Tuesday, January 21, 2020

Hospitals cited for calling police on mental health patients

Vermont is a surprising case study in how things can quickly go wrong when hospitals invite police inside, reported Vice. At least nine of Vermont’s 14 emergency rooms, including six of its eight hospitals serving rural populations, have been cited by national regulators over the past five years for improperly calling police to help with mental health patients.
Cops are not trained in best practices to talk to or help someone suffering with mental health issues, let alone in an emergency room, and often arrest or hurt people they perceive as threatening—or worse. One study found that people with mental illnesses are 16 times more likely to be shot by police, despite a robust body of research showing that the mentally ill are no more dangerous than the average person.
As Vermont’s Department of Mental Health noted in a report from April of this year, federal requirements mandate only hospital staff are permitted to handle patients in psychiatric care. Outside contractors, like private security officers, need to be trained and “under the supervision” of hospital staff when handling patients. And police officers “cannot lay hands on an individual who is committing (or has committed) a crime in the emergency department unless they are going to arrest and remove the individual,” the report said.
But those standards have been ignored in Vermont hospitals in recent years.
One 2016 hospital report describes how a patient seeking treatment for anxiety, depression and suicidal thoughts was tackled by police with an arm-bar takedown; the officers then handcuffed the patient’s arm to a bed. Five officers were called in 2018 to intimidate a patient who was refusing to accept medication for their bipolar disorder. And in two different hospitals last fall, county sheriffs called by staff Tasered two separate patients seeking treatment for mental health issues, neither of whom were in police custody at the time. Only five hospitals nationally were cited in 2018 for the improper use of Tasers; the two in Vermont were the only ones outside major urban areas.
Doctors and nurses in hospitals are allowed to use physical force to calm down a patient who is seeking treatment for mental health issues and is getting agitated or violent. But these medical techniques for restraint, like soft straps to keep a patient in a bed or wheelchair and injectable sedatives, have strict regulations for use. Most techniques police officers use to restrain suspects—like handcuffs, Tasers, and tackling moves—are not considered medically appropriate for a person suffering from mental health problems.
Restraining a mental health patient “is a medical intervention in a hospital,” said Suzanne Leavitt, the state survey director at Vermont’s Division of Licensing and Protection, which licenses and certifies health care organizations in the state.
“If you have the police come in and handcuff somebody, that is not a medical intervention,” Leavitt said.
Vermont and national regulations say that while hospitals may call police for patients committing crimes in ERs, police must arrest the patient and take them into custody after treatment—not act as a security force.
“The hospital cannot call the police and say, we need your help restraining this guy, hold him down please, so we can give him a shot,” Leavitt said.
When hospitals don’t set clear boundaries with police, hospitals can get in trouble with national regulators. Hospitals with multiple bad reports risk losing funding and certification from national and state governments—-a potentially devastating blow to rural populations where medical access, and especially mental health access is already thin on the ground.
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