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

[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.