4. I am seeking inpatient treatment. How can I make sure that everyone knows I am there voluntarily, and that I don’t get shifted to involuntary status?
I want to be really clear on this: in your head, there might be a huge difference between voluntary and involuntary hospitalization. In your doctor’s head, and in the legal system, these are two very slightly different sets of paperwork with tiny differences between them.
It works like this, with slight variation from state to state: involuntary patients are usually in the hospital for a few days while the doctors evaluate them. If at the end of those few days the doctors decide the patient is safe, they’ll discharge them. If, at the end of those few days, the doctors decide the patient is dangerous, the doctors will file for a hearing before a judge, which will take about a week. The patient will stay in the hospital for that week. 99% of the time the judge will side with the doctors, and the patient will stay until the doctors decide they are safe, usually another week or two.
Voluntary patients are technically allowed to leave whenever, but they have to do this by filing a form saying they want to. Once they file that form, their doctors may keep them in the hospital for a few more days while they decide whether they want to accept the form or challenge it. If they want to challenge it, they will file for a hearing before a judge, which will take about a week. The patient will stay in the hospital for that week. 99% of the time the judge will side with the doctors, and the patient will stay until the doctors decide they are safe, usually another week or two.
You may notice that in both cases, the doctors can keep the patient for a few days, plus however long it takes to have a hearing, plus however long the judge gives them after a hearing. So what’s the difference between voluntary and involuntary hospitalization? Pride, I guess, plus a small percent of cases where the doctors just shrug and say “whatever” when the voluntary patient tries to leave.
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> If, at the end of those few days, the doctors decide the patient is dangerous, the doctors will file for a hearing before a judge, which will take about a week. The patient will stay in the hospital for that week. 99% of the time the judge will side with the doctors, and the patient will stay until the doctors decide they are safe, usually another week or two.
This says a slight variation from state to state. I might live in one of the more progressive states (Washington) and have transported hundreds, if not thousands, of voluntary and involuntary patients.
> the doctors will file for a hearing before a judge, which will take about a week.
Not so, here. That hearing here should, by administrative code take no longer than 48 hours and only take longer than 24 hours if further assessments are needed. That patient will also have advocates appointed on their behalf, a MHP, an attorney, or both. It's not just an automatic rubber stamp of the request to hold.
> Voluntary patients are technically allowed to leave whenever, but they have to do this by filing a form saying they want to. Once they file that form, their doctors may keep them in the hospital for a few more days while they decide whether they want to accept the form or challenge it.
There is no such process here. You -may- have to wait for an "appropriate" time to be discharged, i.e. to avoid disruptions to medication, to not threaten the security of the facility, but you are being discharged no different than to hospital.
However, there is a grey area, and it is touched upon. "If you don't do this voluntarily, we will apply for involuntary." But this also works in reverse. For mental health court proceedings in Washington, one of the questions that has to be answered is "If the patient would agree to voluntary treatment, should the involuntary hold be dismissed? And if not, why not?"
That's… not how that works. The _only_ difference between a voluntary stay and an involuntary stay is whether you've demanded to be released yet.
https://slatestarcodex.com/2018/03/22/navigating-and-or-avoi...
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4. I am seeking inpatient treatment. How can I make sure that everyone knows I am there voluntarily, and that I don’t get shifted to involuntary status?
I want to be really clear on this: in your head, there might be a huge difference between voluntary and involuntary hospitalization. In your doctor’s head, and in the legal system, these are two very slightly different sets of paperwork with tiny differences between them.
It works like this, with slight variation from state to state: involuntary patients are usually in the hospital for a few days while the doctors evaluate them. If at the end of those few days the doctors decide the patient is safe, they’ll discharge them. If, at the end of those few days, the doctors decide the patient is dangerous, the doctors will file for a hearing before a judge, which will take about a week. The patient will stay in the hospital for that week. 99% of the time the judge will side with the doctors, and the patient will stay until the doctors decide they are safe, usually another week or two.
Voluntary patients are technically allowed to leave whenever, but they have to do this by filing a form saying they want to. Once they file that form, their doctors may keep them in the hospital for a few more days while they decide whether they want to accept the form or challenge it. If they want to challenge it, they will file for a hearing before a judge, which will take about a week. The patient will stay in the hospital for that week. 99% of the time the judge will side with the doctors, and the patient will stay until the doctors decide they are safe, usually another week or two.
You may notice that in both cases, the doctors can keep the patient for a few days, plus however long it takes to have a hearing, plus however long the judge gives them after a hearing. So what’s the difference between voluntary and involuntary hospitalization? Pride, I guess, plus a small percent of cases where the doctors just shrug and say “whatever” when the voluntary patient tries to leave. ”””