Will the therapist say I am crazy and lock me up?


By David Joel Miller

Being locked up is a fear of some people coming to therapy.

Jail

Jail

The chances of this happening are very close to zero. The fact that you came in on your own means this is highly unlikely for many reasons.

This idea of the upset person who gets “put away” in a mental hospital, usually called an insane asylum, makes for great T. V or a good novel, but in real life that does not happen, at least not very much and particularly not here in the United States.

Here are the reasons why you are not going to get locked up just for going to see a counselor.

Professionals just do not think of mental illness that way anymore.

The old notion was that there were two kinds of people, normal and crazy. If that were true we would need to lock everyone up because I do not see any normal people in my world. Some people may be more normal or less normal than others, normal being a statistical concept. Being different does not make you crazy.

Mental illness is not the same thing as being crazy.

Mental illness is on a continuum, people get unwell, then they get sick, then they move back in the other direction as they recover. Most people have times in their life when they are anxious or depressed. If someone is shooting at you please get anxious. If a family member dies, I hope you get sad. Do not let that anxiety or depression control you for the rest of your life.

People we call mentally ill get stuck at that “too sad” or “too anxious” and do not seem to get back to a better place without help.

There is a big argument about why. Watch for an upcoming post on the causes of mental illness as I see them.

The therapist expects you to have some problems, so no they are not likely to think you are over the edge just because you came for a little emotional help.

There are only three special reasons you can be confined to a psychiatric hospital against your will.

Holds for involuntary psychiatric hospitalization in this area are only written if the client is a danger to themselves, a danger to others, or they are so disabled they can’t feed themselves or cloth themselves. Being poor, or homeless, does not count. I hand you a cookie and you eat it, I offer you a sweater and you put it on, you pass this test.

If you say you are planning to kill yourself then you may be detained until those thoughts pass and you recant that thought. Professionals are suspicious if you were saying you would kill yourself to the police just a few minutes ago and now you are saying that you won’t.

Saying you have thoughts, usually will not get it. You need to also have a plan for when and how you will do it or a history of attempts or some other reason for the official placing you on an involuntary hold to believe this is something you might do.

Being under the influence of drugs or alcohol is a risk factor. People who binge drink or are drunk are 55 times more likely to attempt suicide than sober people. So if when drunk you say you are going to kill yourself and the police are called you may end up in a psychiatric hospital for a very short stay.

Say you are planning to kill someone else, say you also have a gun and you may end up in a hospital or a jail for a while longer. Even then the law just does not let the police or the psych hospital keep people who might someday hurt someone else all that long.

Once the person sobers up or changes their mind, the chances are that they will have to be released even if the police still think that this person may in the future hurt someone.

While this lets some people out who may harm others it also keeps a lot of people from being locked up just because they scare someone else.

The psych hospitals are pretty full and they charge a lot of money.

The hospitals do not want to keep anyone there one minute longer than they have too. The days of years in an asylum are over and gone. Most stays now are a week or less. Stays beyond 30 days are rare.

In crisis units, the stay around here is most often less than a day.

Yes, I know the involuntary hold says 72 hours, but in practice, not many people stay that long. That 72 hours or 3 days is a maximum, not a for-sure.

Most of the complaints I hear are that people were discharged from the hospital before they felt ready, not that they were kept too long.

As soon as someone appears able to cope with life they get let out even if they will need meds or therapy to be able to cope in the future.

Counselors, in most places, are not authorized to write involuntary holds.

Even if a counselor works for the government and writes holds in their day job, they are not able to write them in their private practice. So unless your treating professional is a psychiatrist with treating privileges at the hospital there is a low chance they have that little card that lets them write holds, especially one that would let them write the hold in their private office.

What could happen is if you said you were going to kill yourself or others and you convinced the therapist that you were serious about this, he or she might call the police and get you detained until you change your mind.

There you have it. The things that bring most people to counseling are miles away from the things that might get you locked up in a psych hospital. Stop worrying about this and go get the help you need before you have to live your life in the place of unhappiness.

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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

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2 thoughts on “Will the therapist say I am crazy and lock me up?

  1. Pingback: Why people avoid the doctor and the therapist | counselorssoapbox

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