Mental health 302 advice? Experiences?

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Mental health 302 advice? Experiences?

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My mom has not been well and refused multiple treatment opportunities as well as constantly calls police etc. She suffers from schizophrenia and also has osteoarthritis in knees. Needs assistance for most ADLs etc. Last night she was taken as a 302 to crisis center. She is still there as they haven’t found a bed for her yet. I am looking for anyone who knows how this may play out? I am worried that they will discharge her early/before giving time for medication to really work and then what?
Has anyone had to do a 302 before? Did they come home right after or possibly transferred to an inpatient facility for a little longer? Did it actually help?

Not really sure where to post this question, sorry if it’s in the wrong spot.

Family Caregiver Mental Health Refusing Care

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My son has schizophrenia and we have had an involuntary commitment twice. They can hold them for 72 hours without consent and can begin medications. They have a social worker that is working for the patient but most recognize that the hospitalization is in their best interest and help to make that happen. Most doctors will try for a voluntary commitment so they can stay longer. Insurance is the biggest problem there as most do not want to pay for more than a short stay just for getting them in and out. My son had to go back 6 times. Haldol is generally the first thing given and it does work to subdue things pretty quickly but stabilizing for longer term takes a while. My son was in and out of hospitals for nearly a year before we found a medication that worked. He is doing great now, living on his own, working and has not had a relapse in a very long time. Schizophrenia can be managed.

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I think a 302 is an involuntary psychiatric evaluation. In some places it's called "Baker Act".

Where would they release mom to?

If they think they are simply sending her back home, please bleat "unsafe discharge" as loud and as often as you can and ask for help getting her into a facility.

If they try to guilt you into taking her to YOUR home, state firmly that it's not possible as you need to work. Do not listen to their promises that they will secure you inhome care. They won't.

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I've also heard it called pink-slipping.

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If this is an involuntary admission, there will be a process. There should be a Social Worker to explain it.

There will need to be a legal representative who can make decisions for your Mother while she is deemed unable to at this time. (Maybe you have POA already?) This may be very short in my experience.

If she is of an age to be admitted/funded into aged care (assisted probably) you may wish to push for this rather than return home? Does she live with you? Are you providing the daily ADL help? Now is the time to speak up if this is no longer working.

It may even be that this crises is the beginning & it takes a few admission-home-admission cycles to get on the path you need - the right meds, more in-home care or in a facility.

Be kind to yourself - always remember you didn't cause this condition & while meds can certainly help, it is lifelong. You can though be a great advocate to help find her the care she needs.

I am sorry you have to deal with this very hard situation.

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Hi Indigo108, I’m so sorry to hear about your Mom. I had a similar experience where I initially took my Mom to a crisis center (2013), and they evaluated her as a potential 302, but she was well enough to push back and I took her back home. She eventually called them back and was transported to a Psychiatric hospital where they had a bed available and she was there for a month until she was well enough to return home. Fast forward a little over a year (2015), and she had to return, but this time I had to do a 302, with the assistance of her geriatric psychiatric doctor. They determined her to be too sick and transferred her via ambulance right from their office. She was at the psychiatric hospital for 5 months, and when she was releasable, she went straight to a nursing/rehab center for a few weeks. She didn’t like it too much and kept telling them she was ready to leave and the nursing home staff was supportive. Also, much to my disdain the nursing staff kept telling me they didn’t know why she was there in the first place. (Sighhhhh) The day she was discharged, I was a wreck because I have to admit, the break from caregiving was a blessing. Anyway, very emotional times for me and for you, I’m sure. During her stay, they had to make sure medicines, coupled with therapy would work and they did not want to release her only to have her return, but she did and ended up a lot worse during the second stint. She was assigned a social coordinator, geriatric psychiatrist, case worker, etc. to help us navigate through all the processes.

On another note, I am also partially a caregiver for my autistic niece. She was recently 302‘d by the school due to aggressive violent outbursts, but they didn’t keep her due to no beds and she was pleasant enough during intake where they suggested she’d benefit with outpatient therapy. So depending on how sick your Mom is, I hope they’ll at least suggest hospitalization until a bed becomes available and a psychiatric doctor can help make that determination, especially if the condition is ruled life threatening. I believe during the holidays and winter the demands exceeds the availability, but hopefully, you can get her admitted to a hospital(or an extension of psychiatric facilities) or crisis center (which also has rooms) for immediate help. Feel free to ask any questions as I’ve been down this dark road a few times too many. Good luck and God Bless.

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So sorry you have had to navigate this difficult and painful journey. The complexity of what you're dealing with is incredible. I have a question. What exactly are crisis centers? I live in Virginia. I'm aware of psychiatric units in hospitals of course. State psychiatric hospitals as I understand it provide treatment for patients with severe mental illness who have been convicted of a crime (?) Also what is a TDA and a 302? I'm familiar with the Baker Act following suicide attempts but that is all.

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When you are taken as a 302 or TDO order they have to see a judge.I don't know what state you live in but in VA they call it a TDO order.They see a judge within 72 hrs n u can be there when that judge comes to the hospital.If the judge gives some time to stay there,it helps the doctor to help her.The patient cannot get out on against medical advice.The doctor decides when she can get release.However if the judge dismiss the 302 she goes home.Its important for you to be there when the judge comes so he won't dismiss so she can get the help she needs.Usually they have a code for the patient to protect her identity but if have medical power of attorney they can tell you when she sees the judge.That's how it works in Virginia so I don't know what state you live in.However if you are the one that took that order out on her,u have the right to be a witness against her.I hope this is helpful.

