Jesse: This is season two of Committable, a podcast about involuntary commitments. I'm Jesse Mangan. Producing this podcast involves a lot of reading, reading research, commitment laws, policy proposals, medical journals. Often this material can be challenging to engage with but a few months ago I came across an article that instantly drew me in.
It was titled At the Forefront of Medicine: My Summer Involuntary Hospitalization by Cassidy Wilson. I immediately reached out to Cassidy to ask for an interview.
Cassidy: Sorry, could I like, try that again?
Jesse: This is Cassidy Wilson.
Cassidy: Hi, my name is Cassidy and I'm a student, um, an undergraduate at the University of Chicago and I study neuroscience and Human Rights.
Jesse: Cassidy's article was about an experience that started with a phone call, a call that seemed to spiral out of control into an involuntary process that lasted several days. So I started by asking about the day of that call, what was going on that day? And what happened?
Cassidy: What had happened is, um, on a Friday, so I had like a research internship over the summer and so several like factors and like, uh, aspects of that had caused me to be having like, Flashbacks. I had a previous, um, experience, psychiatric trauma, um, having to do with a psychiatric ward. Um, and I was having flashbacks related to this experience.
So, on Saturday morning I woke up and I was still feeling really distressed. So I called student counseling services. It was a Saturday, um, so I had speak to like the counselor on call and I essentially said that I was feeling like really distraught. I described how I was having like flashbacks to a previous like traumatic experience.
And it was a long call, but at some point in the call, I heard this banging on the door. Um, and I was worried they were gonna like break down the door to my apartment. I didn't know like what was happening, so I went and answered it. Um, and it was, uh, the campus police, the UCPD. Um, and there were several officers.
And I like, so I just like woken up when I like called. I wasn't like fully dressed. Like I, I was wearing essentially like just this like shirt that I sleep in. Um, and I was very emotionally distressed to begin with, like I had been emotionally stressed that had prompted the call and I had remained like, distressed throughout the call.
If anything, I felt like the counselor was like escalating me with the questions that they were asking. So I like was, I didn't like feel any better. I'd been like crying throughout like the whole time, I was still crying. Um, and so these like UCPD officers came in. Um, and one like told me to like, sit down. I had this like folding chair that they had me like sit down and I was like talking to them. And I was distraught to begin with, and then obviously this is a very distressing experience to have like a bunch of police officers come into your home when you're not expecting it when you're not dressed, and when you're distraught to begin with.
Um, but I was sitting, I was talking to one of them. He was talking to me about just like, about the university about, he was telling me about like what he had studied. And then another officer came, um, and told me like stand up and turn around and they handcuffed me. And took me down to a police car.
The handcuffs were really tight, like I remember it really hurting my wrist and my hands. They said, they would like put me in the car with like the female officer but I felt like the gender of the driver of the car is like the point where the gender of the officer matters the least compared to like when I'm actually being like physically handled.
And they drove me to the ER, I remember being really scared that like, that someone would see me cuz we had to like drive past like my campus. So I remember thinking about that, but I got taken to the ER, they gave me like a hospital gown and I had to turn over the very little clothing that I did have.
Jesse: When you were handcuffed, was there any dialogue about why this is happening or what's about to happen?
Cassidy: Well, they didn't ask me to come with them before, like, handcuffing me. They like, they didn't ask me to do anything for me to cooperate or not cooperate with. I had done everything that they had told me to do.
I had sat down when they had told me to. That was literally like the only thing that they asked me to do. Um, so it wasn't like I wasn't cooperating cause there was nothing to be cooperating with. Um, and I think they said that they were gonna take me to get evaluated. Um, it's hard to remember, like when I was told what by who.
Jesse: Um, so, you're transported by police to the ER, where you're given a hospital gown. What happens then?
Cassidy: So I'm on this hospital bed for like a long time. Everyone that like comes in, I like ask them as much as possible, like what's going on. Um, they take like my phone, I didn't know what was happening. So I got visited by like a medical doctor, I got like blood drawn, I got like an EEG taken, this is all like very unpleasant for me.
So I have some like sensory processing issues. It was a very loud environment. Um, I feel very uncomfortable when I like can't have my own clothes. I'm also a sexual assault survivor and I don't like to be touched. Um, I don't like to be touched by people I don't know and given like, this had already happened a lot this day by the police. But also too by various like doctors, or people coming in to take like blood, or take EEGs, or any of that.
