Navigating Health and Aging: Mental illness is not a lifestyle

The following quote is rather alarming: "Mental illness is not a lifestyle; it is a disease that can lead to homelessness, violence and death. But it can often be treated especially when the law isn't in the way." It's from "Toward Rational Commitment Laws: Committed to Help" by Rael Jean Isaac and D.J. Jaffe.

As my regular followers know, I am a nurse and passionate advocate for my patients' rights. I will be their voice when no one else appears to listen, and advocate until I beat my head against the proverbial wall. Although, sometimes, even that is not enough.

If you happened to watch "60 Minutes" this past Sunday and witnessed the frustration of Creigh Deeds, a parent who is also a Virginia State Senator, then you saw first-hand how the legal system can get in the way.

Deeds had a son who was diagnosed as bipolar after turning 21. It is not unusual for mental illness to be more apparent during young adulthood, which is shocking to any family and catches family members completely off-guard. His son's behavior was so concerning that he obtained a court order to have him taken to the hospital for treatment. The law only allowed his son to be held for six hours until a psychiatric bed could be found for him. When it became obvious that a bed was unavailable, he was released. The following day, he attacked his father with a knife and then shot himself to death.

The system failed Deeds and his son. I watch the system fail the mentally ill time and time again.

You can think that this situation and scenario does not personally affect you, but it does. It will continue to affect all of us until something changes. I read a review of the "60 Minutes" piece and my jaw dropped. I cried when I read one comment that implied, "The law and mental health system did not fail your son, you did." It is nearly impossible to persuade small-minded people who have little understanding of mental illness. Sometimes you are even unable to convince brilliant, intelligent people who practice law-making, not medicine.

I am a nurse and do not pretend to practice law. I do not give legal advice. I do not judge people on legal merits. I practice nursing. I listen to people. I understand that someone who has a mental illness is not the same as the next one who has a mental illness. There are no cookie cutters in medicine. When the law intersects and looks at the mold, rather than the person, the problems begin.

Did you know that until the late 1960s, your husband could express that you were crazy and consequently, you could be hauled off to someplace like Springfield hospital so that he and his younger tart could live happily ever after?

Fortunately, the pendulum has swung, yet unfortunately, to the opposite end.

Now you can be mentally ill and be a danger to yourself and others - yet, if you are not considered to be in imminent danger, the law is not going to keep you safe.

Who is it who defines imminent danger? Is it a judge? Is it the deputy who shows up when you call for help who thinks they know whether someone needs to get taken to hospital? Or is it the emergency department doctor who may have had a lousy, long day?

Did you know that many mentally ill people can have what is referred to as "anosognosia"? This is an inability to understand that they have a mental illness, or clinically defined as a "deficit of self-awareness, a condition in which a person who suffers certain disability seems unaware of the existence of his or her disability."

You can show up in an ER with your loved one suffering from mental illness and ask that the medical system care for them and if they say, "No thanks, I don't want to be admitted," then an involuntary admission can only give you 72 hours to treat them before they get to petition for their release. They get legal representation and the chance to say, "I want to go home." Who decides if they stay or go? Not the doctor, and certainly not the family. It's the legal system.

Do not misunderstand: I advocate for patients' rights. People should have their civil liberties. However, when you do not have the ability to know when to exercise those rights to keep yourself and those around you safe, then it is vital that someone keep you safe until you can be treated. Of course, that is only possible if someone has decided that you are dangerous enough to be involuntarily committed. The language is vague and once again, who has the authority to decide what is dangerous enough or imminent enough?

Senate Bill 0067 will be up for vote Feb. 5. It clarifies the Maryland Psychiatric Evaluation and Inpatient Commitment Law. SB67 seeks to clarify the meaning of the current "dangerousness standard for emergency psychiatric evaluation" and for "involuntary hospital admission by defining dangerousness." The resulting definition would clarify that danger includes those with the inability to meet their survival needs, as is included in 46 other states.

Come on Maryland. We are dangerously behind.

In order for all of us to have a voice, the politicians need to hear from us about this important issue. This is our only hope and opportunity for getting closer to a solution and to have our voices finally heard.

Please contact your local representative to vote for this legislation. Go to to find your state senator.

This affects all of us.

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