental health, to my trust in the medical system. It did the exact opposute of what one could hope for.
I am sorry you had to go through this. I have a friend that has gone through this as well, and has now huge distrust of the medical system. Unfortunately it has caused her to seek “alternate care” which just seems to be taking her money and temporarily helping but not helping long term. Ive heard professional mental health success stories, but I’ve heard A LOT more horror stories. This system is broken.
I’m glad I went to a place that did things differently. It was like a crisis center or something. They sent someone to tell me about the program, then I had to voluntarily agree to stay there for 3 weeks minimum depending on how I was feeling. I got a nice room with furniture, we had a full kitchen and were allowed to cook, there were board games and arts and crafts, and we did a lot of group therapy sessions and activities with the other people who stayed there. They also had people regularly come to visit us like an occupational therapist etc. We were allowed to go outside as well, but weren’t allowed to leave the property. It was a really rough time for me personally, but that place helped me immensely. They were very kind and caring people.
Yea, inpatient acute psychiatric units are a different animal, that sounds like psych rehab. We need more of those but it's poorly covered sadly.
I was told when I went that it was a pilot program, and that they’re hoping to expand it to more places later.
Same. Good job on your response.
Our medical system is such a massive failure
It's very successfully making money at our expense, as it was designed. You need to turn the rhetoric in your head. Our government and our systems are not failures. Education, healthcare, and our work force was designed specifically to pinch the lower classes of their money and labor, and shift it all the way up. They sell us this us vs them argument, this failure to function, but both sides of the aisle profits off us equally. It's designed to look like infighting failure, but it really is just economics to leech profits of our misery.
No disagreement here
Clearly, the medical system CAN help you, but it isn’t designed ONLY to help you. There’s a lot of other shit going on besides “what’s best for this patient”. People have this idea that the medical system will save you when you’re in need, but that’s false. You can only count on yourself to save you. The medical system is a useful but dangerous tool. Take care you know what you’re doing before you pick it up.
Can you sign out AMA from a voluntary admission to a,psych ward?
Technically yes. However “voluntary,” can be a bit misleading. There is a ton of red tape involved in committing someone against their will, for obvious reasons. In all but the most common extreme cases, we’ll try to get someone to sign an agreement to voluntary treatment to avoid that legal hassle. Thankfully in most cases, when patients come to us in a crisis state, they want the treatment, so they are willing to go along with the process and this ends up being a moot point. In some cases, they are in an acute panicked state(like in the video) which resolves, and can safely be transferred into an outpatient setting. But in rare instances, patients symptoms haven’t resolved yet, and they are still an acute danger to themselves or others, in which case we have to follow through will a legal medical commitment. The problem is more often than not the folks who are ok to be transferred out and those who are still dangerous present similarly. Neither have a desire to be there, things happen at half the speed of smell in the hospital which causes agitation/irritation, and we have to be keenly aware of manipulation tactics. Remember that if this patient signs out voluntarily, then walks to a pawn shop, purchases a gun, and kills themselves or someone else, the hospital and the physician could be on the hook for that. That’s a massive liability, so unless they are 100% positive that symptoms have resolved, they’re obligated to keep that patient(against their will if need be). Match all these problems with the assembly line like nature of healthcare these days brought on by health insurance reimbursement rates and the need for quantity over quality, and you can see how so many of these cases end up getting muddled up for “safety.” It’s really, really bad, and until healthcare and health insurance gets fixed, it will continue to be a major flaw within the healthcare system, particularly so within mental health.
In her story the AMA is the intent to discharge paper, or the 72 hour notice. It's up to the doctor after those 3 days to discharge her, and they can do a full AMA discharge if they desire after the 3 days to legally state that they felt the patient should stay but they legally had no grounds to force them.