And I ended up being in the ER for about like 37 hours. Um, and it's mostly like, sitting there. I talked to like some medical students and I tried to tell them as much as possible. And I also tried to tell 'em that, like, I feel like I was doing all the right things.
Like I have a psychiatrist, I have like a counselor, I can create like a safety plan, which is like, what they talk about, like creating. Like, I have all of this stuff in place already. I told them all of this, but it didn't matter.
They eventually said that they had to hold me. And this was extremely distressing to me because, um, the thing that I had cited as traumatic during the call with the counselor was an experience on a psychiatric ward. And now I was being like sentenced that I was going to be held in a psychiatric ward again. So like the exact like environment that I had said was traumatic and that I didn't wanna be in.
So I told them like, this is like the worst possible thing that you can do for me. If I think about like, what is good for like my mental health. It's when I'm engaging with stuff that I feel like is meaningful and engaging with people and like my friends and being like with my support network. And the thing that is the worst for me is if you deprive me of everything in my life that is good. And put me in an environment that is actively bad, where I just have to be alone with nothing to do with my thoughts all day and marinate in whatever had put me in crisis in the first place like that doesn't make any sense. How would that help anyone?
But they said that they were going to do that so then at that point there's like, nothing I can do. They said that they were waiting for like a bed at a specific facility. Cuz it had the same like team, the same like team that was like talking to me in the ER would be on this ward apparently.
So this was like near the end of the day on Saturday where they, I think they said that they would like be holding me. And I ended up continuing to be held in the ER through all day on Sunday until about, I guess like 1:00 AM on what was now Monday. And I got transferred to a different room on a different floor in the UChicago hospital.
It was really surreal and ironic later on because after all this happened and I had like gotten discharged, I was still, um, a research intern in a lab and I had to walk through one of the same sections of the hospital that I had been brought through while I was detained. Which was upsetting. And also just like a very like, surreal feeling of thinking about being like I was here, that was me, except now I have clothes, now I can freely enter and exit this building. Now I'm allowed to have water. Oh, that's the thing I forgot. Um, when I was in the ER, I was sedated because I was, um, monopolizing the staff's time. I said monopolizing the staff's time because that's what one of the staff members said to me when I was asking questions and I was asking things like, can I have water? What's going on? Because I wasn't being given these things, like at large.
But someone was like, you can't keep like monopolizing the staff's time like this. So I was, um, I was given sedatives. They said, will you take sedatives orally? Or are we going to have to inject you? And I said I would take them orally.
So I was finally given water, in order to take the sedatives. Um, and then as a result of the sedatives, I was sedated. So I like slept for a long time.
Jesse: So at this point you did not want to go to the ER, but you're brought to the ER and you're asking questions about, can I use my phone? How long am I going to be here? Can I have water? And it seems like because of those questions the staff determined that you needed to be sedated?
Cassidy: I'm not entirely sure because I got sedated shortly after I got told that I was going to be held. And after I was told that I was going to be held, I was lying on the floor because the tile was cold, and I like found that soothing. And like the gurney was not comfortable. And I also, like, I really like lying on the floor just in general, in my life. I'm very comfortable on the floor. So I was lying on the floor and they were like, you can't be acting like this. So I got up, like they told me to and was like sitting there.
And I would try to like talk to anyone who would talk to me because it's very scary, like being there. And it's like, one way that like helps is if you have more information about what's going on. Um, so I would like ask anyone, like anything that they could like tell me. And then someone was like, you can't keep monopolizing the staff's time like this.
Um, so I think it was a combination of how they perceived me to be, and that I was also like asking too many questions. I don't understand the logic behind why they did it. And I also, because I do like read a lot on the system, I was very like frustrated by it. Cuz I'm like this isn't about care. This is about like, you guys protecting yourself from liability. I said a lot, like this is not care. It's not care.
Jesse: So you’re evaluated, you're told you're going to be held, you're sedated. Because you're sedated it's hard to figure out exactly the timeline, but at the end of things you're there for about 37 hours before they actually take you to a facility.
