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

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Psychiatric hospital.
Photo courtesy of pixabay.

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

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 clothe 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.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

If you go to the psychiatric hospital are you crazy? Involuntary holds

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Former psychiatric hospital

Psychiatric hospital.
Photo courtesy of pixabay.

Why do people get hospitalized? Can I send my child or partner there?

There are a lot of misconceptions about going to a psychiatric hospital, who goes and why. In this post, I want to talk with you about some general information about what it means to be in or be sent to a psychiatric hospital.

This may vary from hospital to hospital and from jurisdiction to jurisdiction so for legal information check with the laws or a lawyer in your area.

It is not the people with the most serious mental illnesses that end up in the hospital. Our policies around this have changed a lot over the last century.

There was a time when people were sent to psychiatric hospitals for long periods of time. Stays of a year or more used to be common in the days before medication. Today most hospital stays are as short as possible. The use of medications has shortened stays considerable and so have patient rights laws.

There was a time when a man could put his wife away in a hospital and then get to spend more time with his girlfriend. Families would try to put away people who had a lot of money or were eccentric, to get control of their assets. There were a lot of abuses as a result of having others in the family say you were crazy and then hospitalizing you. Once people got into the hospital it used to be hard to get out. Not anymore.

There are two ways that you might get hospitalized, voluntary, and involuntary.

Voluntary psychiatric hospitalization.

If you go in voluntarily you need a lot of money. A single day could cost thousands of dollars. But just saying you want in will not get you a bed in most hospitals. A doctor needs to say that you have a psychiatric issue that would benefit from hospitalization.  Beds in psychiatric hospitals are at such a premium that you don’t get to stay just because you want to be in the hospital.

If you enter on a voluntary status you are entitled to leave anytime you want regardless of what the doctor says. There may be legal ways for the doctor to keep you by moving you to an involuntary hold but those laws get complicated.

Involuntary psychiatric hospitalization.

People are placed in the hospital involuntarily because they are in a crisis that cannot be resolved on an outpatient basis.

Involuntary holds vary from place to place. In most jurisdictions, there are three reasons you might be placed on an involuntary hold.

1. If you are suicidal.

If you are a danger to yourself, suicidal, you can be put on a hold and kept in the hospital in most places. You stay there until the thoughts of suicide are reduced enough that the treating psychiatrist no longer feels you are a serious threat to take your own life.

2. Are you Homicidal?

The second reason to involuntarily hospitalize you would be if you have a plan to kill a specific person and you will not back down on this. You will stay in the hospital as long as the staff thinks you still plan to kill someone.

This is sometimes referred to as a “danger to others.” This is easily misunderstood.

3. Are you gravely disabled?

If you have food, clothing, and shelter but can’t figure out how to use these things, we might need to hospitalize you to protect you. This person would be referred to as gravely disabled.

Someone may have a serious and persistent mental illness, they are very impaired, but if they can be maintained on an outpatient basis with meds or therapy. They may never end up in the hospital.

Someone who was just laid off or served with divorce papers may end up in the hospital because while upset or angry they think of hurting themselves or others. After a few days in the hospital they change their mind and are sent home. They may never experience a recurrence of these feelings. We still recommend therapy for a while just to make sure they are OK.

The conclusions about involuntary commitments.

1. It is not always the most severely mentally ill that goes to the hospital. It is the people who need to be protected from themselves and others that spend time on an involuntary hold.

2. Just because someone has a severe mental illness does not allow professionals to lock them away. They need to also be currently a danger to themselves or others or gravely disabled.

3. There are currently not many other options for monitoring someone who is mentally ill. They either meet criteria to be hospitalized or they don’t. If they do meet the criteria they stay till they stop being a risk to themselves and others. If they don’t they can’t usually go to the hospital even if they want to.

4. Other options to make help more available to the mentally ill short of a return to full hospitalization are urgently needed.

There is so much more that needs to be said on this topic but I will close for now, but there will be more to follow.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel