Topic: substance-abuse

Question: Can I sign my brother into a mental health facility?
My brother has been diagnosed with paranoid schizophrenia and has not been taking his medication. He's been using methamphetamine and alcohol and was found sleeping naked in my step mom driveway in 12 degree weather.
   I was adopted in by his dad (who just passed) and his mother will not Get involved because she's afraid of financial responsibility.    Do I have the rights to be able to sign my brother into mentalhealth facility?

Answer (from Lauren Ostrowski, MA, LPC, NCC, BC-TMH, CCTP, CCHI tailor my therapeutic approach to each client's strengths and goals):
I'm sorry to hear that your brother has been having such a rough time. He's lucky to have you on his side (although he may not always see it that way).As far as whether you can sign him in, that depends on a lot of different things.I would suggest that you Google the state and county that you live in as well as some phrase similar to "crisis hotline." They can tell you how it works in that county. My guess is that you could sign him in as long as he met the criteria for admission at that moment, but I can't  be entirely sure. You could also ask the person on the phone about financial responsibility. I have not heard of that being a problem, but I guess it would depend on insurance.If you have trouble finding a local  hotline, consider calling the national crisis number (800-273-8255) and ask them to help you find someone local.

Answer (from Eric Ström, JD, MA, LMHCAttorney & Licensed Mental Health Counselor):
Thanks for asking this question. I know it can be really difficult to deal with issues like this.To answer your question, you might be able to get you brother some mental health help, even if he doesn't recognize that he needs it. In most states, an individual can request a mental health evaluation of a family member if that family member poses a danger to themselves or someone else, or if they are unable to take care of their own basic needs.You can always call 911 if you are concerned about his immediate safety (for example if you find him sleeping outside in below freezing weather.  As an alternative to calling 911, you might also be able to request an evaluation from an authorized mental health provider.  The deatsils of who you would contact vary from state to state. Here's a link with some additional resources:http://www.treatmentadvocacycenter.org/someone-i-know-is-in-crisisHe's lucky to have a brother who cares for his wellbeing as much as you do.

Answer (from Sherry Katz, LCSWCouples and Family Therapist, LCSW):
The answer depends on what State you live.Since the description you write here is that your brother may be a serious risk to himself and others, it is worth contacting a mental health hotline or one of your local area hospitals and talk to a social worker or other professional level person in their psychiatry department.  Ask the same question you posted here.   Your question is a good one and merits serious follow through.

Answer (from Karen Keys, LMHC, CASAC, NCCRecovery and Wellness Expertise):
Hello, My heart goes out to you, your brother, and your family, dealing with a very painful and difficult situation. In New York, you can't institutionalize someone else directly. You can, however, call the police or EMS. If they agree that he would benefit from hospitalization (and it sounds like they would), he can be held in the hospital for up to 72 hours, whether he agrees or not. Some hospitals will not hold a person that long, in spite of what we might want. I have seen many patients in and out of hospitals countless times, and it has been my experience that it can be extremely difficult to hold a person long enough to achieve good stability and an appropriate after-care plan. Hospitals in NYC tend to take a "patch and release" approach more often than I would like. It's been my experience that family makes a difference. Assertive, knowledgeable, persistent family can improve the quality of your loved one's care. Hospitals are highly pressured to discharge people quickly but they can not discharge a homeless person without someplace to go. If your family is willing to accept your brother, that will be the path of least resistance for the hospital. If the family refuses, they will be forced to find another path for him. You can also pressure the hospital to refer to rehab after psychiatrically stablized (which may only take a few days) and that may give your brother more time to begin making clear-headed decisions. If your brother has a psychiatrist, that person should be actively involved. I had a patient patched-and-released three times, in spite of my advocacy and him literally begging to remain and stop his voices. We finally got a 90 day hospitalization because I strong-armed his psychiatrist into demanding that the hospital stabilize his patient.  If your brother has a history of non--compliance with oral medications, you can push the hospital for injection, which again will help your brother stay stable for longer. Best wishes to you and your family.