Very disturbing...one of our frequent psych patients (d/c'd) was picked up by the police. For what, I don't know. But I've never known the guy to assaultive. Agitated at times, yes. Assaultive, no.
Police apparently had him and he got agitated. He was Taser'd a few times and died when he got to our hospital.
This is the fourth time *this year* that police in our area have ended up killing a psych patient. Mostly from Tasering, once from being 'restrained' according to the news.
I just think police need some training on dealing with mentally ill people. This is a crying shame. Mentally ill and agitated is not the same as criminal!
Mental Illness does not equal insane, nor that they are all necessarily incapacitated by their disease.
My sister is mental ill. She was fine, completely lucid, able to raise her child and work while on her meds. But like many people (w/chronic medical/psch issues), she does like taking those meds and they are "inconvenient. They make her (list of excuses) gain weight, have water retention, are incompatible with alcohol use, feel tired, require avoiding excess sun exposure, staying well hydrated, etc.
She continually went off the meds or did not obey the simple instructions that kept the disease in control, because being off the meds, gives her a "high" and makes her feel good, is easier with less rules to follow (her words, not mine). This was her choice. And she is classed as disabled because of it.
I have ulcerative colitis, w/severe inflammatory changes in my joints. If I go off my meds, eat improperly, drink excess alcohol, do not maintain proper hydration, am in excessive heat, do not get more than adequate rest...I will have a flare up of either or both problems. It is extremely inconvenient at times, and not nearly as much "fun" to obey these rules, but if I want to remain a productive member of society, I must obey them. The pills make me gain weight, I have to drink enough fluid to keep me going to bathroom a lot (highly inconvenient), I have to avoid most alcohol, and I have to rest alot and avoid heat (as a native Floridian, I cannot live there anymore). And obeying the "rules" have kept me out of the hospital, and taking fewer sick days than my "healthy' coworkers.
While there are patients with chronic disorders (medical or psych) that cannot maintain good control, there are many more that can maintain some reasonable control by taking proper care of themselves, but choose not to. They need to take some responsibility for doing so.
PS. The word is mentally ill, not "crazy". The vast majority of mentally ill are not even close to "insane" or "crazy". You do a disservice to them to refer to them as such.
No offense intended. I used the term "crazy" not to disparage the mentally ill, but in the hope of emphasizing that some of these illnesses, unlike heart disease or colitis, may directly impair the ability to form rational judgements.
Sat with a patient in our ED one night, wasn't sure whether he'd missed a dose of his antipsychotics or had taken them twice, but he new he needed help. After 5-6 hours with essentially no treatment, he wanted to leave, so I was assigned to keep him there. It was a legit assignment--his intention was to walk home ten miles in shirt sleeves on a bitter cold night, but when our hospital security assisted me in returning him after he bolted once, they treated him more like a criminal than a patient. Unfortunate, to say the least. In retrospect, I wish I had reported them to hospital administration, not so much for punishment, but in the hope of clarifying that we have a duty to our patients. I was there to protect that man. I'm not sure what security thought their job was.
I do have a lot of sympathy for those afflicted with mental illness. In neuro, we see a lot of mental status changes, usually organic in origin, but sometimes with psych co-morbidity. Dementia associated with a stroke may be temporary, but for others it's a life sentence. I don't mean to excuse non-compliance, and to a point I'll agree that one has a responsibility to one's own health, be it mental or physical, but I would hope you would agree that it's far from black and white. And while it is entirely possible that everyone involved in the incidents under discussion acted as well as they possibly could, a series of four such deaths should certainly raise concern.
"Police killed our patient," sounds a bit inflammatory to me, given the posts that told more details, but I can no more rule out police misconduct than assume it. As others have noted, I wasn't there, so I may never really know.
The failure of society--OUR failure--to adequately care for the mentally ill among us should be sobering. These deaths should be considered OUR responsibility as citizens, if not healthcare professionals. The fact that police officers, like nurses, are in a Catch-22 of society's making, should make us want to discuss the problem and try to get a handle on a workable solution.
:yeahthat: Angie, while I cannot agree with all of your post, I certainly agree with the conclusion. A very thoughful observation.
