Understanding When and How Psychologists or Psychiatrists Can Commit Individuals Against Their Will
When pursuing mental health services, individuals often wonder about the circumstances under which they might be committed against their will. This article aims to demystify the process by explaining the criteria and procedural aspects of involuntary commitment, particularly from the perspective of a psychologist or psychiatrist.
Criteria for Involuntary Commitment
The process of involuntary commitment varies significantly across jurisdictions. Generally, a person may be committed if they present a danger to themselves or others. However, the specific criteria can be quite nuanced. For instance, in Norway, if a patient expresses a sincere threat of self-harm or harming another person, they can be committed against their wishes.
For example, a therapist may respond differently based on the content of a message. If a patient texts, 'I'm going to kill myself,' it may not be taken as a serious threat, especially if the therapist notes that the patient does not currently experience depression and is unlikely to attempt suicide. However, if the same patient sends, 'I'm going to kill someone right now,' swift action is likely required, such as the involvement of armed police.
Legal and Procedural Frameworks
Legal frameworks for involuntary commitment typically require a specific set of conditions to be met. For instance, a person must be deemed a danger to themselves or others, or they must be expected to deteriorate to that point if proper care is not provided. However, the thresholds for these conditions can be very low, or in some cases, set exorbitantly high.
Even when these conditions are met, there are additional layers of complexity. Assisted inpatient and outpatient treatment laws, such as Meghan's law, add numerous, often convoluted, requirements that make it difficult for patients to meet them. Over time, hospitals may discharge patients based on superficial assessments rather than their actual mental health status. This has led to instances where individuals who are clearly a danger to themselves or others are released from care.
Real-World Examples and Concerns
A notable example is the case of the Virginia Tech shooter. Although he was determined to be a danger to himself and others, he was discharged from a hospital due to the hospital's financial constraints. This reflects a broader problem where hospitals tend to discharge severely mentally ill individuals due to insufficient reimbursement.
The consequences of such situations highlight the need for balanced and humane approaches to mental health care. While ensuring the safety of both the patients and the public is paramount, the system must also address the potential for overly stringent criteria leading to dangerous omissions.
Conclusion
Understanding the criteria and procedures for involuntary commitment is crucial for both patients and therapists. It is a delicate balance that requires vigilance and a commitment to both safety and fairness. While legal frameworks are in place, real-world challenges ensure that the issue remains complex and multifaceted.