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Phony Diagnoses not just at nursing homes, also in mental facilities. Was really surprised (better word-traumatized) that one flippant casual mention of not valuing my life in a private text message was enough to to get me detained by police in a facility for a night. "Doctor" threatened me with drugging just because I refused to answer some of their questions and instead insisted on a lawyer. Funny how freedoms can be taken away so dubiously even when not charged of a crime nor arrested in a system that exists outside the criminal system. I'm surprised and not surprised similar behavior happens in nursing homes.



I picked up my wife yesterday after a 72 hour hold at an in-patient center. I’m so glad that she legally had to be there. She tried to commit suicide Sunday night and spent Monday and Tuesday in the ER. It’s been a horrible week for all of us.

The behavioral health place she was at was not perfect, but she would not be where she is right now if it weren’t for her having to be there.

For years I have told myself that if I somehow become wealthy, I will spend my time and money improving mental health resources in my area. After hearing her stories about the place she was at (one of a couple hundred owned by a public company), I wish I had the resources to start a place that did everything right.

I’m sorry you had a bad experience. It’s really messed up.


I can't even begin to imagine how difficult this must be for the both of you. It must be terrifying having a loved one trying to commit suicide. I hope your wife and you find peace and happiness.


There are times when getting someone on a 72 hour hold has been too difficult. I have been in situations where getting a 72 hour hold was necessary but was not possible. I'm glad it worked out for you. I can see both sides of it. I wish I knew a good solution.


I mean, speaking as someone who was clinically depressed for 25+ years, and about 20 of those years highly violent/homicidal/suicidal, in my opinion, a good solution would be to allow those of us with daily emotional pain and no regard for human life, access to cheap and mediated suicide assistance. Suicide is a human right.


I wish the absolutely best for both you and your wife.


That sounds like an extremely rough time. I hope you and your wife are alright.


There's a free service called crisistextline.org that I wish more people knew about.


>Phony Diagnoses not just at nursing homes, also in mental facilities.

Schools too. My mum spent two decades as a primary schol teacher, and it's an open secret in that industry that Ritalin and other behavioural drugs are, at least in some cases, administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it.


> it's an open secret in that industry that Ritalin and other behavioural drugs are administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it.

Not necessarily does not mean never, so be careful of a claim like that, and maybe back it up. I have a daughter, now an adult, which Ritalin and/or Adderall provided real benefit. The only thing in question was how to find the right one and right dosage to minimize the side effects )lack of appetite and sometimes stomach aches). The difference was very clear, and was exhibited multiple times. For example when we let her go off it at her request during the middle of her sophomore year in high school, and she went from getting B's and C's to getting flunking a quarter of four of six classes, and then going back to not flunking anything and getting mostly B's by the end of the year when she went back on the medication. This was not an isolated incident, it happened 2-3 times over junior high and high school.

That's the thing about medication. Different people respond to it in different ways. That's why studies look for statistical significance, not "guaranteed to do what it says".

Edit: The language of the original comment has since been softened to no longer imply that's the only or main reason, which I appreciate.


In my case, it "worked" by making me far more anxious of failure and the judgement of others. For 8 years. I had never previously had suicidal thoughts but I did less than a year after starting the "meds." Then I got in trouble for discussing suicide with another student. The whole situation is more hellishly dystopian than a grimdark fiction writer could imagine. It's no mystery why gen Z are often aggressive doomers. Maybe we could re-evaluate the school system instead of drugging kids to be more scared and spineless? Once I quit the meds and went to college (and did fine btw but maybe because my brain was already permanently altered), it took about a decade for me to realize most people are pretty cool and don't expect you to bend to every whimsical demand of any size, and you don't need to be terrified of everyone around you who could tell you to do anything at any time and you'll get in massive trouble if you don't.


> I did less than a year after starting the "meds." Then I got in trouble for discussing suicide with another student

I'm sorry to hear that. I believe that's why we had mandated psychiatric visits while my daughter was on the medication. We couldn't get refills without meeting with the doctor to discuss how it was going. It definitely sounds like it wasn't working well for you, either because of how the medication expressed itself in your case or your specific school situation, or a combination thereof.

> Maybe we could re-evaluate the school system instead of drugging kids to be more scared and spineless?

While I'm not going to argue that school couldn't do with a bit of change, I'm not sure it's fair to extrapolate what everyone's experience is from what happened to you.

As an example, I remember an incident early in seventh grade there was an incident in gym class when we were being taught the fundamentals of wrestling, where after one match and unfortunate classmate earned himself the nickname 'boner' and the ridicule to go with it, which lasted a few years. This undoubtedly made his life much harder. A number of lessons could be taken away from that situation, but "we should stop teaching wrestling in gym class" is probably not one of the better ones.

Should we stop medicating students? Maybe. That probably depends on quite a lot of factors, most of which I don't know enough about. But I would hope that a better solution where those that the medication helps take it and those that it doesn't or the problems associated with it are enough to make it a bad choice don't is an achievable outcome that we should strive for.


> I'm not sure it's fair to extrapolate what everyone's experience is from what happened to you.

But the problem is generic. USA schools have all the code smells: employees who are “just doing their job Ma’am”, or reacting knee-jerk, politics being involved leading to no solving issues but communicating a lot on them; no-xyz policies (replace with any CNN topic of the time) which leads to extreme response to normal youth events (overreaction to suicide or misbehavior, police in schools, searches come to my mind, but there is worse), competition between children, not only in curriculum but also in who’s the most popular and the most bully, drugs… And finally, the prevalence of psychologists compared to other countries, but psychologists that prescribe Aderall (US schools are world-famous abroad for threatening to curb energy with drugs on, mostly, boys) instead of working with teachers to better alternate recess/manual classes/theoretical lessons.

Of course it’s easy to tell from abroad that something is wrong, but less easy to tell how to setup different social dynamics that would result in a better system (and France certainly has its own problems with schools). It might even be as subtle as too much sugar in kid’s food, which changes behaviors a lot.


In the US, we were told our son had too much energy and would be medicated when he gets older. We moved to the NL and the teachers say he’s perfectly normal, despite having more energy. She said it would only be an issue if he wasn’t learning; which might indicate an issue with focusing. It turns out, you can still have energy and learn at the same time.


