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Unread 08-28-2016, 10:23 AM   #1
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Default How to Involuntarily Commit a Psychotic Person

my mom and i need help. my sister is very ill. in 2009 she started displaying symptoms of depression. she was 23. soon that morphed into a manic episode where she lost her boyfriend and her job. she was bringing strangers to our house that she had just met at gas stations, doing drugs, lots of alcohol and reckless spending. sounds pretty bipolar, right?

she went to a pdoc and was prescribed abilify and started taking it. things got better. as the years have passed she's gone on and off her meds. she has never been completely med compliant. she refuses to accept that she is mentally ill.

in the beginning of this year we found out she has stopped her meds again. things have spiraled down quickly. first she was manic until about may. the landlord of the house she was renting with 2 other roommates (the landlord lived there as well) called my mom and told her that my sister is not being herself. he said she goes into his room and even slept in his bed!!! she eventually lost her job, she got evicted from that house, lost all of her friends, and is now back home living with my mom. she is 30 years old. she stays up all night doing god knows what.

this is the psychosis part. my sister thinks that various people/businesses are narrating and broadcasting her thoughts to the world. she texts me stuff like this at 1, 2am. i tell her these things are not real, not possible, they are symptoms of psychosis. she then laughs it off saying she was joking. thats a pretty weird joke. well its not a joke. now shes posting her psychotic drivel on social media webpages. she has yelled and threatened my mother. my mom has found her crying under the deck at 3am talking to herself. shes talking to the voices in her head a lot.

the thing is is that my sister refuses to believe she is mentally ill. when my mom confronted her about her impaired thinking and paranoia, she told my mom that me and her are the mentally ill ones. my mom called the police on my sister 2 weeks ago because she was frantically yelling in the shower, got out, and started yelling at my mom.

when the police came she put on her normal act and the cops left as they saw nothing to be alarmed about.

sorry this is so long but here is my question. my mom and i cant sit by and watch my sisters descent into incompetence and psychosis. shes really lost it you guys. she refuses to seek help or take meds. she gets extremely defensive and sometimes even hostile when its brought up.

my mom is planning on going to a magistrate tomorrow to try to get an involuntary commitment order. i have screenshot the weird texts and facebook posts and emialed to my mom to show the magistrate.


is there anything else we can do or show to the magistrate to try to convince him/her that my sister is incompetent? she is not expressing suicidal/homicidal ideation so this is a big grey area.

also, how can we get a judge to rule her as incompetent so my mom can be the guardian and consent to forced medication???



please, if anyone has been in this position, help us.

also, if anyone disagrees with invol. commitment and forced medication then dont bother responding. im aware some people are against that.
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Unread 08-28-2016, 10:42 AM   #2
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Default Re: How to Involuntarily Commit a Psychotic Person

Where I live, you'd call emergency 911. The police will come to the address and talk to the person of concern. They will ask if they plan on hurting themselves. They will ask if they plan on hurting others. Suicidal or Homicidal.

If the person is reasonably lucid, calm, and answers "no" to both questions...they legally cannot be involuntarily committed and the police leave. I tried to involuntarily commit my dad one time and he didn't meet the legal criteria.

I don't know of other ways...you'd need to ask an attorney in your jurisdiction that practices Guardianship law, I believe. Seeking guardianship as to your mom may be in her best interests. I'm not familiar with that area, but ask an attorney if you will have an ongoing situation. I don't think it would be too expensive...it's a court hearing or two.

Good luck at your hearing. It all comes down to whether she meets the legal criteria in your area, I would think. I hope she gets help.

Thinking of you and your family. xo
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Unread 08-28-2016, 10:46 AM   #3
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Default Re: How to Involuntarily Commit a Psychotic Person

In my country (sorry, but I prefer not to specify besides saying it's in Western Europe) you need to be a danger for yourself or others, but that also covers behaving so "weirdly" you're kicked out of your apartment and stuff like that.

I hope your sister will be able to get the help she needs.
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Unread 08-28-2016, 10:49 AM   #4
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Default Re: How to Involuntarily Commit a Psychotic Person

In England, 2 doctors must agree to commit someone. I realise it may be different in the States. Does she have a primary care physician? If s/he could talk to a pdoc - but then that would mean taking her into ER. The trouble with whatever copies of stuff you bring to a magistrate, they might just say maybe she was just drunk or high or that's not that crazy. You need to demonstrate she is a risk to herself or to others. find something that shows she's not med compliant, but needs them. I don't mean her medical records, but something from a pharmacy. I would also ask whoever's going to be paying for this, at your insurer. Or, can you go direct to a private pdoc? S/ he can admit once he's seen her, but that would mean bringing her to his clinic or having him/ her come to your house. Good luck, whatever you decide, it must be so hard. I hope it works out for all of you.
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Unread 08-28-2016, 10:53 AM   #5
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Default Re: How to Involuntarily Commit a Psychotic Person

thanks rainy and breadfish

rainy: there is no hearing set up. we are going to try to commit her tomorrow. where i live you have to go to a magistrate and convince them the person is either A. suicidal B. homicidal or C. unable to care for themselves. in the USA they make it really difficult to commit a person experiencing psychosis they do not meet criteria A and B. its a really huge grey area and mostly depends on what magistrate you encounter.

