Drug-free Mental Health inpatient treatment?

[turil.livejournal.com]

I just called the Cambridge Health Alliance Mental Health emergency services and wanted to check myself in. Before I went in, I wanted to be assured that they wouldn't drug me without my consent. The woman said that she could not "arbitrarily" assure me of that, got angry with me, and actually hung up on me while I was crying. (Seriously.)

So I'm kind of in need of finding some place local that doesn't drug people without consent, and that might have some staff that don't actively try to be mean to depressed individuals looking for help...

Any suggestions?

I also don't have any health insurance or money.

(No, I'm not officially suicidal yet, but I'd rather get this taken care of before that happens, you know?)

Comments

[electricube.livejournal.com]

I'm sorry, I don't have any information on hospitals, but I just wanted to say: don't mind that woman on the phone. It had nothing to do with you. People get burnt out in caring professions all the time. They encounter a great deal of suffering, and some of them grow hostile, because being around it hurts them. But they took the job, and if they can't handle it, it is their responsibility to remove themselves from a situation in which they will hurt other people, particularly in a profession where people approaching your place of business are suffering and in need of care. It's not your fault.

This is not an excuse for treating anyone like that, but it might explain things a bit. In any case, I hope you feel better and find care that will benefit you.

[ayelle.livejournal.com]

I don't have any helpful information, but best of luck, and my thoughts are with you.

[sissychrissy1.livejournal.com]

I've had great experiences with CHA overall, but not the best with the Psychiatric Emergency Service hotline, which is unfortunate. I recommend calling the hospital itself if you can or just going in. I really don't think they can drug you without your consent if you voluntarily sign yourself in.

Legally they can drug you for "emergency" purposes.

[turil.livejournal.com]

I just looked up the law and they can indeed legally drug you if they feel you are a threat to yourself or others. In other words they can give you a "sedative" drug if you get really angry.

And I can easily see myself getting really angry, and I don't think putting nasty chemicals into my brain is going to make me any healthier. A padded room sounds nice, perhaps, but not creepy sleepy drugs :-)

Re: Legally they can drug you for "emergency" purposes.

[sissychrissy1.livejournal.com]

That sucks. I've was really anti-medication for a long time, but it's still better than truly harming yourself.

If you don't find something that better suits your needs this weekend, check out their outpatient services on Monday, which I've found to be really fantastic.

Re: Legally they can drug you for "emergency" purposes.

[lissie930.livejournal.com]

It's my understand that they would have to admit you involuntarily for this (drugging you without your consent), and if you're not suicidal, they would probably not admit you (do not take this as TRUTH because this isn't a system I've worked in, but IME it's pretty hard to get admitted to a psych unit these days). I would be surprised if the first thing they did would be to drug you without your consent. What is your local ER? Cambridge Hospital? Could you call them and see what their protocol is for psych emergencies?

I'm sorry you're hurting, and I'll be thinking about you tonight.

Re: Legally they can drug you for "emergency" purposes.

[emcicle.livejournal.com]

but IME it's pretty hard to get admitted to a psych unit these days)

i do work in this system, and it is true, it is very hard to get admitted inpatient, even when you are suicidal. I'm not saying it's right, but it happens all too often

I do wish you the best of luck.

[msjay.livejournal.com]

I haven't had any personal experience with inpatient care (but have had some major panic and depression issues) but maybe you should check out McLean's in Belmont. It's relatively close, but I don't know much more than that. Hope everything turns out ok!

http://www.mclean.harvard.edu/

[thetathx1138.livejournal.com]

Basically, once you sign yourself in, they can do what they want; you are, literally, telling them you cannot care for yourself and you need someone to make the decisions for you.

[recoiling.livejournal.com]

hey- i was actually just discharged from the post traumatic stress and dissociative disorders ward at mclean on wednesday [it's not just for rich people anymore, i'm on masshealth myself]. unfortunately, as a "frequent flier" of local psych wards i'm quiet familiar with the rules.
1) they'll only admit you if you state you are actively suicidal and/or homicidal- i had a friend who was quite psychotic once and seeking help, only to be forced to say they were homicidal in order for an admission.

