Suicide, Self Injury and Hospitalization: Can your therapist have you hospitalized?Allan N. Schwartz, LCSW, Ph.D. Updated: Mar 7th 2009 Suicide, Self Injury and Hospitalization:
Can your therapist have you hospitalized?
Posting: On March 7, 2009 someone posted this comment entitled: "Distrust of Therapists" http://www.mentalhelp.net/poc/view_doc.php?type=advice&id=3138&at=2&cn=91&ad_2=1&submit=I+Agree#ad8903 "I was hospitalized for self-injury and thoughts (not plans) of suicide and while the increased medication and enforced hospital stay did not help, I am now very afraid to report my true feelings to anyone and have actively avoided therapy, leaving me with no one to trust. In the US, ethics usually doesn't have anything to do with it: as my callous former therapist explained to me, he was having me hospitalized because federal liability laws encouraged him to do so. These laws permit relatives of suicides to sue mental health care workers for neglect, and that's why you see rampant over hospitalization of patients in America." ______________________________________________________________ The anonymous writer of the posting cited above raises an interesting moral, ethical and practical dilemma for patients and their psychotherapist. The dilemma has to do with the question of when it is or is not proper to have a patient sent to the hospital emergency room? Whether the therapist is a Licensed Clinical Psychologist, Licensed Clinical Social Worker, Psychiatrist or Licensed Marriage and Family Therapist, there is an obligation on their part to intervene under certain types of circumstances. By "intervene" is meant that they must report that someone is in imminent danger. This obligation overrides laws of confidentiality. The reason for this is that, under these circumstances, it is clear that a patient is in danger of committing suicide or homicide. If there is clear evidence that a child is being abused, the therapist must report this, as well. Outside of suicide, homicide and child abuse, the laws of confidentiality hold sway. How does "reporting" really work? In the case of a patient whom the therapist is convinced is in danger of suicide, a call can be made to 911 to report the suicide and have them go to the patient's home. In all of my years of practice there was one occasion where I asked 911 to come to my office and pick up the patient. I had to cancel my afternoon schedule to get this accomplished. Other steps that can be taken are to call family, friends or neighbors and have them take the patient to the emergency room. One last possibility is to get the patient to go voluntarily go. The problem here is that, if someone is really suicidal and they are left to their own devices there is a good chance that they will attempt suicide. Here is the KEY POINT in all of this: Once sent to the emergency room of a hospital, there is absolutely no guarantee that a patient will be hospitalized. Instead, the hospital emergency room will do one of two things depending on where you live: 1. They will transfer the patient to a psychiatric hospital for evaluation or, 2. They have their own psychiatric emergency room and will do an evaluation right there. In doing the evaluation, a group of psychiatrists, psychiatric nurses and clinical social workers, will decide whether or not the patient is truly suicidal and in need of hospitalization. Contrary to what the anonymous writer states above, it is not easy to be admitted to a psychiatric hospital. This is the reason why there is no such thing as "over hospitalization" in the United States. I have seen, on numerous occasions, where patients, brought to the hospital emergency room by 911 the emergency response team, were sent home. In order to further elaborate on just how difficult it is to accomplish a psychiatric hospitalization, even if 911 is sent to the patient's home, the emergency response team does an immediate evaluation and can decide that a trip to the ER is not necessary. In my opinion, the writer of the note above, was admitted to the hospital because she was deemed to be dangerously suicidal. I cannot and will not defend the actions of every therapist because I do not know who they are or how well trained and experienced they may be. However, in the case of those therapists I have known, from New York to Colorado and California, the only time they will call 911 is when the fear for the safety of the patient. What about self injury? There are too many people, both male and female, who injure themselves. The most common type of self injury is probably self cutting, often with a razor. The cuts usually leave scars that bear witness to the self cutting. As a result and in order to hide the scars, people wear long sleeves even during the summer and long pants. Cutting occurs on the arms, legs and other parts of the body. The goal of self mutilation is rarely connected to suicide. Instead, the strategy is to feel the sense of