This is one of the stories that a pretty desperate person told me:
‘My sister went from being a professor at a University to a barely functional individual. She was paranoid and her paranoia implicated friends, extended family, neighbors as well as my other sister and I. She truly believed that we were part of a huge conspiracy against her. All this took place inside her untreated, troubled mind.
Our family thought that it was logical to expect her to be treated in a psychiatric hospital even if she did not see the need for treatment. She was clearly so very ill, her mind so impaired, that we were sure there had to be a way to get a court order to force her to receive treatment. Wrong! We learned that involuntary commitment could only occur when our sister became a danger to herself or to others. Fortunately and unfortunately, she was not dangerous at that time.
Our lives were becoming pretty impossible and the position appeared increasingly hopeless. Our home environment had deteriorated. The rest of us withdrew from commitments with friends and our work suffered as we became more exhausted and frustrated.
When my sister made specific threats to harm us and other people, we petitioned the court to hospitalize her against her will but the judge explained with both sympathy and regret that because she had made the threats conditionally and was not wielding a weapon or lunging at anyone at the time, she did not meet the legal standard for involuntary commitment. We were shocked, helpless and very worried about the future. In a way, we were relieved that our parents had passed away some years previously and thus saved this heartache.
A few months went by and one day when I returned from work, my sister was not home. The front door was not locked and her bag together with her wallet, mobile phone and car keys were in it. We reported the fact that she was missing to the police but they told us to call again if she had not returned after 48 hours. We did, but one week later, we had not heard a word. I wondered whether I would ever see her again. The police could find no trace of her and we called everyone we could think of – to no avail.
One day I returned home after work to find her sitting in the kitchen wearing grubby clothes amd eating like a starving person. She was unable to tell me where she had been or how she had survived. It was obvious that she was ill but because she did not pose a danger to herself or to others, there was no way that we could have her hospitalized. I lost track of time but I do know that months later, she finally met the legal standard for commitment.
Following an argument with my sister and me about money, she started shouting at us, whipped out a box of matches, and threw one in the direction of the living room curtains, while shouting about the ‘people who were against her and trying to ruin her life.’ My sister and I were shaken. We did our best to put out the fire and had to call the fire-fighters. We realized that there was no way we could leave her alone at home any longer so called 911 and reported the incident. Two officers arrived and spoke to her for some time. They took her for evaluation and the treating psychiatrist realized that she was mentally ill and sufficiently dangerous to meet the legal criteria for involuntary hospitalization and treatment.
Being hospitalized was a step in the right direction and it didn’t take long for her psychiatrist to diagnose her as suffering from paranoid schizophrenia. Medication was prescribed but she refused to take pills. She made a fuss and managed to negotiate the amount of medication to a negligible amount and either feigned or really imagined that she was suffering dire side effects although medical tests did not substantiate her complaints. While in the hospital someone made sure that she took her pills twice a day.
As soon as she was more stable, she was not kept for long in the hospital and when a medical board sat to decide whether to release her or let her remain in the hospital, she didn’t appear to pose a threat to herself or others, so … to our surprise and shock, she was released and my sister and I had to take her home. A nurse gave her a prescription for Risperidal, an antipsychotic medication. Because my sister refused to speak to us, we had no idea what happened to the prescription because we saw no signs of it nor of any medication in the house.
In desperation, my sister and I joined a support group for relatives of people suffering from mental illness who told us that the only thing to do was to move out of the apartment and leave her alone. They said that she would soon run out of money and when she reached rock bottom, would probably join the ranks of the homeless, live on the streets and only then, she might meet the criteria for treatment.’
If the system is changed, families might not have to go through the agony of seeing a loved one suffer so much and less lives will be so completely disrupted.
Unfortunately, in the past, there have been cases of families who hospitalized relatives simply to ‘get them out of the way,’ and that is how the stringent laws re involuntary hospitalization came about. Patients must be protected too, but there has to be some way of getting help when it is needed.