I guess what bothers me the most about the posters that object to public scrutiny of police actions is their protestation that it isn't fair to rush to judgment without the facts. No, of course it isn't fair. Why then is it unreasonable to expect the actions of these officers to be subject to investigation? How else are we meant to get the facts?
I don't think anyone is against a impartial investigation. I have a problem with people jumping to the conclusion w/o know all the facts. I will be the first to error on the side of the officer because I know that there are very few bad apples. I know that after any time an officer has to use a weapon (weather it is a pepper spray, taser gun, or a pistol) in my area there is an investigation to make sure that the officer had right to use that weapon.
I think that anytime a weapon is used both the officer and situation need to be reviewed. There is a lot to learn from each situation.
I don't think anyone is against a impartial investigation. I have a problem with people jumping to the conclusion w/o know all the facts. I will be the first to error on the side of the officer because I know that there are very few bad apples. I know that after any time an officer has to use a weapon (weather it is a pepper spray, taser gun, or a pistol) in my area there is an investigation to make sure that the officer had right to use that weapon.
I think that anytime a weapon is used both the officer and situation need to be reviewed. There is a lot to learn from each situation.
I don't think you can definitively "know" how many bad apples there are. I assume that many officers go above and beyond their call to duty, I assume that most are at least competent and have integrity, yet the few times that I have come into contact with them, they have been completely unhelpful, rude and intimidating. :uhoh21: Still, though my personal and admitedly scant experience hasn't really upheld the "to serve and protect" label, I know that there are many out there who are true heros and so I will always want to believe that these officers out number the bad.
However, the profession of law enforcement should not be bashed by implying (or even stating) that cops use excessive force and/or are not trained to deal with psych patients. Oh yea, that one about IQ, well, I won't even go there.
Mama, I know you were kidding about the IQ part :wink2:
Flyer, I have to agree with your previous posts. I have been through many CE classes with regard to psych populations, special populations, diversity training, sensitivity training, community policing, etc in the department I worked for as a police officer. Also, any time there was a certain level of force used, the officer was placed on administrative leave until the officer(s) and the incident was thoroughly investigated. I'm sure that this incident will be investigated until all questions are answered. It was a very tragic and unfortunate event for all sides.
With that being said, there has been a lot of cop bashing on this thread which is disheartening, but then again, it's all a part of that job.
Here's the question: What liberties should we allow/guarantee for persons who have been diagnosed as lacking in the ability to correctly assess their environment? Should we lock them all away for life "for their own good"? That made sense 50yrs ago.
In the USA we seem to have decided that that risk is worth taking so that the majority of our psych pts can have a future in freedom.
There's not much choice between the two. Locked up in a mental hospital for life or full freedom with the distinct possibility of spending that time in jail for various reasons. Two ends of the spectrum without a fence to ride.
What would be considered 'in the middle'?
Oh, and please...no 'nice day's for me, thank you. That means something completely different to me than the literal meaning.
Speaking as a person who remembers huge state-operated campuses of 'mental hospitals' that were the sometimes life-long home of most of societies psych pts, I have to point out that 'freeing' psych pts into the general society was a political/ethical/financial decision.
Papaw John
The original intent of deinstituitionalization was that the psychiatric hospital dollars would follow the patients into the community for support services. Sadly, legislators often viewed the new pot of money created by closing psychiatric hospitals as a funding source for other pet projects and did not keep this commitment.
So what has evolved in several states is that the mental health system has been moved into the correctional system. For a patient to receive treatment they have to commit a crime. :angryfire
Actually, I'm not seeing your humor, and after providing a link it is pretty clear that your original post way entirely off base and inflammatory. There is nothing in that article that indicates unjusitified force was used. It's about mentally ill people who break the law.
The issue is not whether people with mental illness need to be held accountable for their behaviors. The issues that Meerkat addressed were:
1. Training police in thereapeutic intervention for the mentally ill.
and
2. What are appropriate responses for managing an agitated psychiatric patient?
After 20+ years of working with psychiatric patients in a forensic hospital I have learned this:
Our actions towards patients can make things better for those with mental illness or worse.
Confrontational speech can definitely increase agitation while calm cool communication can encourage patients to accept help.
Never attribute motives or assume anything.
Mental illness is an illness!
Taking time to listen works. (Agitated patients will often tell you what help they need if you take the time to ask!)