2)they cannot and will not drug you forcibly if you sign in voluntarily. there are catches to this, of course- if you're viewed to be an active threat to yourself or others. most places will have you sign a form upon admission asking what you'd prefer in case of such a situation: restraint, chemicals, check-in, etc

3)if you voluntarily admit yourself and want to leave- you can sign a 3 day notice, which gives them 3 business days upon which to decide whether to release you or get a judge to commit you. i've signed 3 days several times and they've let me go all 3 times- it was against their wishes but they couldn't do anything because i continually stated that i was no longer suicidal.

hospitals are not fun places to be- staff members can get power trips and patients can be scary [although usually only because of the antagonism of fucked up staff]. however, it's far better than nothing if you're feeling suicidal and there are places that will treat you with relative respect and dignity.
stay as far away from arbor in jamaica plain and westwood lodge in westwood as possible- they have an abnormal number of restraints and also a lot of power-tripping staff [in my experience, at least]

i highly recommend mclean hospital, particularly if you are dealing with any trauma issues- as the trauma ward is far quieter and more respectful of people's dignity.

things to know if you decide to go:
-it'll be a long wait in the ER, try to bring a friend, books, magazines- something to keep you occupied.

-about 75% of psych hospitals do strip searches [i know the DID unit at mclean doesn't, but it's either hit or miss w/ other places], prepare to be pretty much demoralized- although when someone having themselves locked up to protect themelves from themselves, they most likely feel pretty low already.

-most hospitals take your cell phone and keep it locked up while you're in- so bring change or a phone card for pay phones- they technically have to give you free phone time, but it's hard to come by

-they'll give you information about your civil rights when you go in, read it and keep it and make sure you understand everything before you sign anything

-upon admission, they'll do a "sharps" check and take anything away that could be used for self-harm. very place is different but some idea: sharp things [obviously], medications, anything that is long enough to wrap around one's neck- such as belts and shoelaces, some places also hold personal care stuff like shampoo and lotion, but that seems to be a rarity around here

-hospitals are good for 1 thing, maybe 2 depending on the team of people you work with: 1)keeping you physically safe- if you need that, please go in- nothing can get better if you're dead. 2)getting you the help you need on the outside- once you've had an admission, your case is given higher status by community outpatient organizations and it will probably be easier to get free care. sadly, sometimes the nature of this system makes it necessary to go in even if you're not in acute danger.

finally, i know there's a lot of information here. even though we don't know each other, if you'd ever like someone to hang out with during these times, let me know.
my email: lia @ glowinthedarkstars.com

ps.

[recoiling.livejournal.com]

sorry to overwhelm you with information, but just 2 more things:
1) i noticed on your profile that you're a vegetarian- if you do decide to go in (and i'm definitely not advocating that you do or don't; i just want you to have as much information as possible to make an informed decision) make sure that they note that upon your admission and be assertive in forcing them to comply. there are some hospitals that think vegetarian means serving the rice and vegetables with the chicken removed. if you have someone who can bring you food, ask the staff to label it and put it in the staff refrigerator.

2)if you're looking for outpatient care, i found these 2 things that seem pretty positive:
http://www.cambridgewomenscenter.org/programs/projects.html
Women's Counseling and Resource Center - The Women's Counseling and Resource Center (WCRC) is a collective of licensed therapists, offering individual psychotherapy to women who are low-income and have no health insurance. Each therapist volunteers her time. WCRC provides a one-to-one relationship with a skilled counselor to women who cannot afford therapy at the Women's Center.

also, the Transformation Center is a peer operated center devoted to wellness and recovery. i know some of the people who work there and they all fucking rock. the website is due to be updated at the moment, but i think you can find more information if you contact the awesome folks at m-power [slogan: "nothing about us without us"]:
http://www.m-power.org/
" The Transformation Center is a peer-operated center that is spinning off from M-POWER to strengthen a mental health focus on wellness and life recovery. We currently offer training for Peer Specialist Certification, Leadership Academy, WRAP Facilitation, Recovery Conversations for Providers and more. Efforts will expand advocacy, resources & information, peer programs & evaluation, and policy input from people with lived experience of mental health conditions and/or addictions. Watch for the new website in June 2007 at Transformation-center.org. Visit our supporters now at mamhtransformation.org.

