A psychiatrist talks about the complexity of involuntarily hospitalizing unhoused people with mentalillness and suggests that the problem is too big for a simplistic solution. PsychTwitter
I met Eleanor when I was writing a book on involuntary psychiatric treatment. She was very ill when she presented to an emergency department in Northern California. She was looking for help and would have signed herself in, but after waiting 8 hours with no food or medical attention, she walked out and went to another hospital.
We don't hear from these combatants as much as we hear from those who trumpet their views on abortion or gun control, yet this battlefield exists. It is not surprising that when New York City Mayor Eric Adams announced a plan to hospitalize homeless people with mental illnesses — involuntarily if necessary, and at the discretion of the police — people were outraged.
I wish I could tell you that Eleanor is unique in saying that she would rather die than go to a hospital unit for treatment, but it is not an uncommon sentiment for patients. Some people who are charged with crimes and end up in the judicial system will opt to go to jail rather than to a psychiatric hospital. It is also not easy to access outpatient psychiatric treatment.
All but four states have some legislation for outpatient commitment, euphemistically called Assisted Outpatient Treatment , yet these laws are difficult to enforce and expensive to enact. They are also not fully effective.
Psychiatric medications are very effective and benefit many people, but they don't help everyone, and some people experience side effects. Also, we can't deny that involuntary care can go wrong; -the conservatorship of Britney Spears for 13 years is a very public example.Many have a stake in how this plays out.
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