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Can I Have My Manic Loved One Hospitalized?
Posted on October 29, 2008 by Dr. Fink
Many friends and family members of people with bipolar disorder become frustrated with the fact that they can rarely, if ever, “make” their loved one obtain treatment. This is more of a challenge when the person is manic rather than depressed. In a manic episode, your loved one is more likely to think that you’re the problem. They are neurologically incapable of having the “insight” to realize that anything they’re saying or doing is out of the ordinary. In fact, they might feel better than ever – on the top of the world!
Fortunately, current laws lean toward protecting the rights of everyone to make decisions for themselves. This is fortunate, because nobody wants to create a police state in which one person can have another institutionalized just by accusing the person of being irrational. (People with bipolar disorder are just as intelligent, oftentimes more so, than others and have every right to get into heated discussions when they disagree with someone, without having the threat of a forced commitment hanging over them.)
It’s unfortunate, however, when, as in the case of bipolar mania, the person’s brain is incapable of realizing that something’s wrong, and destructive (and self-destructive) behaviors are allowed to continue unchecked – emptying bank accounts, destroying relationships, and placing the health and well being of the individual and others at risk.
Hospitalizing a person against their wishes is a very sensitive issue, and I don’t want to come across as though I am “taking sides” here. Nobody really knows what it’s like from either person’s perspective until you’ve been there. It’s difficult for everyone involved. In many cases, however, patients who have been hospitalized against their wishes look back and are thankful for the care they received. Very often, a brief stay in the hospital helps reboot the brain, stabilize moods, and give everyone some pause to catch their breath.
By law, the official line is that only medical or mental health professionals can evaluate a person and mandate that the person stay in a hospital or mental health facility… and only on the condition that they “deem the person to be a danger to themselves or others.” The word “danger” is generally interpreted in terms of physical danger. If the professional thinks that the individual in question is likely to harm himself or herself physically, is suicidal, is physically threatening, or is out of control to the point of causing a serious accident (driving too fast, playing with fire, etc.), they’re obliged to have the person admitted to a hospital or mental healthcare facility, with or without the permission of the person or their friends or family members.
Until a medical or mental health professional deems the person “a danger,” the person remains free to be verbally abusive, to overspend or gamble away the family savings, to be sexually promiscuous, and so forth. They can even be psychotic as long as the psychosis does not create dangerous behavior. Of course, family and friends are likely to interpret such behaviors as the person posing “a danger to themselves and others,” but by law, professionals and the courts must analyze it differently.
So, the question is, what can you do as a friend or relative when your loved one is in the throes of a manic episode and really does need to be hospitalized? Here are some suggestions:
- Call your loved one’s doctor or therapist and report what’s going on. Due to privacy issues, the doctor or therapist can’t give you any information, but there’s no law preventing them from listening to what you have to say.
- If your loved one is obviously talking and behaving irrationally, offer to drive them to their doctor’s office or hospital for something to calm them down. The doctor’s evaluation could lead to a mandatory hospitalization. But be careful – driving with an irrational person in the car can be a risky endeavor.
- Call the police or dial 911 and ask for help. (We provide some specifics on what to say later in this post.)
- Contact your local mental health “crisis team” if one exists. These are mobile teams that will come to you to assess your loved one for safety and the need for care. Be sure that you have the phone number for the team posted several places in your home. You may want to contact the team when there isn’t an emergency to give all the basic information so that in a crisis all of the basic paperwork has already been done. If your loved one is willing to meet with the team before an emergency situation occurs, all the better.
If you cannot access a specialized mental health crisis team, then the police will be the first responders, but they will be unlikely to show up if you simply report that you think you’re loved one is experiencing a manic episode and you’re worried about them. Be specific:
- Report a “violent EDP” or “suicidal EDP.” EDP stands for emotionally disturbed person.
- Describe exactly what your loved one did or said to make you think the person is a danger to himself or others. Did he or she threaten suicide? Did your loved one threaten you or someone else? Is the person driving erratically?
- When the police show up, make a solid case for why you believe your loved one is a potential danger to himself or others. If others have witnessed the incidents, have them back you up. Point out any damage your loved one may have caused. The police don’t want to take your loved one to the ER for an evaluation, so you have to give them good reason.
- Be clear that your loved one has been diagnosed with a mental illness. You want the police to be aware that this is not just someone behaving badly or someone who is intoxicated. Use the term “mental illness” in everything you tell them.
I’m not recommending that you do this, but some people have reported turning over furniture before the police arrive to stage a violent scene. When the police witness the chaos, they’re a little more likely to conclude that your loved one really is in a violent state. Again be careful – police departments vary dramatically in their mental health savvy and level of training for working with those in a mental health crisis. You want to avoid a dangerous confrontation between your loved one and the officers as this could cause another set of problems.
If the mental health emergency team or police take your loved one to a hospital, be sure to follow up with the healthcare team to make sure your friend or relative has everything they need – perhaps most importantly, their medications. Bringing clothes, pajamas, and other “comforts of home” can also help make your loved one’s stay more comfortable, but call the facility beforehand to find out what’s allowed and what’s not.
