throwing people into an Iowa asylum

September 14, 2007 9:05 PM

Iowa & mental health: What can someone do if they're threatened with being admitted for psychiatric reasons against their will? What happens? Does it really only take two other people signing a document? Is threatening someone with this a crime?

The "two other people" thing might be totally wrong. I can't find the relevant laws. I would like to know
a) what does it take to get someone admitted against their will?
b) is it automatic? if you protest, and point out that you're not (e.g.) insane, they must not just lock you up anyway... right?
c) if it really does just take two people signing a document (I doubt this, but just in case), if two people threaten to conspire to get you thrown in a psychiatric ward, is that a criminal act?
d) this sucks.

posted by anonymous to human relations (18 comments total)

I would call Iowa Dept of Human Services for your area. It looks like their department of mental health falls under that. They will have all of these answers. If they aren't around on weekends, call one of the state-run mental health facilities. They should be able to answer these questions as well.

Good luck.
posted by sneakin at 9:17 PM on September 14, 2007

There is probably also a local organization that advocates for the rights of those with mental health problems. They would likely be the best resource for questions on these issues.
posted by winston at 9:20 PM on September 14, 2007

Lying on the document would be a criminal act. Conspiring to commit any criminal act is a criminal act.

If the threat is made in order to get you to do something, it may be extortion or blackmail
posted by winston at 9:26 PM on September 14, 2007

It is much harder to get someone institutionalized than it used to be. Threatening or attempting suicide, threatening to hurt someone else, and otherwise acting in an extreme way that attracts attention from the police are some things that might get a person at least a couple of days in a mental health facility. I imagine you'd be subjected to pretty intensive psychological evaluation prior to being institutionalized.

Good luck, what a horrible situation.
posted by pluckysparrow at 9:27 PM on September 14, 2007

They'll only put someone away against their will if they are an immediate threat to harm themselves or someone else. Really, a person has the right to be as nuts as they want, just as long as no one gets hurt.

Wear underwear on your head and eat dandelions all day = ok
cut yourself = not ok

Usually, if a person is seen at risk for hurting themselves, an on-call psychiatrist/counselor of the state (adult protective services) will make that person sign a contract stating that they will not hurt themselves and have a network of people to call/talk to in case the urge comes up.

Also, in many cases, if someone is sent to a ward, they will be observed for 24 hours and if there is no reason to think they'll be dangerous, then the person is free to go.

It's actually pretty hard to get into a ward, they're overcrowded as it is.
I am not a psychiatrist (but my mom is), and I don't live in your state. YMMV.
posted by idiotfactory at 9:30 PM on September 14, 2007

I've known a couple people this has happened to, I don't know the specifics, but generally speaking, it is simply for a set time to assess you and most people are released within that time (with the appropriate meds, treatment plan, etc). The periods of time I've heard of vary from is as little as 3 days to 3 weeks. Also the people who were committed were psychotic and violent, so as far as my experience goes it was done in very appropriate circumstances. I've actually known people who have attempted suicide and been let out in 24-48 hours.

While I don't know what they specifically are for Iowa (and looking them up would come far too close to me practicing law, like uh, without a license) but there are legal remedies for wrongful confinement in the cases of civil commitments. You can also protest it, get counsel, etc, etc. So all in all you have rights, but yeah your life could be made pretty difficult for a few weeks.
posted by whoaali at 9:31 PM on September 14, 2007

I'm definitely not an expert, but I did type up the actual court rules for Wash, D.C.'s policies on this, which I hope are somewhat standard throughout the country. (I typed them for a legal reference book). Basically, you need to have a psychologist or psychiatrist certify that the person is a harm to themselves or others, which initiates a family court hearing (the accused-insane will have an advocate) and then medical opinions are debated. The judge makes a ruling to place the person into custody or not.

They can't put you into custody immediately unless you've done something that requires attention from a hospital or the police (which have policies of their own which take over). You can't just call up an asylum and have the orderlies tackle someone. A request from a regular person would go through family court and barring any emergencies or obviously dangerous behavior, would move along the lines of being sued by someone (subpoena, assignment of counsel, hearing date, pre-hearing motions, etc.). I'm sure that there are many opportunies for dismissal in pre-hearing motions as the documentation is gathered and affadavits are made. at least in D.C.

