By David Joel Miller.
When law, medicine, and mental health intersect.
Sometimes people have more than one problem.
What happens when someone has a medical problem, a psychiatric problem and they break the law? When something interacts with the law the law usually wins. How these cases at the intersection of disciplines are resolved depends on the laws in your jurisdiction. Most places in the United States have similar statutes often based on uniform law statutes. More and more places on earth are recognizing that mental illness is not a choice and that the mentally ill need special consideration in their encounters with the law. Here are some of the possible outcomes of a drunken suicidal person based on what happens here in my jurisdiction.
Partly this depends on the order in which things happen. Do they go to the hospital for a heart attack and then we discover they are drunk and suicidal? Or have they been arrested for driving under the influence first? What if they killed someone while drunk and now are thinking of killing themselves. All very different scenarios.
While I separate medical, psychiatric and correction issues, some places may have facilities for several of these issues. Hospitals may have psychiatric units, in custody units and so on.
Crisis issues should always get the first look.
If someone is having a heart attack or bleeding to death they need immediate medical attention. They go to the hospital. If medical problems show up while they are in jail or the psychiatric facility they should be transferred to a medical hospital unless where they are also offers that second service.
Alcohol is one of the most life-threatening of all the drug from which to detox. People can and do die from alcohol withdrawals. If someone has ever had the Delirium tremens (DT’s) they are at risk to die while sobering up. This needs to be supervised by a medical doctor.
If someone is suicidal they need psychiatric care.
We have a procedure here in California for placing someone on a psychiatric hold (technically a request for evaluation) and getting them sent for an evaluation. That first hold is only good for 72 hours. After that, a psychiatrist needs to say they need to stay or they get discharged. If they committed a crime they might get discharged from the psychiatric facility and still face legal charges.
Once at a psychiatric hospital and under the care of a psychiatrist, they will be evaluated and kept until the crisis resolved. The laws have lots of safeguards to keep people from putting other people they don’t like away and keeping them locked up for long periods of time.
Once upon a time – people stayed in psychiatric hospitals for a long time. Stays of several years or even forever commitments were common. Not anymore. Since the advent of effective medications, stays at psychiatric hospitals are getting shorter and shorter.
Stays of a week or less are now common. A long-term stay in the psychiatric facilities I have worked in would now run two weeks to a month.
Killing yourself or attempting to is illegal in most places, only the most rabid law and order types would even consider chasing someone down and arresting them because they had thought about suicide while drunk.
With the intoxicated person, they are likely to change their mind about suicide once they sober up. Studies show that people who are binge drinkers, when they drink they get drunk, are 55 times more likely to attempt suicide than people with no alcohol in their system.
So generally speaking a drunken suicidal person will not be sent to jail. If nothing else the jail does not want people killing themselves while in jail. Having clients die in your facility is bad for a business even if you run a jail or prison.
No jail for the drunken suicidal person – unless –
If the drunken person has committed a serious crime while intoxicated they are still held liable. Being drunken is not an excuse for bad or illegal behavior. Being mentally ill does not, and should not, get you a pass either.
You may not go to prison, but you will have consequences, like time in a hospital for the criminally insane, until we are sure you understand what you did and are capable of not doing that again.
Jails do have psychiatric units and they do have to put people who were arrested for serious crimes on a suicide watch from time to time. But no, most times, they have no interest in arresting and detaining someone who is suicidal.
For the record – people who are placed on a psychiatric hold are not under arrest. This does not result in a police record or mean you will have to say yes to having been convicted of a misdemeanor or felony on a job application. You psychiatric treatment record is supposed to be confidential just like your medical treatment record. Do not let fear of legal consequences stop you from calling for psychiatric help if someone is suicidal. Dead people do not worry about having a record.
One consequence of being in the psychiatric hospital will likely be a form you sign at discharge that tells you that you cannot buy or own a firearm for five years after being in a psychiatric hospital. If you want to get a gun, then you will need to appear before a judge and convince him you have a good reason to own one.
But if you are the sort of person who gets drunk and then thinks about killing yourself and others, you are not the kind of person that I would like running around my neighborhood with a weapon.
If someone is medically sick they need to be in a hospital, someone who is suicidal needs psychiatric care and someone who breaks the law gets arrested. When someone has more than one of these issues we may have trouble figuring out what to do.
Hope that answers the question a reader sent in “Does a drunk suicidal person go to jail?” If you have more questions or comments on the issues of suicide, intoxication and our society’s response to people with multiple problems please leave a comment.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books