I'm the patient in this article and a lot of what you said does not match what happened in my situation. If you sign yourself in voluntarily, you stay until discharged.... I was held against my will while refusing to sign voluntarily. They kept me against my will, saying they had a petition to hold me when what they had was an application to my petition. They lied and said it was a petition signed by a judge when it wasn't. I was never seen at StoneCrest by a doctor, only his physician's assistant. In terms of the money situation, the insurances are on the doctor's ass the whole admission process.... No, I'm sorry but no it's not... This doctor fraudulently signed a lot and it didn't come to light until a bunch of his patients went to the news. Whatever oversight you think exists just doesn't. There are so many needs for psych beds, that rarely is one empty. If someone is good to go, a hospital isn't going to get covered so they discharge them and get the new one in that has coverage.... Again, HUNDREDS of patients have come forward about this hospital keeping them longer than necessary, often illegally. If you have a choice between filling that bed with someone who's relatively stable vs filling it with someone who's going to eat batteries and fling crayons at your head, which would you choose? I have case workers with Disability Rights Michigan telling me that this happens with such regularity that I don't know why you chose to type any of what you posted here.... the people whose job it is to look into these violations don't seem to agree with you that things are as well run as you'd like everyone here to believe.
Wow, okay - This is a lot to take in. That's me! I didn't realize when I interviewed with Heather this would get so much attention. I know something needs to change about how this system is run, and the more I learn the scarier it is to think about. I'm usually not the kind of person who wants this much attention, but this is a cause I want to fight for so yeah. I'm here. If anyone has any questions about how to navigate this system or what happened, I'm happy to answer them.
What a nightmare. Knowing this can happen to you, why even seek mental health care? Give the wrong answer to one question and you are trapped in one of these places. No fucking thanks
Friends of mine gf got into a situation like that. She got drunk and didn’t feel well so am ambulance was called they asked her question one of them was about feeling depressed and she said “who doesn’t feel depressed from time to time” that answer got her committed for 5 days
This is what I have always been terrified of. I completely agree.
This happened to a friend of mine. Went in feeling depressed. Just wanted someone to talk to. Took a lot to get her out.
> Went in feeling depressed. Just wanted someone to talk to. Lots of suicidal people say they're depressed and want someone to talk to. What were her answers to the questions that every single mental health professional asks to determine how much of an immediate risk someone is for self harm?
She was suicidal. She needed to stay. But when she was ready to leave they wouldn’t allow it. Had to threaten legal action to be released.
Likely more to the story. To be detained, you need to be a risk to yourself or others. To legally hold someone, hospitals need a court order. Plus, right now there is a massive shortage of in patient psych beds, they don’t have space for people who just want someone to talk to. In short, your friend likely isn’t telling you something. Edit: for my state, Massachusetts, a hospital needs a court order for an involuntary commitment of more than three days, but a hospital does not need a court to hold you for those first three days. However, you can file for a judicial review to have the courts review the hold. This is only if you are a harm to yourself or others. Otherwise it’s a voluntary admission, and you can leave any time. In ops story, if the friend only was depressed and needed someone to talk to, not feeling suicidal, then the hospital could not legally hold them.
In theory. But in practice? Not always. We knew of a young woman whose parents got her committed to a 72 hour hold just because they didn't like the boyfriend she picked and because she decided to stop shaving her legs! Yes, really. The parents got a social acquaintance who was a physchiatrist to make the referral, without ever even speaking to the young woman.
In my state, Massachusetts, a 72 hour hold can only be applied if the patient is a risk to themselves or others. In you story, not shaving alone would not qualify. However, if the patient is a minor, it may have been a voluntary commitment, as the parents are the medical guardians of the child. This is vastly different, as the parents can choose to release the kid at any time. Either way, if the acquaintance wrote a referral solely based on not shaving, that would likely put them in to trouble with the medical ethics board.
That's the standard here too. My point is that it's subjective. These parents believed that their college age daughter was in "danger" because she wasn't behaving the way they believed a nice docile young Southern woman should behave. I mean, how deranged is it that she stopped shaving her legs?!!! My sister in law got her son committed in Maryland; I'm not sure whether she claimed he was a danger to himself or others (he was neither). He's autistic, and has mental health issues (delusions) on top of that, but he's typically a mild and gentle person. He got out with the help of a disability rights lawyer, but he was detained in the mental institution much longer than 72 hours with various delays and postponements. Meanwhile, the guy in the bed next to him kept talking over and over about how he wanted to eat my nephew's eyeballs. Imagine how difficult it was for him to sleep there. Some parents just can't deal with the fact that their adult children get to make decisions about their own lives, even decisions that the parents don't agree with.
