OK real talk: The increased focus on mental health is well intentioned, but we have created a fucking nightmare system wherein people's lives are upended with zero due process and no recourse that almost certainly doesn't pass Constitutional muster and incentivizes repression.

In many states, any cop/doctor/nurse who thinks you're suicidal can have you forcibly arrested and hauled off to a hospital for 3 days (or more).

This involuntary hold will put you completely at the mercy of a facility that's making money every second you are there.

It can take over a week to get judicial review and even then, many judges don't understand the nuances in the law or they just let their paternal feelings override the statutes.

Even when even shady facilities blatantly violate the law, civil suits are almost impossible.

And by the way, that 72+ hour period where you're being held against your will? Yeah that's not covered by state funds, so guess who gets charged for that?

You literally get billed for a 3 day kidnapping. RIP your credit rating.

Some mental health hold laws have no restrictions on treatment beyond basic dignity statutes. If you fight, you can be forcibly restrained (and criminally charged for battery on a healthcare professional). If you refuse to engage, they can use that as evidence of mental illness.

And while all this is going on, you have no job protections. Miss work because they refuse to release you? You can be fired.

Late on paying rent? Hello extortionate fees and/or eviction.

I had a client once get their car towed and got stuck with over $500 in impound fees.

You may want to sit down for this one: For-profit mental health hospitals are not always stalwart protectors of rights.

I've seen horror stories from people who were coerced in attempts to get them to agree to voluntary commitment, family members lied to about their loved ones

The most egregious: A hospital employee intentionally lied to a client's husband, saying she admitted to planning suicide by slitting her wrist.

Her chart revealed no such admission and nobody could pinpoint exactly when this admission occurred.

In my personal opinion, these hold laws are terribly Unconstitutional. Courts usually allow them so long as they have some level of judicial review, even if it's via habeas petition.

Few circumstances allow a person to be held unless criminally charged...

Based solely on the word of a cop/doctor/nurse. Even extreme self-destructive behavior doesn't match up: Unprotected sex with multiple strangers? Fine. Riding a motorcycle without a helmet? Fine (YMMV depending on local laws).

Let a cop think you're suicidal. Boom! In you go.

And yes. Refusing to submit to the arrest will get you charged for resisting an officer.

Finally, these holds are often counter-productive. They traumatize and disrupt lives, but they aren't providing good care.

I've had clients released with no follow up, not even a damn phone call to check in. Clients, especially juveniles, quickly learn to just shut up.

One juvenile client told me straight up: "I will let my demons win and kill myself before I ever let them take me back."

As you may imagine, high schoolers are not kind when they hear you were locked in a psych ward.

That client is doing great now, because she got real help.

Lots of people learn to fear disclosing their feelings, even innocuous admissions like "I sometimes struggle against thoughts of suicide" (which is common) will lead to another psych hold.

They will withhold this information from psychologists and counselors, to their detriment.

To conclude a long thread, these holds are yet another example of American "The law will fix this!" thinking.

Lawmakers are fine doing real harm so long as it feels good ("We're getting people help").

I don't think we can turn these back, but they need stronger protections.

We need to add better judicial review, fund the process so people aren't going into bankruptcy, regulate unethical providers, build in relief for those wrongly held and ensure after-care so we're not doing more harm than good.

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