Oy, if you're very sick and very dangerous, Texas is not the place to be. Oh, it never was and maybe it never will be.
In Maryland, if someone is in the hospital and wants to leave, the vast majority of the time, they get leave. If the staff thinks they should stay, they get to sign a leaving AMA form --against medical advice. In rare instances, if a voluntary patient wants to leave, but they are felt to be imminently dangerous, then they can be certified, and held on the floor until there is hearing. At the hospital where I did my residency, hearings were held on Wednesday when an administrative law judge came in for that purpose, so how long a patient was stuck there without 'due process' depended on what day of the week this went down. In Texas, you can be committed against your will, but apparently as I've learned from yesterday's New York Times, if you've signed in, you can't be held and committed, no matter how sick, psychotic, and dangerous you are. Really? I'm back to my original thought: oy!
From Advocates Seek Mental Health Changes, Including the Power to Detain:
Mr. Thomas, who confessed to the murders of his wife, their son and her daughter by another man, was convicted in 2005 and sentenced to death at age 21. While awaiting trial in 2004, he gouged out one of his eyes, and in 2008 on death row, he removed the other and ate it.
At least twice in the three weeks before the crime, Mr. Thomas had sought mental health treatment, babbling illogically and threatening to commit suicide. On two occasions, staff members at the medical facilities were so worried that his psychosis made him a threat to himself or others that they sought emergency detention warrants for him.
Despite talk of suicide and bizarre biblical delusions, he was not detained for treatment. Mr. Thomas later told the police that he was convinced that Ms. Boren was the wicked Jezebel from the Bible, that his own son was the Antichrist and that Leyha was involved in an evil conspiracy with them.
He was on a mission from God, he said, to free their hearts of demons.
What a travesty. And here in Maryland, yesterday a court sent a 15 year old boy, tried as an adult, to prison for life, commuted down to 35 years, for a school shooting / attempted murder. The boy took his step-father's gun, which fortunately, was not a rapid fire weapon, but a shotgun (I think), and before he could get too many rounds fired, a heroic teacher tackled him and the single wounded victim survived. The boy left a suicide note, but his plan to die that day was foiled. He's reportedly been improving with treatment in a county detention center, and he pleaded guilty to the charges, no insanity defense sought, no trial necessary, just a hearing for sentencing. I won't comment on whether I think it serves society to send a child to prison with adults for 35 years.
To those who oppose involuntary hospitalization under any conditions at all, I have to ask, what do you think should be done if you become so psychotic that you believe it's necessary to kill your own children and eat your own eyeballs? In Texas, it's clear: you're free to do so and the state will just kill you.