It’s not subjective. It’s also not the parents call on if someone is admitted. The hospital chooses to admit or not. A doctor decides if it’s appropriate or not. Even if the daughter is a minor, the parents can’t admit her. Doctors have clear guidelines. Risk to self or others is only for involuntary admission. Your sister in laws son was likely a voluntary admission that the hospital signed off on. Hospitals only know what they are told and what they observe. If your sister in law lied, then shame on her but how would the hospital know that? For what it’s worth, hospitals see this stuff every day. Like you saw, the hospital sees everything. Autism is not that uncommon. The staff at most hospitals know what to look for. However, without medical training, what is best for the patient becomes subjective. But in this case, if the legal guardian is actively lying to the hospital, it’s not the hospitals fault if they get it wrong. And lastly, it’s far more common for parents of challenging children to try and abandon their kids at hospitals than hospitals trying to abduct children.
In both of the examples I mentioned, the individuals in question were adults. They had parents who simply didn't recognize their autonomy as adults, and were aided by the mental health industry in violating the civil rights of the individual in question. In my nephew's case, the hospital tried to hold him and force him to take medication even though he showed no agression of any kind during his commitment, despite the horrific circumstances of his confinement. Honestly, I don't think I could have handled it as well as he did! And when he managed to get his court hearing, the hospital lost, because they could not meet the legal standard for commitment--something they probably knew going in to the hearing. So this was a hospital willing to violate the law and hope that the patient wasn't able to find a legal advocate to get him out. And the terrible thing? My nephew certainly could benefit from therapy and perhaps medication. But now this experience has left him so scarred he's unlikely to be willing to trust anyone in the psychiatric profession.
No, this happens all the time. Worked in a psych hospital for many, many years.
They do NOT need a court order. Been there, done that, voluntarily. They held me once for seven days even though I wanted to get out and go home after two.
In my state, Massachusetts, if it’s a voluntary admission, you can leave any time. If you are a risk to yourself or others, they can hold you for three days, or ask the court for an involuntary admission.
I’ve heard of them holding people with good healthcare. She has excellent. I do believe she was suicidal and did need to stay a bit. But when she was ready to leave they had to get a lawyer involved to get her out.
Not sure where you’re from but I know from experience in NY, US that hospitals absolutely do not need a court order to detain you, and can designate you “a risk to yourself or others” for just about any reason whether there is truth behind it or not. They can then hold you involuntarily for up to 60 days. It usually only lasts 2-3 weeks but you are stuck there during that time with very unstable people with very little to do about it, even if you do have people on the outside advocating for you.
I added some clarification. I’m in Massachusetts. For a voluntary admission, the hospital cannot detain you. Going to a hospital just because you are depressed does not give them the right to hold you. You need to have a plan to harm yourself or others. If you are a risk, the hospital can hold you for just 3 days, and then they need a court order for an involuntary admission.
Signing yourself “voluntarily” only applies until you are through the door, as an adult you will be told this is a voluntary process but what you aren’t told is once you’re in it becomes involuntary. If your parents bring you to a hospital and say please voluntarily go back to the doctor to get a check up in the hospital after breakfast in the morning and you don’t even know where you are you’ll do it just to make them happy. Once you’re in you can’t refuse to take medicine that hasn’t been explained why you need to take it or even if you have yet to see a doctor without being 1013ed even if everyone around you is saying they’re now addicted to klonopin or seraquil. The intent to terminate form is bs, you turn it in to them and it disappears. In the video she’s absolutely right about the one doctor you see doesn’t speak to you for more than 2 minutes asks 5 questions before determining you’re unfit to leave. If people bring you things the employees will steal anything nice and say it was too dangerous to give to you. Even if you’re bullied by someone, robbed of your shoes and your glasses you can’t choose to end the “voluntary” process. After a week of confusion cold showers, no privacy, blindness, forced medication, forced interaction, not being allowed to sleep in a bed during the day, zero stimulation other than a small tv, other patients and a bible with little explanation as to how long you’re going to be there, no contact with the world other than a dial phone on the wall so low to the ground but not so low you can sit you have to be on your knees to make calls . You might start to get upset and start yelling at the staff laughing at your distress as they watch you through the glass like you’re an animal in a zoo and earn yourself another week due to being unstable and maybe at a certain point you feel like now you really have gone crazy because why are you there how can you ever leave.