[siderea]

I'm sorry you're in so much pain. Pretty much definitionally, the way the world works here and now, any facility which can take you in for a mental-health emergency is one which can administer drugs without consent. No hospital, no doctor, would accept just anyone off the street, no matter how out-of-control, floridly psychotic, without the recourse of being able to quickly administer medication without either permission or court order. It's no different than an ER electing to administer medications to an unconscious patient, in an effort to save the patient's life. If you walk into an ER, and they believe you have an impaired ability to make decisions, they will treat first and ask questions later.

Also, if you're not presently suicidal, they may not feel your current situation qualifies as an emergency.

The sorts of help which are available basically lump into "inpatient" (in which case they can administer medication against your will) and "outpatient". Outpatient care basically consists of 1) medication and/or 2) psychotherapy.

If you want outpatient care, here is one way to approach it. I'm assuming, since you mention "not officially suicidal yet", that you're talking about depression. Cambridge Health Alliance clinics -- at least the one on Mass Ave. north of Porter (2067 Mass. Ave.) -- have walk-in hours. They also have a sliding scale. Call them on Monday (or for that matter, just show up) and explain you need to see a doctor (we're talking a perfectly normal garden-variety general practitioner family doctor) and don't know if you can afford it. If they can arrange for you to see a doctor and you can afford it, accept. I expect there will be plenty of paperwork to fill out, and maybe a long wait. They'll have a nurse take your height, weight and blood pressure. Then the doctor will see you. When he or she asks you what the problem is, you say the magic incantation, "I think I have depression, and it's really, really bad." And then you list your symptoms. Be sure to mention anything you have been able to do in the past which is presently impaired. In doing so, you are presenting your depression as a medical illness, which is a paradigm doctors are familiar with.

The doctor may interrupt to ask questions, if he's really up on his psychiatric diagnostics; if he does, work with him because he's documenting the legitimacy of your claim for you which will help in the system. The official diagnosis of Major Depression is done by checklist. You have to have so many symptoms off the official list.

If he agrees with your self-diagnosis, he will then probably offer you a prescription for (or even a free sample of) antidepressants. Any doctor (not just psychiatrists!) can prescribe antidepressants (or any other medication they like). You may turn him down (though if you are in as serious distress as you say, you might consider the offer) and ask if he can refer you to a psychotherapist (important magic buzzword) who would be willing to see you pro bono or on a sliding scale. Either he'll say no or he'll will get a slightly perplext yet slightly thoughtful look, as he wonders whether that's a service that his system provides; in the latter case, he'll sic his staff on the process of running it down. I suspect you are far more likely to get to see a therapist on the cheap and in a hurry in any medical system (such as CHA) if you have a general practitioner's referral behind you.

[recoiling.livejournal.com]

No hospital, no doctor, would accept just anyone off the street, no matter how out-of-control, floridly psychotic, without the recourse of being able to quickly administer medication without either permission or court order...If you walk into an ER, and they believe you have an impaired ability to make decisions, they will treat first and ask questions later.

i just want to say that's not exactly true- while human rights for psych patients do completely suck, i was just inpatient at mclean during a manic episode after a suicide attempt and i successfully refused everything [antidepressants and antipsychotics] but benadryl for sleep for the entire week. as craptastic and human-rights-abusing as hospitals can be, the situation is not nearly as "one flew over the cuckoo's nest"-esque as it once was- at least not in massachusetts. this is due to the extreme hard work and dedication of patient's rights groups such as M-POWER [www.m-power.org/]- (not NAMI though as they strongly support pro-forced medicating and hospitalizing.)

[siderea]

i just want to say that's not exactly true- while human rights for psych patients do completely suck, i was just inpatient at mclean during a manic episode after a suicide attempt and i successfully refused everything [antidepressants and antipsychotics] but benadryl for sleep for the entire week.

Sure. But it was at their discretion. I wasn't saying they would do anything to one against one's will, just that they're always going to have that option. And that's the point: nobody will make the guarantee the OP was asking for, and for a very good reason.