Like what everyone else has said, don't think for a minute that this is a credible threat against you if you're not a danger to yourself or others. Lawyer up and start documenting that harassment!
posted by cowbellemoo at 9:59 PM on September 14, 2007

Here's the letter of the law. (sect. 229.6 onwards)

In short, it takes a petitioner and a supporting affadavit to file a petition; the respondent has the right to an attorney (supplied and paid by the county, if unable to pay); a medical examination by a licensed physician is ordered within 48 hours.

If the judge considers there's probable cause to merit immediate confinement, then that can be authorised and carried out by the sheriff's dept., with a hearing scheduled five days later (unless the fifth day is a weekend or holiday).

In the state with which I have personal (though not professional) experience, the sheriff's department is usually the instigator of that kind of rapid commitment, after being called to deal with situations of potential or actual self-harm or harm to others. In emergency cases like that -- aka 'wake up the on-call judge' cases -- it also requires an evaluation from a psychiatrist or counselor who'll then sign off on confinement or some other form of custody. (Then usually call round for hours trying to find an available bed.)

In short, if you're not wearing a police uniform, it's rare to show up with a petition and get someone confined right away.

Filing a false affidavit is a criminal offence. The 'under penalty of perjury' on the form is not there for show.
posted by holgate at 10:01 PM on September 14, 2007

What will happen, from personal experience. (This EXACT situation happened to me. Here's how it went down.)

1. The police will arrive at a place where you are. They may or be accompanied by medical professionals and/or an ambulance. They will very very likely handcuff you.

2. Step 2 varies. In one case, they may take you to a police station and book you first. In the other, you just go straight to the hospital's psych ward where:

3. You will have all your stuff taken away from you, put into a biohazard bag/locked up/etc. This may include your clothes, be prepared to be in a hospital gown, barefoot and cold. Feel free to ask for blankets, don't always expect to get them. I found that asking really nicely helped there.

4. You will either then sit around in a padded cell-like room or in a exam room, depending on how seriously they took the person who tried to have you committed. This can take a number of hours. It's hella boring.

5. Eventually a nurse and/or doctor will speak to you and ask you a lot of questions. Most of those will be testing to see how rational you are, how grounded you are, and if you want to hurt anyone, including yourself.

6. If you are grounded in reality, non-violent and non-suicidal or prone to self-harm, you will be released, get your clothes and stuff back, sign a bunch of forms, MAYBE get billed by the hospital and go home. Or you are violent, suicidal or not grounded in reality, you may still get your clothes back, but you will be admitted/go to a longer-stay ward and get treatment.

--

If the person accusing you of insanity does it repeatedly, or has no basis in fact for the accusations or is obviously doing it for some kind of personal gain, you can accuse them of harassment. If you want to do this - GET A LAWYER. Hell, if someone is trying to have you committed, and you don't need to be, get a lawyer anyway.
posted by FritoKAL at 10:05 PM on September 14, 2007 [1 favorite]

If someone is threatening you with this, they need to stop.
posted by Ironmouth at 11:04 PM on September 14, 2007

My third-party experience in Iowa: A friend's roommate stated he planned to kill himself. I accompanied the friend back to their house to see what was going on. There was a small package of OTC sleeping pills on the counter and the roommate wouldn't come out of the bathroom. We called police, they showed up, the roommate was disrespectful/resistant so the cops got the bathroom door open and they took him to the local psych ward. He stayed there for 12 hours and was released. A few weeks later the roommate got a bill for $75 or so.

You're going to talk to cops, hospital staff, and a judge before you're actually committed (though perhaps not before you get an involuntary "evaluation"). As long as you're rational, I don't think you have much to worry about. You won't be railroaded into a rubber room. At least not for long. It would be worth talking to a lawyer or social worker about these threats just to get it "on the record." If the people are trying to extort something out of you, then call the cops and file a report. In any case, you might see about getting a restraining order against these people.