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We experienced this situation a number of times when our bipolar daughter was in a manic, psychotic stage and when she was suicidal. A few times it was obvious to anyone who observed her for a few minutes that she needed in-patient treatment, but she was not deemed violent enough either to herself or to others to be admitted. Usually what happened was that her condition deteriorated until she did meet the criteria. It makes no sense to make people become more violent in order to treat them for their mental illness.
She was released too quickly from her last hospitalization, and three days later, she died by suicide. A tragic ending that was preventable.
When contacting the police, I suggest that you ask for a Crisis Intervention Team (CIT) officer. These are officers who are specially trained to handle situations related to mental health and possible criminal behavior. If your local police authority does not have the CIT program, urge them to begin one quickly. CIT trained officers are able to diffuse potentially volatile scenes, and studies show that they save lives.
Tom Smith
Author of “A Balanced Life” and Co-Founder of the Karla Smith Foundation
http://karlasmithfoundation.org/
For more about A Balanced Life: 9 Strategies for Coping with the Mental Health Problems of a Loved One and its author and to read an excerpt from the book, check out Tom’s page in the Bipolar Stories & Insights section: Tom Smith on “Mental Illness and Unconditional Love.”
I think my husband was trying to hospitalize me. I’m glad there are rights that protect people from being hospitalized without cause.
The problem is that I’m not sure if I am bipolar or not. My doctor seems to think I am based on my husband’s complaint. I bought a business and its not doing well (I believe its our economy). My husband told my doctor that I have mood swings because I get along well with other, but not him and that I get really mad intermittently. My doctor said he was concerned that I was manic. I then told him the following true story. I told the doctor this: When I met my husband 20 years ago, he was a cheater. I forgave him and we raise his daughter (who is 3 weeks younger than my son) until she was 3. Her mother and I never got along. After her mother sent her to daycare, he was forced to pay child support. Years went by, about 12 years or so, which brought us to 2008. My husband told me in early in the year that he cheated on me with a woman. He met up and cheated with this woman not once, but twice. I’ve been mad ever since. Not with others, just him. I get mad when he brings certain things up and he acts like because it was 3 years ago, it should be old news to me. I don’t think I’m bipolar… I think I handled myself sanely (I’m still with him). He recently retired (and didnt’ tell me) and now is putting his money in a separate banking account, which made me mad again (because of his cheating past). He makes comments that I would be calmer if I took meds. He is the one actually driving me nutty!!! By the way, I’m selling the business so I have choices in life (and because my husband runs around more). I kinda feel like I need to move on. Tell me your thoughts PLEASE….
Hello Monica,
So are you raising his child and yours? You wrote until she was 3? Is she now with her mother? It sounds as if you are very unhappy and if he is making you “NUTTY” as you say he is then why don’t you leave? Unless you do believe something is wrong with you then you should talk to a pychiatrist.
My daughter was hospitalized once by her choice. It did help some. Hospitalization has to be either voluntary or court committed. The may courts decide if someone are proven to be a danger to themselves or other people if there is no guardian in place. You can’t just show up at a treatment center and try to have someone committed.
I have a sister with severe bipolar disorder. She lives with my parents and has no responsibility yet still can not seem to stay stabilize. She has been treated/dx with bipolar disorder for over 30 years. She is manic right now and won’t go to a hospital for the intensive treatment she needs at this point. Can anything be done? I live out of state, half way across the country. I fear this will cause my elderly mother’s death because she will not kick my sister out of her home.
I was in the hospital psych ward for being suicidal. I hated it there and I did not believe I belonged with the real “crazies” I encountered there. So, I just acted happy and “normal” and got out after 5 days with little treatment. Luckily, I did get Prozac for 6 months. It took me 8 months to begin life again. The hospital scared me enough to want to find out what was wrong and my doctor says PTSD, my daughter says Bipolar Disorder. All I know now is that I don’t want to be locked up, so I do all I can to control my impulses. I am functioning, hold a good job, pay my bills. But if my daughter could commit me, she would, I believe. I do not want someone emotionally involved to possess the power to have me locked up. Only a doctor or the effected person should make this decision.
I was hospitalized after a horrific manic-delusional episode where I had no idea what was reality and what wasn\’t. I did some awful things thinking it was the best thing for me to do, like I was in survival mode. I did things I can\’t write, because they shake me to the bone, I will say I stole my mothers car, and sped off believing I was in a mock universe. It was all so surreal. The police found me running across the state line, after I plunged my mom\’s car into a swamp, and I was praying.
They took me in and I lied and lied and lied about who I was.
Besides the point, the county pressed charges or something, I was facing being committed or on a stay of committment. It was all so confusing and horrible. My poor mother went through so much, that I don\’t blame them for doing what they did. Although I think the small town\’s judicial system was corrupt. I ended up being sentenced as having bipolar 1 sever psychotic symptoms, and put on a 6 month stay of committment and forced to take my meds.
