Hospital

I still have of course medical care but she says I will neverbe kept in psych again. Would the US keep me for overnight+ stays in psychiatry as a nonresident with no insurance? It seems like a long stretch.

Googling doesn't get me a specific answer about psychiatric care, but for physical care, apparently yes in at least some instances.

Also, if you ever do try this - try going to a hospital with a Catholic mission statement. They are generally not profit-driven (and operate at loss) and many of them interpret their mission as taking care of whoever needs it. (Other hospitals with religious missions may do the same - I just happen to know only about Catholic hospitals.) Avoid any hospital that seems to be part of a big medical conglomerate.

In my jurisdiction, a hospital would try to get a court order to hold someone for treatment and possibly then try to deport them. I have had non-citizen clients before from public teaching hospitals and private hospitals. I am nowhere near the canadian border. In my opinion, it would depend upon the state and the hospital. But that is true even for citizens. My state has had a problem with mds in the bordering state bringing people to our hospitals rather than the state the client is domiciled in because it is easier to get a court hold here than in the other state.

I don't mean to rain on anyone's parade in regard to mental health inpatient care here in the US as being a better option, but the reality is, mental health professionals in US hospital settings are pretty harsh as a group when it comes to patients who struggle with SI or repeated S attempts. I don't see it as being much different than in the US than what the OP has been posting about in regard to the treatment she's getting in Canada. The other issue is something the OP has talked about in regard to a BPD diagnosis. Once many mental health professionals see that diagnosis, their brains shut down and go on automatic pilot--manipulation and attention seeking behavior. It's disgusting and poor practice. I'm sorry you're having to deal with this.

That only really applies if someone is near death and needs care in order to live, like emergency surgery. Unfortunately they most likely wont see pink's state that way, even though it is life or death at this point

I've gotten good care until now.

Idon't get it because I'm in danger and it hurts. Maybe the more dangerous it is, the lesswilling they are to help. It's more than little cuts.the thing that confuses me is that I've always been there involuntarily.

I really think this is what is happening. My psychiatrist once told me people with chronic SI are hard to treat and most clinicians are reluctant to deal with that population, because of the intense emotions that come with it. General psychiatry, especially in the hospital setting, isn't really able to deal with PTSD, SI, chronic suicidality, adjustment disorders etc, very well. They actually do a very poor job.

Clinicians believe long hospitalizations are detrimental for people living with BPD. It is in the literature. There always seems to be a disagreement between treatment providers when it comes to hospital stays.

There is hope. I've heard of Canadians with BPD getting specialized treatment at Maclean Hospital in the US. They had to pay thousands of dollars. It is possible to get their provincial health insurance to cover the full cost or part of. It has to be approved. Another option is assertive community treatment teams. Unfortunately not all are willing to take a BPD client on their caseload. Perhaps another evaluation needs to take place out of province. E.g., The Centre for Addiction and Mental Health.

I really think it's about what you've mentioned previously, PF; it's about the new diagnosis. I seem remember that before you were re-diagnosed, you were having very good outpatient care and helpful hospitalizations when you required it. But then you posted about the new diagnosis and everything began to change. Others are right, it's in the BPD literature--many mental health professionals espouse the view that hospitalizing someone with BPD is counter-productive. They feel that it causes someone with BPD to become "more dependent" and to deteriorate behaviorally. By deterioration, they mean that the person will escalate his/her SI behavior in order to be in the hospital again. Personally, I think that is ridiculous and hurtful. Why they wouldn't find a way to provide the level of support an individual needs based on the individual needs of each and every client is beyond me.

Little Didgee is correct--McLean Hospital does have an excellent, cutting edge program for people who wrestle with SI and BPD. They have inpatient and long term outpatient programs. It might be worth looking into what she mentions about getting the Health Insurance program in Canada to seek such an option for you. I sure hope someone steps up and gives you the assistance you need.

[QUOTE=The_little_didgee;5306314]
I really think this is what is happening. My psychiatrist once told me people with chronic SI are hard to treat and most clinicians are reluctant to deal with that population, because of the intense emotions that come with it. General psychiatry, especially in the hospital setting, isn't really able to deal with PTSD, SI, chronic suicidality, adjustment disorders etc, very well. They actually do a very poor job.

Clinicians believe long hospitalizations are detrimental for people living with BPD. It is in the literature. There always seems to be a disagreement between treatment providers when it comes to hospital stays.

There is hope. I've heard of Canadians with BPD getting specialized treatment at Maclean Hospital in the US. They had to pay thousands of dollars. It is possible to get their provincial health insurance to cover the full cost or part of. It has to be approved. Another option is assertive community treatment teams. Unfortunately not all are willing to take a BPD client on their caseload. Perhaps another evaluation needs to take place out of province. E.g., The Centre for Addiction and Mental Health.


[/QUOTE

Yes but makes me wonder why they kept court ordering me inpatient. I also have had 3 clinical evaluators tell me I do not have BPD. This is a new thing and also



I always thought of hospital as temp crisis management for when I was really struggling, not a "heAling" measure like therapy.