Exactly this. This is one reason we homeschool. Public school in the US was so incredibly oppressive (cops patrolling the halls and writing lewd conduct tickets for kids cussin'???), I was frankly shocked that most kids and parents put up with it.


Ritalin (methylphenidate) has an effect on one type of serotonin receptors. Most physicians are unaware of this, and, indeed, many think that methylphenidate is an amphetamine derivative, which is not the case.

For many people, d-amphetamine or cannabis are better treatments with less side effects.


Ritalin displays no significant activity on 5HT receptors, in contrast to dexamphetamine, which does have significant serotogenic effects.

Yes, they are not related, but both are taken for their dopaminergic effects, though they achieve this by different methods (reuptake inhibitor vs agonist).

Generally, in the course of treatment for ADHD, patients will get to try both to see which one they respond to better. They often exhibit strong preference for one over the other (personally, dex does nothing for me, even at recreational doses of 50mg).

Their risk profiles are very similar, and one cannot be said to have "less side effects", unless referring to a specific individual's response.


Yes, I smoked weed for about 10 years after, partially because it was nice to relax for once even if it made me really dumb while high, and partially because "my brain is already ruined by drugs, what does it even matter at this point?"


Do mean to imply that giving a 10-year-old a few hits from a bong as part of their morning and evening routine is advisable?


Its wild that THAT is where the line is wrt giving drugs to children, particularly in the context of giving kids incredibly powerful, schedule-class stimulants


Yes. One difference is that a number of legitimate studies have linked consumption of THC by those in certain developmental stages with functional deficits in later life (as with alcohol, and FES is definitely a thing). Of course, a rigourous scientific experiment would give definitive proof but would be unethical.

Are there similar studies regarding the ADHD meds?


I suspect the kind of poorly-controlled, correlative studies done for THC would also show correlation between ADHD meds in childhood and a variety of functional problems later in life. (The known comorbities of ADHD alone should account for that.)


Definitely not. Smoke is bad for the lungs.


>The whole situation is more hellishly dystopian than a grimdark fiction writer could imagine. It's no mystery why gen Z are often aggressive doomers.

Ah yes gen z are the only ones... the only ones to be sad and mad. Never mind the generation having to be drafted and die in Vietnam. Never mind the generation having to fight in WW2. Never mind the generation having to take care of your ass.

I had breakdowns from social anxiety everyday in 7th grade in 2003. I got nothing. I would have rather have drugs.

the zoom zoom is showing. Go to bed please its past your bedtime.


The phrasing of the poster you're responding to does not discount the experience you're describing. I don't see how they could be more careful.


I could have explicitly acknowledged that sometimes the child's welfare is the primary concern. I could have used weaker language, too. I've updated my comment a bit to more accurately reflect my understanding.


I find we often project or minimize opinions and positions that don't account for our pet emphases. I agree with your take.

Take an example of someone who posts solely facts in a controversial topic. Folks that disagree with the direction the facts point will ascribe all manner of negative projection to said poster. But does that reflect on the facts-poster, or on the interpreters?

Online communication is such an odd thing.


> does not discount the experience you're describing

It's not about saying it's not possible, it's about setting expectations, and scaring people away from a medication which may be helpful.

>> Ritalin and other behavioural drugs are administered for the benefit of the teacher and other students in the class - not necessarily for the child receiving it.

That clearly states the reason it's administered is not primarily for the child's benefit. While it doesn't discount that the child may benefit, it clearly sets the expectation that it's not the child's well being that's being considered. The natural extension of accepting that is to wonder if there's any actual benefit to the child or if that part is just in service to "the secret".

Implying that the reason a specific medicine is prescribed is not actually for the benefit of the patient might have real repercussions if it scares away someone that it could have haloed. At a minimum, I think a statement like that should be backed up in some manner.


I'm sorry, we cannot easily back this up. It would take confession of an intent, which most prescribers aren't even aware of.

A single mom, exhausted with 2 part time jobs and 3 young kids put them in front of tele tubies all day long. Is that for her own benefit or for the benefits of the children? We don't even have clear evidence of the overall impart of such educating programs on child development. But we have to use common sense and agree it benefits carers if they want to get more time for themselves. It doesn't imply careless attitude, or consciousness of the motive, the kids appear to enjoy anyway. I think the comment was made out of common sense: attention deficit of just one student can cause serious classroom management issues, it isn't naive or prejudicial to point out what we don't hear very often: the prescription isn't for the child own' benefit.


Have 2 daughters on adhd medication.

I held off a long time. But finally relented. Night and day difference. Rolling around on the floor endlessly to top of class.

I haven’t found one my body can tolerate for long. But it was so weird to feel normal and not this horrific agony at trying to stay on task.


Try sativa-type cannabis with a vaporizer. Steer clear of indica-type.


Self-medication is a symptom, not a treatment.


Get a prescription, then? Cannabis is a valid medical treatment for ADHD.


No thank you. I won’t go near they stuff. Even the smoke from someone else causes a severe reaction.

I do have an actual diagnosis and doctor for ADHD


Grades are not really a reflection of well-being though. Not saying that she is not better off with the drugs, just that you failed to show that.

You can be a horribly depressed empty shell pf a human, but still "function" in society.


>Not necessarily does not mean never, so be careful of a claim like that, and maybe back it up.

That's definitely correct. It can be a great help for some children, and some teachers (maybe even the majority) do make carefully considered decisions where the primary concern is for the welfare of the child receiving the drugs.

Other times, though, they just want some ratbag kid to STFU so they can get on with their job.

I distinctly remember overhearing a conversation where a teacher wanted to (in her words) "sedate" a problem child so that they don't disrupt the rest of the classroom.


> some teachers (maybe even the majority) do make carefully considered decisions

In the United States, teachers do not prescribe medications. They may make a recommendation that parents seek the guidance of a doctor, and a qualified medical professional (usually a psychiatrist) will diagnose the child, and the parent may choose to pursue medicating or not. In our case, we had regular checkup appointments with a psychiatrist where our daughter and us were present at the same time, and a later point in the session where the parents were asked to leave so the psychiatrist could speak with her privately.

> I distinctly remember overhearing a conversation where a teacher wanted to (in her words) "sedate" a problem child so that they don't disrupt the rest of the classroom.

