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I have a feeling that the only way this will change is when a legislator's loved one has to through the same situation. But - they won't. Odds are that they have appropriate insurance to get the mental health services they need.

Medical (of which I include mental health) financial decisions are made by MBAs, not physicians. MBAs are taught to conserve money, and mental health agencies are more about getting those MBAs a bonus when they save money than about who the agencies were designed to treat. Until we remove the financial incentives from healthcare, we will have the issues such as your client faced.

That being said, I have had the opportunity to meet with mental health deputies and they are taught to be compassionate and gentle as possible with people going through a mental health crisis. But couldn't there be funding for a crisis team from, say, MHMR who are specially trained to "bring in" a client in crisis without the badges and the guns. The mental health deputies could still be on standby to be called if a client does become dangerous or violent, which rarely happens with a person in the type of crisis as your client was.

When did we reach the point that we had to depend on law enforcement to do an agency's job full time?

wow, what a dreadful catch-22. would you believe, New Orleans has the same process. a classmate of mine had a client who chose to leave the office rather than having to go through the handcuffing etc ... at which point i can't help but think this process creates a huge ethical dilemma for us as clinicians. while i would be gravely concerned about a client's safety in such a situation, i also really can't say as i would blame them AT ALL for choosing to walk away. what a mess.

I couldn't agree more. We have MBAs running social service agencies instead of grant writers and social workers. They changed it from a nonprofit agency to a fee for service design and the results are telling. They worry more about making a profit than in providing the services needed.

Thanks for the feedback. It's nice to know I'm not alone in being disturbed by this.

I'm sad to hear this is happening elsewhere, but not surprised. You made an excellent point about walking away. Unfortunately, here in Texas if someone was been determined to be actively homicidal or suicidal we cannot allow them to walk away. They will be forcibly detained and remanded for treatment. If they are not actively homicidal ro suicidal they do have the option of walking away and I personally would not blame them for doing so.

I've watched the criminilization of mental health issues throughout the years. If someone is wandering the streets naked or doing donuts in the capitol lawn they are arrested and prosecuted for indecency, trespassing, property destruction, etc. instead of being treated. And that criminal record haunts them for the rest of their life. Every time they apply for a job or an apartment they have to explain that they were mentally ill and what happened. It's embarrassing and many go on disability to avoid the humiliation. This further victimizes them by preventing them from being able to fully participate in life.

Oh dear, I didn't mean to rant. Can you tell you hit a nerve?

Thanks for your feedback. It's good to know this concerns someone else.

As a full time caseworker in a homeless shelter, this bothers me to no end.

City or County law enforcement resources are dispatched day in and day out to respond to mental health calls, where the officers on scene assess the person.

It is generally accepted that a large percentage of inmates nationwide are incarcerated as a byproduct of their mental illnesses. Revolving door for some. The point I'm getting at is "the power that be" have decided that law enforcement must respond to such suicide risk calls, therefore they should have "officers" that are as specialized as bomb technicians, detectives, SWAT, and child protective services.
If any constituents cry "budget!! can't afford this!!" calmly reply that the police officers are tied up on these calls anyway. Get qualified resources to respond and fix the problem...not just assessing whether the person in question is about to commit a crime against themselves and warrants being taken away in handcuffs for treatment.


Dean,

Well said. Thank you for your feedback.

I just experienced this yesterday with my daughter. Severely depressed, she made a suicide attempt even with her therapist and own psychiatrist in contact with her throughout the day. After she was stabilized in the local hospital with no psychiatrist on staff, she was transported to the one and only psychiatric hospital allowed in their legal dogma- in handcuffs. I was not allowed to ride along. I offered to pay for a private ambulance with security. Her psychiatrist called the hospital repeatedly to try and get her transferred to another facility differently. No way...talk about about making an already horribly painful experience even worse.It's barbaric. I will never get this scene out of my head and for her the humiliation made her depression a million times worse.

1] I was placed on psychiatry hold in LA hospital for saying I think about suicide. (No handcuffs cause I went there myself!!!!! To see if I sprained my elbow after trip on the stairs at home (it was okay.))
2]I saw writeups from Doctors after talking to me the next morning that summaried that I said things that were 'vague' and caused 'mis-understanding' but I did NOT want suicide really and agreed to 'be SAFE’.......
3] I kept ASKING and ASKING since I first got there if I HAD to be there could I be on a regular floor with doors PLEASE. I was LOCKED up for ALL the THREE days and NOT let be voluntary. I don't know why.(***)......
4] THEN I didn't know anything then about 5150 or that I was SUPPOSED to maybe be VOLUNTARY. I would have been ok for that too____just crying because I had been depressed and broke up with someone but NO way violent and never in jail and don't drink and I have a job AND I have Doctor insurance AND?????
___What can I do to learn about what happened. Who do I talk to. I have no idea where to go.
___Maybe they did not have room for me on the open floor then anyhow. What do I know?
___What kind of place or department to complain to at the hospital about stuff. Does anyone have advise for my????'s
5] How can I find a good fit PRO person to hear me out JUST for a LITTLE while ONLY about this problem to get it off my chest. I know they meant well at the hospital they were really really nice all other things and I can't do a thing AT all to change it now but it irks me still for MORE than a year that it happened like that being LOCKED up. And I do LOVE my outside psychologist (for 3 YEARS!!!!!!!!!!) for all BUT THIS____she cuts me off when I try to talk on this at all because she works there too and does NOT think her Doctor friends could make mistakes (hello? they DID because I did NOT want to be like IN JAIL for three days)
6] I want to say also that this is a very interesting web_site and has lots of good stuff. I learned a LOT already. Thanks for the time and work it took.
(***)After that I said I would stay for 4 MORE days anyway BUT that was on a different floor and I said ok even before I went to there. Talked to my regular psychologist anyway and went to support groups and stuff then. Boring BUT fine else wise.

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Hi R,

I don't know about California, but I would imagine it is much the same as Texas. Here in Texas you can only be held involuntarily if you are an "imminent threat" to yourself or others. In other words, you have to be in immediate danger of committing suicide or homicide. And this is based on the mental health professional's belief of your intentions from what you say to them (since we can't read minds). It sounds as if they were concerned about suicide, but I wasn't there and can't know for sure. If you said you were "thinking about suicide" and were vague about your intentions or plans, this alone could result in hospitalization. I won't apologize for someone hospitalizing you if they feared for your safety. I would probably have done the same thing. If it turned out later you weren't actually suicidal, I could live with that. On the other hand, if you were suicidal and I failed to act and as a result of my inaction you completed the suicide, I would have a hard time living with that. (And yes, mental health professionals are human and think about ourselves as well as you.) It is also a requirement of most licenses that if a client threatens suicide the clinician must act - or risk losing their license. So, I hope that helps you understand what might have happened.

I hope you have recovered and are feeling better.

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