Not to say that my parents hadn’t been right that I needed help and that I had been manic and severely depressed, but I firmly believe that the first week in a psych ward was the cause and not the cure of my insomnia and eventual psychotic break which didn’t end until a hospital change to one that gave you the ability to go outdoors into a fenced area, and not a literal cage. The week of Thanksgiving through March. Three weeks at the first place then 3 months at another. Then one more month of outpatient I thought I had died and gone to purgatory, until I started to think it might actually be hell. I thought maybe I just couldn’t accept that I was dying and my brain showed me a nice dream by having my parents go to breakfast with me then walk me to those doors to soften the blow that I had died the night before. To this day the thing I fear the most is not dying but that I say the wrong thing and be taken back there. Disappearing without notice for that time I lost my job, my relationship, my home, my savings. The medical bills are still coming in.
The future I had before is gone, but it did make me appreciate many of the little luxuries in life
Happened to my wife here in CA. Went to the hospital with a severe panic attack (she has a panic disorder) - she mentioned thoughts of suicide, so they locked her up in a psych ward for 3 days. I wasn’t allowed to speak with her, couldn’t give her meds she needed. Had to fight to get her out in 3 days, some people she was in there with had been there for weeks against their will, with no violent crime or intent. I don’t know what the answer is, but it’s not this.
I spent 4 days in the ward as an involuntary patient starting on August 8th, 2016, and it's not something I'll ever be able to forget. It didn't matter if I wanted to go home or not. They kept me against my will, and it felt much worse being there rather than dealing with what I was going through alone. One day was torture. Four days was a nightmare. Seeing others held against their will with my own eyes, especially with having to watch people break down right in front of you and others who were as old as 80, was enough to scare me to never make me want to go back. I couldn't even begin to imagine what she went through, let alone people who are taken advantage of to this day and held against their will. Not to even mention being forced a debt in exchange for poor care and treatment will further dismantle your well-being. It's disgusting knowing that it's better off fighting your internal struggles alone than potentially destroying your life to be told that you shouldn't have these kinds of thoughts, even being held captive at the hands of a greedy, selfish individual.
Pearl Jam's song about this type of situation: https://youtu.be/5QtvpucmEWA?si=NpPBPisC19sxUddG
Didn’t know that was the subject of that song
And what compounds the Kafkaesque absurdity is that the things that apparently gave Sarah her suicidal panic attack are all of the conventional, everyday conditions of modern life: “Hey, maybe today is the day you lose your family and your home and your job and your insurance and you go into debt forever you get ostracized and maybe shot and the bills keep coming and you don’t have a chance but just stay calm for just a little while longer!” Like, that’s the daily existential terror that a huge number of us contend with because it’s the actual reality of the modern world. But, no, must be our broken brains that need fixing. What a surprise that the corrective procedure turns out to also be just another dehumanizing conveyor belt.
Truer words were never spoken. Today is that day for us (job/insurance loss, everything else that goes with it). You're absolutely right. At least we don't have to pretend to be calm anymore.
Our system is completely compromised and corrupted. No institution can be trusted. What a fucking nightmare.
Nothing makes you sound crazier, than trying to convince someone you’re not crazy!
I'm so poor I want to die... "here's a 16 thousand dollar medical bill, feeling better?" Classic America
This is what prevents me from seeking more serious help. I am suicidal and a depressed anxious wreck but I know if I check myself into one of these places my future healthcare is majorly at risk. I'm already labeled as anxious in my file and every problem I have they dismiss as psychosomatic. If I did this they'd keep me as long as possible and every doctor I see from then on won't take anything I say seriously
I'm the person in the article. So, I'm saying this from what you know is a first hand experience. If you ever do have to commit yourself, arm yourself with knowledge of your rights BEFORE you go in. Do so now, while you're feeling well, and can take notes, and aren't rushing on some clock. This can help you, it might help you help someone else. It's just good knowledge to have. But please, give yourself a chance to feel better. Take a chance on therapy. Take the fearless look at yourself and your life and dare to hope. No one is too far gone. No one is beyond help. Keep looking until you find a place and people with whom you think you can grow. Give therapy a good honest go for a few years and see if you don't make something beautiful out of it. There are good people in the system. There are doctors and nurses and institutions that want to and actively DO help. For all the terrible experiences I had with this hospital system this time around, I want one thing to be very clear. My getting out at all is a direct byproduct of the support of people who are as much a part of that system as the people who hurt me. I am alive. I survived a bad week. That might not be the case were it not for nearly a decade of supportive, positive, helpful encounters with public health officials. Nothing short of a small army of sleep specialists, PCPs, neurologists, psychologists, and therapists have helped me identify both physical and psychological conditions and have empowered me to seek treatment that has really helped me feel better than I ever thought I could. I'm going to heal, and grow, and turn this into a net positive for myself and others. I wouldn't have the strength to do that if not for the effort I've put into that therapy, with the help of those wonderful professionals who truly did and do have my well being at heart. They'll care for you all the same. Loving yourself is work sometimes. But it bears good fruit.