Unless the laws have changed since then in Australia, Ritalin is a controlled substance, according to this, and it's not even guaranteed a general practitioner can prescribe it, and a psychiatrist is preferred.[1] Maybe you misheard, or maybe the teacher misunderstood what their capabilities were?

1: https://www.health.nsw.gov.au/pharmaceutical/patients/Pages/...


>Unless the laws have changed since then in Australia, Ritalin is a controlled substance, according to this, and it's not even guaranteed a general practitioner can prescribe it, and a psychiatrist is preferred.[1] Maybe you misheard, or maybe the teacher misunderstood what their capabilities were?

Just like in the US, teachers here can make recommendations for parents to seek medical treatment. Said recommendations can include comments like "I suspect your child has ADHD". While nothing is guaranteed, if the parent follows up on it there's a good chance the child will be medicated.


> if the parent follows up on it there's a good chance the child will be medicated.

You say that, but we went through three recommendations over 5 years or so and following doctors visits where we were told initially that it was hard to tell because she was young, and that she might grow out of it, and the doctors did not recommend medication at that time (so we didn't, until on the last one where that diagnosis and recommendation changed based on her age and behavior).

The problem with statements like "there's a good chance" is that it's likely based on your understanding of things and not actual statistics or hard data, and meanwhile I have my understanding of things based on my singular experience (anecdote) that's also not based on hard data, so without any of that data all I'd agree with you on is that sure, some parents might end up with medicated children that don't need it based on a teacher recommendation, but I'm not sure whether it's a "good chance" or not, and unless you have more info you haven't disclosed, I'm not sure whether you know that either.


>The problem with statements like "there's a good chance" is that it's likely based on your understanding of things and not actual statistics or hard data

That's a fair comment. I'd be interested to hear directly from someone who does have hard data, or at least a teacher who's actually done this multiple times.


> Just like in the US, teachers here can make recommendations for parents to seek medical treatment. Said recommendations can include comments like "I suspect your child has ADHD". While nothing is guaranteed, if the parent follows up on it there's a good chance the child will be medicated.

Sounds like the system works then!


Ritalin absolutely is a controlled substance in Australia and requires a psychiatrist or paediatrician to prescribe it. I've never heard of a GP prescribing it (unless they're also appropriately qualified as one of the above).


GP can prescribe it if the patient has been diagnosed by a specialist (like the psychiatrist/paediatrician you mentioned). They can't prescribe it if you have not been diagnosed. This is just so the patients can get repeats on their meds without having to see the specialists all the time.


Every `ratbag kid` is someones child, someone who's brain who has been at odds with the expectations foisted upon them their entire life, and who may be tired of failing but can't figure out how not do.

It makes me sad to read comments like this.


But overall such a kid disrupts the whole class so we have worse outcomes for the whole group, kid included if the teaching can’t continue


I worked as a camp counselor- that’s a very popular situation for parents to have kids go on a medication vacation. The stories I could tell. After whatever insanity we’d be trying to figure out what in the hell was going on with the kid. Too often when we dug in it was a medication vacation - many for serious but some for less so issues.

My takeaway - don’t just stop taking these even if you think it’s just for adults benefit - there has to be a way to come off them more slowly


Isn't that child abuse or something? Dumping their kid into an isolated environment without their medication and without people's knowledge... Sounds like a horrible idea.


Because that child with behavioral issues is sharing a classroom with 10 to 20 other children. It has never been fair to everyone else to put up with the issues on the one.

In more brutal prior days, they'd be expelled and become the parent's problem. Now, they get medicated into compliance. It isn't fair to anyone, neither that child nor the others, that they get streamed in with everyone and everyone has to figure out how to cope.

I don't know what the right answer is, but pretending there isn't a problem in the first place is definitely not the beginning of an answer.


In more brutal prior days, there was corporal punishment - I was frequently caned and variously otherwise bodily punished as a child, because I was a habitual miscreant - were I a decade younger, I probably would have been drugged.

Personally, I’ll take the memories of violence over being medicated for life any day of the week.

Oh, and it generally worked - fear of retribution is quite the motivator.


My anecdotal experience was also that corporal punishment worked ... until I grew too old for it.

Having spent my formative years being motivated by avoiding beatings, rather than seeking praise, made it very difficult to adjust to adulthood in a world that relies on positive reinforcement for motivation.

For every "...and I turned out just fine", there are many who didn't. Your "memories of violence" aren't the alternative to "being medicated for life", they're often the very cause of it.


Gentle reminder that in the good old times of beatings, these kids were more likely to end up in jails, being violent, more likely to end up addicted to drugs and so on.

Not that current time is perfect, but statistically it has better results.


Better for what ? Suicide rates in young population are going up for example. But even so - if your only goal is to prevent negative outcomes might as well put everyone in a coma and tube feed them - bound to get 0% crime, violence, addiction.

Hard to judge quantitatively - but TBH as fucked up as my childhood was I wouldn't want to grow up in the modern system and working with the zoomer generation I'm not impressed with the outcome.


You would had to really show more for me to believe the suicide rates go up because kids are not beaten enough. Extraordinary claim requires some proof.

> if your only goal is to prevent negative outcomes might as well put everyone in a coma and tube feed them - bound to get 0% crime, violence, addiction.

This is fairly absurd jump.

Also, beating kids into obeisance makes them more likely to beat others onto obeisance. Which has no repercussions if against a kid, but has large ones if against adults. And even if not physical, leads to bullies. The more authority they get, the more coercive bullying happen.


I doubt regular beatings work, but having authority over your child, even if it takes physical punishment to obtain is one thing I see extremely lacking with my peers who are parents.

But my point was more about comparing generations, I feel like a lot of struggles like having to learn how to control your temper or focus, are wiped away with drugs, and in general society is very good at removing historic hardships you had to overcome. On the flip side a lot of artificial stress and challenges are introduced with modern life (grade chasing since preschool, social media) - I don't feel like this would have felt meaningful to me so I don't envy the current generation of children.


It was the beatings? Just last week people like you were telling us it was all leaded gas's fault. Make up your mind.


Maybe that is one place were we could spend more resources. Even if separating them from other kinds might sound wrong. It might be for best. That is move them to smaller groups with specialised teachers who have adequate support in place.

It is harsh, but clearly trying to integrate all of them to general population is not working for anyone, but administrators...


