July 7, 2025

The History and Process of Psychiatric Detainment

Show Notes

This episode hit harder than I expected. Margaret and I talk about what it feels like to care for patients who remind us a little too much of ourselves, especially when we’re also the ones filling out the paperwork for a psychiatric hold. We dig into what a 5150 (or 5585) really means, how to sit with that kind of authority, and the emotional mess of seeing a patient’s fear reflect your own. This one’s about boundaries, over-identification, supervision, and the heartbreak of sometimes needing to say, “I care about you and I can’t be your doctor anymore.”

Takeaways:

Signing a psych hold form never feels casual—especially when the patient could’ve been me.
Overidentifying isn’t compassion—it’s a signal that I might need supervision, fast.
Letting go of a patient isn’t always a failure. Sometimes it’s a kindness.
Psychiatric holds carry legal weight, but emotional weight, too. We talk about what it’s like to sit with both.
Empathy is powerful—until it gets in the way. Learning where to stop is part of learning how to stay.