I was voluntarily hospitalized under Section 201 (Pennsylvania) for severe depression. While at the hospital, I refused medication. I had taken SSRIs and other antidepressants in the past, and they provided no noticeable benefits. The psychiatrist was persistent, even though I explained that I was stable and not in need of drug therapy. Shortly thereafter, the hospital filed a petition under Section 304c to have me involuntarily committed. I was never notified that this action was taken and found out on the day of the court hearing. I also never received a copy of the petition, which I thought was mandatory. On the paperwork itself, there is a spot for a hospital representative to sign, where he or she certifies that the patient's rights were explained. Whoever signed this document is clearly lying, because to this day, I still have not seen a copy of the 304 (and never had anyone talk to me about my rights).

After the petition was granted, I was injected involuntarily with antipsychotic medication. I do not have bipolar disorder or schizophrenia and was not unruly in any way. The staff came into my room, held me down, and injected me with a syringe. Even my own Psychiatrist could not understand why they would be giving me a neuroleptic drug. My understanding is that there is supposed to be an independent examination by a second doctor before an injection can be given. This never occurred, and I was not even informed by the doctor that I would be getting an antipsychotic. The following day, I had an EPS/dystonic reaction to the medication and had to be given two shots of Benadryl to relieve the muscle contractions.

Did they (the hospital/doctor) violate the Pennsylvania Mental Health Procedures? Do I have any recourse, since no "physical" injury occurred? Could I file a complaint with the PA Department of Welfare? I feel like they disregarded patient rights, and I'd like to make sure that they don't do this in the future.

Sorry, something does not add up, if you have your own Psychiatrist, he just orders treatment stopped, If you have your own doctor, he can start or stop treatment.

To say he did not know why and act like he did not do anything, obviously he must have known way and was just not wanting to confront you about it for some reason.

Where your rights abused? Perhaps, proving it will be an issue, since according to medical records you were not competent at the time, so they would have had to notify not you but the person responsible for your care.

So who was responsible for your medical choices at this time, that is not you?

Fr_Chuck, a person's outside shrink is not the inside shrink unless he or she works in that hospital. The outside shrink doesn't get to tell the inside ones what to do.

This violation of rights is extremely common, and they get away with it by using a stupid loophole. They can override your rights if they feel you are a danger to yourself or others, and refusing medication is considered a given. Refusing medication is almost universally responded to with injections of antipsychotics (or an offer of a liquid form while several staff stand around watching you swallow it). It has become a drug crazy industry. It makes the Patient Bill of Rights a total sham. They get away with saying you had your rights explained to you by saying you got a packet of information when you entered, and they can claim they explained it then. They can get a signature of a second doctor, and they consider an 'exam' reading your chart, not talking with you.

I know two people who had the same thing happen as you, and both are accomplished people with depression. Both persisted in refusing, and both were almost shipped off to a long term facility where they would have rotted away, but a civil rights group got each one out.

Can you sue? Of course, but I predict that you will get nowhere.

Fr_Chuck, you clearly have no idea how the mental health system works. Consider yourself lucky. It's not that simple, and if you think having your own doctor (ie. Private psychiatrist), makes it easy to simply start, stop, or change treatment, think again. In my own experience, my private psychiatrist had very little to do with my actual treatment. He didn't even call me until about 2-3 days into my hospital stay. When I did speak with him, he had told me that he called my doctor and had left a voicemail. He was waiting for a return phone call. Basically, when you're inpatient, your own doctor does nothing. I imagine they sometimes provide input to the hospital physician, but that's probably very minimal. My private psych is busy on the outside with his other patients. I can remember the day that they were threatening to inject me with medication. I called my own doctor, and these were his exact words: "Don't worry about it. They're not going to inject you...Wellbutrin isn't even injectable. Only antipsychotics can be given by syringe." He was right about Wellbutrin not being injectable, so instead, I was "lucky" to get an antipsychotic instead. I remember when I was discharged, and I went to see my doctor the next day. He was in awe that I had been given an antipsychotic, and it was clear that he was never consulted.

I think you may have misunderstood what I wrote, because this line doesn't make any sense: "To say he did not know why and act like he did not do anything, obviously he must have known way and was just not wanting to confront you about it for some reason." When I said "my own Psychiatrist" I meant my own doctor outside of the hospital. I have a feeling that you think I meant the hospital inpatient doctor. I'm assuming that's where the confusion lies.