I'm not arguing the ethics of it, just stating that (at least to the best of my understanding) there is a culture of that thing happening.


I would say drugging young kids with stimulants that have lifelong dependency implications as a kind of sacrifice for the greater good of the larger class is just morally reprehensible.

Let's keep treatment focused on healing the individual, not drugging them into compliance. We are talking about kids here.


What do you mean with "lifelong dependency implications"? I take such medication and whenever I stop taking it for a time period, all of the side effects of the medication completely vanish. This type of medication is not addictive, actually it's a bit unpleasant, I don't think anyone would get addicted to it. And it's not like people with ADHD are rendered completely useless if they're not on their medication. We grow up like everyone else, and take on the responsibilities of becoming an adult. Granted, maybe a bit slower than everyone else but still.. there are no such dependency implications as you claim.


Have you tried researching the long term effects of these medications? There is plenty of scientific literature available.

Be sure to consider the age which the treatment starts. A major aspect of concern for all drug use is how it affects developing minds.


The catch is that unmedicated ADHD outcomes aren't good.

I worked with the same group of students for a 2.5 year period of pre-K and kindergarten. Low self esteem, anxiety and depression and to a less extent conduct disorder were plain to see in the majority of the low executive function students by the end of Kindergarten. I saw these negative outcomes develop as a direct consequence of difficulty managing behavior in class and keeping up with peers.

Particularly for kids with combined inattentive hyperactive ADHD symptoms it's nearly impossible for them to get through the day while keeping up academically AND keeping their behavior inside the realm of "acceptable classroom behavior". Lacking a robust support system for students with extra needs (think an additional teacher or teaching assistant in classroom at all times) there is a very finite limit to how much you can assist without creating issues for the progress of the class as a whole.

The reason that I am careful to use low executive function (EF) as the label at this age is that even for experts in this area it's incredibly difficult to predict who will "grow out" of their lower than average EF issues and who plateaus with maturity.

I think the current consensus that diagnosis and especially medication for ADHD is too difficult prior to 6 or 7 is correct. I've seen too many students have seeming miraculous gains in EF and catch up with peers in a matter of weeks to think that preschool is the appropriate time to diagnose and treat ADHD.

The students who continue to lag behind in EF are substantially behind in basic grade level knowledge when they set foot in primary school. The amount of catch up they have to do is substantial even for neurotypical students by time that a formal diagnosis and medication is an option.

Now add in the fact that a large portion of the parents of ADHD kids have a parent with ADHD or less than average EF skills. They are less able than most to give their children the extra out of classroom help they need.

Getting kids on medication ASAP once a diagnosis is confirmed and a well tolerated treatment is found is a no brainer. By the time that this comes into play you are already in educational triage. We're talking about 1st graders that can't read simple consonant vowel consonant words in some cases.

The obvious solution is putting in a low EF safety net in pre-k and kindergarten. Extra teachers in classrooms, extra help with literacy. Making sure all parents are aware that their child is has an elevated risk for ADHD diagnosis later down the road, so they can familiarize themself with the diagnosis and treatment options-- and more importantly so that people are assessing and testing to see if they catch up in EF function.


The other side of this is parents latching on to this reality and thinking their child cant possibly have any attention deficit issues

My brother got an adult diagnosis and would have benefitted a from a child diagnosis


> administered for the benefit of the teacher and other students in the class

I agree that it is wrong.

But the protection of other students is not a bad thing in principle. It is a thing that is often missing. Yes the school should help problem kids. And absolutely, the school should make sure other kids don't get victimized in the process.


Drugging young children into quiet compliance and uniformity cannot be the answer.

This ADHD epidemic is localized in the US, so either people there are being overdiagnosed for the sake of sinplicity, so they can just be drugged; or there is something horribly wrong, causing all those children to suddenly develop ADHD.

My money is on the former explanation.


Wait, where on Earth are teachers free to dose students with “behavioral” drugs?


Officially, they can't prescribe medication, but they can recommend to the parents that a child see a doctor. If the kid is actually a problem child, the outcome for this will often will be drugs.


And the recommendation from the teacher comes with a friendly recommendation to a psychologist that works with other kids in the class. The teacher and the doc probably have wine together once a week.


In the land of sensationalist news stories?


Suicide is offensive to society and many individuals on a deep level, especially of people who do not have a "good reason" (such as a terminal illness). While it may have progressed beyond being a criminal act, it is still taboo enough for alternative and equally good avenues to exist for society to deal with it, in this case, police and physicians empowered by law with the "duty of care" concept. This is of course better than suicidal intentions being dealt with as criminal, but not as good (in my opinion) as it being dealt with as something that someone has a right to do and therefore cannot have force used against them, but perhaps should be dissuaded from, maybe similarly to abortion.


It's one of the two things every therapist will tell you that can force them to break the confidentiality. That it can take away your freedom, get you institutionalized, remove your ability to make your own medical decisions.

It's important to take ideations seriously but as someone who struggled with that at points in my life I never felt completely safe about discuss it.


It makes sense when you consider that the therapist is there to help you but only in a way that does not challenge society. You are right to not feel completely safe to discuss it, unfortunately. I'm not sure why this taboo has evolved to be so strong, though I would guess it runs very deep psychologically in peoples' fear of death and also has something to do with the potential societal implications to any culture which does not treat it as something to be dealt with with extreme prejudice.


>societal implications

I'd expect the quality of a party you're allowed to leave to be higher than one you're not.


I would agree, hence the offensiveness of suicide to society in the large.


american society.


It's not much better in Europe.


Are you American?


The majority of people who attempt suicide do not then go on to commit suicide. Though ironically it does mean that a suicide attempt is the strongest predictor for death by suicide - but the rate is still 1% over the successive 12 month interval.[1]

There is no strong evidence that suicidal people have a genuinely held belief that they wish to stop living, as opposed to a psychiatric episode that once passed does not reflect their actual world view. This, in part reflected in the fact that one of the riskiest periods for clinically treated depression is shortly after anti-depressive medication is started, since depression manifests in large part as a lack of motivation, and the first effect of treatment tends to be to allow people enough action to actually attempt suicide. But again: this is episodic.

Note that this is entirely different to terminally ill people seeking euthansia, who amongst other things will pursue the goal for years if necessary i.e. it is a strongly held belief of a rational mind.

