<p>I have a friend who is experiencing what I will call a “mental breakdown,” for lack of an official term. This person is exhibiting paranoia, left home, and has been hiding and living outdoors for a week, although apparently sometimes sleeping in people’s garages during the day. The person appears to have left home with only a credit card and car keys, although the car was abandoned 30 miles away weeks ago. (This has been a cascading catastrophe, replete with bizarre behaviors, culminating in the disappearance.) It is unknown whether the credit card is still in the person’s possession, or whether the person has used it to obtain food and drink. It seems clear that it has not been used to obtain lodging. The spouse has been in close contact with the local police, and filed a missing persons report. The person friend was found by someone who knows them several days ago, and consented to go to their house, where the friend stayed overnight and ate a meal. When the police showed up the next day, because of the missing person report, the friend tried to run away, failed, then promised to go to the doctor the next day etc and the police LEFT. The friend then ran away, and hasn’t been sighted since (except for the evidence of possibly sleeping in garages). The family is completely distraught, and has tried to make arrangements to get the person into crisis care IF the person will consent, and IF the person can be found. We have gone to the area where the person was last seen, and have driven and walked around looking for the person, to no avail. It seems as if the police do not consider the fact that a person is living this way as sufficient evidence of self-harm to take the person into custody and deliver them to a hospital, willy-nilly. We are all frantic. What can we do?</p>
<p>I can provide more details in a PM if necessary. I am trying to get help without violating the person’s privacy.</p>
<p>Mental health law varies from state to state, but most states do have a process by which you can obtain what amounts to a “warrant” to have the police bring the person in for psychiatric evaluation. In Maryland, it is called an Emergency Petition and there is a process for a family member obtaining one via the law enforcement system, but a doctor can also complete an EP and call the police as well.</p>
<p>To find out the process in your area, you might consider one of the following sources:</p>
<ul>
<li>the local community mental health center–try the yellow pages</li>
<li>the social worker or psychiatrist on call at a local hospital ER</li>
<li>the local chapter of the National Alliance for the Mentally Ill</li>
</ul>
<p>Good luck. What you have described would clearly qualify as suitable for an EP in my book.</p>
<p>(I no longer practice but did complete residency training in psychiatry.)</p>
<p>Agree that laws vary by state. In some states the family can sign an emergency form if the personis acutely mentally ill and a danger to themselves. Police or sheriff (depends on state) can pick them up and transport to the emergency receiving facility for evaluation. But you need to know where the person is.</p>
<p>Thanks. I just talked to the local NAMI person and got excellent advice, which I’ve passed on to the spouse.</p>
<p>We know where the person was two days ago–on foot, no public transportation. Who knows where s/he could be now, thanks to the numbnuts police. (It would be better if they hadn’t showed up at all.) The spouse is attempting to get some kind of court order. The person’s doctor’s office is willing to cooperate, but has no idea how to do it. Once they have it, then it is a question of getting the police to actively LOOK. These are quiet suburban towns. It’s not as if they are overwhelmed with street people and crime.</p>
<p>Whether the person is considered a danger to themselves is the question. Apparently some think that anything short of an outright declaration of an intent to commit suicide doesn’t qualify. I think that hiding outdoors in yards and possibly public parks for a week, roaming without shoes or a coat, and possibly not eating (they must be drinking SOMETHING, even if it is pond water), would qualify. It sure as hell will qualify when it starts to get really cold at night, if my friend survives that long. :(</p>
<p>In addition to being a danger to self or others, a person can be placed on a 72 hour hold if it is deemed that he/she is gravely disabled – i.e. unable to care for him/herself. Additionally, some states have PET teams – psychiatric emergency teams – that are dispatched to make these types of evaluations in the field and those teams can make a recommendation. It’s worth noting that there is a legal process whereby a person can be held for additional time if it is deemed they are still a danger to self or gravely disabled after the initial 72 hours.</p>
<p>No cell phone, alas. The spouse is working on getting what in Maine is called a “blue paper,” which is the authority necessary to hold a person involuntarily for psychiatric evaluation, I think for 72 hours. Apparently the physician is willing to do it, but his office doesn’t know how… Then another level of authorization can be gotten to hospitalize the person for a longer period, perhaps a couple of weeks. </p>
