Should All Psychiatric Patients Be Handcuffed When Transported?
April 8, 2008, around one in the afternoon, was one of the worst experiences of my life. My borderline personality disorder (BPD) and other mental illnesses basically derailed my life. I agreed to go to the state hospital voluntarily, and did not contest the court order.
The transfer began with 10 minutes notice. A Marion County Sheriff's Deputy put a chain around my waist, handcuffed me to the chain, and snapped shackles on my legs. She escorted me to a paddy wagon, and so began the longest 90-minute trip of my life.
Transporting Psych Patients in Cuffs Is Standard Practice
One psych nurse told me that the worst part of a routine admission to the state hospital was the transfer. I agree. I'll never forget wanting to quip to a similarly accessorized jail inmate "I'm in for being crazy in public, what did you do?" I still wince when I remember trying to look through the wire mesh of the paddy wagon.
Earlier that week, the committing psychiatrist told me "Of course you'll know when the transfer is; you're not a Marion County prisoner." That latter bit was hard to remember when I was decked out in chains. In Indiana, it's standard procedure to handcuff and chain psychiatric patients.
When humiliation is standard procedure, standard procedure is wrong.
Ways to Transport Psych Patients Without Humiliating Handcuffs
Use Officer Discretion and Specialized Training
In Indianapolis, it is policy for the police to handcuff all people who are being taken to the psychiatric ward involuntarily. Not all officers follow this policy. Some officers judge by the person's conduct or speech whether or not they need to be handcuffed. It's called "officer discretion."
Any police officer can tell you that no two situations are alike. This is especially true when dealing with someone in a psychiatric crisis. In Indianapolis, officers can become certified in Crisis Intervention Training. This is special training that teaches officers how to deal with people in emotional turmoil.
When a CIT officer arrives on the scene, he or she assesses the situation to determine the best way to respond. These officers use their training and discretion to determine how to handle someone who may behave unpredictably.
Why is transporting a compliant patient any different? Why can't a CIT officer use discretion and determine the best way to transport the patient?
Use Knowledge and Input From Treatment Team
There are almost 10,000 different combinations of symptoms that merit a diagnosis of BPD. My symptoms may not be the same as your symptoms. My triggers are different from your triggers. We have the same diagnosis, but our treatment depends on what merits that diagnosis. That's why treatment is on a case-by-case basis.
Why, then, does one size fit all when it comes to transportation?
The unit director at Richmond State Hospital told me it was hard on the staff to see patients admitted. "They do that to everybody," she said. "Even people we know aren't dangerous."
Why, then, should someone who wouldn't fight back receive the same treatment as someone who would? Why can't the knowledge and experience of the treatment team factor in to whether or not the patient is handcuffed and shackled?
Respect The Dignity of the Patient
A therapeutic relationship must have respect in order to work. When the patient's dignity is harmed unnecessarily, like mine was during the transfer, it becomes hard for the patient to trust anybody. Even if the therapist had nothing to do with the policy, the resulting humiliation can cause the patient to associate the therapist with the trauma.
If the patient has to worry about a humiliating admission, he or she will be less likely to seek help when needed. This usually ends badly--injuries from a suicide attempt, suicide, and in some cases suicide by police. Even one incident involving these scenarios is one too many.
When patients are spared this humiliation, they may be more likely to seek help. Yes, it's not policy. But why not? Why isn't it policy to try not to make things worse for the patient than they already are? When the patient feels respected and safe, things are considerably less likely to turn sour--the very outcome chains are designed to avoid.
Oberg, B. (2011, March 29). Should All Psychiatric Patients Be Handcuffed When Transported?, HealthyPlace. Retrieved on 2020, March 28 from https://www.healthyplace.com/blogs/borderline/2011/03/when-policy-is-harmful-should-psychiatric-patients-be-handcuffed-when-transported
Author: Becky Oberg
Back in August I was handcuffed and transported IVC, even though I Volunteered to come in but the place had no beds. Worst experience! The place I went to was hell. I self harmed there and tried to kill myself there. Next time I am suicidal I will not seek help!
Hi there, I can hear you've had an absolutely terrible experience being in the place you were. In a place you needed to be safe I can hear you hurt yourself and also tried to kill yourself. I can hear how much pain you must have been in. I want to share with you the Healthy Place Hotlines and Resources page- there are people on those hotlines who will listen to you when you feel suicidal. This is the link: http://www.healthyplace.com/other-info/resources/mental-health-hotline-numbers-and-referr… I want to tell you you deserve to be taken care and to be safe. Sending you all my best wishes. - Rosie, author of More than Borderline
I go to DBT, and they have skills coaching to call, to help you do skills to stop yourself from doing anything as much as even that.
