Take My Advice: Research Well Before Committing Yourself to a Mental Health Institution

As a mental health services consumer (mental patient), the hospital and investigating agencies already presume you are unreliable, while the staff and records are presumed reliable, compassionate, truthful, and accurate. This is not necessarily true, you are reliable, and they may be lying to cover their incompetent mistakes. BUT.. since they write the medical record which is a legal document that can be used against you later, it is important that you gather evidence to counter their allegations. You need an effective strategy to present your case in an objective fashion. You need to get past your word vs theirs. Then when you show them the evidence in their own charts, they will either deny it exists, claim it means something else, or claim it was a simple mistake by the person who wrote it. Think of a child with his hand caught in a cookie jar innocently asking “What jar?”. Don’t let them rattle you into believing their lie that white is black and black is white.

A suggestion. Should anyone suggest a person suffering from psychological disorder to go to a mental hospital or other behavioral health institution for a rest, consider them dangerous. Keep up some small talk and appear to take their suggestion seriously. Slowly back away while facing them (as you would a rabid dog). When you get around a corner run don’t walk. Most mental institutions are about force, control, medication, and locked doors. Not rest. Sexual assault for females is a real possibility. Going to a mental institution for a *rest* is insane. If you need a rest, go to a Holiday Inn.

None of these suggestions are “magic bullets” to protect your rights, but they can be the basis of your plan for protection. They enable you to take some measure of control of the situation. Again the key is documentation.

1. Have an ally. This is a trusted friend or family member who is willing to advocate for you. Give written permission for your ally to view your medical records and discuss your case with the hospital. Don’t let health record confidentiality be a barrier. The ally should record the time and content of any interaction with the hospital and staff.

2. Write it down ASAP. If you can keep a journal in the hospital do so. If not, then your first task out of the hospital is to write down what happened with as much detail as possible. With each passing day, memories will fade. As best you can, document exactly what happened, when it happened, who said what, who was there, etc as soon as possible. If your ally visits on a regular basis, give them information dumps on what occurred since their last visit so that they can keep a log for you outside the hospital. If something significant happens, call your ally now. Tell them in detail what happened. Show them during the next visit.

3. Get corroboration. Have your ally present as much as possible. Tell them at every opportunity what has occurred. Get them to keep a contemporaneous journal that distinguishes what you tell them from what they personally observe. Given involuntary injections? Show your ally the puncture marks, tell them exactly what happened. What you did and said. Who was present, staff and patients. What the hospital staff did and said. Have the ally present with medical consults if possible. Have them ask the doctor about your diagnosis, treatment plan, medications, side effects, probable outcome, etc. They should document this information as it is obtained. If there is an rights violation incident, have them ask the hospital to explain what happened. They may get a different story than that written on your charts. This can be used to impeach the charts. The key is details. You have to be as detailed as possible. Details, Details, Details.

4. Get your medical record. When you are released, request a copy of your entire medical record on your way out. You will probably have pay for the copying fee. If you have a trusted doctor or lawyer, have a copy sent to them as well. The hospital may try and withhold part of the record, if so contest it. You want the whole thing. If the doctor has a separate record, get a copy of that as well. If they won’t release the whole record, force them to explain in writing why. Suggest it is needed for legal action. This may make them reconsider since if they with hold information it might look bad.

5. Get your detailed billing records from the hospital and the doctor. These will show every appointment you had with the doctor and every medication the hospital gave you. You will cross reference these with the medical records.

6. Consider a physical exam. If there is any physical evidence, bruises, abrasions, needle punctures, etc; get it documented by another doctor after you leave the hospital.

7. Continue to document everything. Record phone calls, meetings, and letters to advocates, lawyers, police, the hospital, doctors, etc. Send important correspondence by registered mail with return receipt requested. In meetings, try to have your ally present. Continue to document details.

8. Consider an Advanced Healthcare Directive. Specify how you want to be treated under specific conditions. In case you are incapacitated or declared incompetent, specify whom you want to direct your health care.

9. Police The police are generally not trained to deal with mental health issues. They fall back on their standard procedures of:

a. Take control:. They will dictate what you may or may not do. They will not compromise or negotiate. Once the police arrive, they will take control. Anyone who fails to fall in line is subject to physical restraint and or arrest.

b. Force: They have handcuffs, batons, guns, pepper spray,and attack dogs and will use whatever force THEY feel is necessary. They also have legal immunity to do just about anything they want. Should you try and argue, well see (a) above.

c. 5150: In California the only response the police will provide is to place you on a 5150 and transport you to the destination they choose. If you don’t want to go there, too bad.

d. Deadly Force: Police involvement in mental disturbances frequently results in the mental patient being shot to death. The San Francisco Bay Area has had several cases of people shot by the police. Know this before you call them.