Heavy subject, but point being, if the situation is the matter between life and death, unfortunately their aren\’t many choices.
Please check out my bipolar blog at http://manicviolet.com/blog/
I more than appreciate comments or feedback.
Great subject, if those are the right words…
My husband is giving me the impression he is bipolar. He has been drinkin a lot. He cheated on me, and physically abused me. We have a special needs 2 year old who misses his dad. Sometimes I wish that is he was committed to a psych ward he would see the errors of his ways. I don’t want him in my life romatically but I do want him to be a good father for his son. He is not living with us. I took out a PPO because I was afraid he would attack me again. We have spoke to each other in the past week and he has apologized but I believe he only apologized because he is without income and living with his mom. I encouraged him to seek inpatient treatment but he refuses. I don’t believe he will complete outpatient. I am looking for suggestions. Thanks.
My mother has bipolar I have never seen her manic but now she is. She was arrested and taken to the hospital last week and this week my self and my sister are going to try hospitalizing her again. Last time they said she was manic but not dangerous so they sent her back home. I delt with it alone for a month because my sister and brother were at colladge. Now they are back and stuff is happining. I am 13 and I am sending my mom to the hospital, so I hpe I am right and she should be there.
Jen, on july 11,09 at 12:32pm
Im so glad i’m not the only one going through this. My mom had to be hospitalized while manic and thinking she was perfectly fine. She was extremely agitated but not suicidal so they were ready to send her back home even though i got her there with the ambulance. I didn’t feel safe sleeping with her at night with my 3yr old in the house. I had to get her minister to talk her into signing the papers to commit herself. She wasn’t happy about it but she for some reason listens to him and not me. Its been 13 days and i can see the improvement, she is talking to me now where at 1st she hated me when i went to visit. She should be coming home soon and hope she realize that it was only because we love her that we wanted to admit her. its not fair that we have to wait until suicide attempts or violent threats to take a loved one to hospital to get help. ITS BETTER TO CATCH AND TREAT IT EARLY.
I’m a 49 year old woman who had no history of mental illness. I was involutarily committed for a three week stay at a mental hospital in May 2008 because of a psychotic episode. I was destroying our retirement nest-egg because I believed that money meant nothing. I bought a $55,000 car and wrote a hot check for it, then bought thousands of dollars worth of clothes and plants. I thought I was a mermaid named Pangea. I took my clothes off at the emergency room and went running out of the building. That wasn’t enough to get me committed. It was only when I started throwing furniture while I was in my waiting cubicle that the decision was made to have me assessed by the mental health professional. The process from the initial emergency room visit to the admission to the mental hospital took 8 hours because the number of mental hospital beds in Washington State has been steadily decreasing every year. I am writing a book about the experience. The working title is “I Thought I Was A Mermaid”. I also have a blog at crazymer1.wordpress.com.
What do u say when you have been with your husband for 7 plus years then all of a sudden one day.He says that I have to choose between my son and brother-in-law or him,I DO NOT believe in having to choose.If you dissagree with him then he threatens me and I feel that my life and my frinds are all in major danger.He has a way of sugar coating something like when I dragged you through the house it was for your own good.That is complete Bullshit.What advice can you give me?
My mother was bipolar and she self medicated herself to death (heroin, crack, wahtever she could) at the ripe old age of 38. I was 20 at the time and hadn’t spoken with her in at least a year. She never met my daughter (she was 3 months old when my mom died) and was very sad that I wouldn’t let her. I told her to get clean and get hel, then we would talk about her knowin her granddaughter. Well My daughter is now 16 and her boyfreind shows clear signs of bipolar. He goes in to manic rages and cant control himself, he is needles to say not allowed aroud my daughter anymore. He is a sweet kid and he has a good heart, but he needs help. The nice kid moments are few and far between these days, I have given his mother number and number, website after website and she just says he wants attention. Today he is threatening suicide (which he has done before)while I was on the phone with him, I told his mother to call the cops, tell them he is in a rage and threatwning to kill himself. I told her they will take him to the hospitol for a psych hold, but she just says he wants attention, I told her to get her head out of her ass, that her sons problems will not just go away, you cant wish him better. I told her I know its scary to think your son may be mentally ill, but not as scarey as finding him dead in his room. I know it sounds harsh but sometimes you just need to be blunt with people, I dont want to see her son in pain needlessly because with the right help he will be a productive wonderful person.
my husband of 7 years was alittle stressed out at work, he told me he was suicidal in the past 1 attempt, on 03-01-2010 while my teenage daughter was sleeping my husband attempted suicide by overdose prescription meds, anti-depressants,valium, he must have fallen asleep for several hours out in his truck, woke up beating on the door scared the heck out of my poor daughter she called me i called 911, he almost died , he returned home is refusing to seek help, we are devastated by this ..but without medication & therapy i will have to remove myself & kids from this situation, is there any hope for him?