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I feel for you with this. We’ve gone through it with my MIL (60 years in Milwaukee,WI) and my brother (30 in FL) and SIL (29 in Chicago). It will depend on insurance and the facility as well as your mom’s behavior.

If she’s demanding release after a certain point and staff has not seen that she is a danger to herself and others (basically saying she’s going to commit suicide or harm someone) then they’ll release her. This is a tough situation as you need to start removing yourself for your sanity but also make sure she has care. I’d call Aging and Disability and see what options there are. If none, wait it’s out a few days and call for a wellness check and they’ll readmit her if needed.

If they’ve medicated her to the point that she’s not fighting the stay or is being cooperative, they’ll keep her until they deem her stable or until her insurance benefits run out (for us it’s the 3 week mark). At this point if she can’t make her own decisions you can deny discharge. We’ve had to do this many times until the proper care was given and my MIL was truly stable or moved to an appropriate facility to give her the right type of care. The hospital discharge unit will likely give you a hard time (get ready for guilt trips) but just keep saying she’s a safety risk, can’t manage her daily needs, could fall or start the house on fire....whatever you need to do to keep her there. If they absolutely demand she has to leave the facility try to get them to work with social services to find her an appropriate living situation (we were able to get my MIL into a nice small group home setting paid for mainly by Title 19 and she gets to keep 1/3rd of her SSDI check) or a crisis respite (they’ll keep her for a week near us). If she is not at her baseline and willing to be in a facility for some more time. You could also drive her around the block and readmit her to the hospital or a different one.

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This situation must be extremely stressful for you and I'm so sorry you're having to go through this. Hopefully your mom will receive the medication, treatment and placement she needs to stabilize her situation. Hang in there, but remember to take time to nurture and soothe yourself as much as you possibly can. Hugs.

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A 302 is an involuntary mental health commitment. A person is committed to an inpatient facility for a minimum of 5 days at which time a hearing takes place in front of a mental health judge. At that point, the mental health judge may rule to continue the commitment now known as a 303 or decide that the person is no longer a threat to themselves or others. If the 303 is granted, it cannot exceed 20 days. During that time, the person receives evaluation as well as treatment. There are recommendations for treatment given upon discharge. Once she is placed, I would suggest working with the facility social worker.

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This is very accurate and I recall that my Mom was deemed too sick for an appearance with the mental health judge hearing. However, I recall the head doctor of the psychiatric hospital calling me to explain my Mom's condition and that if I were okay they would continue to keep her and had to speak with the judge about the state of her condition. I also recall vaguely having to go into a small hearing to provide like a witness statement in an interview setting, as well as, a staff meeting with a team of doctors to do a recorded statement with representatives to explain what I saw and what they evaluated her condition to be which was major depressive disorder and psychosis. It's all a blur now because I was in an emotional state with adrenaline rushing and not sure if I was coming or going...I was a mess, but stayed strong for my Mom. In the end, treatment has helped her but I wish elder care support and decisions were a lot easier for the families.

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There is a mental health spot in the category selection but it doesn’t matter where you posted it. It’s fine.

I have no idea what a 302 is. There are people who will know so stick around.

I’m so sorry that you are dealing with this situation.

Best wishes to you and your family.

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It's a TDO order.Temporary Detained Order.Its not only for mental health ppl,but it's also for ppl that have a serious alcohol and drug problems.Im a patient advocate and I know what I'm talking about.Relatives are not the only ppl that can take this order out.If a person becomes a danger to themselves or other's, Substance Abuse n Mental Health counselors, Patient Advocates, hospital doctors or nurses can also get that order on someone that has made a threat to harm themselves or other's.The magistrate is the person that you tell what's going on with a person that is harmful to themselves or other's or both.Thats who you get that order from.U do not have the right to harm or threatened to harm themselves or others.Different states have different laws.The law in Virginia,that can give you as much time as he sees fit.Its up to the doctor when you can go home or wherever.Say the judge gives the person 15 days,if the doctor feels that the person is not ready to be released at 15 days,an ECO (Emergency Custody Order)is rendered also by the magistrate n u can't go AMA(Against Medical Advice).U go back in front of that judge again n the judge rules by what the doctor recommends.Anyway I pray that your loved one gets the proper care.If you feel that your loved ones is not getting the help u think is not that's when u contact a Patient Advocate.All hospitals have them.We hear ur concerns n we investigate the situation by looking at the patients records and notes from the doctor and nurses and also we make contact with the patient n the person that has contacted us.We will ask the relative to come to the facility and we try our best to make sure that patient is getting the proper help.If we find that the patient is not getting the proper treatment,we will move the patient to a better facility.I go above and beyond to help the people get the proper help.Their are some places I wouldn't send my animal there.So please help keep up with ur loved ones treatment plan n such.

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Thank you for the information, the problem is my brother in law keeps letting her come home. (Just one more chance) but it always happens
again. She refuses her meds, says she's gonna kill herself etc... Throws things. Screams that the neighbors hear .He has papers drawn up for the attorney that he's her poa. But still will not commit her when they want to release her. They had a placement for her this last time but told them no he's gonna give her another chance. Meantime every episode she has is not good for my mother in law with dementia. My husband which is his older brother and i have tried to talk to him and tell him this kind of behavior is not good for mom or him seeing he is schizophrenic. But he's on meds and keep under controll . the whole. Situation is just crazy just loss on what can be done

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