Cassidy: No, I wasn't taken to a facility then, I was taken to a different room within the UChicago hospital around 1:00 AM on what's now Monday. And I'm in that separate room, so no longer in the ER. So it was like a much better environment for me. Like, it was nice that I had a window, um, which was very nice, cuz I didn't have that in the ER, which is why, like, it was very hard to have a sense of time.
We determined 37 hours cause I was able to figure out like what time I was like moved and based off of like my mom’s phone records. So that's how we like figured out that it was like 37 hours in the ER. Um, then I was in this other room in the UChicago hospital until late in the afternoon, early evening on Monday.And then I was transferred by ambulance to another facility. That was the actual like psych ward.
I was also like, so like when I was in the ER, they were talking about like that they'll like move me upstairs, which I was really looking forward cuz I was hoping to be like less loud. And it was also like, um, In the ER, there was like a bathroom sort of, but I wasn't allowed to like close the door and there wasn't any like toilet paper or anything.
So then when I got moved to this other room in the UChicago hospital it was much nicer. It was like more private. I was allowed to shower then, which that was probably one of the lowest points is because, um, I wasn't allowed to like, hold the soap bottle myself. Like the nurse's aid had to like, hold it for me and like pump the soap.
And when I asked why, she said that, like, when you're here for what you're here for they can't take any risks. And I asked her, what am I here for? And it turned out she didn't actually know. It was just by the fact that I was there that she assumed that there was a reason for it. It was very like, it was very teleological. It was very rhetorical. Just by the fact that I was present there, that I must be a danger. Like she didn't actually know why it was just my presence there that gave her whatever information, whatever surety, to know that I couldn't, um, hold a soap bottle myself.
So I had to shower with her staring at me the whole time, um, and like intermittently reaching out for soap. And that was a really low point.
Jesse: So then sometime Monday, Monday evening, you arrive at the second facility.
Cassidy: Yes.
Jesse: What happens then?
Cassidy: Well, they like, take my vitals again. And they give me a different hospital gown and different socks. Um, and the water was out cuz I wanted to shower or brush my teeth but they were like the water's out, I think that was just like a coincidence. Like something with the plumbing, the water happened to be out that day.
Jesse: The water for the facility was out?
Cassidy: Yeah. They were like, if you wanna like brush your teeth you can use like bottled water. Cause they had like small bottles of water. But they were like, you can't shower and things like that because the water happened to be out.
Jesse: At this point are you shown to a room?
Cassidy: Yeah, so I had a room, it was a very classic psych facility room. Um, I had a roommate and then you have like a very sparse like bed. At this point you're allowed toilet paper, it's very exciting. Um, they had baby shampoo was the only like soap there were these like, bottles of baby shampoo. Um, there wasn't really any other soap. I had a toothbrush then.
I had a hard time sleeping. So I, um, in my day to day life I have to take medications to be able to sleep and I didn't have access to that. And I also, um, as I mentioned earlier, I have, um, some sensory processing issues and I also need like weighted blankets in order to sleep. So I also didn't have that. So I wasn't sleeping well. And also, um, they come into your room every 15 minutes, uh, to check on you. And sometimes they turn on the lights when they do this. So you're not sleeping well.
Jesse: Now that you're in this facility, has anyone given you an explanation of what your rights are? Of what's going to happen next?
Cassidy: No one had like spontaneously told me what the rights were, but on Tuesday morning I was talking to someone and they were saying that I needed to like sign in. Cause I was currently “under certain petition”, which I'm not entirely sure what that means, but I need to like sign in. Um, and I asked them if I had any rights, cuz I said, I like, didn't feel like I had any rights.
Um, and they're like, oh, you have rights. And they gave me this piece of paper and I read like the first one and maybe I was misreading it, but I was like, this paper makes it sound like I can request discharge right now. Can I do that? And they were like, oh, that paper's actually very misleading and they took it away.
So I didn't get to read the rest of my supposed rights. It's very, very gray what your rights are. Um, and I think that's in part intentional cause if you don't know what your rights are, the more they can get away with.
Jesse: So Tuesday morning, you're in the facility. Have they told you a timeline? Have they told you 48 hours or…
Cassidy: No, but they did say that after five business days, I can request discharge.
