
When the Hospital Fires the Bullet - Anthony-G
http://www.nytimes.com/2016/02/14/us/hospital-guns-mental-health.html
======
tsunamifury
My uncle died in 2009 in a room alone, straight jacketed. He suffered a
cardiac arrest likely cause by terror at a country hospital in Wisconsin. He
had committed himself and was dead within 24 hours.

It wasn't the first time the hospital has killed a patient using the same
technique. In the subsequent years I have spent a lot of time thinking about
why he died and the indifference of those around him when he was most
vulnerable. Law enforcement refused to investigate mostly on the grounds that
he was insane and there was nothing anyone could do.

He had three kids and a wife who was a social worker. She was later fired as
the state of Wisconsin decided social services where no longer a priority.

I've come to the conclusion that most of us would rather ignore the problem of
mental illness rather than solve it. It's more convenient to kill the ill than
treat them and society simply looks the other way.

I am given hope that his son is now a leading neuroscience Ph.D. Candidate at
UC Davis. He has vowed to not let his father's death be in vain.

~~~
specialist
I'm sorry for your loss.

FWIW, I anticipate (hope) that addressing the needs of the mentally ill will
be the next big civil rights movement, at least in the USA. Mostly due to
increased awareness, for better or worse, thru social mediums.

Just like with homosexuality before, I had no empathy because I couldn't
relate. But then when you discover that its your friend, your family, your
loved ones who is affected, I learned "Oh, they're just people, just like me."
And then someone shares their story, like you just did, and I learn "Oh, it's
not just me and mine."

So I thank you for sharing. All the best.

------
jakobegger
Over the years I've observed that a certain kind of people goes to work in law
enforcement or security. They are often a bit aggressive, they seem to have
this feeling of superiority, and they enjoy positions of authority. It's
rarely the calm, humble, balanced types that work in those fields.

I think this is extremely dangerous.

Has anybody else made this observation? Is there anything that could be done
to change this?

~~~
sebcat
The good security guys don't work a hospital security job. As with everything
else, you get what you pay for. The calm, humble, balanced types go for
greener pastures.

~~~
DennisP
The shooters were police officers, not regular hospital security.

NPR did a piece on this case last night. They emphasized that there are
standard procedures for dealing with mentally unstable patients in a hospital
setting, and the cops weren't trained in those procedures. They ended up
escalating the situation.

They also interviewed a hospital security guard, who said the shooting was
ridiculous. He said "We don't carry guns. We get hit all the time. We just
deal with it."

That wasn't the police approach. One got hit, so they responded like they
would on the street and deployed tasers, then lethal force, and followed up
with felony charges.

Another issue was that the family asked for a mental health evaluation of the
patient. Standard procedure is to immediately provide that upon request.
Instead the hospital ignored it. Had they done a proper evaluation, the
patient would have been moved to an area where they used regular security
instead of police.

As of now the hospital is at risk of losing federal funding, if it doesn't
reform its policies to the satisfaction of federal investigators, including
better training for the cops and further restriction of their areas of
operation.

~~~
chris_wot
Except these officers were moonlighting as security guards. How is that even
possible?

~~~
URSpider94
One of the standard perks of being a policeman in most jurisdictions is that
you're allowed to take paid gigs off-hours as a security guard and use your
gun and uniform, and in some cases your patrol car if it's assigned to you
permanently as it is for many state police officers.

~~~
chris_wot
That must make taking bribes hard to catch!

------
k-mcgrady
So we have a person clearly very ill and he can get seen more quickly by armed
police officers than a medical professional who can actually help the
situation? If he was in a room alone why, instead of sending in armed men,
didn't they lock the door, get a doctor and some sedatives and then get
security to restrain him while they actually gave him the care he came to the
hospital for? I'm absolutely blown away that this could happen.

------
tamana
The victim survived, but is now being persecuted by the government prosecution
complex, including being charged with a crime for rushing himself to the
hospital for treatment. I hope he finds a strong lawyer who can find justice
and win a large settlement from the Rambo cops.

~~~
consto
After reading the article, the reckless driving charge is the only one I agree
with.

------
davak
Working in hospitals over the last ten years, I have noticed an increase in
how violent patients are. I believe the increasing use of synthetic rec drugs
and the failing mental health system is to blame.

Previously many of these dangerous cases would be locked up until they were
safe. Now, everybody just tries to treat them as an outpatient. That with the
easy access to guns makes hospitals very dangerous places these days.

~~~
ZenoArrow
I caught pneumonia when I visited NYC a few years ago and was brought by
ambulance to a hospital in Brooklyn. Some of the things I heard in the
emergency room were shocking compared to what I'd experienced in emergency
rooms before (I'm from the UK). The most surprising thing to me was how many
of the patients were verbally abusive to the nurses. Perhaps these people were
mentally unstable, I don't know, but I never expected to hear any patients
attacking the people that were there to help them.

~~~
Zelphyr
Nurses generally get treated terribly compared to doctors and others in the
profession, despite the fact they are often the ones who are actually taking
care of you (doctors diagnose, nurses treat). I guess it's because they're
considered lower in the hierarchy simply because doctors went to school
longer.