Though finally I'd note I don't know what you propose "challenging" society is meant to mean here. A therapist isn't there to sign off on you killing yourself, nor is that ever required. That option, especially in the US with the absolutely minimal checks on firearms ownership, is constantly available and has exactly one outcome. Dead people don't feel, or have to justify, anything to anyone.

[1] https://en.wikipedia.org/wiki/Suicide_attempt


I wonder, though, if people who attempt and fail suicide are more likely to be the ones doing it impulsively after a psychiatric episode or other major emotional setback. If someone has thought it through and genuinely wants to die I suspect they would have a better chance of succeeding.


It means anything which violates the social norms and laws that undergird a society, one of which is suicide. Another might be illicit drug use, including psychedelics. Any solution or help a state-linked therapist provides must necessarily steer away, if necessary by force, from anything that involves these. This even may be if something like psychedelics could help the individual, although psychedelics are likely to become legal in the future for this purpose. Suicide in most jurisdictions is entirely illegal not excepting euthanasia and in such jurisdictions, a therapist engaging with a rational terminally ill person as you describe would not be allowed in an official capacity to have an honest discussion about euthanasia as an option for their situation.

> There is no strong evidence that suicidal people have a genuinely held belief that they wish to stop living, as opposed to a psychiatric episode that once passed does not reflect their actual world view.

I would argue that there is an overwhelming amount of evidence that suicidal people have a genuine held belief that they wish to stop living, in the form of genuine and sometimes successful suicide attempts. To redescribe it as a "psychiatric episode that once passed does not reflect their actual world view" is to simply negate the validity of the belief by viewing it through a medical rubric which affirms suicidality as something pathological. This is a value judgement. Compound with the complication that, as described through the comments on this post, any discussion of intent towards suicide can have severe consequences and therefore suicidal people will necessarily be coerced into denying their true beliefs of things, and must acknowledge the consensus view that their desire to kill themselves was in fact not "a genuine beliefe". That they may come at some point (possibly much later on) to have genuinely changed their mind not to kill themselves or to have kill themselves may be great but does not invalidate their previous belief at the time they were suicidal.

For comparison, imagine a society in which intent towards abortion was viewed as a pathological state of mind, and any talk towards such was met by extreme force from the state similar to that which it is for suicide, to wit: forced imprisonment, pharmaceutical intervention and koshing of a person until they no longer expressed (openly) a desire to have an abortion. A statement like "There is no strong evidence that these women have a genuinely held belief that they wish to not have their baby, as opposed to a psychiatric episode that once passed does not reflect their actual world view." may sound valid to people living under such a value system but we might recognise something more going on here.


100 percent of those who succeed on their first attempt do not go on to try suicide again.


What's the other thing besides mentioning suicide?


A serious intent to harm/kill others.


Step 1) fabricate an SMS

Step 2) call police

Step 3) enjoy

Wow so easy to take down your political enemies huh


This happened to a friend of mine. "Friend" of theirs who was angry they didn't have a romantic interest in him called the police claiming they were suicidal. Police came, handcuffed them, verbally abused them, and dragged them to a hospital against their will even though they were clearly fine. They were forced to stay there for ~a day and then had no means to get home, thankfully a friend was able to pick them up and drive them home from the hospital.

No consequences for the guy, of course.


Something similar happened to a friend of mine and you can find plenty of stories on the internet - the way suicidal people are treated by the police is actually cruel and I can't imagine it helps anyone who is really feeling suicidal.

My buddy got arrested, restrained to a hospital bed against his will, was given a cocktail of drugs, and had to stay there multiple days while getting a 'wellness check' every fifteen minutes where a nurse shakes you awake.

To top it all off they sent him home with a $60,000 medical bill.

Not a great way to treat someone who's going through a hard time. I definitely learned never to call the police unless someone is literally getting ready to jump off a building.


> I definitely learned never to call the police unless someone is literally getting ready to jump off a building.

This is an important lesson. Do not call the police unless you literally just want them to remove a nuisance and you don't care what happens to the person or how they are dealt with. Even then, police are just a wild card with the potential for life altering outcomes.

My brother called the police once because his then girlfriend was acting really crazy/violent after a night out drinking (not the first time) and they almost arrested HIM.


Calling police is rolling the dice on a range of possible outcomes often times putting you in the crosshairs and rarely resulting in what you would expect.


Wow, that sounds like a good way to make someone suicidal even if they weren't to begin with.


>the way suicidal people are treated by the police is actually cruel

The way people are treated by the police is actually cruel. If you dug into it you would be ill.


> while getting a 'wellness check' every fifteen minutes where a nurse shakes you awake.

Actually, speaking of practices that are implemented for the convenience of administrators rather than the benefit of the patient...

There is a popular belief that, if you have a head injury, you must stay awake because losing consciousness is dangerous. This is completely false. Your urge to sleep reflects the fact that that is what's healthiest for you. If (1) you are caring for someone with a head injury, (2) they want to sleep, and (3) you have no means of addressing a very serious problem such as massive internal bleeding, you should let them sleep, because that is their best chance to recover.

It is, however, absolutely true that, if you have a head injury, 911 will tell whoever is caring for you to make sure that you remain conscious, and if you're already in a hospital, the staff will do their best to ensure you remain conscious. This is not because staying conscious is good for you. It is because they are relying on an index of how severe your injury is ("is he behaving oddly?") which only applies if you're conscious. Everyone who's unconscious is behaving normally.


If the patient is conscious and starts exhibiting symptoms indicative of a medical emergency then there's the possibility of treating it. If they're unconscious you might not know about it until you start seeing cardiac or respiratory symptoms, at which point you've already waited too late and they could die, be left in a comatose state, or suffer from brain damage. How is improving the odds of preventing that not "for the benefit of the patient"?


"convenience" is a hell of a word to use here when the alternative is that medical professionals would have no way to know if your condition is worsening. Which is to say, if you want to sleep you can basically just go home for all the good they'll be able to do.

If it's inconvenient to you then you always have the option of checking out of the hospital whenever you want: you are always (except in psychiatric hold cases) able to sign a form saying you understand it may be Against Medical Advice and want to leave.


> the alternative is that medical professionals would have no way to know if your condition is worsening.

