Shrinks and Lawyers III

It was a hectic day at Green Acres. The day began with a three-hour court hearing, to determine if we could extend an involuntary commitment for one of my patients. The patient insisted on appearing pro se, and the judge allowed it, which was novel. In the courtroom, the patient sat where his attorney would usually sit; he allowed his rejected court-appointed attorney to sit in the back row, but would not permit her to speak. After my testimony, and that of two psychologists, the judge asked the patient if he wished to testify himself.

“Yes”, he said.
Judge: “Go ahead.”
Patient: “Ask me some questions.”
Judge: “That’s really not my role. Would you like your attorney to ask you some questions?”
Patient: “What’s the point of her asking me questions?”
Attorney: “It might be good if you could tell the court how—“
Patient (to Judge): “I didn’t say she could ask questions. I said YOU could ask questions.”
Judge (to Attorney): “Why don’t you write down two questions, pass them to me, and I’ll ask your client the questions.”
Patient (to Judge): “Are you going to make up your own questions, or just read hers?”
Judge: “I’m going to read them to you.”
Patient: “Well then they aren’t your questions, so I’m not allowing it.”

It went on like that. Later, a psychologist who had already testified needed to leave for another hearing—but because the patient was also the “defense attorney”, the judge made the psychologist ask the patient for permission to leave the proceedings—which the patient denied.

In the end, the judge found that the patient had a mental illness and presented a danger to himself and others—but also found that we did not have right to keep him in the hospital. This made little sense to me, and was the worst trouncing I’ve ever had in court when there wasn’t even a lawyer on the other side. Plus, although I was mandated to discharge him, I still felt strongly that the patient represented an immediate threat to a person in the community. So, for the first time in my shrinking career, I felt obligated to follow the duties laid out under Tarasoff—contacting the threatened individual and warning him of the danger, and contacting the sheriff’s department to notify them of my concerns. The patient walked out the front doors of Green Acres into the icy slushscape. I’ve been sitting up tonight worrying if everyone’s okay.

The Smallish State is a very strange place to practice shrinking. The laws are highly protective of individual rights, but seem endlessly designed to thwart success in treatment.