calmness that is followed by an episode of cutting. It is speculated that this calmness stems from endorphins that create a almost a euphoric state. Therefore, it is unlikely that a therapist will feel impelled to report self cutting. Of course, there can be exceptions as for example, if it is believed that suicide is the intention. Just to repeat, suicide is very rarely the goal of self cutting. It should go without having to say it that there is always the risk of cutting in the wrong place, hitting an artery and causing a deadly bleed out. In my individual experience I have not come across or read about such an occurrence. In by opinion, a psychiatric hospital will not admit a patient for self cutting unless the evaluating team lead by the psychiatrist, determine that the individual is suicidal. This even happens in cases of Anorexia Nervosa in which a patient will not be admitted unless the body weight places them in danger of death. In an age where hospital and medical costs continue to surge and in which health insurance companies are reluctant to reimburse, it is unlikely that anyone will be admitted for frivolous reasons. Trust: It is true that trust is a key element to the successful completion of a psychotherapy. There are those times where a therapist may decide that a visit to the emergency room is important for a patient. In my experience, that happens with mutual cooperation between therapist and patient. Even in the case where I asked 911 to come to my office, the patient was cooperative, In fact, that individual was admitted and remained for quite a lengthy period (by today's standards, one week) and was not angry upon returning to treatment. Trust is important because only with trust, can a person be willing to talk about all that they are thinking about and feeling. Conclusion: To answer the question within the title of this essay, a therapist can attempt to have you hospitalized if he has determined that you are in danger of attempting to kill yourself. However, in no way does that mean that, after being taken or going to the emergency room, will you be admitted. Only if you prove to the emergency room team and even the emergency response team, that you are suicidal, will you be admitted. Your comments are encouraged. Allan N. Schwartz, PhD response to comments Oct. - - Nov 17th 2009
I wanted to thank you for your concern, but I have decided that not to pursue a complaint about the hospitalization as I really feel that the doctors that 5150 did not do anything illegal in their actions. I had some issues focusing that caused me not to undertand what was happening to me at the time.
I have other pressing concerns, financial and health that
I have been making a priority.
As a result of the hospitalization I now qualify for disability, my regular psychiatrict did an evaluation for me.
I tend to agree now that the "hospitalization" turned out to be a "good" thing as it helped my case for disability retirement.
It is unfortunate, however, that I still remain so "paranoid" that I can't imagine having therapy.
But, with PTSD it sometimes makes it hard for a person to focus and trust.
It's hard for someone who does not go through this to understand what paranoia can do to a person.
I want to thank Dr. Swartz for letting me participate in this forum.
Karen Who do we trust? - - Oct 7th 2009
Therapists having the right to hospitalize patients makes it sometimes hard for honest communication. For this a reason I never tell my therapist I am in danger of killing myself. It's just one more thing I have to worry about. I undersand their resonsibility. I trust my therapist but this causes me great distress and forces me to find other means to talk about how to deal with suicide. It's just makes it hard for me and feel I need to keep it inside which is overwhelming. What is a safe outlet? Who do I trust, with a secret most will never understand. Hospitalization - Allan N. Schwartz, PhD - Oct 7th 2009
Hello, Questioner,
Actually, the laws do not dictate hospitalization and a therapist cannot force a patient into hospitalization. I would even add that I did not answer purely in the affirmative. The only time when someone can be hospitalized is if they are clearly sucidal or homicidal. Even then, if the patient gets to the hospital emergency room, the staff will do there own assessment. If they deem that the person is suicidal or homicidal, they will hospitalize that individual.
Court orders??? This just does not fit. People come to psychotherapy because they choose to, of their own choice and volition. Remember, I am not discussing attending a clinic or out patient psych service. This is completely private practice and court orders do not fit or have any relevance. I, for one, would never accept a court ordered patient. Force is counter productive. People I work with and have always worked with are NOT ON THE LAMB, so to speak. So, I am puzzled about where you are coming from.