There are other ways; they are more expensive, less accurate, and possibly more dangerous to the patient, but they exist.

But if you go back and read my comment again, you'll see that I'm talking about the popular belief that losing consciousness is detrimental to the patient. It isn't; it is beneficial. The doctor may have good reason to keep the patient awake anyway, because, if the patient suddenly starts to die, he might be able to do something about it.

But if you are not in that situation -- if there's nothing you can do if your injured friend suddenly starts to die -- then you should not be trying to keep your friend awake.


Why on Earth would the police be considered the appropriate service to deal with this situation? There is no overlap between paramilitary law enforcement and social services.

This is where calls for defunding the police come in. Take some of the money spent on using physical force on those whose thoughts do not conform to social norms and use it on a more appropriate agency. We no longer regularly physically restrain and torture the mentally ill in treatment settings. Why do we insist on funding other institutions to do so?


In Soviet Russia, government officials would remove someone, and then claim suicide. In America, they first claim suicide (risk), then remove them.


Soviet Russia also did use phony psychiatry to get rid of opponents.

Political abuse of psychiatry in Soviet Union has its own Wikipedia page.


There is a big difference between murdering someone and detaining someone for a day if a trained professional believes there is a high risk of suicide.


Believing unaccountable decisions placed in the hands of powerful doctors without recourse results in a professional suicide assessment is not what actually happens. You may be detained for no reason and have no recourse. They may pump drugs into you.


Not only that, you may permanently lose some civil rights and privileges, such as the right to own a firearm or pilot a commercial flight.


Scary.

Any ideas of how to fix it?


Come up with a reasonable objective bar to pass before subjecting someone to confinement and medical treatment against their will. Right now police are all too willing to basically arrest someone off of some nebulous accusation. It should be treated no different than the standard of proof for an arrest and should face the same repercussions if done wrongly, both for police and an accuser.

Make it contingent on prompt medical evaluation. The current timeframes for involuntary commitment in certain states can leave people confined on a Friday afternoon and waiting to be evaluated until Monday morning. If it's urgent enough for involuntary confinement it's urgent enough to have a medical professional oncall for prompt evaluation.

The medical necessity of all involuntary medical treatment should have to be substantiated in front of a judge, even if the patient is released before statutory deadlines would have required a judge to approve continued involuntary commitment. The medical facility should have to explain their actions e.g. "On Feb 12th at 5:12AM patient started scratching the skin off of their left arm (Exhibit A) which necessitated the administration of 10 mg of Midazolam intramuscularly". Any medication should also be limited to the shortest duration feasible until a court order is issued, no depot injections of Haldol that will last a month.

No financial liability for the patient. The state doesn't have to foot the bill for all of it, you could mandate that insurance picks up the tab and leave the state to pay for only the uninsured. It's profoundly unjust to not only deprive someone their bodily autonomy but also saddle them with a mountain of debt with no recourse even if the involuntary commitment turned out to be unjustified. If it came out of municipal budgets maybe police departments would be more diligent about making sure that involuntary commitment was necessary instead of using it like a blunt tool to pawn off a tiresome person onto someone else.


trained professional my ass. I have a disability, and I tell you what: Even the people "specialized" in certain disabilities usually have no idea what the fuck they are talking about. But they get good pay and are being treated like specialists by those which have even less of an idea... Outsiders usually have absolutely no idea whats going on.


Swatting only has steps 2 and 3 to worry about.


Step 1) plant evidence of crime

Step 2) call police

Step 3) enjoy

Do you propose that we do away with police, telephones, or crime, to solve this problem?


I think you're joking, but this is actually so true that you might be committing a crime by suggesting it.


> this is actually so true that you might be committing a crime by suggesting it

Perhaps where you live. The legal system I live under has strong protections for freedom of speech that ensure that such a statement cannot be criminalized.


This statement is legal in the USA.


Yeah, I've read some incredible stories. Locking the doors behind the patient. Using some tiny remark as cause for involuntary institutionalization. It made me think american psychiatry was like american prisons where they get paid per person and are therefore incentivized to stuff as many people in the building as possible.


All the while I can drive 15 min and find thousands of obviously mentally ill people in need of involuntary mental health treatment (the type perhaps not even available at this point in the US) wandering around and the police cannot do anything about it because their only avenue for detaining them is to wait until they catch them committing a crime. And even then they are shortly released onto their own recognizance if it is anything short of attempted murder.


The reason they aren't in a psychiatric hospital is because the only reasons we can involuntarily commit someone is if they are a risk to themselves or others, and like stated elsewhere in the thread is generally reassessed by a judicial process every 72 hours depending on the state. What I'm reading in your post is that you're in favor of involuntarily holding more people which I find interesting because many others in the thread are complaining that it's too easy to have someone committed. There are a lot of armchair psychiatrists in this thread who have never seen someone in psychosis or truly manic suggesting that it's a joke to have someone committed. I spent 3 weeks rotating in a psych emergency department and only saw 2 patients out of probably more than one hundred total patients admitted for being suicidal. Neither were involuntary. From what I've seen unless you have just attempted or have a concrete plan to attempt suicide again you're not going to be admitted. There are just too many people who are in not-on-the-same-planet level of psychosis or mania that are taking up beds to admit someone who is not really about to attempt suicide.

Not trying to pick on your post or anything just thought it is a good example to say that it's maybe not as easy as it may seem to decide who gets admitted/committed, and the dichotomy in this thread shows that point.

Regarding potential overuse of sedation (benzos) or antipsychotics in nursing homes, it's easier for a nurse to push a doctor to prescribe meds to "snow" a patient than to spend time in the room and try to reorient a sundowning delirious dementia patient.


> Not trying to pick on your post or anything just thought it is a good example to say that it's maybe not as easy as it may seem to decide who gets admitted/committed, and the dichotomy in this thread shows that point.

Of course the topic of involuntary committal and people’s rights and prevention of abuse is extremely difficult, and that is why the pendulum swings back and forth. I just think it might be at or nearing the other end of the swing.


Keep in mind that the involuntary commitment system that was largely dismantled in the 80s was a hotbed of abuse - both of the people committed to it, and of the reasons for which people would get committed to it.

Falling out with your business partner? Want to get rid of your wife, so you can move in with your mistress? Your kid came out gay, or atheist? Dad has money, and you don't want to wait for him to die? Involuntary commitment was a fantastic solution for all of these problems.