IF the magistrate agrees that my sister is unable to care for herself, the police are called to come get her. that means they will come to my mom's house and take my sister to an emergency room. THEN she will meet with a psychiatrist and the psychiatrist will determine if her state warrants a 72 hour hold.

if she is admitted to a psych unit, she can still refuse meds til shes blue in the face. we are not sure, but we think if 2 psych docs agree that medication is necessary, they can force meds. OR, you have to have a hearing and have a judge declare she is incompetent. my mom would then become the guardian and consent to forced medication.

OUR HUGE FEAR is that my sister will either A. NOT be admitted to the psych ward because she comes in and out of this state. she seems to realize when it's getting her in trouble, backpedals, puts on her normal face, and no one sees that anything is wrong. or B. she IS admitted to a psych unit, refuses meds, no docs or judge sees anything that warrants forced meds, and she is discharged after 3 days.

OUR FEAR is that if either of those scenarios happen that she will be come very aggressive and hostile, hate us, totally shut us out for who knows how long, maybe even leave my mom's house and become another psychotic homesless person.

i do not recognize this person as my sister anymore. she has endured a TOTAL personality change. i desperately want my sister back. another thing to consider, though, is that she might actually like the space she's in. which, in that case, there is nothing we can do.
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Unread 08-28-2016, 10:53 AM   #6
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Default Re: How to Involuntarily Commit a Psychotic Person

How does she manage to act normal when the police come round? If she was genuinely psychotic it would be really hard I would think. It's not like a psychopath where you can turn on the charm.

I don't live in the US but I know you have to be certain that hospital is the best place for her. What they do to people in these places is dehumanising and criminal. If she is a danger to herself or others then she maybe should be. But as you are in a different country from me I don't know the rules over there.
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Unread 08-28-2016, 10:55 AM   #7
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Default Re: How to Involuntarily Commit a Psychotic Person

Quote:
Originally Posted by junkDNA View Post
my mom and i need help. my sister is very ill. in 2009 she started displaying symptoms of depression. she was 23. soon that morphed into a manic episode where she lost her boyfriend and her job. she was bringing strangers to our house that she had just met at gas stations, doing drugs, lots of alcohol and reckless spending. sounds pretty bipolar, right?

she went to a pdoc and was prescribed abilify and started taking it. things got better. as the years have passed she's gone on and off her meds. she has never been completely med compliant. she refuses to accept that she is mentally ill.

in the beginning of this year we found out she has stopped her meds again. things have spiraled down quickly. first she was manic until about may. the landlord of the house she was renting with 2 other roommates (the landlord lived there as well) called my mom and told her that my sister is not being herself. he said she goes into his room and even slept in his bed!!! she eventually lost her job, she got evicted from that house, lost all of her friends, and is now back home living with my mom. she is 30 years old. she stays up all night doing god knows what.

this is the psychosis part. my sister thinks that various people/businesses are narrating and broadcasting her thoughts to the world. she texts me stuff like this at 1, 2am. i tell her these things are not real, not possible, they are symptoms of psychosis. she then laughs it off saying she was joking. thats a pretty weird joke. well its not a joke. now shes posting her psychotic drivel on social media webpages. she has yelled and threatened my mother. my mom has found her crying under the deck at 3am talking to herself. shes talking to the voices in her head a lot.

the thing is is that my sister refuses to believe she is mentally ill. when my mom confronted her about her impaired thinking and paranoia, she told my mom that me and her are the mentally ill ones. my mom called the police on my sister 2 weeks ago because she was frantically yelling in the shower, got out, and started yelling at my mom.

when the police came she put on her normal act and the cops left as they saw nothing to be alarmed about.

sorry this is so long but here is my question. my mom and i cant sit by and watch my sisters descent into incompetence and psychosis. shes really lost it you guys. she refuses to seek help or take meds. she gets extremely defensive and sometimes even hostile when its brought up.

my mom is planning on going to a magistrate tomorrow to try to get an involuntary commitment order. i have screenshot the weird texts and facebook posts and emialed to my mom to show the magistrate.


is there anything else we can do or show to the magistrate to try to convince him/her that my sister is incompetent? she is not expressing suicidal/homicidal ideation so this is a big grey area.

also, how can we get a judge to rule her as incompetent so my mom can be the guardian and consent to forced medication???



please, if anyone has been in this position, help us.

also, if anyone disagrees with invol. commitment and forced medication then dont bother responding. im aware some people are against that.
not sure about other locations but here in the USA the only people that have the authority to do involuntary commitment are psychiatrists and the court system.

short version relatives can take their family member to a psychiatrist or to the ER or call the police when the person is being a danger to their self or others.

if taken to a psychiatrist or to the ER the psychiatrists evaluates whether the person is indeed a danger to their self or others. if so they are put inpatient at which ever mental health unit or mental facility has an available bed for them. if they are showing no signs of being a danger to their self or others they are not kept and placed inpatient.

if the police are called they assess whether the person is a danger to their self or others at that moment. if so the police make a determination as to whether a crime is being committed and whether to arrest \detain them \ transport them to the ER for a psychiatric evaluation and placed under arrest. if no crime is being committed the police advise the family on non criminal routes like calling 911 due to medical or mental crisis. then the paramedics come and transport the mentally ill person in crisis to the ER for a psychiatric evaluation. this new way of dealing with the mentally ill is in place in many USA cities now so that less mentally ill people end up in the prison /justice system. some locations even have special out patient, out of the prison system type of mental health courts now rather than the police jailing the mentally ill that have committed crimes while under the influence of their mental illness.

my suggestion is the next time your sister is being a danger to her self and others (suicidal\homicidal\ making threats of harm to herself or others...) contact 911 for the paramedics.

you can also contact your sister mental health providers if you are listed as your sisters guardian/custodian or your sister has signed a release of information form with her treatment providers giving you permission to speak with her treatment providers.

otherwise theres nothing you can do as her family member unless you want to petition the courts for the courts to place her in a mental or residential facility that can take care of her special mental health needs like seeing that she takes her meds and that she is safe when she does go through her psychotic episodes. one thing you need to know, having a psychotic episode doesnt necessarily mean a person has stopped their meds. it can be that their body has built up to a point where that medication and dosage no longer works for them.

if outside the USA you will need to contact a mental health treatment provider and they will tell you what the laws are in this situation for your location.

otherwise all I can suggest is follow what her psychiatrists and the police say to do since they are the ones saying she doesnt need inpatient care.
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Unread 08-28-2016, 10:55 AM   #8
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Default Re: How to Involuntarily Commit a Psychotic Person

Junk, if your mom can't handle her meds and it puts her life in danger...that likely would satisfy the harm to self part. I put "Suicidal" above but I think it could be argued med mismanagement risk. That's sort of where guardianship would be best. I guess just focus on tomorrow that's all you can do. Sorry if I'm overwhelming you with info. I know how stressful it is after going through it with my dad. xo
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Unread 08-28-2016, 10:56 AM   #9
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Default Re: How to Involuntarily Commit a Psychotic Person

pfrog- im not sure if yo've have experience with psychosis but sometimes the insight come s and goes during an episode. i have been psychotic myself and can attest to this. there were days i was convinced of my delusions and paranoias. then there were days where i thought things were fine. its not like in the movies that portray psychotic people as bats**t insane all the time. sure, some are like that. but some are not.i am not living at my mom's house, i live 1.5 hours away. she would never agree to go to counselling as she doesnt see that there is anything wrong. thank you for your response and support.

LittleCat: my sister would never agree to see a pdoc, GP, therapist, or anyone like that. we have tried so many times. thank you for your support
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Unread 08-28-2016, 10:58 AM   #10
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Default Re: How to Involuntarily Commit a Psychotic Person

Quote:
Originally Posted by junkDNA View Post
thanks rainy and breadfish

rainy: there is no hearing set up. we are going to try to commit her tomorrow. where i live you have to go to a magistrate and convince them the person is either A. suicidal B. homicidal or C. unable to care for themselves. in the USA they make it really difficult to commit a person experiencing psychosis they do not meet criteria A and B. its a really huge grey area and mostly depends on what magistrate you encounter.

IF the magistrate agrees that my sister is unable to care for herself, the police are called to come get her. that means they will come to my mom's house and take my sister to an emergency room. THEN she will meet with a psychiatrist and the psychiatrist will determine if her state warrants a 72 hour hold.

if she is admitted to a psych unit, she can still refuse meds til shes blue in the face. we are not sure, but we think if 2 psych docs agree that medication is necessary, they can force meds. OR, you have to have a hearing and have a judge declare she is incompetent. my mom would then become the guardian and consent to forced medication.

OUR HUGE FEAR is that my sister will either A. NOT be admitted to the psych ward because she comes in and out of this state. she seems to realize when it's getting her in trouble, backpedals, puts on her normal face, and no one sees that anything is wrong. or B. she IS admitted to a psych unit, refuses meds, no docs or judge sees anything that warrants forced meds, and she is discharged after 3 days.

OUR FEAR is that if either of those scenarios happen that she will be come very aggressive and hostile, hate us, totally shut us out for who knows how long, maybe even leave my mom's house and become another psychotic homesless person.

i do not recognize this person as my sister anymore. she has endured a TOTAL personality change. i desperately want my sister back. another thing to consider, though, is that she might actually like the space she's in. which, in that case, there is nothing we can do.
Oh, okay I was mistaken and thought it was set, sorry. So the plan is to hopefully voluntarily commit tomorrow and then get a hearing to keep her there longer. Well shoot, I'm ignorant on this issue, I'm sorry. I've always gone in voluntarily and was never ordered to be held longer. And I took my meds.

If she ends up back home maybe you'll get sympathetic police officers...it's worth a shot.
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