Cops!

[nursesunny, ASN, BSN, MSN, LPN, RN]

Ok, I am exhausted by this whole thing. The officers in my area bring everyone and I mean EVERYONE to the hospital.

Attempted murder of your father???...must be psych....

Walked into the sheriff's station holding a knife threatening to cut your own throat if they don't release your spouse???? jail you say...NO, psych....

I get it that these guys and gals (officers) are getting slammed in the media these days but wow, my unit is full of inmate material and the inpatient 19 year old suicidal depressed girl is a victim in the waiting....

THEN upon discharge a homeless patient throws papers and pen in a nurses face causing small scratch, cops were called, uuummmm did they even show up to take a report??? NO....

Thanks for listening to me vent. (like you had a choice lol)

[Jules A, MSN]

We also get many who after committing a crime report to the officers that they are suicidal. In my experience it isn't so much inappropriate referrals because I don't mind them seeking a psych eval prior to dragging someone to jail. The caveat is how your ED and hospital system handles this and the expectations of the officers.

One hospital where I work requires officers stay with the individual. They are assessed and in many of the cases you described above the recommendation is quickly made that they are "cleared from a mental health standpoint" to be taken to jail often with the recommendation they remain on suicide watch until assessed by the jail psychiatrist.

In another hospital where I work the police essentially drop off all of the above and high tail it out of there without actually having placed the person under arrest. This in my opinion is completely unacceptable as in those cases our options are admit or street. I don't know about you but I'm a bit squeamish about cutting someone loose who just attacked their wife etc.

[nursesunny, ASN, BSN, MSN, LPN, RN]

In another hospital where I work the police essentially drop off all of the above and high tail it out of there without actually having placed the person under arrest. This in my opinion is completely unacceptable as in those cases our options are admit or street. I don't know about you but I'm a bit squeamish about cutting someone loose who just attacked their wife etc.

Exactly!!! They pretty much dump them at the ED and don't stay at all. I don't think it is our place to "jail" them in a hospital but since they just chased dad with a knife how do we cut them loose? It isn't safe for staff or other patients but if we let them go what about the community. It just feels like we are used to prevent the officers from walking a political tightrope....oh, and doing tons of paperwork....

[nursejessica722]

OMG I just came across this post and I don't know where you live but it speaks to me and my current frustrations!!!!! I feel like local law enforcement and the courts think that just because a patient has ANY kind of psych diagnosis, its a reason to throw out court cases or plead them down to probation, particularly with assauts again hospital staff. I'm not talking about the psychotic patient who assaulted a hospital staff member because of their delusions or hallucinations, I'm meaning the addict with a substance induced mood disorder who got pissed because they didn't get their benzos or opiates prescribed. Glad I'm not the only one frustrated by this!

[SpankedInPittsburgh, DNP, RN]

Yeah, I used to met the cops at the door and ask the patient if he had a condition he wanted to be seen for in the ER. After that I'd ask the cops if they were going to initiate 302 proceedings against the individual in custody. If the answer to both those questions was no (almost always) I'll tell them "see ya" essentially. This greatly cut down on the amount of that BS.

[nursesunny, ASN, BSN, MSN, LPN, RN]

This is in reference to Los Angeles but I think it is likely all over...

[angeloublue22, BSN, RN]

Wow, it's completely different where I worked. I actually worked at a jail that was also connected to the holding area for new arrest. It was like running an urgent care, ER, chronic care clinic, and mental health clinic all rolled into one by yourself with no back up. We would only send patients to the ER for severe medical issues since we had mental health members on staff. The suicidal pts would be moved to a safe room and all belongings and clothes removed, and given thick gowns just like at a psych facility. Looks like they need to get with the times and get some mental health measures in place so they can stop dropping them off at the ER. Even though that place frustrated me, now that I just hear from you, I realize they were actually trying.

In the town I'm living now, I work with mental health/addiction patients. We have to call the police at times. We had some bad run-ins with how they dealt with our pts and staff. They actually stood there and did nothing while our case manager got chase into building and almost choked. I called their sergeant and reported it. He made a big deal out of it because we are supposed to be working closely together. Now, our local police get their intervention training through us. It's fun, we get to roll play. It has made a world of difference. It does help to reach out.

[nursesunny, ASN, BSN, MSN, LPN, RN]

I was involved in a "cross training" with the local police headed by a Psychiatrist and sponsored through UC San Diego...it doesn't seem to have helped. I do like the idea of the jail with all the medical connections. I work full time in prison and per diem in the local hospital. We have wonderful services in prison, it just seems getting them here is the hurdle :)