So business days is important, Saturdays and Sundays don't count for your time, but they do count in terms of billing. Um, but yeah, so I know that like after five business days I request, but then when they were signing, they were like, you probably like, won't be here that long. Like they haven't like said any like timeline. It's also like, what one person says doesn't actually necessarily mean anything because it seems like there's a lot of like telephone going on or not even like telephone, you're just interacting with so many different people and they don't seem to like, effectively like communicate with each other.
So even if someone had told me something, it's not necessarily gonna hold true for the next person that talks to me.
Jesse: I want to pause here for a moment because the name of this podcast is Committable, but everything you've just heard; the apprehension by police, the detention for evaluation, the psychiatric hold.
All of that is what happens before a civil commitment.
All of that is what happens before you get a court hearing. Before there is any legal check against whatever authority decided that you…you don't get to go home today. Or tomorrow. You don't get to go anywhere until we say.
So I asked Cassidy, now that she's in this psychiatric facility, what happens next?
Cassidy: So I sign in because they said that it looks better if I sign in and it shows that I'm being cooperative, and that I'm willing to work, and I have to be there anyway, so I might as well sign in. So you can tell it's very coercive and, um, there's like not much, there's like essentially nothing to do the day is somewhat like blended together.
But I know that there's like supposed to be two therapy groups a day. Sometimes not all of them happen but you're like supposed to go to them and they like, say like, it looks better if you go to them. So I like go to them, but they're not very helpful. Like one of them, we read a printout of a WebMD article on nervous breakdowns.
One of them they gave an explanation of neurotransmitters and like, they're like, there are these things in your brains called neurotransmitters. Their explanation, it was completely wrong. I'm a neuroscience major. Um, the way that they explained what neurotransmitters were and how they work was just completely inaccurate.
Not that like, as a patient that you need to know that, but it's just like, if they're gonna have a therapy group on it, you would want it to be accurate. And you would also want the people who were supposedly caring for you to actually know what these things are.
They had one on like healthy eating and exercise, um, but they were talking about like how bad processed foods are and how bad processed juices are. Which is like the main thing that they give you to drink on the psych ward. And they’re talking about how important it's to go like exercise, but we like writ large aren't allowed to go outside.
Um, and then maybe occasionally you would talk to a social worker or a psychiatrist. And every time I would talk to anyone I would just express like how much I wanted to get out and how this was like the worst like environment for me. But it would be really annoying because I feel like every time I would like talk to someone, they would just be like, so you made this call on Saturday. And it felt like it didn't matter at all any of the things that I had said in between, like, and I didn't know if it was because that hadn't been like charted or that hadn't been told to the next person, cuz it kept being different people. Even though they had said that the whole reason that they were like waiting for a bed to open up at this facility was that I could work with the same people. It didn't seem to be like a cohesive team or that things I said were actually like being like passed in between team members. Or things that they said, so…
Jesse: So what happens the rest of the week? Like, how long are you there and what is happening every day?
Cassidy: So what happens every day is not very much. It's really, really boring.
Um, cuz there's nothing to do. Um, there were three books in the ward. Um, one of them was Plato Republic. One of them was Anna Carina by Leo Tolstoy. Um, and one of them was, I forget what book, but it was booked by Ayn Rand. Those were the only books, uh, available.
Jesse: How long are you actually there in the facility?
Cassidy: I'm actually there in the facility until Thursday afternoon/evening. Um, it seems like the Illinois law has the like 72 hour hold. So I I'd say like around that long. And, but it's hard to tell, like what time, like counts. Like I, I know that not business days don't count, but it's like, it's very ambiguous. It's very unclear and they make it very hard to find out.
Jesse: When you are released, has something changed? Have they told you why you're being released?
Cassidy: No. No, actually nothing has changed. Like, I feel like it's not like I suddenly had a big difference in how I was feeling. It's not like they gave me some medication and it suddenly worked super well. It's not like there was a big change in the circumstances of my life.
The changes of the circumstances of my life had happened Saturday. So, there was really no difference in my state from when I entered to when I left. If anything I just felt much worse. Maybe like, I had like convinced them that it was bad for me to be there. Cuz literally every time they would like ask me, I would be like, This is the worst place for me to be. Or like sometimes they would ask me like, how are you feeling? And I'd be like,I feel like that's a really unfair question. Cause I haven't been sleeping, I can't do like adequate like hygiene practices. I don't have my clothes. I am so uncomfortable. I have endured all of these things. I feel like that's a really unfair question to ask me how I'm doing when I'm in like, my tailor made hellscape.