~~~
tamana
In the case parent described, it's just because nurses actually interact with
patients, but doctors don't.

------
unquietcode
I suffer from deep bouts of depression. Lately I've had to go back and forth
with myself about going to the hospital when things get bad, but now I'm just
scared even more. I was afraid that not going to the ER would kill me, but
now... it's like fuck, who will help you? When you have a mental health
emergency, the police will shoot you, fellow citizens will ignore you, the
hospital may or may not treat you, and now they might even kill you. With
mental health, it's so important for the patient to feel safe, and if a
hospital isn't safe then, well, I dunno. Humans are always making other humans
suffer needlessly, it's awful.

------
pmorici
Since when is it acceptable to shoot an unarmed person? There isn't even any
doubt in this case as to whether or not he had a weapon.

~~~
nordsieck
The most common times are when there is a size or numbers disadvantage, but
all it takes is a reasonable fear of imminent grave bodily harm or death.
Those are the rules for private citizens (the details vary from state to
state).

Official security probably has more latitude to take action because they are
responsible for the safety of everyone in the area.

~~~
huac
> Official security probably has more latitude to take action because they are
> responsible for the safety of everyone in the area.

probably, but they should have _less_ latitude because of their training in
other, non-violent methods to remove the threat. negotiation can help defuse
most situations better than a taser or gunshot would.

(was this sarcastic? or just hopeful?)

~~~
Kalium
Just hopeful, I'm afraid. It's easy to assume from the distance of many miles
and a computer screen that every single situation can be addressed safely and
easily by a soft word or three.

Abstractly, that may be true, if you free yourself of certain constraints
imposed by reality. For one, you have to assume that every single person in
every single situation is open to negotiation. Second, you have to assume that
nuanced and complex communication of the sort that enables negotiation is
readily possible. Third, you have to assume that entering into negotiation
will remove any threat the subject may pose to other people nearby. Fourth,
you have to assume that trained negotiators arrive sufficiently fast for their
magic stop-all-threats-to-everyone powers to engage in time.

In reality, some or all of these can fail. I read about an incident in my city
in the past few months where a mentally ill man was reported to police as
wandering the streets, carrying a chain. The police arrived. An officer
approached the man, attempting to speak with him. She wanted to find out if
anything was wrong and see if there was a problem that needed addressing. He
proceeded to beat her with the aforementioned chain. If memory serves, the
situation was resolved when the armed, actively violent, mentally ill man was
shot dead.

And this is a scenario where presumably everyone speaks English! Where in
there was she supposed to negotiate with him to solve all the problems at
hand? What non-violent methods do you expect to bring a rapid halt to someone
actively beating a police officer with a weapon that will be remotely as fast
as lethal force? What happens if you have no shared languages, someone deep in
the grips of hallucinations, and actively shooting people nearby? Do you
expect negotiating police to defuse that problem by negotiating with someone
incapable of recognizing them as people who want to negotiate?

~~~
DanBC
> It's easy to assume from the distance of many miles and a computer screen
> that every single situation can be addressed safely and easily by a soft
> word or three.

It's easy to assume for me because I've seen the vast amounts of work
currently happening around "behaviour seen as challenging" in people with
mental illness or learning disability[1] or brain injury.

Here shooting people is absolutely not possible in the vast majority of cases
of behaviour seen as challenging. Tasering people is also absolutely not
acceptable.

Rapid tranquillisation is common, but not acceptable because of the amount of
restraint needed immediately prior to the injection.

Various methods of restraint are common, but are not acceptable because of the
risk of injury or death.

A lot of money is being spent on better training on de-escalation, diversion,
prevention, etc.

It's fucking baffling to me that people think it's okay to kill someone in
distress just because the people doing the shooting are so lacking in skills
that they have no other option. To me it's clearly a failure of everyone
involved (and the departments they work for).

In your example with the chain: you seem to think this is a situation where a
violent response is undeniably the right thing. I see that and I think how
fucking clueless the woman was, and how fucking clueless the people who shot
the man were. There are plenty of Youtube videos comparing UK and US police
responses to these situations.