They avoid calling the hospital, cuz they want to help us live life without being in the hospital.
Also, where I live, they don't hand cuff people that have suicidal thoughts.
Both of my recent exes had ended up being transported by ambulance for suicidal thoughts. One of them was having a mental breakdown and was losing his mind, and I think they restrained him in the gurney, NOT hand cuffs. The other one was just depressed and wasn't losing his mind, and was transported to the hospital very calmly.
I can very much sympathize with those of you that have been handcuffed. I can not imagine the humiliation and emotional pain that it caused. I do know though that if my therapist did that to me, I would stop seeing her. I wouldn't be able to trust her.
I'm sorry they have that rule where you live, and I hope that eventually something can change in a way where everyone is safe, and the patient doesn't feel like a felon.
I was sobbing in my psychologist clinic when I was informed I was going to be transported to a hospital.
The police arrived, and said he had to put me in shackles and handcuffs. I broke down and cried, asking my psychologist to convince him to not to so.
Fortunately, the officer said something like this:
"Its alright, you are not a criminal and you are not under arrest. I know it is tough, but we are required to shackle patients during transport so they do not pose a harm to themselves or others. Many times, we did not do this and it led to harm. Shackling you is good for you as it helps you get treatment. I will put on the shackles and handcuffs loosely so you wont feel so uncomfortable, is that ok miss?"
Seeing that he was so kind and gentle, I put my hands in front of me. He put a chain around my waist, double locked it, and put a hand on my shoulder, saying thank you for cooperating. I smiled, then he asked me: "I'm going to handcuff and shackle you now, are you ready?"
I cooperated and he handcuffed me loosely to the belly chain, snapped shackles on my legs, and double locked them.
He then did something unexpected: he gave me a face mask (the one to filter dirty air surgeons used) to put on so i was not embarrassed when I walked out in front of many people!
It was so sweet. He walked me to the paddy wagon, put in seat belts on me. Then he talked to me a bit and comforted me, saying I was very brave and thanked me again.
All the way during the 2 hour journey to hospital, he talked and joked with me. He even stopped by the van to let me use the toilet once (I was still shackled, or course). Once on the van again, he uncuffed my wrists to let me rest and soothe the marking on it, then asked me if I was ready to be cuffed again.
I cried saying I felt so humiliated like a criminal, but he smiled and comforted me, saying treatment will arrive soon. He said I'm so brave to endure this, but reminded me, it is required by county to shackle patients during transport with no exception regardless of how harmless one was, to be absolutely safe. He joked with me a bit and since he was so compassionate, I let him cuff me again and I blushed.
What I didnt know at first was that the cuffs this time were really tight and uncomfortable. After a while, I told him this and he loosened it for me by stopping the van 10 mins later.
I arrived at the hospital and he escorted me inside. He thanked me and wished me luck and unshackled me, while asking me if the red markings left behind were painful. I smiled and thanked him since he was so humane.
After being warded, I was given an assessment - one of them was an IQ test which I cried through but the docs said it was necessary to see If I had cognitive issues. I scored I think 92 on the test, and was very sad since it was below expectations, but the doctor assured me it was depressed due to my depression (no pun intended). But it was in normal range and I had no neurological issues. I took other questionnaires for anxiety and depression.
Long story, I'm tired to type, but in 10 days I was released.
Strangely enough, as I left, I saw the same police officer escorting another patient in shackles and handcuffs.
I greeted him and thanked him for being so compassionate. He hugged me and he offered to drop me by the metro station. The new patient who was shackled seemed peaceful- I knew how well and gentle she was treated by the officer.
It was definitely a rather benign treatment. It made me feel better, knowing I was shackled to protect myself and others. Although undignified, the compassion made this a memorable and good experience for me, and I got over it fast.
I am strengthened yet saddened to read some of the stories here that are just like mine. Has anyone had any success in suing the hospital and/or getting the hospital to change its policies toward individuals in crisis who self report to a local hospital?
Hi. I'm 15 years old and a a while ago, I was on the phone with the suicide hotline and i started getting very anxious and so I kept telling the counselor that I was ready to end the conversation. I even told her that i was just going to go take a nice bath, watch my favorite TV show, then go to bed and I did my best to tell her I was safe, I was just tired and anxious and I was ready to hang up. We successfully ended the conversation and 10 minutes later, three police cars and an ambulance show up. My parents were furious with me. I was in a good mood, my intense emotions had passed and I wanted to go to bed. It was around 12:30am. They had they had to transport me to the Emergency Room. I told them I was doing fine, I was tired, I hadn't hurt myself, I had no way of hurting myself, but they still handcuffed me behind my back and put me in the back of a police car. I'm getting shaky writing about this because the thought of being in the back of the police car like that scares me. After waiting 6 hours in the ER for a psych consult, I was sent home. There was no need for me to be there in the first place, nor did i need to be handcuffed. I havent reached out for help like that since. The fact that I feel unable to ask for help leads me to suffering more physical damage to my body then there needs to be. I am not a criminal. So why do I feel like one? None of this is fair .
I'm so sorry. I was just handcuffed for a long time in a similar situation. I am older, in my sixties. I was fighting with my insurance company because they were denying me life saving medication that had relieved excruciating pain. And I told them the intense relentless pain had made me have suicidal ideation and that is why I needed the medication. They called the police. it was terrible.
Be tough! I am planning to sue the police for violating the Americans with Disability Act. Criminalizing suicidal ideation is only making it harder for people to get help. I know this incident (December 10-11th last year) made life much more difficult.
Well, I’ve read through this article and it’s comments. I am a sheriff deputy in the state of Ohio, and have taken over 100 mentally ill patients from our local hospitals, to specialized centers for treatment. Most the time, these trip range from 60-120 miles away. The office policy is for the patient to be belted and cuffed in the front and shackled at the ankles. It was very hard for me to apply this policy to people, because I felt that it scarred them more than it’s worth. However, I can also say I have gotten into some horrible situations in heavy traffic on a highway, with a unrestrained patient in the back seat. I had one guy who had been in the local hospital for 3-4 days. I picked him up for a transport and spoke to his nurse and doctor who said he had been great, no issues. I spoke with the patient and I felt like restraints would not be needed. We left the hospital doors and I allowed him to smoke before we left. We talked for 2-3 minutes and everything was fine. Within 30 minutes of the transport, as we were traveling 70 mph in heavy traffic he banged on the cage and said “ for my own safety and yours, I think you need to stop and cuff me, cause I am about to hurt one of us”. So there you are trying to make a decision, out on a open highway, to stop and try to restrain, or try to talk them down. He then grabbed a hold of the seat belt and unbuckled it and was trying to tie it around his neck. I was able to safely pull over to a rest area and get things straitened out. But now I always question my own and the health professionals opinions of how a patient may end up acting while in transport. I now always, at a minimum, use a soft belt and front cuffs. This is just one example. But as I see it, if this guy would have caused enough problems to make us wreck, and cause injury to ourselves and the others on the road, then it’s not worth the risk. I totally get both sides because the patient feels they are in “trouble”. I always try to explain to the patient it is for the safety of us both. I don’t have to worry about you possibly harming yourself while in my care, therefore I would not have to use any force to stop it. I know I just kinda rambled on but I hope this helps clear up slightly. There is also many reasons why we don’t make stops along the way on a transport. I can go into detail on that if anyone really wants to hear it.
It is so sad that because of being totally unnecessarily cuffed for hours, I have really felt a lot of hatred towards police. Handcuffing me, an old disabled lady, who was not a danger to anyone, was a horrific degrading experience. I know many of you are decent, but I was so hurt and humiliated that I cannot help but feel that the police are now my enemies. I just feel totally betrayed.
I can see where you're coming from, but there's got to be an alternative way. I also was handcuffed when I didn't do anything wrong, I was going willingly. After my experiences this last week and reading these articles I will never call a suicide hotline again, or go to the emergency room. I don't foresee this in my future because that is not something I've ever wanted to do to myself, but the medication I was taking was causing those thoughts so I sought out help. I will never, ever do that again because of what the police are doing. As I said, heads need to come together and find a better way to protect the person that you're transporting and you. I'm sure there is a better solution than handcuffs and shackles. It causes unneeded trauma and as you're seeing here it causes people to not seek help. I will be talking to authorities and lawyers here in my area to make a change.
No cop should be allowed to even tough a patient. It is NOT the responsibility pf a damn cop to transport. I personality would have felt better being in an ambulance in a straight jacket than with a cop. I have no trust in them , the courts, and judges. You are not DRs you do not belong in the medical field. But what if patient has to use bathroom? Man cop- female patient? Cops stay out of the medical field!! There needs to be a way to sue the courts and take this away from those that have no right to transport a patient.
I think it's quite inappropriate to restrain sick people travelling to or between hospitals with metal handcuffs intended for criminals and which cause pain and injury. If it's really necessary, there are leather or other soft cuffs they can use which will prevent someone self-harming or attacking staff for the time it takes to get them to hospital. In the case Raneem described, they could have used a car to take her the 200 miles instead of holding her on a stretcher which caused unnecessary trauma to an already traumatised person.
I would rather die than be humiliated and traumatized by the police handcuffing me, putting me in the back of a patrol car and taken to the ER, when I was calm and cooperative; just feeling like I needed help. They should have called for an ambulance. I don't mind being strapped onto a stretcher- I see it like wearing a seatbelt. Never again- the trauma from being handcuffed when I needed some kind words and understanding. The police were unkind and uncaring.
It is not justifiable.
There are ways to transport with restraints with out being criminalized. We used to do it when the EMT came to get you and used the standard arm and leg cuffs. The absolute worst thing you can do in any planned suicide is criminalize the person. You do that you lost the fight, make people who wont seek help, will kill the first responder if caught or even kill a family member who threatens or seeks help. I deal with police created problems daily.
i am bipolar and i had called 911 because i had tried to take an overdose of pill. i was put in the hospital for 2 hrs while the looked for a facilaty to take me. when the police cam to my room. they were driving me to a mental health facilit 2hr and 30 minutes away. they put hand cuff, leg cuff and a chain around my waist. this was so humiliating. especially since i was cooperating. All the way there the police man complained about having to drive me to my destination. Hesaid they wouldnt be making any stops so going to the bathroom was out of the question. being chained made it hard to sit in the rear seat. the safety belt dug into my throat because i couldn't move it. it was cold that night. i only had on hospital scrubs. He made me walk (chained) about 400 yrds to the facility when we parked. If i knew i was going to be treated like that. I am sure i would have never call for help.
I have a more interesting story than most people here. When I was 18 I was (violently) raped and three years later I suffered a major depressive episode because of it and I kept having flashbacks where I completely lost touch with reality. One night I was in my bathtub and used a razor to cut up my body and the water was filled with blood (it was scary) and I had a bottle of pills that I was about to swallow. But then I said "wait Raneem, you don't want to die, you have so much to live for. So I bandaged my wounds, got on my bath robe and called 911 and the police came to take me to the hospital. When they got there they were very nice and they got me to go in the car but even though I was going voluntarily they still were going to restrain me in the back and I will say that AT THE TIME it felt horrible. And it wasn't just handcuffs they restrained me with; like you they had the handcuffs hooked to a chain around my waist they used shackles on my legs and another chain that attached the handcuffs to the shackles. On top of that they had me sit in the middle seat and two officers sat by the window seats. Many people here have described how they were treated like common criminals but these restraints aren't used for common criminals but for felons. And while my attacker was never brought to justice, here I was the victim of a felony being treated like a felon. They dropped me off at the hospital and I was evaluated at the ER and they recommended that I go inpatient (I don't know if they would have committed me if I didn't because I didn't ask). However the nearest psych ward with a bed was 200 miles away so I would have to be transported via air ambulance and they walked me to the roof of the hospital where the helipad was. They then pulled out a stretcher with full restraints with one strap horizontal across my sternum that was attached to two straps that ran vertically across my chest and over my shoulders like a backpack. Another strap was around my waist with two wrist restraints attached that kept my hands at my side. a third horizontal strap went around my thighs and the fourth one went under my ankles with two ankle restraints attached. While they were putting me in the restraints, I again felt awful; I asked to go to the hospital and listened to their recommendations without question (they didn't even threaten me with commitment) so I didn't understand why they were doing this to me. After they loaded me into the helicopter I remember trying to move; not to actually break out but to see how far I could move and all I could really do was slightly rotate my arms and to a lesser degree my ankles. I felt so numb, powerless and helpless; completely at the mercy of others. There was one paramedic in the back with me and she tried to start up a conversation but I just laid their looking at the ceiling and after a few minutes she gave up and just sat there. About 25 minutes into the flight I decided to try to pass the time so I closed my eyes and when I opened them I was in the room where I was raped and my attacker was pinning me down. I was struggling to get him off and I just wanted to run out of the door to my left. But then I felt (but didn't see) a hand on my arm and my head. I tried to bite at the hand on my head but then I heard the paramedics voice saying "Raneem, Raneem, can you hear me, are you OK. Then I shook my head and when I opened my eyes I was in the helicopter and the paramedic was standing over me with one hand on my head and the other on my arm. I took a few deep breaths and realized that I just had a flashback. When I calmed down she sat down again and said "I could tell you were upset about being strapped to the stretcher, but even if they come to us voluntarily, if a patient is having psychotic episodes they have to be fully restrained because how willing they are to get help doesn't make a difference should they suddenly lose touch with reality." And given that position of the door in my flashback was exactly where the side door of the helicopter was and we were a few thousand feet in the air, it's needless to say that I grasped the rationale for the restraints very quickly. Knowing that I probably would have ended up falling to my death had I not been strapped down, I no longer felt bad about it and started a cheerful conversation with the paramedic and after about 15 minutes I even forgot that I was restrained; even though I was fully bound it still felt like a plain old conversation and it did allot to put my mind at ease once we landed and I had my admissions interview at the psych ward. So in my case I think they were pretty justified but I met people at the ward who said that they were handcuffed for depression and said that it was a traumatic experience for them in their already mentally compromised situation so I do agree with you that it should treated on a case by case basis. If you don't mind me asking, why were you transferred from a psych ward to a state hospital?
I am glad that you were helped. There is no doubt that people in psychosis need special help. But saying everyone with a psychological problem should be restrained is not fair to those who are not dangerous and find the event stigmatizing and traumatic.
But Hope you are better. You have really been through a lot and are very brave to share.
I see what you are saying about feeling like a criminal. I live in Des Moines Iowa. The DMPD come and talk to the person that is struggling. They usually search your pockets. I always am honest to them and let them know if I have a weapon or not. One time I had a weapon I told them about it. Every time they come to talk to me now they always put me in Handcuffs and they always put them on tight. I have Bipolar disorder and I have a minor case of Caribe Palsy. I have very bad PTSD too. they don't get rough with me anymore. I'm 6'5 and I weigh 210 pounds. I have had as much as 5 officers trying to take me down. after the 6th officer got on me I was on the ground and they struggled to get the handcuffs on me. Yeah it sucks to be handcuffed but they do it so you can't hurt your self. to all those that struggle with other disorders out there. hang in there.
My husband has a external defibrillator and was handcuff by the police. Is that a hazard if his defibrillator went off for a treatment and his hands are hand cuff. And it gave him a shock and didn't need one
I work as a mental health professional and struggle with depresion, anxeity, and was in an abusive relationship. As such, I have experience being on the psychoterapists end and the client/patients end. Where I used to work in the plains of Colorado we did not have a psychiatric hospital so clients had to be transported by police. I hated seeing this procedure and found myself being reluctant to committ individuals due to fear the transport would cause increased psychological harm. On top of transport being done with handcuffs, footcuffs, and the metal chain around waist clients were held at the local jail while we were searching for open psychiatric beds. While in the jail clients were kept in a padded room and had mugshots taken, despite the fact that they were not criminals. Then my ex-husband (who was abusive) made a false accusation that I was suicidal and threatened to hurt him to the police. I had had two glasses of wine (it was new years eve) prior to when police came to my home. The professional sent to assess me worked at the same community mental health facility I worked at and had less training than myself; therefore, she did not dare say I was fine or not fine and decided to have me committed so I could be assessed elsewhere (despite the fact that I was calm, logical, and no harm to self or others). I panicked when I was handcuffed and forced to strip in front of jail officers to show that I did not have weapons on me ... it was worse seems I was on my period and they inisted on making sure my tampon was truely a tampon so I had to take it out in front of the officers. I know that I went from being upset from arguing with my ex-husband to being in a full blown panic where I really was out of control once I was treated without respect and was humiliated.
I hate this procedure and believe there is a better way to ensure the safety of clients and police. I recognize that mentally ill clients can become aggressive and violent when they are in a panic; I believe that the current way of transporting clients makes this worse, not better. I do not have a full solution for this problem, but, intend to over my career work with others to figure out ways to keep everyone safe ... one big barrier at hand here is money and beliefs concerning mental illness.
Please read my blog at sparkpeople.com. Look for me- jennaashly.We MUST continue to talk about this and make change. I'm glad other dignified people feel we must talk about this horrific event that has left lasting emotional trauma on me.
I've had another panic attack today but it was the worst I've ever encountered, had to get home & take a lot of pills. My life would be better of over with the way I have to live with the torment of what I had to go through. I pray that God will punish everyone that had a hand in it!