I hope this clarifies.

Fr_Chuck, a person's outside shrink is not the inside shrink unless he or she works in that hospital. The outside shrink doesn't get to tell the inside ones what to do.


I take as much offense calling a psychiatrist a "shrink" as I do calling someone a retard. That is totally uncalled for In my opinion.

I take as much offense calling a psychiatrist a "shrink" as I do calling someone a retard. That is totally uncalled for IMHO.

I must remember to add the word "shrink" to the politically incorrect "do not use" word-list.

*roll eyes*

I must remember to add the word "shrink" to the politically incorrect "do not use" word-list.

*roll eyes*

Yes, please do. It is very degrading for those that have ever had to have treatment. I assume you haven't, or have had family members with mental and/or emotional disabilities, and that's why you rolled your eyes.

Yes, please do. It is very degrading for those that have ever had to have treatment. I assume you haven't, or have had family members with mental and/or emotional disabilities, and that's why you rolled your eyes.

No, not exactly.

It describes a psychologist or psychiatrist, not the patient. Equivalent to calling a police officer a "cop". It's a metaphor for a primitive savage who processes a human head into a "shrunken head". I fail to understand how it can be viewed as degrading to a patient.

No, not exactly.

It describes a psychologist or psychiatrist, not the patient. Equivalent to calling a police officer a "cop". It's a metaphor for a primitive savage who processes a human head into a "shrunken head". I fail to understand how it can be viewed as degrading to a patient.

I know what it is referred to, but thanks for the lesson anyway.

No, not exactly.

It describes a psychologist or psychiatrist, not the patient. Equivalent to calling a police officer a "cop". It's a metaphor for a primitive savage who processes a human head into a "shrunken head". I fail to understand how it can be viewed as degrading to a patient.

I can tell you that my father, who underwent EST involuntarily over 20 years ago would be rolling in his grave to find that people who tried to help him would be referred to as "shrinks." So, my father's head was shrunk?

Okay, I digress. We need to help the OP rather than argue over terminology.

As far as the Patient Bill of Rights is concerned, it is different in the psychiatric setting than it is the medical setting.

To better help the OP, we need to know what the actual diagnosis was according to the psychiatric DSM IV. "Severe Depression" is not a clinical diagnosis.

There is more to this story that we are just not getting at this point.

I can tell you that my father, who underwent EST involuntarily over 20 years ago would be rolling in his grave to find that people who tried to help him would be referred to as "shrinks." ...

So your father, with you being his proxy, would be offended by the professional being described with that term? You made my point: it's not derogatory with respect to the patient.

In the same way, calling a police officer a "cop" doesn't have the tendency to diminish the self-image of suspects or victims.


... So, my father's head was shrunk?

Metaphorically speaking, yes. His brain (or mind, actually) was treated.

Okay, I digress. We need to help the OP rather than argue over terminology.


Back to the topic at hand rather than having this thread closed.

J_9... I know this sounds hard to believe, but there is honestly not more to the story. The doctor was very annoyed that I would not take Wellbutrin. I had already tried it before, and I did not like it. I also had a negative experience when I tried SSRIs (Lexapro/Zoloft), so I wasn't interested in medication. They actually didn't even offer me an SSRI... just Wellbutrin.

When I found out that they filed the petition (on the day of court), they said that they were taking me there because of medication noncompliance. In Pennsylvania, that requires you to file a 304c, which converted me from voluntary to involuntary treatment. It was a bizarre experience, because I actually thought that I would have an opportunity to speak in my own defense. I don't think the mediator/judge allowed me to talk for more than 15 seconds. I really couldn't provide any input or refute any of the claims made by the doctor. The doctor at court had never previously met with me and knew nothing at all about my history. I had never even seen him before, and I don't even know if he was affiliated with the hospital where I was staying.

After they were granted the 304c, the nurse told me that if I refused the Wellbutrin, they would inject me (they never said with an antipsychotic). I was upset, so I called my own doctor, and he reassured me. He basically said the following: "Wellbutrin isn't a bad drug...we've talked about it before. I don't think it would be horrible to take it. It's not injectable, so don't worry about that. Only the antipsychotics can be injected."

