An Ordinary Mom's Musings

Some of you may be dealing with heavy psychological issues with a friend, significant other, or family member. Their behavior is erratic and/or frightening. You need a psych hold.

You don’t know what to do.

What can you do?

There are many different psychological issues that could lead you down this road. Bipolar, schizophrenia, depression for example.

What can you do?

What do you need to know?

First, you need to know that none of this is your fault. You didn’t cause any of this. And if this is a life-threatening emergency call 911 immediately.

Second, you can encourage them to get help. Make it as easy as possible for them. Offer to find the doctor or therapist, make the appointment, to drive or go with them. But don’t take it wrong if they decline your assistance or feel there is nothing wrong with them. It’s about them, not you.

Third, if they don’t seek help on their own, you may need to set boundaries for your relationship. Where is your personal line that you will not allow to be crossed? Depending on the situation, you may have to distance yourself. Keep those boundaries strong. It’s in everyone’s best interest.

Fourth, you need to know what the requirements are for getting them placed on an involuntary psych hold at your local hospital.

What are the criteria?

• Are they a danger to themselves? This is self-harming. Are they cutting? Talking about suicide? Purposely driving too fast so they can end things?
• Are they a danger to others? Are they hurting you or someone else purposefully or trying to? What about animals?
• Do they suffer from a grave disability as a result of mental illness? This one can be a little trickier to understand. An example one professor gave of this, was a woman who felt compelled to walk up and down the street all day long due to her mental illness. She was completely harmless, wasn’t quite as bright, but she wasn’t going to hurt others or purposely hurt herself in the traditional sense. One summer day my professor got a call that they needed to put this woman on an involuntary psych hold for grave disability. She wondered why. When she found her, the woman’s body was covered in blisters from the sun while she walked up and down the street all day. Because this walking was a compulsion that she couldn’t stop, she needed to be admitted and treated.

These are the criteria to get an involuntary psych hold for 72 hours. Only one of the criteria has to be met, but the doctor’s at the ER are the ones who decide if the patient qualifies.

Fifth, how do you get them there?

Sometimes, the patient becomes disturbed themselves, by what is going on with them and can admit themselves.

Other times, when they don’t recognize their need for a psych hold-

You need to call 911 immediately. Police will be dispatched to your location. Some municipalities have officers who are specially trained to respond to these types of psychiatric emergencies. Explain to the dispatcher what is going on and ask if they have one of these officers. Depending on the situation an ambulance may be dispatched at the same time or can be called by the officers once they arrive. Your loved one is going to leave either in the back of a police car or in an ambulance.

Six, remember that you are not to blame for this no matter what comes out of their mouth at you during this time. Your loved one is likely not going to be happy about the situation. But right now, their brain isn’t working right. It’s telling them lies, and they can’t tell that right now.

Seventh, you need to know that after 72 hours and the doctors have been unable to stabilize them, their case goes before a judge and the judge decides whether they need to stay longer. This is how it works for adults. With adolescents, it depends on the state. Some states like Washington State have declared 13-year-olds medically adults. They are considered capable of refusing psychiatric or drug rehabilitation treatment. In other states, it’s a range of ages usually up to 18. When they are legally considered an adolescent, the parent can decide in conjunction with the doctor’s how long they need to stay.

These are the basic steps. But I would be remiss if I didn’t warn you about a few other things.

Many of the patients can be stabilized with medication within 72 hours. However, because they start feeling better, quite a few will choose to discontinue the medication too soon. This will be without the doctor or anyone else’s knowledge. You can end up right back where you started. So it’s really important that as they transition back home, you watch closely for any re-emerging behaviors or lack of taking medication.

The other thing is something I have learned from my experiences getting someone admitted to a psychiatric ward. The amount of mental health practitioners and psychiatric beds we have in this country is criminally too low. Getting them to the ER is your first step. But many patients are being left living in the ER for months (even pediatric), waiting for beds on psychiatric units. They will be safe (they are watched 24/7), but they won’t be being treated properly medically. The ER does the best it can but they are not a psychiatric unit.

If you have questions about this process, please feel free to reach out. The information you share with me will be kept confidential. You can email me at Calleen@anordinarymom.site. Please, stay safe, and keep those you love safe.