Private practice is a comfy and safe place. Even the few people who have been hospitalized from my practice, over the years, returned to me afterwards, pleased with the results and with no resentment because they knew it was necessary.
I really believe you are thinking of something very different.
Dr. Schwartz Location... - Questioner - Oct 7th 2009
"court order" was meant as the courts directive to hospitalize a patient.
The confusion here (I see on other boards as well) as there are horror stories, there is also a balance of what happens.
Typical scenario is you go for help because of thoughts of sucide. You're told that honesty is necessary to 'heal' in therapy but then when you are honest, the laws can dictate hospitalization which might be more traumatic than the patient is ready to experience, especially in their current status.
So, can a therapist get a patient hospitalized (which you pretty much answered this as an affirmative) but what if they can't locate the patient due to 'a move' or a wrong address given, etc. Will they keep searching for the patient or will they let the patient go? The reason I think so many area asking is because the police is involved, does it state it on the records? How does this happen.
Thank you in advance!!
-inquiring minds want to know :) Panic and Location - dransphd@aol.com - Oct 3rd 2009
Dear Karen,
I hope you win in court. After the way you were treated you deserve to win, not only on your own behalf but for many others who could end up being treated that badly.
Therapist Gender,
I know people who prefer a male therapist or a female therapist and that is fine. In my experience, it is the quality of the therapist, as a human being and as a professional that is most important. However, I support you fully in prefering a female.
Location,
To the person who writes about a suicidal person not being located, I do not know what you mean by "court order?"
Dr. Schwartz Unable to Locate - Questioner - Oct 3rd 2009
Thank you so much Dr. Schwartz, this is an excellent web site! However, I still am curious about locating those that perhaps did not provide a form, or perhaps lied about the information.
Additionally, how long does the court order stay open? Perhaps they can not locate the person but if the person surfaces months later, does this mean they have this on their record? Can they use insurance to locate the person?
Thank you! Address - Allan N. Schwartz, PhD - Oct 1st 2009
Hello Questioner and others,
Any licensed and competent psychotherapist, whether a Psychiatrist, Clinical Psychologist, Licensed Clinical Social Worker, always, at the start of or prior to the first session, asks patients to fill out several documents. These documents include addresses, phone numbers, emergency contacts, etc. They also ask patients to complete a HIPPA form that informs them of the therapist's credentials and rights to privacy, including the state agency to contact if the patient has a complaint to file.
In thirty years of practice in the field of mental health there was only one person who flatly and absolutely refused to provide me with their address and phone number even after I informed them that I therefore could not see them.
Unless a patient has run away I cannot imagine not knowing where a patient is or where family or friends are whom I could contact.
I will admit this: If someone is absolutely, 100% intent on taking their own life (very rare) nothing much can be done. That is why suicide attempts can happen despite our very, very, very best of intents.
We, in this field, are not here to hurt people but to help. I have know many people who were close to considering suicide but with hard work realized that life was worth living and went on to live those lives.
If you are feeling suicidal please reach out for help. Help is available, especially today.
Dr. Schwartz How do they find you? - Questioner - Oct 1st 2009
This question wasnt answered but I wanted to know as well:
What if they can't locate the patient? - Blair - Aug 26th 2009
What if a therapist reports that someone is suicidal however they do not have their home address or way to reach them? Then what? Do they research to find the person or do they just let it go? Do they trick the person into being 'caught'. How does this work?
THanks! an update - karen - Sep 27th 2009
This is an update. I made 10 copies of a photograph that was taken of my left arm last October 2, 2008. I fell and received very large bruises on my arm while in the mental hospital. I asked the staff for an ice pack and they never furnished me with one in three days. I am giving picutres of the arm to the pastor of my church, some close friends and my psychiatrist (not involved in the hospitalization, but helping with disability). The pastor of my church has worked in mental health settings and supports me in filing a complaint against the ER doctors to the California Medical Board. I know that I will probably not win a lawsuit, but I cannot live with what I believe is possible fraud on my medical record. I requested the medical records 100 pages and was told that it wa mailed to me in July, but apparently the whole record was returned to the hospital. I paid $37.00 for this so far. I cannot believe what appears to be either incompetence or "the runaround I have had to endure this year.
