Posted by yxibow on December 7, 2008, at 15:28:06
In reply to Re: Locked wards 'harm patients' » yxibow, posted by SLS on December 7, 2008, at 6:56:26
> Hi.
>
> Do you feel that there is something inherently wrong with the concept of forced hospitalization, or is it that you feel it is a good idea, but that in many instances it is being administered poorly?No I don't think there's anything wrong with forced hospitalization for those who fit the description of being in immediate harm to themselves or others, which is what a doctor would have to do, and the police also would have to do also, in their non-scientific judgment, in general, in the US at least.
I absolutely would agree with the statement that it can be administered poorly if you have staff that aren't really concerned and just go around giving people Haldol to calm them down and mismanage medication. Strapping people down in restraints when it isn't necessary because the patient becomes compliant with medication. All these and more have occurred in hospitals in the past and I'm sure still continue in underfunded hospitals today.
> Perfectly reasonable people at Thanksgiving can become psychotically ill by Christmas and kill your parents to comply with the wishes of a prophetic dog. Might it be desirable to hospitalize such people if they can be identified prior to acting on their psychotic thought disturbances?
You can't be prophetic. There is no crystal ball in psychiatry. If the person dumps their medication or shows significant disturbing signs, during the holidays, signs of things that 911 should really be hearing, yes, they and their prophetic dog should be taken post haste to a hospital.That's when you call 911, that's when you are walked into a ward. Well actually you're not, you and everyone else is still sitting around in some locked waiting room for hours unless you arrive in an ambulance. But yes, you get the point.
You don't just put someone in a locked ward over Christmas because though they're suffering they "might be better". In fact, the ward would probably not admit them because there's no signs of anything occurring other than fugue and they have beds that are filled.
In that case, they're better home with a family or a caretaker, yes, there are always RISKS in life -- but the BENEFIT could be that they might survive through the holidays better than being locked in and strapped down and feel even WORSE over the holidays for no reason.>
> Where would you draw lines, assuming there are any that need to be drawn?You've pretty much described a scenario where I would draw the line, if someone with a known illness is muttering about channeling the power of hell through a pitt bull with the kitchen accessories, I would highly suggest to call 911 and they would end up on a hold.
But just because an ill bipolar or schizophrenic patient is facing the holidays doesn't mean that they need to be driven to the hospital at 80 miles an hour and made to feel even worse about themselves than they might already feel.
They need some sort of either home or community support -outside- a hospital in whatever they and the people around them view as the Here and Now.
That's only humane.
I mean I have some sort of never seen before psychosis NOS with my vision and sometimes auditory, really just exaggerations of normal psychiatric vision but hypervigilence and some discontinuity.
I certainly don't fit any category of homicidal idealization and my suicidal idealizations (not actual concrete things) though they have been there in the past and have gotten a little better perhaps with changes in medication, I don't need to be in a hospital.
I'm fairly intelligent though things are trapped in a medical and psychiatric fog at times and I don't need to hurt the people around me.
I know its going to be tough without therapy around for a bit and I probably will be more depressed unless I go to a party with the few people I still know or do some proactive work over vacation, and this is revealing a bit more than I wanted to about my situation, but I'm trying to point out that the holidays are a tough time for everyone and there is a sliding spectrum of when it really is necessary to seek 911.
> - Scott
>-- tidings
Jay
poster:yxibow
thread:865930
URL: http://www.dr-bob.org/babble/20081204/msgs/867282.html