Commitment.

Marriage means commitment. Of course, so does insanity. I'm up to my neck in both.

Over the last several days, my husband has increasingly talked of a desire to hurt himself. He has been caught somewhere between wanting to turn himself in to the police to deal with his warrant and to find some help to detox. Feeling like these two options were the only ones, he's vacillated between hopelessness and fear. Yesterday morning, when we woke up, he wanted to go to the emergency room. He'd called a few detox facilities, and they'd all suggested that going to the emergency room would be a good first start to being connected to resources to help him with his suicidal feelings and his detox.

We went to an emergency room, and he told the doctor that he was feeling suicidal and that he wanted help with his substance abuse problems. He told him that he was on methadone maintenance, but that he is out of money and has no way to secure methadone and continue weaning down. He said that he is horribly afraid of being dopesick, and that he's feeling like he'd rather kill himself than detox on his own again. He told him that he is violent toward me, aggressive, and angry when he's detoxing, and that he doesn't want to be a risk to me, to himself, or to anyone.

The doctor called a detox center, which said that his methadone dose was too high to help him. He explained that while he has been prescribed a high dose of methadone, that he's not been able to get it regularly because of his financial problems, and so he's been spreading out his doses over several days. They said that he should get back on his methadone program, and that was all the advice they had in spite of his protests that he is out of money. This doctor gave him a prescription to help him with nausea, and sent him home. No one addressed the fact that he was saying that he wanted to kill himself, and they didn't offer suggestions for anymore resources.

He was becoming increasingly agitated and talked more and more about wanting to cut his throat or slit his wrists. I recommended that we try our county's psychiatric emergency room, as it seemed like that might be a place where they'd listen to you when you were saying that you wanted to kill yourself. We went there next.

Again, he told the intake nurse that he was thinking about killing himself, and he wanted help with his suicidal feelings as well as some ideas about resources to help him detox from methadone. The doctors took him back in a room, had him dress in scrubs, and took away his pocketknife. They brought me out a bag full of his things, and I was very excited. I thought that they must be admitting him, and it seemed like they were trying to get him some help. They let me go back to visit him, behind a set of locked doors, and he said that they were going to send him to the county detox facility, where they'd promised he'd be able to see a nurse to get some help for the symptoms of his detox. I sat in with him while he explained his fears and his suicidal thoughts to a psychiatrist, and I expressed my own fears for his safety as well as my own. I told her about all his crazy behavior in the recent and the distant past, and how I was both afraid to leave him alone and to stay with him when he was detoxing. The psychiatrist said she understood, and she promised him that he wouldn't leave her care without getting the help he needed. She said that he seemed paranoid about the medical system, but that there was no reason to be afraid. She assured him that there was help for people like him. He thanked her, and she asked us to go wait in the main waiting room.

A nurse brought out a customer satisfaction survey, and my husband filled it out, writing a note at the end thanking them for helping him. We sat for a few minutes, and the nurse came out with his paperwork. She asked us to step into another room.

She handed him his discharge papers, and then she said, "I'm sorry, but we're not going to be able to help you. They can't take you at the county detox unless you get your methadone dose down to 30 milligrams. We recommend you go back to the methadone clinic and wean down according to their plan."

And that was it...no further suggestions for other resources. No attempts to help him with his suicidal threats. He began to cry, and he asked, "Is that it? There's nothing else? Nobody can help me? What if I kill myself? Can somebody help me with that?"

The nurse said that he'd have to leave. A security guard came and escorted us away from the premises. Another nurse, who'd not spoken with my husband at all. yelled at him from the parking lot that he was going to have to help himself if he wanted to get off drugs. He said that he was trying to help himself, and she continued to shout at him that he was going to have to get some help and that he couldn't do it on his own. When he tried to respond to her, the security guards became increasingly aggressive.

My husband was pretty worked up at this point, and he called the emergency room back to try to speak with the psychiatrist who had promised he wouldn't leave her facility without proper care. No one would let him speak with her, and when he threatened to kill himself again, the nurse on the phone said, "I'm going to have to end this call now," and hung up on him.

A friend of mine was on the phone with me listening to all this, and so she called the police. My husband insisted I drive him to a hardware store so that he could buy some razor blades to kill himself. We were intercepted by police officers, who took the razor blades from my husband and escorted him back to the emergency room. Even when escorted by police officers who had just removed razor blades from him, the psychiatrist refused to treat him. The same nurse who had never seen my husband and who had yelled at him in the parking lot before came outside and told the police officers that they needed to have him arrested, and they told her that they couldn't arrest him for trying to get some help.

The police officers recommended that we meet with their suicide crisis team, and my husband and I went home. The suicide crisis worker came to our house, and her goal was to smooth things over with the psychiatric emergency room. My husband was afraid to go back there, so the next suggestion was to have him involuntarily committed.

So that's what happened next. I went to the magistrate's office, and I had my husband committed. Oddly, the same magistrate who married us filled out the paperwork for the commitment. About an hour after I swore on a Bible that my husband was a danger to himself and to other people, the police came and got him and took him away to get help. They told him that they'd have to investigate the warrants for his probation violation, but that getting him medical and psychiatric care was the first priority. The police were the people most interested in getting him help. It was kind of strange...the medical and psychiatric folks kept saying, "No. No. No," while the police kept saying, "Yes! Yes! Yes!"

So now, he is in a hospital bed in the county psychiatric center, waiting for a bed at a detox facility that's not too far away. Word is, it will be next week before he gets there. In the mean time, they are treating his detox symptoms to the best of their ability. I spoke with him briefly, and he seems afraid and uncomfortable, but hopeful.

I also have spent a lot of time today telling his story to anybody who will listen to me. I know that he's a drug addict without money or health insurance, but he deserves to be heard, and he deserves respect and help when it's available. It is sad to me that he had to be carried away from his home in handcuffs in order to get the help that he'd been seeking all day long. A few hospital administrators are investigating what happened yesterday, and they've assured me that my husband will get proper care in the mean time and that they'll let me know what comes of their investigation.

So that's my story. It's complicated and hard to write. It's not a story that reads prettily, but it's what happened. I'm tired now, and I'm going to nap.