Hospital treatment is for people who are so severely disturbed that
they’re handicapped by their disorder. People who have been hospitalized
are not expected to live normal lives. They’re often told that they need heavy
medication and readmission if symptoms recur. This is usually not true of
the disorders in this book, but it can become true if it’s what people believe.
People should not consider psychiatric hospitalization unless their lives
are at stake, or unless such treatment is recommended by a therapist whose
practice is primarily outpatient. In some cases the most therapeutic aspect of
a hospital stay is convincing people that they aren’t crazy enough to be there.
In most communities there is little integration between inpatient and
outpatient treatment. The most common criticism of hospitals is that they
discharge people as soon as the people cease being actively dangerous,
with no provision for follow-up care.
Commitment
Even in this day and age, I’ve heard families talk about having a doctor
sign a person into the hospital for treatment. In most places this has not
been possible since the early 1970s, when involuntary treatment laws were
revamped to protect patients’ rights. Today, to be involuntarily hospitalized,
a person must present a serious likelihood of harm to self or others.
A convincing suicide threat may constitute a danger to self, but usu-
ally it requires an attempt or a serious plan. Investigation for involuntary
treatment is often a good way to get people to realize that they really don’t
want to die.
Your primary care physician will probably not know how to get
someone committed. Calling the police nonemergency number, a psy-
chiatric unit, the mental health center, or the emergency room of the
largest hospital in town are better bets. One of them is typically in charge
of local involuntary treatment.
Substance Abuse Treatment Programs
Because of cost, most substance abuse treatment is outpatient, involving
daily groups, appointments with counselors, and Alcoholics Anonymous
meetings. Urban areas will have several different kinds of programs listed in
the yellow pages under Alcohol treatment. If you call, they’ll give you infor-
mation and set up an initial screening appointment at no cost or obligation.
It is very important to check a program out carefully before signing on.
Where to Get Help ❧ 275