<p>If only we could FIND the person. I’ve gone over and driven around and around the area where s/he was last seen three times in the last day, tromped through a large park that is right there twice, looking in the underbrush and along the river banks, to no avail. Today it’s been raining half the time. Even though it is warm, this can’t be good. Has s/he eaten anything? Is s/he dehydrated and hallucinating? This is just agonizing.</p>
<p>The homeless shelters are in Portland, which is about 15 miles from where the person was last seen. No public transportation. When picked up and taken to this town, s/he was barefoot. They gave the person shoes, but who knows if s/he still has them. S/he seems to have left the house with a credit card, so could have checked into a motel, but evidently has not. Who knows if s/he still has the card…of maybe s/he buried it under a bush in the yard with the household tools (aka “weapons”). :(</p>
<p>Thank you, everyone, for your kind thoughts. If this is driving ME crazy, how much worse for the college-age D of my friend, and the spouse. The poor kid is really suffering.</p>
<p>Have you considered looking by the back entrances of the restaurants he/she used to enjoy eating at? They will get hungry sooner or later. Check houses of worship too</p>
<p>How sad. Bless you for helping. Continue to use NAMI as a resource; their people are knowledgeable and caring. Have their photo circulated to the police in a 10 to 20 mile radius - there is no saying how far a person fueled on adrenalin can travel. </p>
<p>In this heat, wandering around all day without eating or drinking can dehydrate a person. Failure to eat or drink can be used as a basis for a 72 hour hold.</p>
<p>Nothing yet. I’m going to check in with the spouse soon. If nothing else, I can volunteer to circulate a photo. I know the spouse had copies made…we were talking about how it felt, bizarrely, like posting photos of a lost pet on telephone poles!</p>
<p>I have to go to another state tomorrow to help my mother with some stuff, and will be away for a week. It would be REALLY nice to know my friend was in the hospital by then.</p>
<p>Thanks, everyone, for your kind words and thoughts.</p>
<p>Consolation…I was hoping since we have not heard from you that maybe it meant that your friend was found. This is so sad, and it must be agonizing for all of you…I hope that today will hold better news. </p>
<p>Are there people looking at the back of supermarkets where the dumpsters are and in the wooded areas around them? I can’t imagine someone in this state of mind being in an obvious place. I would imagine the hiding places to be somewhere familiar to that person yet very hidden…like under someones deck, in a shed, in old houses where their are basement steps on the outside of the house leading to the basement, under bushes or gazebos in parks. I hope you have better luck today. It is an awful feeling searching for a person who is not in control of their own emotions.</p>
<p>Latest news: the police in friend’s town now refuse to accept another missing persons report from spouse because police in neighboring town spoke to my friend on Monday! (Which caused the latest disappearance. Note that this person has now been missing for 5 days since this conversation with police!! This is a far cry from Without A Trace…it reminds me more of the desperate parents of one of John Wayne Gacy’s victims who could not persuade the police that their missing son was not just another runaway.) They refuse to act without the full blue paper, but the full blue paper cannot be obtained unless the person is actually “in custody,” so to speak. It’s Catch-22. I’m ready to go over to the PD and give them a piece of my mind. Spouse is emailing me photos and I will start taking them to area businesses to see if friend has been seen. Friend’s family has decided to try to organize a door-to-door search tomorrow morning, but plans are not formed yet. I will delay my departure to participate. This whole thing is, pun intended, maddening!</p>
<p>Momma-three, those are good places to look. Unfortunately, my friend is currently in somewhat unfamiliar territory. At least, as far as we know. But I’m going to try some stores and other places today.</p>
The friend then ran away, and hasn’t been sighted since (except for the evidence of possibly sleeping in garages). The family is completely distraught, and has tried to make arrangements to get the person into crisis care IF the person will consent, and IF the person can be found. We have gone to the area where the person was last seen, and have driven and walked around looking for the person, to no avail. It seems as if the police do not consider the fact that a person is living this way as sufficient evidence of self-harm to take the person into custody and deliver them to a hospital, willy-nilly. We are all frantic. What can we do?</p>