Thank you.
Karen serious panic attack - karen - Sep 5th 2009
Hi- I had another really serious panic attack which lasted for almost a day this week. It was the first time I actually thought I was going to die alone in my sleep. I had not slept at all the previous night. I went to an ER where I was treated with respect, listened to and a gentlemen actually drove me as he is diabetic and was concerned about my driving. They tested my blood sugar and it was 113. They were extremely courteous and I appreciate the professionalism in the way I was treated.
I was able to use the phone and get a message to my psychiatrist ,which was all I needed last year.
Even though I was unable to focus, I at least had my medic alert bracelt and I felt more secure.
I would have gladly gone to a hospital for observation this time since I was allowed to contact friends to feed my cats if necessary, since I felt that I was being listened to. But I was released with sleeping pillsafter a few hours. So it is possible to listen to an anxious patient without trying to trick them.
I believe I now have agrophobia due to the incident from last fall perious 5150. The doctor listened to me and that helped a lot this time.
I had planned on going on a camping trip this weekend with a small group from church, and I think I could not deal with traveling out of town.
I haven't been able to travel any distance out of town for over a year now.
Thanks, for listening, it really does help.
Karen
I react badly to male psychologists - karen - Sep 1st 2009
Dear Dr. Swartz- I know you are only trying to be helpful. You are right that I am angry, but I have at least learned not to be trusting. That was my problem in the first place. I know now that I have episodes of hypoglycemia and I have taken precautions to make sure that my doctors have my up to date medical history and I have medic alert bracelets on me at all times. I think my anger is that I was retraumatized many times within a few hours and since I was 5150d I felt I could not be "myself" in the hospital. I would not have complained so much if they had just released me after a day or so, but it was a weekend. I did not get to see the psychiatrist assigned to me (the patients said he was very nice) and he was nice. I think the worst trauma was having to tell my sisters to go to hell as they yelled at me and blamed me for the hospitalization, when it was mostly a misunderstanding. THey were probably scared, but I feel that their behavior was totally "innappropriate"
When it comes down to it, I'm probably the most "sane" of my siblings as I at least respect boundaries. I'm glad they are out of my life. They are too critical of my daughters and I do not criticize my sister's kids at all. I should not have had to choose between my relationships with my siblings and my daughters, but I did.
I react badly to male psychologists, maybe not all as I have some friends that are psychologists ;as my personal perception is that they appear to me as condescending. I think I know myself better what is helpful to me most of the time.
I am also a battered woman and was labled as having symptoms of "boderline personality".as part of a custody evaluation. The psychologist did not understand the anger and anxiety that I suffered in my marriage was unfortunately a symptom of the fear and trauma of living with an extremely controlling spouse who battered me, sexually abused me, kidnapped the children at one point and threatened me with bodily harm for two years. The psychologist wrote (when I kept insisting on counseling for the minor children) that I should get my own therapy. Well, I was undergoing my own therapy, I think he just assumed I felt I didn't have any "problems". He made an assumption that I was not undergoing my own therapy. I even had to resort to taking my daughters to the therapist without his knowledge as I was afraid I was breaking our agreement. I finally told my attorney that I had done this and expecting to be in trouble she asked if anything had been learned by the sessions. This taught me to follow my own instincts and not listen to a professional. I play by the rules, but when the rules don't work then they have to be adjusted. I feel like I get the run around when I'm trying to be helpful. That is demoralizing.
