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?