Later that night, I saw the nurse, and she said "we're going to inject you if you don't take your Wellbutrin." They came in my room at about 8:00 PM and injected me with an antipsychotic. It was the worst experience I ever had. I was completely comatose the next day and couldn't even get out of bed. I think I finally woke up for an hour or two at 6:00 PM, and then went right to bed again after dinner. That following morning, I had a bad reaction (dystonia and EPS) and was given two shots of Benadryl. I was released that same day and saw my doctor the following afternoon. He was very surprised that they gave me an antispychotic. I think that he thought I was joking at first, but he realized that I wasn't kidding. It was really scary to me, and it was a horrible experience. I am very thankful that I have good parents. When my mom found out what happened, she was able to get me out of there. She called the social worker and the doctor, and she let them know that her and my dad were not happy.

These were my diagnoses according to my discharge paperwork (I know you asked about them):

Axis I - Mood disorder, NOS
Rule out Autistic spectrum disorder
Axis II - Deferred
Axis III - Underweight
Axis IV - Family conflict
Axis V - GAF: 40

I know this isn't some huge malpractice case, where I'm going to receive a monetary settlement. That's not my motive at all. I just want the doctor/hospital to be disciplined if there are patient's rights violations. They treated me horribly. These are the main issues:

1. I was never served with the 304c, which is required. Someone had to sign the petition certifying that they informed me of the action being taken and explained to me my rights. No one did that. I also never received a "Notice of a Hearing on Petition for Involuntary Treatment and Explanation of Rights."

2. I do not understand how they had the authority to forcibly medicate me. In Pennsylvania, these are the rules:

Informed consent must be sought and the reasons for the medication discussed with the patient. NOT DONE

If the patient refuses treatment, a second psychiatrist must complete an independent examination of the patient and his/her medical records. NOT DONE

I hope this clarifies my original post. I appreciate any input.

cai24, I'm a little hurt that you sailed right over my response.


(And I use shrink as a former patient and have had the doctors call themselves shrinks, and I don't see how one person can speak for everyone in this regard.)

joypulv - I am so sorry. It was not intentional, and I apologize if I insulted you in any way. The experiences you described mimic my own.

Refusing medication is almost universally responded to with injections of antipsychotics (or an offer of a liquid form while several staff stand around watching you swallow it). It seemed like the forced medication was excessive. I heard so many patients get threatened with a needle for various reasons (some probably legitimate and others completely questionable).

It makes the Patient Bill of Rights a total sham. They get away with saying you had your rights explained to you by saying you got a packet of information when you entered, and they can claim they explained it then. I couldn't agree with you more. It's outrageous, and I cannot believe that this type of behavior is tolerated.

They can get a signature of a second doctor, and they consider an 'exam' reading your chart, not talking with you. I did not know that this was the case. The Pennsylvania guidelines specifically state that an independent examination is necessary, although nothing surprises me.

I'm not looking to sue, but I would like to file a complaint with the PA Department of Welfare. Not that I expect them to actually review my grievances. I know that, in reality, the doctors and hospitals can do whatever they want, and no one is going to stop them. If you're in one of these institutions, you are automatically deemed incompetent regardless of your mental status. I think people need to realize that being suicidal, depressed, etc. does not necessarily make someone completely devoid of cognitive function.

Thanks so much for your post. It was much appreciated.

You write well, and pursuing this might be good for your depression, as long as you can take being ignored throughout most of it.
It's all a double edged sword, because hospitals are far calmer now than they were 60 years ago, with patients screaming and flinging feces and getting violent. So drugs are the first treatment out of the gate, and drugs rule. It boggles the mind that the procedure is the same for everyone, even if supposedly thoughtful caring people listen to you. The bureaucracy is bigger than any one person.
And are there nice places to go for depression, that are more like a house with lamps and chairs and books and kitchens, and staff willing to meet your needs? Yes, a few private places, and they are very expensive.

I would definitely contact the DOH, not the DPW as the DOH is in charge of inpatient psychiatric facilities. I would also contact your insurance company and file a grievance. It is definitely the standard of care that a second MD review the case and document findings before medications are forced. The DOH always investigates claims - I know this as a behavioral health professional and patient advocate.

Good luck to you