If you weren't crazy before you get sent to a mental institution, you almost certainly would be after you involuntarily spent some time in one.


Yes, there is of course potential for abuse, but I am thinking the pendulum has swung too far in the other direction now.


> All the while I can drive 15 min and find thousands of obviously mentally ill people in need of involuntary mental health treatment. because their only avenue for detaining them is to wait until they catch them committing a crime.

Let's say you were wandering the streets of a major city, looking very odd to everyone else and muttering to yourself (likely someone you'd see on a drive who is "obviously mentally ill"), but otherwise very happy and not breaking any laws, would you want the police to be able to snatch you off the street and involuntarily lock you away?

Likely not, and this is why the laws in some countries like the US are the way they are.


> but otherwise very happy and not breaking any laws

This is obviously not the case with a sizable portion of the people wandering the streets. An ideal world is nice to theorize, but practically, there will always be type 1 and type 2 errors.

Transparency and other efforts to reduce them should of course be a never ending goal, but abandoning a problem completely because it cannot be done perfectly is not a long term solution either.

> Likely not, and this is why the laws in some countries like the US are the way they are.

I think the laws are the way they are because it was cheaper to simply dismantle whatever existed of the mental health care system rather than invest in improving it. And it is still cheaper to ignore it on the federal level while the rich people cloister themselves in affluent suburbs and gated communities.


> This is obviously not the case with a sizable portion of the people wandering the streets.

I'll bite.

Give me an example of someone who fits your definition of someone who should be forcibly taken under the wing of mental health treatment (whatever that entails) who isn't breaking any laws. Putting someone into a mental institution strips of them of all rights and requires convincing a judge to ever get out.

This logic essentially wants to "arrest" people without "arresting" them because they aren't doing anything illegal. That requires a very precise definition of the conditions under which you can do this.

Very much like a law.


> Give me an example of someone who fits your definition of someone who should be forcibly taken under the wing of mental health treatment (whatever that entails) who isn't breaking any laws.

I did not suggest involuntary committal for those not breaking laws. I wrote a sizable portion of those who need mental health treatment are breaking laws (more importantly, they are behaving in a manner that is destructive to other members of society - littering, biological hazards, fire hazards, property crime, etc). Whether it be for schizophrenia, meth and drug addiction, or some combination thereof that make involuntary mental health treatment the only option.


It's less about pay and more about liability. Mental health is terrified that someone will do something to harm themselves.

The incentive systems have yet to realize that there needs to be some balance in bad outcomes to support the good ones. It results in a system where any mention of self-harm is taken extremely seriously, even at the cost of a larger treatment plan.


> Mental health is terrified that someone will do something to harm themselves.

I can understand that but involuntary institutionalization should be implemented only if there's an immediate danger to someone's life.

A currently euthymic person mentioning casually there were times they wished they were dead is not cause for institutionalization.

A depressed person who not only thinks about taking their own life but has made plans for it and has the means to execute that plan is in great danger and in need of immediate help.


I think we are seeing literal survivorship bias here where the person whose texts were taken too seriously is alive to tell their tale and everyone whose weren't successfully committed suicide.


"detained...for a night"

"freedoms can be taken away so dubiously even when not charged of a crime nor arrested in a system that exists outside the criminal system"

I'm sorry this happened to you.

Not defending it, but I don't think it's fair to say your experience represents some runaway extra-judicial outcome.

For better or worse, in the US, a judge's approval is required to detain someone in a psychiatric facility beyond an initial period (in my state it's 24 hours).

This is more or less the same standard we apply to people arrested for crimes, no?

I.e. you can be detained involuntarily for a bit, but they have to put you before the court or let you go.


>I don't think it's fair to say your experience represents some runaway extra-judicial outcome.

Being involuntarily committed makes you a "prohibited person" and includes a lifetime ban on owning a firearm.[1] It wouldn't surprise me if there were other strings attached to having that on your record too.

[1] https://uclawreview.org/2021/08/18/pulling-the-trigger-on-am...


.


Are there any states where people can be involuntarily committed indefinitely without judicial involvement?

[edit responding to your edit] you were responding to the tone of my original comment, which I softened while you were responding, so sorry for the original combativeness. For what it's worth, holy crap does what you described suck. i would have done exactly what you did. no amount of knowing that it's not "indefinite" would have made it any better. the circularity of being falsely accused of something, and then having your (justifiable) non-compliance used to justify threats of further force, is blood boilingly unfair. sorry my apology sounded insincere. i sincerely feel that your experience should not be minimized.


Florida. I knew people in high school that were in there for weeks.

https://en.wikipedia.org/wiki/Baker_Act


"Examinations may last up to 72 hours after a person is deemed medically stable"

"There are many possible outcomes following examination of the patient. These include

(1) the release of the individual to the community (or other community placement),

(2) a petition for involuntary inpatient placement

...

(3) involuntary outpatient placement (what some call outpatient commitment or assisted treatment orders), or

(4) voluntary treatment (if the person is competent to consent to voluntary treatment and consents to voluntary treatment)."

[Numbers mine]

So assuming #2 and #3 are the "bad" outcomes: both seem to require a judge's order within 72 hours?

Unless the definition of "stable" has a wiggle room I am not appreciating? Or some other practical nuance?


Definitely can happen in Arkansas. BUT, it will not be indefinitely, it will be when the insurance money/mom and dad's bank account runs out.


Doesn't really seem like this is correct.

https://law.justia.com/codes/arkansas/2018/title-20/subtitle...

> (a) An individual with a behavioral health impairment who is admitted to a psychiatric emergency service under a crisis intervention protocol under this subchapter shall have a final disposition within a maximum of seventy-two (72) hours or be released from custody.

> (b) If the individual with a behavioral health impairment cannot be stabilized within seventy-two (72) hours of entering into a crisis intervention protocol, a participating partner may institute commitment proceedings as authorized under § 20-47-201 et seq.

> (c) An individual who has been released from custody and has chosen to stay at a crisis stabilization unit voluntarily under § 20-47-804(c) is not bound by the seventy-two-hour maximum time of detention under this section.

