I would never speak to a therapist unless all the laws regarding mandatory reporting, red flags, FAA and firearms licensing record searches, and involuntary committal are repealed. Until then they are a huge blinking hazard that the slightest misinterpreted phrase will result in serious legal hassles.
And for the same reason, you should probably lie to your doctor about any drug use, past or present. Which is a terrible policy to have, as you may be given treatments or prescriptions that interact negatively. But at least you can independently research those possible effects.
An example of a variant on this, when my wife and I started the journey to adopt in our State (NJ), we were required to give permission to speak to our doctors, and they went through everything. I mentioned something once to my doctor about cutting down on alcohol and that became a big deal in our interviews with State workers.
I'd be curious when adoption started becoming so much more cumbersome, and whether the outcomes for the children have been significantly better. Including taking into account that some children get left to bounce around in foster care because loving parents who want to adopt them get hit as "false positives" as baddies in the onerous screening process.
If I knew you and you said that to me, I would consider that a huge red flag. What is it that you think you were going to say to a therapist that is going to wind up triggering any of the things you just mentioned?
Therapists aren’t just running around mandatory reporting people for talking about their problems. The things that you mention are triggered when someone is at risk either the patient presents a very clear hazard to themselves or others, or a therapist learns about abuse.
I’ve never heard of this happening lightly. The idea that a misinterpreted phrase is going to land you in legal trouble or involuntarily committed is simply wrong.
Source: am married to a therapist and know what actually would trigger mandatory reporting. They might need some tweaking, but they absolutely shouldn’t be repealed.
It's a red flag to be worried that you could possibly be misinterpreted and that the misinterpretation (innocent or otherwise) could lead to a red flag? That is some dystopian shit.... I'm not even allowed to be a skeptic about the red flag without being flagged. I think you've proven the case as to why I wouldn't want to see a therapist.
If you have an understanding of what leads to mandatory reporting, etc., and you think something you say is going to put you in jeopardy during a therapy session, it's absolutely a red flag. Just what in the Hell do you think you're going to say to a therapist that's going to trigger a mandatory report? Is there some huge wave of people being involuntarily committed I've somehow missed?
Therapists don't try to have people committed or make reports lightly. They're not going to try to take your guns away or have you committed because you use bad words or seem angry during a session. They're not going to report you or whatever for disclosing drug use, or an unusual (but consensual) fetish.
They won't even report you or try to have you committed if you talk about suicide unless you meet certain criteria around likely self-harm. Saying, "man, I just don't want to live anymore" isn't going to do it. Saying "I don't want to live anymore and I have a plan to end my life in the next 24 hours" might. Even then, they're going to try really hard to guide you to voluntary actions and not involuntary ones.
The mandatory reporting laws are in place for specific scenarios like imminent danger, self-harm, or child abuse.
So - if you've actually looked into this at all and think "hey, something I say in therapy is going to trigger mandatory reporting" - yeah, that's a huge, enormous, red flag.
As I said, I'm married to a therapist. I know pretty well what triggers these things, what the process is, etc. It is an enormous headache for a therapist to have to do any of this - and it's certainly not like they're getting paid extra for every patient they report. And it's not like they have a red button that sends the men in white coats running into the room.
In normal therapy it's a multi-step process of notifications and follow-ups where a patient would have ample opportunity to raise objections, etc. If law enforcement is involved, they're not going to just cuff somebody and ask questions later unless you confess to murder in a session or something. And, maybe it's just me, but I kind of think mandatory reporting laws that kick in if someone admits to murder or imminent plans to murder someone are a good thing, not a bad one.
If you're working with a therapist through a hospital or whatever, they'll have a risk management department that will be involved in these scenarios. They're not going to support mandatory reporting or involuntary committing unless they feel it's necessary. If anything, those institutions are probably going to be biased against these things because of costs.
Independent therapists are going to avoid this because it's a huge hassle for them, too. Plus it's usually going to risk their relationship with that patient and possibly put them at liability if the patient decides to sue or go after them with their certifying board. (There is also risk, of course, if they clearly have a mandatory reporting situation and don't take action.)
> Is there some huge wave of people being involuntarily committed I've somehow missed?
Sort of. It's more complicated than providers necessarily jumping through the formal hoops every time; it can be a mix of informal coercion, asking leading questions to prompt the necessary "red flag" answers, and putting up practical barriers to the person leaving even if they're "voluntarily" admitted on paper. [1] [2] [3] [4]
There's also often little punishment for a provider acting outside of consent or court order.