Cheap/free legal help:

Iowa Legal Aid
If you're a college student: UI, ISU
More generally
posted by the christopher hundreds at 11:05 PM on September 14, 2007

I'm not in the US, but have had a family member sectioned several times, and have worked as a 'civilian' in a psych unit. I don't know the vagaries of state law, but here assessment of a person to be sectioned (as they call it) involves two mental health professionals (not just any two people, such as one's own relatives). At least in my experience, the person was clearly having a psychotic break of some kind and from what I've seen, sectioning is only used in these types of extreme situations.

That someone might be threatening this, possibly as some kind of psychological manipulation, strikes such a nerve with me. Seek legal advice as others have suggested.
posted by poissonrouge at 2:11 AM on September 15, 2007

You might also consider that if someone is suggesting this then it might actually be beneficial.
posted by caddis at 4:57 AM on September 15, 2007 [1 favorite]

you can't be committed against your will without an evaluation by a psychiatrist, so don't worry about that. you might get held for 48 or 72 hours, though, so it's not nothing.

the victim can then, i suppose, sue his or her persecutors for damages. ianal, but i imagine they would have to have a pretty reasonable case--some real proof of malice on the part of the persecutors, and probably a dearth of evidence of bad behavior/psychiatric problems on behalf of the victim. if the victim in question has been hospitalized in the past, or has a history of behaving erratically or dangerously, this may be harder to prove.

depending on local laws, it may also be illegal to falsify a crime and/or crisis requiring emergency services, so that would be worth looking into.
posted by thinkingwoman at 10:23 AM on September 15, 2007

Go to a counseling service, therapist, psychiatrist. If someone is under psychological care, that professional would be consulted. Plus, if a person actually needed help, they'd get some.

If someone is harassing you with threats like this, document the threats in a diary, blog, whatever. Forward emails to a safe gmail account, or a trusted friend.
posted by theora55 at 11:36 AM on September 15, 2007

I have heard of people volunteering to be committed in situations like this. When you are voluntarily committed, you have more freedom to sign yourself out at will, vs. involuntary commitment.
posted by croutonsupafreak at 4:21 PM on September 15, 2007

Just to piggy-back... does anyone know what the deal is if you involuntarily commited?

Someone told me that the same shrink that was the principal signer-inner has to be the signer-outer, and is your shrink while you're in.

Also, that this person has no monetary incentive to sign you out- while you're in, you're automatically signed up for appointments with him. Can this possibly be true?

How hard is it to get out once you're in? Who's in charge of making those decisions? How hard is it to change shrinks?

How easy is it for that shrink to demand you be medicated? What are the safeguards against overmedicating? Wouldn't professional courtesy mean that other professionals would be inclined to let things go, even if they personally disagreed with the treatment?

I just heard someone ranting about this a couple days ago; obviously it's still on my mind. It sounded like such a dime-store-novel nightmare!
posted by small_ruminant at 11:26 PM on September 15, 2007

FritoKAL and the christopher hundreds provide good anecdotal information, I would like to reply in kind.

Not knowing the circumstances I would simply add that things are different if you're a minor. Depending on the facilities you are admitted to the stay can be a week minimum, and you have to go through a lot of psychological evaluations - individual sessions and a final "board review" - to be deemed reasonable for release; this is entirely extraneous to the law itself and again, varies by location. You may also be required to participate in group activities which are also judged and evaluated by "counselors/supervisors" and this information is used in the aforementioned process - like anything else this can all be made easier or more difficult by the individual, depending on their perspective and rationality.

This process is incredibly expensive, which is why I have never seen anything like that for people who are of legal age and were culled in on "suicide watch" type behavior. The "admissions" I've observed were a 16 year old and a 19 year old male being taken to the same facilities in the same county in Iowa, although the incidents were years apart - this was 2000 and 2004 respectively.

The "cosigner" on the admission documents had to be a relative - uncle, grandfather, etc but other than that there were no stipulations - random acquaintances can't band together to commit you. At the same time, someone who may not really know you all that well can cosign, as long as they are a relative and are convinced by another of your immediate distress...

As far as section D of your question is concerned, I would advise you to make this as easy on yourself as possible, as impossible as that might seem...
posted by prostyle at 8:04 AM on September 17, 2007