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?
, I know that often we are termed PARANOID well gee i wonder why.....it is like we aren't fully human to some of these places like that 
for in places like hospitals the docs and nurses are portrayed as Godlike and their decisions written in stone....NOT!) also just to get BASIC and i mean BASIC needs met and he wasn't in a mental institution but in a regular hospital for a physical illness he had no mental illnesses at all but...the compassion is no longer there people
, i really don't think it is.
...
...keep up the good, loving work dear sir....
....it is my nightmare that i too will one day need to admit to the hospital and be forgotten there among the masses, however, i have the best family support system i could ever ask for so like the man who spoke of his wife i can only hope that my family would be as insistant as he on treatment procedures and "professional's" behavior toward me. 
G.J.
We both see eye to eye on this one. There are times that we need to exercise our rights as families to do a short involuntary stint for our loved ones. But in the cases you provided, excluding your sons case…Where are the families??? How is $2500 going to give them back 10 years of their lives of usually being heavily medicated causing sedation? Where are the patient advocates?
I have a personal story in that my wife held the status for 2 1/2 weeks of voluntary status until an incident. Since then she has been in an acute unit that is next to worthless in care and over drugging is used as a way to deal with patients.
I have tried for the past two weeks to get her over to a state run facility that I did visit and seemed a lot nicer. The point I am trying to make is that I have had to since day one advocate for my wife.
For heavens sake, don't just go along with things and put your loved ones care totally in their hands. The thing you need to understand is there are a number of these places that some if not most of the people that are left to watch your loved ones need constant monitoring.
Your loved one looses a voice and is discounted for everything by saying their crazy and it never happened. Great control mechanism huh, for the people left in charge.
About twice a week I am running their ***** over the coals for something stupid that should never have happened. This week...wife is too heavily medicated and fringes on an over dose (eyes rolling up toward the forehead) nurse comes in and agrees that they need to back it down a little. They refused to give her a hormone patch saying they didn't have any even after I explained calmly that I had brought them in the following day... a week ago.
So again...where is the advocate?? We the families are the advocates and need to demand good treatment of our loved ones. I want mine home as soon as possible and the thought of them keeping her one day more than they need to is unconscionable.
Some families have found it too unbearable and used these facilities for a dumping ground. I would much rather have those in outpatient residential housing than involuntary committed.
Eric,
I hope things improve soon for your wife, I can't imagine the stress and pain I'd feel if I were in your position. It's been said if we don't advocate for our loved ones, nobody else will. And that's very true, but it assumes we all have the ability and strength to be an effective advocate. You have my respect for being that kind of advocate. I've gotten to know another person also thrust into an advocate role, you might take some comfort from a peer struggling in a similar way. You can read her stories here:
http://bipolarsoupkitchen-stephany.blogspot.com/
Thanks for sharing your experiences.
Eric,
As GJ wrote in comment [thanks for that] you can read my blog and know the role of advocate is imperative, and necessary, as it sounds like you have discovered like I did. I find it works best to be in person, and many times unexpected. I've been advocating intensely since Oct 10 to prevent my 19 year old from being discharged to the state hospital [per her current inpatient doctor plan]. I single-handedly found a solution, and have spent the last 5 days from basically 9-5 being everywhere, talking to everyone. Keep all contacts names and phone numbers you ever get--some of mine are people I have known for years in the system, and I was able to call them to consider my plan. It worked. I will be writing more on my blog on Monday Oct.29th about what I did, and how it all turned out. For now, I wish you energy and strength to do what you can to be your wife's voice. The pure terror that the doc wanted to send my daughter for warehousing at the state institution[unacceptable]is what has given me a super-human ability to forge ahead fatigue or not.
Funding is a large problem and reason there are no advocates to find for individuals, and often times the hospital staff perceives a proactive advocate family member as interference. It's a tough road to travel. Keep emotions out of it, and remain the advocate. That asks a lot doesn't it? But we know who we fight for--so we fight on.
Good luck.-stephany at soulful sepulcher