Violence in Mental Health

My work is full of violent actions – my violent actions against others.
I have chased youth. I have called codes to have others restrain them. I have completed paperwork so that they can be picked up by the police.

Many times, because of documents I have written, young people have been picked up by the police and brought to a hospital in a police car, often handcuffed, although that is changing as police become more knowledgeable about mental illness.
I have ordered that young people be observed on a one-to-one basis, not allowing them even to go to the bathroom without having a Mental Health Worker’s foot held in the door to keep it open.

Many psychiatric inpatient units have a double door locking system, much like a prison.
Medication is sometimes used to restrain patients who become violent – not all of them are suffering from delusions.

These actions are taken to keep people safe, both from themselves, and so that others are not hurt. Each of these actions requires specific documentation on my part. But, make no mistake, these are violent actions.

These violent acts are the most overbearing tools available to keep people safe. But, whenever I am obliged to use them, it is a failure. It is a failure because these violent actions, carried out to keep people safe, delay healing and recovery.

People do not always understand how violent these measures truly are, but, if you have ever experienced them, you know. You know these are violent actions. You may understand why I have had to take these measures but I will always see these as a failure, in some way.

One of the most important results of early intervention in strong outpatient programs in psychiatry is that we can avoid hospitalization, as well as these violent measures. That is always the goal. Hospitalization itself is a failure and the less time a person spends in inpatient psychiatric treatment, the better.

Psychiatric hospitalization is sometimes necessary, but it is usually best to avoid this measure, if at all possible.

Think about the measures I have described. How would you like it if these happened to you?

3 thoughts on “Violence in Mental Health

  1. The violence isn’t always against mental health workers or prison staff – often it happens against the person with mental health disorders. My son has been beaten badly by police more times than I could possibly know. In prison he has been kept in solitary confinement for months at a time, given medications that kept him asleep for 23 hours a day and caused a stomach bleed that came very close to killing him. The forensic psychiatrist has kept his last psych assessment quiet as it contradicts all former assessments yet is the same as the assessment he had when he was 11 years old – ADHD. I can’t find anyone to help him. He cannot find a general practice physician who will accept him as a patient and he is absolutely terrified of seeing another psychiatrist. He is a large man however until his last few experiences with psychiatrists he was a gentle, non-violent person. Perhaps the system needs to take a look at its treatment of people who are someone’s child.

  2. Yes, very difficult situation and more often than people think in mental care facilities and even that violence is in schools and occasionally faced by priests and others in counselling sessions. Kids are so exposed to violence as a solution rather than other means. I think as a society we have to also examine and seriously begin to reframe the many means how we “reward” violence in media, video games and in social media.

  3. Yes, using your powers is always a last resort. It’s too bad it happens as often as it does. My experience with hospital is that there is a code about every day. Sometimes the police are already there because they are watching a prisoner who needs the hospital. I’ve see them jump in on code whites to help hospital security and nurses and always thought that was very inappropriate. I don’t know how any of this could be avoided though. An out of control patient can sometimes take the path of most resistance and what is the hospital to do? There are other patients to think about too. All that said I have seen doctors use their powers in imperfect ways and wonder if coercion (in the eyes of some) is considered part of maintaining a doctors authority. It’s insightful to read a doctors reflections.

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