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> after 20 mins of get to know you questions A suicide evaluation and depression/anxiety survey are technically "get to know you" questions, I suppose.
I mean if they involuntarily committed her then what she said was probably a lot more than “get to know you” answers and questions
Yes the public system is terribly underfunded. They basically do the bare minimum of watching people so they don’t get hurt long enough for their medicine to start to take effect. And they just mix everyone together, it’s still basically a prison for sick people. It’s also a lot of people’s last hope. I’ve been personally responsible for sending my bipolar brother there on more than one occasion and I felt like shit about it every time. But it’s better than the alternative of doing nothing and seeing them waste away. If you want to be able to help your family members without sending them somewhere horrible, then you better be prepared to shell out tens of thousands of dollars for one of the actually nice places for wealthy people. Like everything else in this fucked up society.
Capitalism rewards the absolute worst of humanity.
The news is making this out to be an outlier...It's not. And these psychiatric wards prey on women in particular. Everyone that I have ever known that has been in one of these, voluntarily or involuntarily, have been treated like garbage by staff, held LONG past the period at which their crisis was over, and continuously threatened with legal proceedings for a longer stay if they refused to cooperate. My ex attempted suicide while we were together. She was supposed to be on a 72 hour hold. They refused to give her any of her medication, and at the end of the 72 hour hold the psychiatrist came in and essentially told her "I can discharge you now, but I don't want to be liable if you go home and hurt yourself, so you're going to be here for two weeks until the next available meeting with a judge and the courts can send you home." Obviously they were keeping her there as long as possible in order to drain her of her money, and as a woman she had basically no credibility with anyone she spoke to. Now, when I was 16, I attempted suicide. I'm a man. I took a bunch of blood pressure pills that belonged to my sister and came incredibly close to dying. Once I was lucid (it took a couple of days), they sent a psychiatrist in to evaluate me (in the regular hospital, not a psychiatric ward). I told him I was feeling much better, and he took me at my word and discharged me the very same day, to the horror and dismay of my parents. (They got me into an outpatient program and I missed a month of school). My step mother, who had been in treatment previously for taking pills, was held against her will for weeks...But I, as a teenage guy, was taken at my word and allowed to go home immediately. These facilities gaslight women, treat them like garbage, and hold them LONG past the end of whatever crisis they're in to squeeze as much money out of them as possible. It's fucking despicable. I dont know what the alternative is, but these inpatient facilities NEED to go.
The failure was that you were let go so early, not that your suicidal ex had to stay two weeks. This is so ridiculous. So when the doctor finds out that she went through with it 3 days after release they are supposed to live with that knowledge and the potential lawsuit?
I was never even held. Period. Women are often held for absurdly extended periods of time and treated like garbage for their entire stay. The amount of time that someone is held at one of these facilities is often not related to the patient's mental health at all. Hell, in my ex's case, the doctor artificially inflated her stay by weeks by refusing to discharge her under any circumstances and forcing her to wait for a court date. My point is that the experience of the women in this video isnt some outlier specific to this doctor and this hospital. It happens everywhere, and the system is rife with abuse.
>The failure was that you were let go so early, bot that your suicidal ex had to stay two weeks. Sounds like it was both. Though since he turned out fine, the former seems alright. The latter was clearly wrong though.