And unfortuntely the psychologist did not following the court order and my exhusband moved the children to far away to make a 50/50 joint custody plan work at all. My two daughters are now victims. As far as I can tell, they have very few friends due to the fact that my exhusband was able to move them to numerous schools. I feel really bad for the youngest one as she knows that "no one likes her father." She has no friends. Children get their self esteem largely from their parents. I do what I can, but it's an uphill battle for self esteem.
As far as a lawsuit, I think I would really be satisfied with a written apology from even one of the doctors or head of a department. I'm not sure if I could withstand the trauma and I really don't want to hurt anyone. I just want to make sure that someone else is not hurt.
I really have not had any "bad" experience with any psychiatrist over the years, though sometimes I have felt they did not understand what I was trying to tell them. The one I have now, I met in 1991 and he has treated me very well. He has been an oustanding advocate for me at work and he's a great doctor.
thanks, for replying Awful incident - Allan N. Schwartz, PhD - Aug 29th 2009
Gee, Karen,
I thought I was being empathetic to your first comments but I guess that did not come across because you seem even more angry at me. No, I would not want to go through what you experienced. That was awful. I can't help but think that you may have a law suit against the hospital? Perhaps that could redress some of your concerns.
While I do feel empathetic I do have a concern about the level of your anger. This much anger is not healthy for anyone. What happened is awful and should not have happened, but, it did happen. Now, you need to take a deep breath and let go of the intensity of your anger. After all, you do have the legal system available to you if you decide to go that route.
In your anger you seem furious with me, and I am not sure why. You also seem furious at African Americans and I am not sure why. This is not a racial issue and should not be.
Let me just try to come across more clearly: I feel very, very empathetic and sympathetic about the awful things that happened to you. Because I am concerned I really do hope that you will reduce the level of your anger because it is not good for your health and well being.
Good Luck to You,
Dr. Schwartz response to your comments - kare - Aug 28th 2009
I'll tell you why I'm angry. I guess it has to be spelled out to you as I making the "assumption" that you would enjoy being a victim of medical negligance, First of all, I was suffering from hypoglycemia and accused of drinking when I am a not a drinker. Then I was lied to by the ER doctor, he did not tell me I was going to be evaluated. This is legally assault. Then I was 5150d against my will, but first I offered to leave the ER in peace and let the doctors go on to treating patients with emergencies. I was prevented from leaving prior to the 5150. This is against the law.
Then I was mistreated by two African American staff members who were gruff with me. I offered to watch my person belongings, but a security guard, very gruff and condescending with me, would not allow me to watch my tote bag. No one bothered to lock my property up. When I arrived at the mental hospital in the middle of the night, the first thing I noticed was that my some of my property was missing (inventory lists did not match) I was prevented from having pain medications or antidepressants for that matter, for a whole night. I cried and was given tylenol by a nurse (this was refused to me in the ER even though they KNEW I HAD CHRONIC PAIN) In chronic pain at the mental hospital (denied medication for eights hours in hospital) I decided that I should get out of the very uncomfotable bed and stretch my legs. I became very dizzy (from stress and misdiagnosis of hypoglycemia) I fell and landed on a wooden floor. I received terrible bruising to my left arm and received no first aid, even though I requested an ice pack for the bruising. The hospital denied I had bruises (even though visitors saw them, I pointed it out to staff and I had a friend from church take a picture of it.) So this is medical negligance.
Then I was prevented from contacting my workplace, (I was a first grade teacher and needed to arrange for a substitute) I was forced to attend group "therapy" against my will sitting on very uncomfortable furniture for an hour at a time when I was demoralized and could have used some sleep. I did not get any sleep for the first two days at all. I have chronic pain and the beds were very uncomfortable. The temperature of the locked unit was very cold and I was not given any extra blankets, had to beg for one in the dayroom.
I have sleep apnea and no one bothered to get me a CPAP machine to sleep at night. My rescue inhaler, I have epsisodes where I literally wake up in the middle of the night when I cannot breathe at all, was locked up. I was terrified that I would stop breathing in the middle of the night and not be able to get any staff assistance. I thought that I was going to die.