> (d) As part of the discharge process after the seventy-two-hour hold has expired and the individual is being released from custody, and subject to the consent of the individual no longer in custody, a crisis stabilization unit may provide the individual with a follow-up treatment plan and a request that the individual utilize the treatment plan, including subsequent appointments with a mental health professional.

Sounds like you're talking about (b), but I wouldn't really assume we're talking about children (as in America they don't really have rights).


Oh interesting, this must be new (2018?).

“Stabilized” indeed… (rolls eyes completely around head.)


California.


When I traveled to the east coast near DC to help take care of my mother in her final years I talked with some people about my work with startups and the tech side projects I was developing and not only did they all think I was completely crazy but I got referred to a psychiatrist who was insistent that I should get started on antipsychotic medications right away.


Why would talking about tech make people think you're crazy?


A good job is one where you do the same thing in the same place with the same people year after year. Such a job should offer good benefits and be exceptionally stable.

In contrast working as a contractor, intentionally contributing to more than one job per year, taking a big salary hit to be on a cool project with cool people are all things that are completely and utterly insane. No reasonable people would do such a thing.

And one of my side project was a mini MPORG with no combat, just some puzzles. Obviously no one can make good money providing something like that, and turning such a thing into a good job opportunity is not possible.

Take your meds and get a steady job at a big company, or better yet the Federal Government.

It is kind of surprising to me that this is considered so odd. Have any long time tech workers here tried to explain how their work is organized to anyone who has worked for the federal government for a decade or two? Maybe I was just lucky.


I wonder what the side projects were…


Maybe brain wallets?!


I think this is meant to be a comment on SV culture.


A lot of the behavior is driven by liability avoidance by doctors and mental health professionals. They do not want to be put in a long drawn out lawsuit, convicted or not by someone's family members because they didn't report and deal with someone who wanted to commit suicide. Remove that possibility and I think many doctors will stop doing that too.

I know a few and they really, really, really hate how the system & law forces them into this corner, to the point where they actively try to avoid suicidal patients, because they don't want to report them. There is a similar dynamic with being a mandated reporter for children when giving them therapy.


Mandatory reporting seems to be a tool invented to keep abused children away from health and mental care workers, since parents who are worried about mandatory reporting will simply choose to not have their child treated.

Even for those who dearly love and care for their children, it's not a great feeling knowing that the slightest misinterpretation _requires_ that health / mental professional to refer you for prosecution. Instead of helpers, doctors and therapists have to be viewed as threats.


Reminds me of Élan School [1] and how kids (under 18) can be abducted with the permission of their parents and put in confinement for dubious behavioral benefits, against their wishes – sometimes with the help of the judicial system.

The road to hell is paved with good intentions.

[1] https://en.wikipedia.org/wiki/%C3%89lan_School


There is a very good/gripping series of illustrations about the school drawn by one of its victims:

https://elan.school/


Kids can be forced into electric shock therapy because of their parents.


Look at all the recent brittney spears stuff. An insane legal world out there noone knows anything about. I never would have guessed a situation like that would be possible and for so long.


Careful, criticism of the medical industry and concern for your rights is verboten. You will take the drugs the experts tell you to take, and you will like it.


LPS holds are 72hr. It's the only situation where you can be detained against your will. Unfortunately, many seriously ill people can not get the psychiatric help they need because of how difficult it is to forcibly medicate(in CA, at least) or keep a person beyond 72hr if they improve slightly.

IMHO, the system errors too much on the side of caution when it comes to psychiatric holds and ignores history of repeated hospitalizations.


This is literal survivorship bias. I'm sure there are many people who are no longer alive because people did not take their texts seriously. I can easily imagine someone posting something just like this from the other side of the coin.


> I'm sure there are many people who are no longer alive because people did not take their texts seriously.

So? If they wanted to die, that's what they wanted. Do we have to forcibly be required to live in a mental institution, pumped with drugs, for the benefit of others if we don't want to be here anymore?


Suicide should be an accepted life choice. No one should be forced to live just because others want them to. "Life, liberty, and the pursuit of happiness".


No one is being forced to live in a mental institution because they sent someone texts one time that expressed suicidal ideation... There aren't enough psych beds to take care of the patients with schizophrenia, bipolar disorder, and suicidal intent with a plan to spare any to suicidal ideation patients. The OP spent one night in a psych emergency room, was not forced to take any medication, and was released.

People who are suicidal with a plan are not generally thinking clearly and are happy that they received care once they've been treated. We take people who are acutely intoxicated or unconscious to the hospital all the time and have no qualms about that.

Regarding being "pumped with drugs", I can only speak from experience rotating for 6 weeks at two different psych hospitals, but the only people who I saw forced to take medication were acutely psychotic, manic, or incredibly agitated. The schizophrenics that are picked up and brought to psychiatric hospitals generally are so psychotic that they would not be able to care for themselves - risk of harm to themselves. Same thing with acutely manic bipolar patients.


> People who are suicidal with a plan are not generally thinking clearly and are happy that they received care once they've been treated.

As if preference on this is always treatable. For example, what kind of treatment do you give a person who wants to die because they have no support network and had a stroke which rendered them disabled and homeless? What realistic treatment is going to give them hope? A bed in a state funded nursing home surrounded for the rest of their days by untrained, uncaring people who are just there for the low wage paycheck?


I can't possibly imagine how trauma, torture and debt can at all help with suicidal ideation. It sounds barbaric.


I don't think torture is a remotely accurate description of psychiatric care. How do you think they treat people with suicidal ideation? Tie them down with chains, stuff a sock in their mouth, beat them with whips, and inject them with deliriants? Seriously dude... You get a room that looks like a normal hospital room. You have the choice to take antidepressants or not. You do group and individual therapy for a couple days. If you're actually being held on a 72 hour hold, your time will be up and you will be free to go. Otherwise you may realize that being in the hospital is beneficial and you choose to stay.

I respond to these comments because I don't want people to hesitate to call for help if someone they know reaches out in need because of what a bunch of software engineers on HN who've never seen the inside of a hospital have to say about psychiatric care.


I'm mostly referring to what comments like this[1] one sound like. They may be lies or they may be isolated cases in specific states or counties, but it's not at all the first time I've read such accounts. Grain of salt since it's the internet of course.

[1] https://news.ycombinator.com/item?id=28497547


That doesn't justify violating somone and stripping them of their rights. There are plnety of possible nterventions short of that




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