Many mentally ill people will self medicate with drugs (caffeine, nicotine, water, cannabis etc) in an attempt to manage the symptoms of their mental illness. (in other words the symptoms of MI often cause drug use/abuse which can exacerbate psychotic symptoms.)
I wasn't there on site for this case so I do not know if the patient was assaultive or not. From my reading of the original post it seemed like this patient was agitated but was not necessarily aggressive. Taking the time to call for backup may very well have prevented this tragedy. (I do think that it was tragic for the officer involved as well.) I think that the point stands that police officers need to to be trained and retrained both in how to interact with the mentally ill and how to recognize potential symptoms of MI.
I asked a few pages back for RNs to identify the specific tactics they use to safely deal with a mental patient and subdue the type of situation the police face. I'm still waiting. I'm beginning to think that everyone who is so sure the police are "killing" mental health patients (due to not knowing the "right" way to deal with these patients) should be on-call for those police officers and show up to the calls they are facing so they can show them exactly how it should be done. Of course you'll want to leave your Ativan behind as police are not allowed to use chemical restraints.
And re: the IQ comment about police officers. Perhaps the same should apply to registered nurses. Expressive superiority is the one thing I really can't stand about so many members of my profession.
I posted some of the approaches that I have found useful tonight....
Please get off the high horse. Reading the last sentence of the IQ comment it was obviously meant to be a joke. I was certain, though, that even if it *had* been meant to be serious, no doubt the issue of nurses and IQ tests would have come up in response.
This confirms for me that mental illness is the worst kind of illness a person can have. Incredibly sad. I highly doubt many cops see the glory in having to use such drastic measures to control a person. It's just a bad situation all the way around. There is no happy ending in a situation like this for anyone.
I also have to add that "drug use" has been implicated in a number of these Taser deaths, but no distinction is ever made between street drugs and prescribed drugs. Who knows but that the poor soul who was Tasered and died later of a heart attack was on some MAOI inhibitor or Prozac or Xanax, Ativan, Ambien?
The failure of society--OUR failure--to adequately care for the mentally ill among us should be sobering. These deaths should be considered OUR responsibility as citizens, if not healthcare professionals. The fact that police officers, like nurses, are in a Catch-22 of society's making, should make us want to discuss the problem and try to get a handle on a workable solution.
All great posts to this thread, and as usual, the conundrum has no easy answer.
It's all about balance in the end, whether you are the householder trying to keep your castle intact against a "crazy" trying to break down your door; to the "crazy" who is lucid one minute and out of control the next when he stops taking his meds; because he is an outpatient by way of state budget cuts; and doesn't feel in need of those meds that blunt down his manic high; or the police officer who is called in to deal with the social argument which is staring you in the face with a 7 inch butcher knife...
nursemike, ASN, RN
1 Article; 2,362 Posts
No offense intended. I used the term "crazy" not to disparage the mentally ill, but in the hope of emphasizing that some of these illnesses, unlike heart disease or colitis, may directly impair the ability to form rational judgements.
Sat with a patient in our ED one night, wasn't sure whether he'd missed a dose of his antipsychotics or had taken them twice, but he new he needed help. After 5-6 hours with essentially no treatment, he wanted to leave, so I was assigned to keep him there. It was a legit assignment--his intention was to walk home ten miles in shirt sleeves on a bitter cold night, but when our hospital security assisted me in returning him after he bolted once, they treated him more like a criminal than a patient. Unfortunate, to say the least. In retrospect, I wish I had reported them to hospital administration, not so much for punishment, but in the hope of clarifying that we have a duty to our patients. I was there to protect that man. I'm not sure what security thought their job was.
I do have a lot of sympathy for those afflicted with mental illness. In neuro, we see a lot of mental status changes, usually organic in origin, but sometimes with psych co-morbidity. Dementia associated with a stroke may be temporary, but for others it's a life sentence. I don't mean to excuse non-compliance, and to a point I'll agree that one has a responsibility to one's own health, be it mental or physical, but I would hope you would agree that it's far from black and white. And while it is entirely possible that everyone involved in the incidents under discussion acted as well as they possibly could, a series of four such deaths should certainly raise concern.
"Police killed our patient," sounds a bit inflammatory to me, given the posts that told more details, but I can no more rule out police misconduct than assume it. As others have noted, I wasn't there, so I may never really know.