An ongoing topic of discussion when bipolar disorder advocates and patients get together is the involuntary treatment issue. Is it right to commit someone for treatment against their will? Is it sometimes necessary, or is it never appropriate?
My personal opinion, for what it's worth, is that there are situations in which involuntary treatment is absolutely necessary. With my son Kyle, it was an involuntary hospital stay that stopped his slide and gave him a new lease on life. We feel it may have saved his life. But there are also situations where it's not appropriate. It's never appropriate when it's done for the convenience of someone besides the person being committed. When other legitimate courses of treatment are available, it is not appropriate. And it's never appropriate without a series of checks and audits in place that insure those committed receive the treatment they need, and are eased back into society in a timely manner.
I was visiting Liz Spikol's blog, The Trouble With Spikol, and saw a link to a story that chilled me:
Bergen Regional (Medical Center) deaf to patients' plight, suit says.
Per the story:
"Thirteen mentally ill patients involuntarily committed to Bergen Regional Medical Center languished in the hospital's psychiatric unit for up to a decade, their cases forgotten and never revisited, according to a whistle-blower lawsuit going to trial Wednesday."
Thirteen patients, up to 10 years each. You would think someone – family, friends, even hospital employees would notice something was wrong. But someone finally did:
"In 2005 (Former hospital employee Diane) Burger discovered a patient in the psychiatric unit who had been confined involuntarily for 10 years, without any review by a judge. That case was eventually reviewed by a judge who fined the hospital $2,500. Burger subsequently found 12 more patients who had been confined without a hearing for years and without any review of their case."
How could the staff not know that patients have been there for a decade without a review? Not the staff in general, but any single member of the staff? From administrator down to housekeeping?
"Under state law, involuntary confinement to a psychiatric hospital occurs after a panel of psychiatrists determines the patient is a threat to himself or others, mental health advocates say.
"That confinement, which essentially strips the patient of all day-to-day decisions and can include forced medication, must be reviewed periodically by a judge, advocates say, usually every 90 days to six months, to determine whether the patient is eligible for release."
To potentially go even three months without a review for involuntary confinement is unconscionable. And how many audits should have caught this? Department audits, hospital audits, hospital financial audits (who was paying for this?), supporting agency (agency responsible for authorizing payment for treatment) audits, and finally legal system audits. This hospital is run by a for-profit organization, folks, and they actually lost track of these patients. Imagine the cost of long term psych care for a decade, and their accountants didn't catch this?