I put that I wanted my daughters to be notified of my whereabouts and , of course, no one bothered to let me know where I was. (they were extremely angry about this) This is another violation of the law. I ended up coughing up $200.00 in long distance toll calls trying to get people help me with many issues. No on bothered to talk to me about what happened to me prior to the hospitalization at all. I was frightened, humiliated and very upset, but I could not be "myself" lest I appear "mentally ill or unstable"
My older sister came charging down to my home and intruded into my affairs even though I told my other sister not to notifiy her. She verbally abused me and accused me up being taken in by the police even though I was the one who called 911 myself after being threatened by two large African American men in a very dangerous neighborhood. I was so upset by her abuse after I was let go that I have severed all ties with her and my other sister since they yelled at me over the phone and in person. They did not understand why I was in the hospital (apparently someone had probably told them I had made or threatened a suicide attempt) when I had done nothing of the kind. I was very embarssed that my oldest sister called my younger brother to my home without my permission and they got into my things.
Furthermore, just as I predicted, I got in trouble when I got back to my school, (missing two full days of work with no substitute). I was given a written reprimand for not being at work which today is still in my personnel file. (I had never been written up before in 20 years of teaching) I was so traumatized my daughter (who had to leave her job from out of town and babysit me) thought I should not return to work permanently.
I have received over 60 verbal apolgies from the hospital about rude and deceptive behavior, but not one word from either of the doctors who used bad judgement in the interactions with me. (this is because I was told by two different legal opinions that I have a claim about "unlawful imprisonment" and they would want to avoid a lawsuit) My therapist (also African American) tried to blame me for my "impulsive behavior" and became defensive when I was angry. She then encouraged me to file a complaint and then turned around the next time I saw her and wrote that she couldn't help me. I never wanted to file a complaint in the first place.
I have discontinued therapy with her, as I am tired of explaining things I should not have to explain. In other words, I'm tired of doing other people's jobs for them.
Since this time, as part of my complaint with the state I have obtained medical records from four parties and I found substantial errors and comments taken out of context by three out of the four. I have had to spend many hours correcting mistakes by people who are supposed to have liscenses, training and should have basis listening skills.
How many times have I been victimized?
Perhaps this is the way you would have liked to have been treated?
Oh, yes, how would you like to have to go to court like I now have to and try and explain that you would not like to be on a firearms prohibition list as you were a victim of deception, hypoglycemia and medical negligance?
Would you like to be a woman living alone and be told that you are not elligible to defend yourself for five years if someone tried to break into YOUR home? Please note, I have never owned a gun and I hope to never have one, but now I'm on a list.
Perhaps you would like to have cried yourself to sleep for months, hurt and humiliated living by yourself? I was so depressed I was unable to do anything but go to work. I did not celebrate Christmas, was unable to pay bills, work on back taxes or do any housework. I lived in constant squalor and have now had fees for past due bills and taxes not filed.
I have told my psychiatrist, who no one bothered to contact, of course, even though I have been a patient of his for over 15 years:,that I now suffer from even greater PTSD then I ever had before. He is sympathetic, but cannot do anything other then to make sure that I am not "victimized" again. HE IS THE ONLY ONE THAT BOTHERS TO LISTEN TO ME, HE IS THE ONLY ONE THAT I REALLY TRUST AND I WAS PREVENTED FROM ANY CONTACT WITH HIM IN A CRISIS. What was the medical rationale for not contacting him? There is none.
Oh yes, I tried to get messages to some of my doctors while I was in the ER concerning my chronic medical conditions and hope they could help US, but I was told by an advise nurse in a very ugly tone of voice that I could not communicate with my doctors because I was "5150d" The hospital wrote me a letter explaining why my phone calls were not relayed, but it doesn't make any sense as my doctors are mostly female and they said a male doctor (no name supplied) was supposed to be looking out for me.
I gave plenty of suggestions and tried to help those in charge of my "medical care" some assistance in helping me, but I was condescended to, ignored every step of the way. At any point in the ER if someone had taken 5 minutes to listen to my legitimate concerns, I would have agree with you not to be angry. But the point I'm trying to make is that my health and well being were not considered and I could have ended up a lot worse physically with an untreated asthma attack leading to a serious medical crisis.
I don't know you personally, but you sound like an insensitive jerk and I think your reasoning is a rationalization that makes excuses about mistakes that are made. And these are excuses. What if they can't locate the patient? - Blair - Aug 26th 2009
What if a therapist reports that someone is suicidal however they do not have their home address or way to reach them? Then what? Do they research to find the person or do they just let it go? Do they trick the person into being 'caught'. How does this work?
THanks! Hospitalization - Allan N. Schwartz, PhD - Aug 22nd 2009
Hi Karen,
Clearly, you are very angry but I am not sure why. You wrote that "I should not tell you about over hospitalization..." Well, I was not telling you. We write to the person asking a specific question and for the general public. Surely you must know that there are always exceptions to anything and everything. Hospitals are not perfect, Doctors are not mind readers and everyone makes mistakes.
I fully understand and am sympathetic if you were treated badly at the hospital. Unfair and unjust treatment angers me as well.
We here at Mental Help.Net are not the enemy. We are just trying to be helpful. I regret the fact that you had such a bad experience.
In point of fact, I have seen people who I believed should have been hospitalized but were not, and I have seen situations where people who were not hospitalized and who should have been. It is not a perfect system.
Thank you for your comments,
Dr. Schwartz
hypoglycemia - karen - Aug 21st 2009
Well, guess what I was a threatened with bodiy harm by two men last year in a dangerous neighborhood. I called 911 and the police responded and took a report as the men were intoxicated. I have hypoglycemia and hadn't eaten much that day. I didn't realize I had "slurred speech" and the ER doctor tricked me into talking to a psychologist and I ended up 5150d for "suicidal ideation". I ended up having to file a complaint with the state for unlawful imprisonment, spending countless hours amending medical records with many mistakes, having property stolen at the hospital, no right to contact family, or even my doctors for that matter. Then on top of that I was coerced into a followup appointment with my therpist who added insult to injury by blaming me for the hospitalization.
My two sisters were told that I was on a "behavrioral hold" and someone jumped to the conclusion that I had threatened a suicide attempt and yelled at me so badly that I have told them I never want to have anything to do with them. If it hadn't been for my daughters, my psychiatrist (who was NEVER CONTACTED AT ALL EVEN THOUGH HIS NAME IS LISTED ON MY MEDIC ALERT CARD and some good friends, I would have truely been suicidal. The stay at the hospital made me miss two days of work and since I was forced to attend group "therapy" I was not allowed to fill my supervisor in about when I would be able to go to work. I was traumatized, embarssed and extremely depressed for months.
Don't tell me about overhospitalization. You don't know what you're talking about. I was treated like a "naughty child" because the ER doctors couldn't rule out my "panic attack" as a side effect of hypoglycemia. DOn't they teach these things in medical school? Oh, by the way I fell and hit my arm against hard wooden furniture the first night I was imprisoned and even though I pointed out the extensive brusing to a nurse and other staff member and asked for some ice, I was not offered first aid.
Signed
another garbage "mental" patient injured and retraumatized by so called
Professionals" Hospital Admissions (Involuntary) are Extremely Difficult - - Jun 29th 2009
My experience has been that unless you tell your therapist "I am going to go home and kill myself tonight" it is almost impossible for someone to put you in a psych ward. I have a long history of serious self-injury, chronic suicidally, heavy substance abuse, and extremely dangerous and reckless behavior. I don't have to lie to my therapist about any of it. He is always compassionate, empathetic, and understanding.
