How often do you interact with people with mental issues?

[PD Sgt.]

If you include my chain of command, daily.

[UNM1136]

If you include my chain of command, daily.

Four pages and we finally get it....

I would include co-workers, and the chain...

Seriously, the county hospital and county mental health facility are on the same campus here, and we deal constantly with the mentally ill. Starting my 17th year as a CIT officer. Our record is involuntarily committing someone and getting a call to come pick her up and take her home within 45 minutes.

Even if patient's aren't working the docs, sometimes the docs aren't too keen on making extra work for themselves. I have seen a few instances of docs being lazy, completely discounting anything and everything that I told them from the scene; and I have seen it go the other way (check roll call stories). Docs signed a commitment order for a patient that walked out AMA who was in the ED for constipation. They THOUGHT she walked out with an IV cath still in her arm that they said placed her in jeopardy of great bodily harm or death if she decided to inject anything into it. The cath had clearly been removed by hospital staff.

We, based on our training tend to secure and commit all that we can in the best interests of the patient's (and others) safety. Even the marginal ones I can frequently talk into going in voluntarily. Looking at it from the other side, docs are biased the other way, just making sure that there clear and compelling need to keep them, and then releasing them for followup care. In our state we use a probable cause standard to determine who we take in, while the docs frequently seem to use a preponderance of the evidence level of risk assessment for who is now "their" patient. We err on the side of locking up the borderlines, while they err on the side of releasing the borderlines, both honestly looking at the best interests of the patient and the public. They got bigger books, and in many cases more experience to justify their positions.

And most days those decisions are the right ones, on the law enforcement side, and most likely on the medical side.

pat

[Nephrology]

Docs signed a commitment order for a patient that walked out AMA who was in the ED for constipation. They THOUGHT she walked out with an IV cath still in her arm that they said placed her in jeopardy of great bodily harm or death if she decided to inject anything into it. The cath had clearly been removed by hospital staff.

Wildly inappropriate use of the 72h hold...

[LJP]

Almost daily, but then again, I’m a medic and it’s par for the course. Concur with the observation that the patient population seems to be getting younger and younger every day. I have long held a dim view of formal psychiatric/psychological clinical services, and I fear my experiences in the medical field have not improved my opinion.


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[voodoo_man]

Because that's the policy. The powers that be somehow concluded that the ridiculous 5 man takedown from the CIT training meant that we needed 4 officers and a supervisor at every CIT call.

That is insanely wasteful of manpower.

[w provence]

Yes. Everyday at work.


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[txdpd]

That is insanely wasteful of manpower.

On the taxi service calls, which the overwhelming majority are, we really only need two officers responding. For potential excited delirium cases and our known violent customers the four man response is the right way. The problem is that someone calls and says "I'm schizo and need a ride to a hospital" gets four officers and a supervisor, but someone calls and says "my son OD'd on meth and K2 and is ransacking the house" defaults to two officer.

[Kyle Reese]

Had another one this morning, 5 minutes after going into service.

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[Nephrology]

I have long held a dim view of formal psychiatric/psychological clinical services, and I fear my experiences in the medical field have not improved my opinion.


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If you get the chance, ask to shadow the local 24/7 Psych ER service, or similar. You will probably have a change of heart.

As with most things, it's all very simple until the shoe is on the other foot.

[voodoo_man]

On the taxi service calls, which the overwhelming majority are, we really only need two officers responding. For potential excited delirium cases and our known violent customers the four man response is the right way. The problem is that someone calls and says "I'm schizo and need a ride to a hospital" gets four officers and a supervisor, but someone calls and says "my son OD'd on meth and K2 and is ransacking the house" defaults to two officer.

We get those as well, but they are still, at the very most 3 man calls (that's if a supervisor even decides to show up).

If two guys cannot handle the call, then someone better be in the hospital, but I can see the possible reasoning behind it, I just don't agree with it.