I want to ask the guy who diagnosed me WHY he changed a 10+ year diagnosis of chronic dep, OCD, and BPD traits to straught up BPD. But he's been my osoc since May and I've only seen him 3x, 2 of which he was signing my involuntary30 day hospitalization papers. (As recently as about 6 weeks ago).

The thing that scares me is I'm in trouble. The things I do to myself are dangerous, I'm with it enough to knowthat. I have nowhere to go. I wish it wasn't Saturday. I need to talk to someone so bad.

I don't go just to "attention seek." I have neve made the choice myslf even to stay overnight. All forcd observationsvor holds. It took over a year for my T to get me ok to get stitches withoit being shoved in a medical taxi. Now I'm afraid again. I've never gotten less than abot 25 stitches at once (the least) so my harm is serious.

Since the new diagnosis I'm treated like is just some kind of attentiom seekinmg measure.

I can only imagine to kind of pain you must be in to do that Pink. I hope you get the help you need.

Is it possible to get reevaluated by someone else? What makes this one T or p-doc the final say on what your diagnosis is? Especially if you've been diagnosed otherwise by multiple people in the past. I just don't understand the treatment methods for BPD--is it basically just do nothing? Because, OK, that makes me think of the whole thing ages ago where they'd diagnose women with "hysteria" (or even further back--being a witch), as a way to just cast them aside. Not trying to make this a gender thing, just more saying this seems like discrimination. You deserve help just as much as anyone else, no matter what your diagnosis. You're a human being who deserves to be treated like one, not like a code from the DSM V.

Hm, this made me think of something. So my marriage counselor talked at one point about how, if he's working with a client who is depressed, he tries to move them not directly to being happy, but first to being angry. Because anger is an active emotion, while depression is more passive. I think in your case, you're taking out the pain (and maybe anger) on yourself. But what if you channeled it in a different way? What if you thought, "This isn't fair for me to be treated like this because one p-doc gave me this diagnosis"? And then you started fighting for your rights and for yourself? Like if you were fighting against the mental health system, rather than against yourself? Maybe that would give you a reason to go on, to fight against someone rather then just take it out on yourself? Not sure if this would work, but something like, "Screw you guys for trying to stick a label on me. I'm going to fight and be OK and get better just to show you that you're wrong! And to help other people like me..."

(Hope that makes some sort of sense...)

This guy is "my" new outpatient pdoc and ge evaluates everyone who comes in with self-harm. I hate him.

What do you do when you're unsafe but banned from the ER?



Just crossed "go to ER" and "go to crisis centre" off my safety plan. I think my arm hurts too much anyway to SH.

Does your t allow you to call between sessions?

Find an attorney?

Not on the weeknd. We have to use the hospital system, only open weekdays.

Do i really want to be somewhere I'm not wanted? Maybe tgeres a US residential facility with a scholarship?

((Pink))) I am so sorry you don't have the support you need. What does your t think of this er catch 22 situation? Can he offer a different safety plan? Something has to change

Gunderson Residence | Borderline Personality Disorder Treatment

There was a center in MI that my pdoc from years ago recommended in Holly, MI. Rosehillcenter.org
He had diagnosed me BPD and I had chronic suicide attempts and considered going but was unable to for various reasons. I know they have financial help and I believe it talks about non US residents. Check it out.

Borderline Personality Disorder Treatment | Austen Riggs Center

Maybe a lawyer or a mental health advocate from your area would have some helpful ideas. It might not need to be a confrontation....
Can you do some information gathering?



I feel angry about your situation- on your behalf.

I don't know why they did this. Something tells me the court ordered admissions were used to punish or get you to change your behavior. It is obvious general psychiatry is failing you (it fails most patients). You need specialized care.

No one can be banned from the ER. You haven't been banned from the psych inpatient service. Thy just limited your admissions to 24 hours. I think the day pass incident has something to do with their decision and your persistent struggle with SI.

Can you get another assessment? Is it possible that one of more of your medications is causing you to SI?

Your SI appears to be isolating you from yourself, family, friends, your treatment team, and the world. It also seems to be making you worse, by preventing you from feeling emotions that are required for recovery.

I'm sorry my replies aren't very gentle. I believe in being straightforward with people. I feel for you. I also believe you will recover.

They keep court-ordering you inpatient because you keep harming someone ie yourself.

I guess i would want to know, and it seems like youre testing them on this - what happens if you dont stop? Do they declare you incompetent at some point? I would not want to lose my freedom.

It seems like the hospital people are trying to get you to see that you DONT want stay in a hospital, but you keep doing things to get back in, like thats your only safe place. Im afraid they are going to believe you at some point and start making decisions for you. Altho i dont know if/how that happens in canada. Or the usa.

Eta - Here is some info about ontarios laws. Looks like if they start keeping you longer than two weeks, the time period grows from there.

"At the end of the two weeks, if the facility is to continue to keep the patient on an involuntary basis, a certificate of renewal (Form 4) must be filled out. The first time a Form 4 is filled out, it is valid for one month, the second time it is filled out it is valid for two months, each time after that, it is valid for three months.[12] Each time a Form 4 is filled out, another Form 30 must be filled out, notifying the patient."