[1] UK definition.

~~~
Kalium
In the scenario I described, what do you think that the right non-violent
solution was? I should also add that the PD had no way to know ahead of time
that they were responding to a situation with a victim of mental illness in a
time of distress who would exhibit behavior seen as challenging.

Incidentally, this was not a situation where there were a half-dozen officers
on hand to swarm the guy. Should officers always move in groups of six or
more, so that any sudden violence can be handled with grappling? Seems
expensive, at the very least. How do you propose that a single officer being
_actively beaten about the head with a chain_ de-escalate the situation? I'm
deeply curious how you think that could be reasonably accomplished. Maybe
saying please?

What would an officer in the UK do in the situation I described when being
actively beat about the head with a chain? How would it be totally different
and reliably yield an ideal outcome?

Another detail of relevance: the incident did not provide the officer with an
opportunity to speak to the victim of mental illness in a time of distress.
The victim attacked immediately upon the officer exiting her vehicle. If any
and all forms of violence are ruled out, with de-escalation and negotiation
being the order of the day, how _should_ this officer have reacted to being
beaten with a chain? What peaceful, non-violent, resolution skills are
available to someone subject to such immediate violence?

------
Anthony-G
For those who found this story to be interesting, I’d recommend listening to
the associated _This American Life_ episode. [1]

It provides an insight into the internal experiences of somebody suffering
from delusions. In his interview, Alan Pean tells a vividly detailed account
of how he experienced the manic episode. He recalled how, at times, he would
be able to rationalise the delusional thoughts away but they came so quickly,
it was difficult to stay rational as the delusions had their own internal
coherence.

One memorable part of his story was when he described how he “escaped” from
his third floor apartment building to get to the hospital: he locked his front
door (which he thought was being watched by enemy agents) and then swung down
from his balcony to the one below it and on to the ground, all the time
telling himself to “Remember your training, remember your training” (while in
reality, he’d never trained as a secret agent).

In his delusion, Alan thought he would be killed by either a missile strike on
his apartment complex or be shot by the enemy agents who were circling in for
the kill. The interviewer points out the tragic irony that when Alan finally
made it to the place he felt would be safe, that he was _actually_ shot.

Alan still finds it difficult to deal with the fact that a police officer was
willing to take his life with a gunshot to the chest. I can imagine such an
experience being deeply traumatic for those of us with good mental health but
it must be much more difficult for someone already dealing with psychological
issues.

From a personal point of view, a woman in my social circle about 15 years ago
was suffering from bipolar disorder. I’d known her for about a year but had no
clue that she had any problems with mental health. Then one day my brother and
I met her on the street while she was having a manic episode. We took her into
our home to look after her. I can’t recall the details but we found looking
after her to be a distressing experience. We invited other friends in common
around to help as we felt very much out of our depth. The next day her parents
took her to a psychiatric hospital where she spent a few weeks while the
doctors found a combination of medication that helped even out the mood
swings.

[1] [http://www.thisamericanlife.org/radio-
archives/episode/579/m...](http://www.thisamericanlife.org/radio-
archives/episode/579/my-damn-mind)

------
smoyer
I don't know whether anyone else is seeing it but the subject's eyes appear to
move when I use the scroll wheel on my mouse. I'm using the current Firefox
Developer's Edition. It could be some effect of my graphics hardware, monitor
or even the refresh rate versus the distance being scrolled but the effect is
really creepy!

~~~
AI_Overlord
If I were you I'd be careful on which hospital to choose in case you need care
for delusions... :)

~~~
smoyer
If I weren't being so lazy on a sunny Saturday, I'd be inclined to see whether
my screen-casting software would capture it. Of course, then I'd be accused of
tampering with it! When my wife gets home I'll ask her if she sees it too.

------
nommm-nommm
>While St. Joseph does have a psychiatric ward, Mr. Pean was never seen by a
psychiatrist

Why does this happen? I know someone who showed up to the ER after crashing
his car during a delusional manic episode. His wife showed up and said he has
a history of bipolar disorder and needs a psychiatric evaluation. The nurse
literally _laughed_ at her!

~~~
GoodOldNe
This happens because psychiatric units will not take patients who are not
"medically cleared". Meaning that, if a patient has any evidence of injury or
medical illness (or they think that the symptoms may be caused by something
physiologic that has gone wrong -- leaving aside the fact that mental illness
_is_ physiologic at some level, you know what I mean) the psychiatric units
want nothing to do with them.

~~~
nommm-nommm
They were releasing him from the ER and he was already medically cleared.

------
chris_wot
Are police officers allowed to moonlight as security guards?!?

~~~
sp332
Why on earth not?

~~~
chris_wot
Conflict of interest.

~~~
nommm-nommm
Whats the conflict of interest?

~~~
chris_wot
Think about it for a second. You can hire cops, doesn't matter what the cost.
Oh, hi officer, you work for me as a security officer in your down time. Hey,
if you still want that work, why don't we just agree to ignore that traffic
infringement?

That customer posting a bad review of my restaurant. He's acting like he's
been on the wacky tabacky, nudge nudge... Best get him out of here to the
police station, and whilst you're about it those comments are clearly drug
affected. Just clear them. Incidentally, about that bonus for working extra
hours - I put that in your account last night.

Good work officer!

 _edit:_ my new iPad didn't pick up the fact I wrote restaraunt. Aside from
being a great typo to say aloud, wtf?

------
JoeAltmaier
Simple answer: it was the night shift.