[recoiling.livejournal.com]

And that's the point: nobody will make the guarantee the OP was asking for, and for a very good reason.

very much agreed- however, i wouldn't want the OP to be scared off if they were in extreme need of a physically safe place. i'm not advocating admission- i just personally feel that potential psych abuse is better than suicide, no matter how horrible a choice it is to make. also, i've never heard of a hospital in massachustts forcibly medicating an adult whose chief symptoms are depression and suicidality. [children & teenagers on the other hand, are a different story]

in short, hospitals are horrible places, but in general, people who do not display overt traditionally "psychotic" symptoms don't need to be afraid of being forcibly medicated or locked up against their will for long periods of time- unless they are actively pursuing self-harm. the OP appears to be someone who'd be able to keep themself from attempting that sort of thing while in an ER or on a psych ward. they only really force fast-acting medication such as haldol and thorazine. anti-depressants very rarely get forced on their own because the person will most likely be discharged long before they feel any effect, if any.

[siderea]

Agreed, completely.

[peregrinehill.livejournal.com]

Boy, have I been where you are. Something about mental health places, when you're at your worst they want you to hand over your self-determination on a plate. My advice, if you can stand it, is to avoid the emergency room or urgent care. If you can make it until Monday, then you can find maybe a short-term sliding-scale therapist. They, unlike urgent care intake people are not COMPLETE JERKS.

And I have a really good huge ear for short term crises like these, and the added benefit is you don't even know me, so shoot an email this way if you'd like. I am nice.

And occasionally soothing or witty.

[elements.livejournal.com]

I know nothing about the drugging issue, but I had a friend spend some time in the psych area of Cambridge hospital, and I visited her there, and it felt to me that her dignity was being respected overall. If McLean isn't close enough for you, Cambridge might work.

[abilouise.livejournal.com]

I believe that the Cambridge City Hospital still has their 9-5 day treatment program wherein you retain all your civil liberties and spend your day in structured small group behavioral therapy and art therapy and get a caseworker and doctor and such, but go home at night. It's not for everyone, but it can add an element of structure and supervision that can be helpful.

[tastyanagram.livejournal.com]

There is a day program, but I don't know how "stable" you have to be to get in. It's definitely worth asking about, though.

[tt02144.livejournal.com]

First I'd like to say that I'm sorry for your troubles and wish you the best of luck.
Afer experiences with CHA's substance abuse 'program' I would stay very far away from them. This includes both Somerville Hospital and Cambridge Hospital, both owned and operated by CHA. I think that several of the clinics in the city are also operated by them. I am in the midst of a possible law suit against them.
I would suggest Mclean Hospital in Belmont, which is private, but may offer free care. They have a long reputation of serving those with mental illness.
I would also try Baldpate Hospital in Georgetown, MA.
I also think that Mass. General may have a psych unit, although I'm not too sure on that.
Do you have a regular doctor who could advise you? There are doctors in SOmerville who accept Mass Health patients. The advice of a good doctor can be invaluable.
Best of luck - keep us posted.

[recoiling.livejournal.com]

I believe Mclean offers free care, as it is a teaching hospital. I've heard good reports on Mass General, which I think might be affiliated with Maclean.

Take care*

[buymeaclue.livejournal.com]

I have no useful advice here, but wanted to say that I hope you get whatever help you need to be in a better brainspace ASAP.

[hr-macgirl.livejournal.com]

I assume you don't have an outpatient treatment situation in place (psychiatrist, psychopharmacologist, psychotherapist, even a regular primary care provider). If you do, I suggest you contact them first. Sometimes they can grease your way in the door.

Both Mass General and Cambridge Hospital offer telephone referral services. The descriptions sound remarkably similar, so calls to each may well be directed to the same place. Cambridge Health Alliance (http://www.challiance.org/psychiatry/acute.shtml) (including Cambridge Hospital, Mass General (http://massgeneral.org/allpsych/aps/best.asp).

I agree with the person who said that if you have to go to the emergency room/emergency department, take a friend (or two) and a book (or five). You will have a long wait. Even though the Boston area is well staffed with psychiatric services, there still isn't enough to meet demand.

If you do end up having to seek more intensive treatment, I hope you can use it to get yourself hooked up with good outpatient treatment. In the end, an inpatient stay is only crisis intervention/stabilization; the real work is done on the outside.

good luck.

[obie119.livejournal.com]

Nothing useful except ditto on the bringing a friend or book - my friend went through this last year and the waits are long.
I hope you are feeling better soon.