For half of my confinement, the health care providers had neither my consent nor a court order allowing care. Some of them chose to touch me against my will anyway. I presented a signed/sworn affidavit with the signatures of two doctors, another nurse, an HSI detective, and a federal judge showing they had acted before they had a court order or consent. The state board rejected the claim, stating medical care providers can provide care involuntarily even when the patient is alert/oriented/capable of informed denial of consent even when there is no order and in my case even when there was no evidence of altered mental state or mental disorder.
That is, the state board's claim is a health care provider can do what they damn well please under the banner of health care without consent, regardless of the (lack) of presence fo a court order or other legal basis otherwise. There's simply no punishment.
The interesting thing is, when they finally did get a warrant to act without consent, they refused to do anything further. By then, their legal department got involved and realized I was going to sue the ever living shit out of them when nothing was found. That is, in the end it was discovered for some health care providers they never gave a single shit about the rights of the patient; the only thing that talks is money.
Final note:
To others reading this who find themselves in a similar situation, learn from someone who learned the hard way. "I don't consent" or "patient rights" or "get a warrant" don't work, even though they should be said for posterity. Here's what does: "lawsuit", "HIPAA complaint", "I will file a grievance", "I will be informing the medical board" (yes many of these may not work, but the doctor may not want the hassle even when they do have an order authorizing care.) Your denial of care has to involve something that makes things extremely inconvenient for them, simple appeal to ethics and patient rights do not work. THIS IS NOT LEGAL ADVICE.
I'm just curious, but have you ever been confined in a hospital because of a misunderstanding? This is something that actually happened to me, it was an awful experience and I was treated like shit and then left with debt collectors chasing me when it was all over (despite being vindicated of the accusation). I'd like to believe humans aren't capable of misunderstandings, but sadly this doesn't match my experience of reality.
It's honestly quite an astonishing revelation that you've said being cautious about these possibilities in this way is a certain red flag. That's basically a "thought crime" where being cynical of the system makes you an even bigger concern than someone who says they have a plan to end their life in the next 24 hours which apparently only earns a "might" be a flagging. Thus I choose not to interact, to the extent I can, with said system.
Agree with you. Being committed is the same as being in jail. They take your belongings and lock you in a room with a guard making sure you don't leave. Then you stay there at their discretion. I understand the reasoning in that if you hold someone off from suicide it should subside hopefully but it's all guesswork.
I keep seeing articles about a new suicide booth in Switzerland and the rate of euthanasia increasing in Canada... I understand people don't have a solution, but it feels like the experts aren't even trying.
I think some good advice is to treat therapy like medicine and realize it might not solve the problem and there are real risks involved. I don't want to turn anyone away from therapy, but it isn't for me.
> I understand people don't have a solution, but it feels like the experts aren't even trying.
This is definitely the vibe I get from the mental health establishment. There's so much hot air about "awareness" and "stigma" and telling people "there is help", but that's essentially just marketing. That's not going to do much for someone who's seen a dozen therapists and tried as many medications to virtually no effect, or someone who found the "right treatment" and can hold down a job now but still feels like shit most of the time.
I was immediately presumed guilty and cursed at by nurses. Looked down upon by cops. Laughed at when I asked for a signed warrant or consent before acting.
Oh yeah, I wasn't there for a mental health hold. A cop claimed there were drugs up my ass. Literally.
They found nothing. Never got an apology. Just a bunch of judgemental assholes that assume if you're being evaluated for something it must be true. Even when discharged they marked "overdose" on my paperwork.... I was stone cold sober and was only there because some officer apparently thought I fit the profile of a drug smuggler. The medical workers didn't want to admit they were wrong so they just marked it as an overdose when absolutely nothing was found, including never performing a tox screen (it would have been negative). On the way out the doctor bragged about how he was monitoring closely to try and find a way to hold me longer, with the implied threat being he had hoped since whatever preconceived notion he had about me being a drug smuggler had no evidence that he could punish me instead by involuntarily committing me.
I was admitted "voluntarily", and it wasn't a whole lot better. I went willingly, and then when I started having second thoughts they basically told me to either sign the consent form or they'd do things the hard way. I didn't face any direct abuse, but the whole framework was organized around achieving compliance, not remission. Some people working there seemed to actually care, but they also had no actual power to improve things.
It's not a great situation to be in, and I absolutely would lie to a mental health professional to avoid going through it again.
Probably better to talk to a therapist overseas virtually to avoid silly government rules. It also lets you keep a good therapist even when you move to a different territory or change insurance (as an American)
