Can your ideas get you hospitalized?

Well, Bats, getting hospitalized is a bit harder than you imagine. Also, your therapist does not have the authority to "hospitalize" you. Inpatient psych beds are in short supply everywhere, while "suicidal ideation" is rampant among the despondent. There simply is nowhere near enough space in psych units to take in all the folks who reveal to therapists that they've been musing about doing themselves in. If you are an adult who appears rational, then the expectation is that you can take some responsibility for yourself. You would be asked whether or not you have a plan for how you would commit suicide. Even having a concrete plan and the means to carry it out won't necessarily get you hospitalized. Next you would be flat out asked what your intention is. If you dither on that, you would be asked to make a commitment to not harm yourself for a short period of time. You would be asked to agree to notify someone if your intention becomes more serious. Your answers are documented.

Your therapist can recommend that you go to an emergency room for a psych evaluation, usually performed by a social worker or a nurse (ir a psychiatrist in an actual psych facility.) If you seem utterly distraught, your therapist could call police to intervene. They would ask you some questions. Depending on your answers, the police can decide to forcibly bring you to a hospital E.R. or the crisis unit of a psych facility. Only a doctor can "hospitalize" you. If the interviewer doing the psych evaluation thinks you are an imminent danger to yourself, that person would notify a doctor. The doctor has the authority to mandate that you be involuntarily hospitalized for a short stay.

During this whole process, you are given ample opportunity to make a "contract" for safety, whereby you are released based on you agreeing to stay safe, or call for help, if you feel you are about to commit suicide. Unless you're practically psychotic, the assumption is made that a rational adult can make a commitment to be responsible for his or her own safety.

In unusual circumstances, an individual may be deemed unable to make that commitment. For instance, if you get arrested and incarcerated for causing an auto accident, in which someone is killed, the jail may choose to regard you as having a high potential for suicide, regardless of what you say. You might be automatically placed on a "suicide watch." That might mean you are kept under close surveillance and your condition documented every 15 minutes.

So you can go right ahead and be very forthright is discussing exactly what your thoughts have been on the subject of suicide. For that to lead to you getting involuntarily hospitalized involves quite a process that has built in opportunities for you to agree to be responsible for your own safety, which is what everyone engaged in the process hopes you will do.

To be involuntarily kept for more than a short period of time is something that not even a doctor can mandate. Extended hospitalization requires an order from a judge. For that purpose any hospital with a psych unit also has a conference room that serves as a courtroom where hearings are held, presided over by a judge. The doctor tells the judge that the patient is unwilling to stay hospitalized voluntarily and seems too much a danger to self to be released. The doctor must say why that danger is feared. The judge asks the patient for input. Then the judge orders a "hold" or a release. Judges don't always agree with doctors. In a society, such as ours, where liberty is a fundamental right, the system wants to be slow to deprive anyone of their freedom.

Some people think that the system will be quick to lock you up, just to be on the safe side, and out of fear of being sued, if they let you go and you do actually kill yourself. That's a myth. Our society considers that, if you are a rational adult, then the main responsibility for your safety is with you. Suicides occur from time to time in any large city jail. Courts have determined that it is not possible for any facility to prevent all suicides. If a facility gets sued, they are judged based on whether or not the suicide victim was offered reasonable access to mental health support and whether or not people doing mental health evaluations made a reasonable attempt to promote the victims safety, without subjecting the person to undue restriction of freedom.

Again, Bats, your therapist doesn't have the authority to "hospitalize" you. The most she could do would be to send you to the ER for a crisis evaluation. She does not control the outcome of that evaluation.

I say this because it's important to know who can "order" what. It's important to know this system isn't foolproof. In my community a family is suing a hospital that failed to "hospitalize" their daughter who went to the hospital with suicidal thinking. They discharged her and she went and successfully committed suicide that night. This was less than 2 years ago.

There simply are no set, ironclad guidelines that determine who does and who doesn't get admitted. To a fairly good extent, it depends on the gut reaction of the ER physician. That is true everywhere in the U.S. It is not an exact science. Guidelines do exist, as discussed above. They look for "plan, lethality of plan and intent." They look for "prior history of attempts." But many people have been sent away who proved to be way more serious than was believed.

Sometimes a person shows up who makes very specific threats, but just is not considered entirely credible, based on just gut feeling of ER staff. That person may be detained in the E.R. for hours and hours, possibly left sitting in a chair and not given a great deal of attention, other than being observed and detained behind a locked door. A security guard may be the main observer. This can be a test. The ER staff may be seeing whether this may cause the individual to become so bored, tired and uncomfortable that he or she will simply ask to leave, saying "I'll be alright."

Not quite rose I have never had a suicide tendency. Everytime I have been sent to the e.r. I have been hospitalized even acting completely normal. Now I dramatize a bit and tell the cops I'd rather go to jail at least there is or will be an honest meeting with attorney.

Suicidality is not the only reason for a person to be hospitalized. CJ, why do you think you were hospitalized? Do you know?

Every time I have been hospitalized, in the petition was the words, ``a danger to self or others'', and I have never been a danger to myself or others. And they never have proven I was. Still the petition goes through.

I suspect there is a little more to the story than what you're sharing. Not that you have to share any of it.

What is an op?

OP=Opening party, the first person to post in a thread.

I always thought OP was Original Poster. Same meaning.

I have never been hospitalized. My son was, he was very depressed.

I think a lot of time, it has to do with beds available. Most hospital and wards are very crowded.

I wish everyone could have the same experiences I've had with my hospitalizations. I am so sad when I read about bad places because I know it doesn't have to be so bad. I know I'll probably be back there someday and that is ok with me because I consider it a safe place.

Everyone should get placed in places that are like that. I'm so sorry for those who aren't.

Are you anywhere near a teaching hospital? That's how I get the good hospital experience. It helps that my pdoc is in charge of the residents so they aren't about to screw up with me, but everyone is treated well. The reason I say teaching hospital is that they tend to be more up to date and some have mood disorders units which is what I go to and it isn't bad. It does take a voluntary admit; I don't think they do involuntaries but it is such a good place to bee safe.

If you are saying Henry Ford I assume Detroit area? I know there is a mood disorder unit at Michigan State (or Michigan? I lived in Michigan for 3 years but stayed a Buckeye and II can't keep them straight except in football terms). I know its a drive; my hospital is 2.5 hours away but totally worth. My 4/5th admission my mom said I sounded better within 2 hours of admission than I had in months. Granted I was rapid cycling and hadn't had most of my meds the night before while stuck in the ER but I hadn't been manic in months at that point.

I imagine if you call the ombudsman office and file a complaint that the issue with you mom can be resolved. Ombudsmen are very helpful in that kind of situation.

I don't think I will be going back there again. they use to force me there cause It was on my crisis sheet it's only 5 blocks away. They are a teaching hospital. I got my nursing certification there.
What's a pdoc