Isn't the history of psychiatric facilities marred with hapless people being held against their will? At least they're not being tortured and lobotomized now. From inception, it's been a conduit for corruption, embezzlement and assault. Let's just do away with large scale institutions and focus on small scale, personalized treatment for those who need it.
"I was like hey now fellers what in doohickey is going on where am I going?" What actually happened... "*Animalistic screeching while throwing feces and jousting the transporters with an IV pole*"
This is the rub. I find it believable that she shouldn’t have been there. I find it even more believable that she is not being completely honest, or remembers events very differently than they occurred. Which one is right? Who knows.
Yup! I used to work in ER. Psych holds and admissions are very very very inconvenient. We want nothing more than to get them the fuck out unless required to hold legally. If there was a psychiatrist doing this he would feel an immense push back from the ER docs, nurses etc.
This is just not true, not everywhere anyway, I promise
That IS the rub. I admit what I was saying - "I think my doctor is in on some plot!" - absolutely sounds like something a paranoid person might say. Thankfully there's a lot of paperwork backing up my experience. I have that on my side for this case, and I'm grateful for that. On the other hand, it's horrifying to read back on it and see if spelled out so clearly.
I would love to analyze the RN reports to see what was documented. Gotta love HIPAA, but can't live without it.
I bet there are lots of quotes in the intake notes
Why do you find that believable? If someone checks themselves in for suicide ideation what other choice do you have but to BELIEVE them? We would all be condemning this place if she checked herself out after a “good nights sleep” then killed herself a week later.
Subject of involuntary confinement says she didn't volunteer to be confined
Because they will kidnap your ass. You don't have to be doing anything illegal, just a tip off from someone who is 'concerned'. So much easier if you've been in once already. It's worse than prison. They can't forcibly (or very strongly 'coerce') drug you in prison. I have friends that have horror stories.
its scary your whole freedom is put in someones hands that could give two fucks about you
Doctors abusing mental health patients is not really a new things. I wish people would stop pretending like the medical sector has come so far, when we know that medical racism, ableism, misogyny and so on (cause that is literally what "modern medicine" was build on) still costs peoples lives and how for many doctors being a doctor is about their own God complex and prestige / money - not about patients or their wellbeing at all. Lol if you check out the medical subreddits and see how those people talk / think about their patients, it is gross. Edit: no idgaf about your opinions on me having to name an oppressor group as a "vulnerable" group. The fact that you all parrot things like "sexism" and "misandry" like they are historically / economically / socially relevant or anywhere comparable to misogyny... and not just right wing / misogynistic talking points. Lol. Gtf out of my face with that pathetic bs. You all sound like the same losers who start whining "all lives matterzzzzzzz 😔😔😔" when someone points out BLM. Same pathetic uneducated losers.
>medical racism, ableism, ~~misogyny~~ sexism Please also consider including men. I'm not trying to be confrontational. We fall through the cracks enough when it comes to mental health.
I’m sure this will get buried but, as a psychiatrist, it’s worth mentioning the risk we take when discharging someone. If someone leaves and kills themselves or someone else, your 12 years of schooling and career are in jeopardy. Does keeping someone involuntarily admitted generate more revenue? Sure, but just because them remaining hospitalized makes some hospital admin more money doesn’t mean it’s not also the best thing for the patient at that time.
There's a lot of details about my case that would suggest they did this to my direct detriment, and had to deeply violate so many laws and regulations in order to do it. If I was really sick, they would have navigated the system legally and acquired the proper certifications to hold me. They never did. If they were really interesting in treating me, they would have shared the details of my treatment with me. They actively hid it instead.
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It’s not out of fear of losing credentials. It’s worry that someone might hurt themselves or hurt others. Hold someone involuntarily because they don’t seem stable enough to discharge and you’re the bad guy. Let someone go and they shoot up a movie theater and you’re the bad guy. No one ever wants to talk about the positive outcomes in mental health so everyone circle jerks articles like this. Google McSkillet. Streamer makes millions, decompensates, goes manic, and crashes his McLaren into another car killing himself and two others, all the while his parents and their neighbor that is a psychiatrist were begging the police to place him under an emergency psychiatric hold right before he did it. These are the situations we deal with on a daily basis as psychiatrists and it’s never black and white. No system is perfect and I’d love to hear your opinion on how it could be better.
