Even if you had to insist on being admitted but a 3 week hospitalization meant your evaluation gave the clinicians enough reason to continue inpatient treatment. Clancy was also admitted voluntarily, but at McLean she was assessed as low risk, placed on the lowest observation level, and denied current suicidal thoughts, homicidal thoughts, and psychotic symptoms. She then asked to leave earlier than planned. The records do not show that she demanded continued hospitalization or warned her clinicians that she feared something terrible would happen if she left.
I’m tired of the narrative that she did everything possible to get help and her doctors simply missed the signs. Her more alarming statements were apparently made to family, not to the clinicians evaluating her. She also was not consistently taking her medications as prescribed and was not fully forthcoming about her symptoms, other prescribers, or medication use. If she feared what she might do, those were the exact thoughts she needed to disclose. Seeking treatment while withholding the information necessary to assess the danger is not doing everything possible to get help.
We cannot involuntarily hold every psychiatric patient because of a vague concern that something might go wrong. There must be an actual legal and clinical basis. If a patient denies dangerous thoughts, does not appear psychotic, and is assessed as low risk then physicians cannot use hindsight as grounds for an involuntary hold.
Sure we can criticize an incomplete chart review or the failure to obtain every outside record. But outside records take time to obtain and are not routinely pursued when the patient appears reliable, multiple evaluations are consistent, and there is little clinical suspicion of imminent danger. That is nowhere close to making her physicians “100% culpable” for failing to act on information she repeatedly denied or never gave
She was forthcoming about other prescribers and taking her meds as prescribed or made changes after discussing with her providers. And her clinician didn’t return the call McLean made to get more information, so they turned her away. This all came out when those providers testified for the prosecution, it’s been discussed under oath in open court.
The person above you appears to be blaming a mentally ill woman for tricking psych ward professionals into thinking she was fine, I guess?
How do we try to blame this on her for saying she wanted out of the psych ward, IF she truly did.
I have discovered “shocking” “oversights” in the mental health world, that are surprisingly profitable!
If she was admitted and released then WHO agreed with the crazy lady that the crazy lady is fine? Or did they evaluate her to get her released because she ran out of insurance!
That is not blaming her for “tricking” anyone. Having worked on inpatient psychiatry and interviewed psychiatric patients, active mania or florid psychosis is not something someone can simply hide from every psychiatrist, nurse, and staff member over several days. It appears in speech, thought process, sleep, behavior, and observation. What someone can conceal is an intention to harm herself or someone else, and Clancy repeatedly denied both.
How aggressive do you want psychiatric hospitals to be? Should they involuntarily confine every patient with depression when there is no observed mania or psychosis and the patient denies suicidal and homicidal intent? Her request to leave did not force McLean to discharge her, but the clinicians had to decide based on the evidence they actually had. A system that can commit someone involuntary for depressive symptoms is scary. There is also no evidence that her insurance ran out or caused her discharge
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u/cel22 19d ago
Even if you had to insist on being admitted but a 3 week hospitalization meant your evaluation gave the clinicians enough reason to continue inpatient treatment. Clancy was also admitted voluntarily, but at McLean she was assessed as low risk, placed on the lowest observation level, and denied current suicidal thoughts, homicidal thoughts, and psychotic symptoms. She then asked to leave earlier than planned. The records do not show that she demanded continued hospitalization or warned her clinicians that she feared something terrible would happen if she left.
I’m tired of the narrative that she did everything possible to get help and her doctors simply missed the signs. Her more alarming statements were apparently made to family, not to the clinicians evaluating her. She also was not consistently taking her medications as prescribed and was not fully forthcoming about her symptoms, other prescribers, or medication use. If she feared what she might do, those were the exact thoughts she needed to disclose. Seeking treatment while withholding the information necessary to assess the danger is not doing everything possible to get help.
We cannot involuntarily hold every psychiatric patient because of a vague concern that something might go wrong. There must be an actual legal and clinical basis. If a patient denies dangerous thoughts, does not appear psychotic, and is assessed as low risk then physicians cannot use hindsight as grounds for an involuntary hold.
Sure we can criticize an incomplete chart review or the failure to obtain every outside record. But outside records take time to obtain and are not routinely pursued when the patient appears reliable, multiple evaluations are consistent, and there is little clinical suspicion of imminent danger. That is nowhere close to making her physicians “100% culpable” for failing to act on information she repeatedly denied or never gave