I would tell this to like anyone who would listen about just how it was the worst thing for me to like, be there. And I think also too, like they called it gathering collateral. Like I would talk to them and I like, cuz every time I would go, I'd be like, can I get discharged? Can I get discharged soon? When can I get discharged? And they're like, we feel like we're ready to discharge you but we have to gather collateral.
Um, and I guess what that meant was they needed to, again, like talk to people. So they talked to my mother, they also said they needed to talk to the Dean in the college. And they asked me to sign this like release of information. And I was like, what happens if I don't sign it? And they're like, well, uh, it doesn't matter because they already know that you're here because you came via student counseling. So it doesn't matter because they already know, so you should sign it. So I signed it, but it was very coercive. And also it seemed likewhat information was I consenting to be released if it had already been released? I think it was a release of information, I don't know, permission for them to talk to them.
Cuz they also said that when I got discharged I would have a follow up meeting with the Dean. And I got an email about that but then they never, then they said they would email me to schedule it, but then they never scheduled it. And I never had the meeting with Dean. Which seems a bit odd because they were very much emphasizing that that was something that I needed to do to get out, but then it never actually happened.
And I think my mother really emphasized just like about how important it was that I not be there. And I think like through emphasizing this, they like eventually discharged me. I don't know. I also feel like I was like…because like also every time I move, I'd be like, this isn't care. Like how can you think that this helps?
Like I remember, like I was talking to one student and I was like, how can you do this? Like, can't you see what this is doing to people?
Yeah. So I don't know what changed, cause at a functional level it was like nothing.
Jesse: So throughout this process, the situation was not voluntary but was there anything that helped? Is there anything that they're doing that is actually helping your situation?
Cassidy: For me personally? No, I guess like I called the head of my program and asked if I could change labs, but that wasn't something they did. No, I can't think of anything that they did that helped. They didn't like set me up with a counselor or anything.
I thought that's a big reason cause I, I like told them like who my, like psychiatrist was, but then later when I met with her after discharge she didn't even know that any of this had happened. So I'm not sure if they communicated any of that with her.
For me personally, they didn't do anything that was helpful. And I know sometimes like people do have like helpful detentions. Like sometimes, like it can allow you to get like medications that you need, or it can get you like set up with something or sometimes it can help. But for me personally, in this specific scenario, nothing that they did helped me.
Jesse: So you’re released, what happens then? Do you just go back to your life? Does anything about your situation change after you're released?
Cassidy: Uh, no. So I get released and go just back to my life and no nothing has changed. Except for that I feel worse, um, yeah, that my mental health is substantially worse.
Jesse: I relate to Cassidy's experience. A lot. Every time I was committed or detained in a facility it was in response to asking for help.
And to this day I live in constant fear of being pulled back into one of those systems again, because the trauma from those experiences, it didn't dissipate. It accumulated. So this season of committable is five episodes focusing on Cassidy's story. On better understanding the systems involved.
What were these systems designed to accomplish?
Who are they for?
What could be done differently?
And when you really need help, what choice do you have?
Coming up this season on Committable.
Hannah Zeavin: Studies and studies and studies have shown that both forced hospitalization and police intervention actually increase suicidality, not just for individuals, but in communities.
Jamie Livingston: And we're repeatedly seeing people with mental health issues being placed at risk and dying during these interactions. Particularly if people are poor, are homeless, are racialized, so black or indigenous. Those sort of things increase their risk of dying during these interactions.
Molly Linhorst: And I don't think a lot of people realize the immense power of the state to take away your Liberty in what is a civil process.
Tim Wand: There's a culture of blame around mental health, um, services that you're supposed to be able to identify with some accuracy that this person is gonna act in that way. Despite no evidence that we can do that.
Morgan Shields: Of all of the places in a hospital, you would hope that the psychiatric unit would be the most mindful of psychological safety, of trauma, of interpersonal relationships. And I have found that that is really not the case. For some people it could be helpful, but for a lot of people it's actually left them with PTSD. Psychological treatment should not give you PTSD.
This episode of Committable was produced by Michelle Stockman, Cassidy Wilson, Jim McQuaid and me, Jesse Mangan.
All music is from the song Reasonable by Christopher G. Brown.