We have agreed (a mutual understanding between us) that if he feels I am in danger or that my safety is compromised, he will call 911 and have me hospitalized. I would not in any way be angry with him for this. Despite my aversion to being hospitalized, if I am telling my therapist something that clearly indicates that I am in danger then I probably on some level really do want to be safe and protected. Even if I don't recognize that at the moment.
I firmly believe that people who think that they have been treated unfairly, don't realize or act on their personal right to say no. People should be more informed about what their rights (and responsibilities) are regarding the treatment of their mental illness. afraid to go to the emergency room because of self-injury - Pog - Mar 18th 2009
I injured myself in my leg fairly severly and was actually afraid to go to the emergency room because of their right to detain people for such behavior for a 72 hour period (extended upon evaluation). Hospital Admissions - Allan N Schwartz - Mar 9th 2009
It is true that once patients become known to the emergency staff at hospitals, it becomes easier to achieve admission. Most often, what happens is what the other fellow before you mentioned and that is people are held for roughly 72 hours for observation and evaluation. Sometimes they are hospitalized after that and often they are not. It all depends on whether or not a person is considered to be a threat to themselves. The same is true about self inflicted wounds. If the wounds are of a dangerous and life threatening nature, the likelihood increases that they will be admitted to the hospital. With regard to mental health professionals, they may not live the same life as those with psychiatric problems but they are able to learn, empathize and try to be helpful. As in every profession, there are those who are more talented and capable than others but, from my observations and experiences, most try very hard, have good intentions and do very well by their patients. Remember, a lot depends upon the match between therapist and patient in addition to the skill of the therapist. Just to let you know that I do understand, it is true that there are a few therapists who do not seem to have empathy, or even care. But, again, that is true in every career. Dr. Schwartz just a comment - - Mar 9th 2009
i think it's absolutely untrue that it's difficult to be admitted to a psychiatric hospital in the united states. i've been hospitalized over a dozen times, and will admit that MOST of them were justified based on my actions. however, there were a couple where i simply should not have been hospitalized. the very first time i was sent to the crisis center of the ER was because i had told my therapist i felt like dying but did NOT have a plan and at the time was not engaging in any self-injury. yet the therapist said that since i didn't have a plan, i couldnt' sign a safety contract, and therefore had to be hospitalized. i was also ambushed one time when i thought i was doing better and committed to a psychiatric hospital for "medication adjustments" because the doctor felt i was unstable. at the time i had not cut myself for weeks and was not actively suicidal. unfortunately, professionals do not experience the same world that patients do. professionals also believe that they are the only ones who can be right, and that patients just do not understand the process because we are ill. make no mistake, it's extremely easy to be unfairly hospitalized in the US, and difficult to appeal a formal commitment. Self Injury & Hospitialization - mscat - Mar 8th 2009
I have personal experience regarding this topic . I had self injured fairly severely and went to therapy , I felf confident that the therapist was going to be nonchalent about it , because Self injury is not considered a suicide attempt. To my surprise the therapist asked for my brother's phone number and called him into the office. He asked my brother to take me in to the hospital for treatment for the injuries. My brother takes me to the nearest ER, and then I end up getting 5150'D to A different City, being carted off in an ambulance. This has happend A couple of times.... Other experiences have been , due to the severity of the self inflicted injuries I've been place directly on psych holds in the Critical Unit of A trauma ward. Then have been evaluated by A Psych team. This has also been done after A 5150 .... The severe injuries that had been inflicted were not the standard SI though, however not suicide attemtps either. I go through these eposoides 2-3 times a year, and many of the staff know me , unfortunately. I also know nOT to ever mention the word suicide or wanting to die either. Typically after A severe self injury, I am feeling much better anyway, and can answer questions coherently .... not behave nutty and able to to feel right again. The SI , typically knocks me back into reality and everything is ok again. | 
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Readers in the Boulder, Colorado metro area (or Denver area people willing to drive) may contact Dr. Schwartz for face-to-face consultation and psychotherapy. Email him at dransphd@aol.com for details.