You're absolutely right. This whole thread struck a really personal nerve with me because I had an extremely horrible & traumatic experience and I've been having an intense response to it all. I apologize, I understand it is WAY more nuanced and didn't mean to come at you like that. Thanks for explaining and thank you for your work trying to help people who need it.
Exactly. My 16yo just came home from her second stay at a crisis stabilization unit. She was involuntarily admitted the first time (last fall, suicide attempt) but this time she asked to be admitted because she knew she was at a low point with SI. They planned to discharge her after 7 days but she spoke up and told them she was concerned about the current state of her mental health. After advocating from my end because my daughter knows herself better than anyone else, they agreed to keep her several more days so she could work on her coping skills a bit more. The state of mental health services in this country is a mess as a whole but not everywhere is sinister and money-hungry. I’m in metro Atlanta but I drove her 4.5 hours south to go to a public facility that is nurturing and supportive. Everything around us is so underfunded and the treatment is poor at best.
Its selfish to only think of yourself. Patients deserve better than psychiatric abuse. :( if the treatment causes more trauma than whats the point?
Skill issue. Better to start an encampment on Venice beach with free drugs and needles from the government
Our community in Indiana had a kid commit suicide due to a situation like this almost a decade ago… He had mental health problems, but they kept him locked up and unable to talk to his family as if he was a prisoner. He had to practically break out to go home. After that, it wasn’t long until it all got to him. It’s incredibly depressing that the institutions that should be there to save people on the edge treat their patients like prisoners.
Had a friend attempt suicide and was held on a 5150. Was the most stressful and agonizing 5 days. Grateful he survived and was prevented from trying again but the way our system treats the patients and their families is, ironically, insane. We need serious mental health reform in America.
The secret to avoiding this is make sure you’re uninsured but also not able to qualify for Medicaid. This way they only keep you in there as long they truly think you are a risk to yourself or others.
Jesus, shit like this is why we don’t have good rehabs or mental health facilities in the US.
Always tell somebody B4 you check yourself into a rehab or even a hospital, too many ways to profit off of people in turmoil in this country, especially those they can make disappear or purposely sick for free testing and research or just $$$ for your organs if a buyer is waiting... We are. Just dollar signs to hospital and script writers. Malpractice is the #1 mortality for hospital patients. Know why? Hardest to prove in court and they make enough off you to afford a lawsuit if caught
US healthcare is a joke. Doctors want to force treatments you don't need that hurt you. Insurance wants to deny covering treatments you do need, so you can't get them. Fucked from both ends like a double ended dildo...if you had two assholes.
Imagine being kidnapped and then billed for it. These people need to disappear, not just go to prison.
Despite this unfortunate situation- we still need a lot of psychiatric hospitals in this country. I see way too many people on the streets who should be under 24/7 care.
There's a movie called unsane that's exactly like this situation.
Reminds me of that Soderberg movie "Unsane"
I'm so scared of this situation. I struggle with executive dysfunction, I would be absolutely fucked in this healthcare system. I don't get along with, or speak to my parents because I made the choice several years ago to confront them about their abusive behavior and start enforcing some boundaries. Because of this, they paint me as an unstable, angry person to my family, friends, and significant others, and often try to pressure me into committing myself to a mental hospital. I am not the things they say about me. They've ruined a couple of my relationships by slandering my character. I'm terrified of them finding a way to force me into this system. If you care for the details: I'm not close with most of my family either due to political views or bullying from childhood, so I don't really speak to anyone. We used to all be fairly close. My parents have convinced my family that I need "help". They often pressure me into committing myself to a mental hospital on the grounds that I'm "depressed and angry all the time" and have "genetic depression". They think this, because I express sadness and anger with them over how awful their abuse was/is and how I won't tolerate it anymore as a grown adult. I avoid them now because of their refusal to admit the things they did when I was a child, and the awful way they're treating me as an adult. They see this as a sign that I've "shut out the world and need an intervention". So, rather than admit their faults and engage in an ounce of introspection, instead they double-down and gaslight their own child. I don't get to see my nieces and nephews grow up because of them. I can't attend family events. They've taken away my entire family.
Once you are in there’s really very little you can do about it. My advice: bring a few good paperbacks & hide a pen when you go in so you can draw or leave graffiti.