National news indicated that actress Amanda Bynes, who has been in the news for quirky behavior, outfits and semi nude photos has recently been arrested for lighting or attempting to light a fire in someone’s driveway.
Many people have had questions about Amanda Bynes over the past year or so, including stories reportedly from her parents. Concerns have spread the gamut of her smoking dope and throwing a bong from a city apartment window, to wearing wigs, talking trash about other performers, internet distributed photos of her in various poses in undress and seemingly having some facial surgeries which have greatly altered her looks.
The police have been involved and she has been arrested for the bong incident and a DUI prior to this arrest. This is a little more along the lines of what most thought would have happened sooner.
Just what happens when a person is detained on a mental health hold? In most states there is a law that declares that if a person appears to be at risk to harm themselves or another, then law enforcement, a physician or other licensed professionals can fill out papers that will detain the person in question for 24-72 hours in a locked mental health assessment facility.
So there is a question of whether the person may be trying to directly or indirectly kill themselves or another by their actions.
Some of the question includes if the person has the means to harm another. If a person is found, say making a fire in a private driveway of a know or unknown other, and the person has publicly behaved erratically over time, that fire could be considered a direct gesture to harm another and would result in a 24-72 hour hold.
Especially in combination with the recent prior arrests.
Mental health holds are designed to do specific things. 1.) contain the person so they cannot harm self or others 2.) provide an environment for evaluation under the watch of trained staff. 3.) systematically assess the person to determine if they have a health problem, mental health problem or an addictions issue. 4.) determine if the person can function without supervision or supportive structure
If the person is deemed to be suicidal or homicidal, they may be placed in an even more restrictive environment or in a 1:1 with a staff member at the facility. If being followed by a single person who is trained in managing mental health and behavioral crises is not sufficient to aid the person in not injuring themselves, a person may require sedation, restriction to a specific space usually called a seclusion or quiet room, mechanical restraints ( hand and ankle leather straps to a bed in a contained room) or a combination of the above.
A physician must sign an order to keep a person in the hospital. A physician must sign an order to medicate, restrict or restrain a person beyond that. Shortened intervals of high observation must be kept in a log, and the orders must be revisited with review of the log in certain time frames, as the law states a person must be kept in the least restrictive environment at all times.
Persons entering any locked facility must undergo a strip search. At an acute admission where there is a question of self harm, the person typically is allowed few if any personal belongings and is restricted from things like shoelaces, belts, pencils… anything that might harm self or another. Facilities like this typically offer individual therapy, group therapy, education about mental health or addictions coping skills and family therapy.
If a person is to stay in a facility , a Judge typically comes to the property and a hearing is held regarding findings of the medical staff. The Judge decides if the person needs to remain on a court related evaluative hold, and that can go on for more days, sometimes as much as 30. If the person is declared to be incompetent, then another person may be designated as a guardian or primary decision maker for the person in and out of the hospital on a court order.
Extended holds usually refer the person to prescribed treatments over time as follow up care post discharge. So, think Lilo. Unclear if Lilo does or doesn’t get it, but she keeps attracting arrests and Judge’s orders that she reportedly complete some kind of residential treatment options that never comes to pass. And so it all starts again. Lilo does not have a disclosed guardian, but is given treatment as a consequence of some kind. Her diagnoses have also not been made public.
So, as with what happened with Britney Spears a few years ago, (which was never completely diagnostically disclosed to the public) after a similar set of spewing, family members are often indicated as caregivers or supervisors of the person. When Britney “got it” the wierdness stopped and these required supports were dissolved, and haven’t been reinstated.
Some of the question is what is the cause:
- what is going on with the person that they would do this?
- is will the person try to harm themselves or others again?
- does the person have a medical, mental health or addictions diagnosis that needs treatment?
- can the person function in the community without supervision?
- is the person willing to stay in the facility or another facility to work on getting more stable?
- or does the medical community guided by law have to take action to manage the person?
Due to cases like this, many people perceive mental health and addictions acute care as a punishment.
Diagnoses like bipolar disorders and post partum depressions often happen in young women in these age groups. These can be complicated by drug and alcohol use.
Sometimes erratic behaviors are caused purely by medical issues that are undiagnosed or untreated or poorly medically managed. (Halle Berry has diabetes.)
If you are a young person struggling, or the parent of one… web pages like the National Alliance for the Mentally Ill offer educational sheets that address emerging young people diagnoses. calling 211 in your community from a land line can line you up with local help.