I agree with you totally it is down right horrifying. I have nightmares about it. I've had to take more anxiety pills & pain pills because of what & how the police treated me. I have panic attacks a lot because of what happened to me. It is disgradeing & humility & they enjoyed every minute of it, & my sister & brother enjoyed every minute of it too, they laughed about it in court. People get paid back by God for doing others wrong that hasn't done anything to them. I wasn't a threat to anyone, not even myself, I had made a comment & they took it all wrong. Now I can't do anything but go to doctors & get more anxiety pills because of all of it.
Yes, Tara, it was hard having the neighbors seeing me stuffed into the back of a police car in handcuffs to be taken to the local "asylum."
Anne, I too have a high IQ. For what it's worth, my brother was a police officer here in Florida for a few years. As someone said in an earlier post, we are wildcards, and the committing officers do not know us personally; they have no way of knowing how we will act.
What I really mind is this: the facility here in a Central Florida receiving center puts everyone together, whether they be folks who are well in touch with reality; but are having emotional issue, or they be folks who are totally out of contact with reality. Everything is "dumbed down" (I do not like using that term, but I can not think of one better)to those who don't know front from back, so to speak. I know there is a shortage of beds, but it would help if those of us who are aware, so to speak, would be treated as such. Sadly, for those who are not in touch there seems to be no long term place for them, and that is not right.
Having been treated like an animal within the nhs system, being treated as thick etc, despite the fact having an IQ of 165 and 2 degrees and the vile treatement in hostipal and abuse I saw of other paitents, finally I,m being treated with compassion by a schema mode specialist, who can see I,m a lovely person. To be honest if you get to the stage of being sactioned as I was, you are already at a piont of complete trauma, your not a crimal and the treatement from many nhs staff is beyond contempt, they should be charged with abuse, really quite unreal how I was treated, I,ll never forget it, a very very bleak time in my life, but I,m a fighter and have defined myself beyond all their limiting messages, will set up my business, I,ll never stop going for who I know I can be
I was brought to the hospital involuntarily by the police from my home. I can only imagine what my neighbours must have thought seeing me handcuffed and taken away in the back of the police car. It was absolutely humiliating for someone who hasn't had so much as a speeding ticket in my entire life!
I used to appreciate and respect the police but now I have an intense stress response whenever I see them.
Thank you for sharing your story. It is hard to see police officers after something so traumatic, which is why I believe a cooperative patient should not be handcuffed. It's all about officer discretion and how to help the person in crisis.
Recently I broke down at my doctor's office and said I wanted to go home and hang myself.
They took this to heart, and called a county deputy to transport me to the county's receiving facility for the mentally ill.
The deputy told me he would have to handcuff me according to county policy.
I'd been transported twice before by city police who had never done that.
Again he stated it was Orange County Florida's policy.
He then told me he would handcuff me in front.
I offered my wrists to him so he could handcuff me, which he did.
I offered no resistance.
I went quietly.
When we got to the receiving facility he told me he would remove my handcuffs After we got inside.
I wasn't crazy (no pun intended) about being handcuffed, but as he said it was for my safety and for his safety. I can understand that, and have no ill feelings towards him or the Department.
I was very compliant, but I gather some folks may not be so; hence the handcuff rule.
Several years ago, I was involved in a lawsuit regarding a patient that had expired at the hands of the police during a transfer from out acute care unit to a long term unit. During my deposition, the attorney blatantly asked why we do not routinely place handcuffs on our clients for transfer? I stated they are not prisoners, the majority of them have not committed a crime and if that were so, then the client wold not be committed to a long term facility. In the 10+ years working in acute psych, I have only placed cuffs <5 times that I can recall.
Even after that event we still not do not use handcuffs. If we do, they are based on the individual and what behaviors are being exhibited. I have needed the hospital police to help escort from room to vehicle, just because they were adamant about not being transferred.
Forcible hospitalization is imperative undertaking in psychiatric practice, especially when it is the question on violator patient. This manner of hospitalization is accomplish in order to protect oneself patient and his social milieu. Legislator this matter has arranged by legal dispositions upon patient law and civil law as well. Because this is a sensible and debatable matter, there is many abuses, misunderstandings and misinterpretations in daily application of these legal procedures. The main defect of these legal solutions is the fact that lawmaker didn't consult enough professionists of mental health. Entirely legal settlements are approved by experts of justice. They possesses superficial knowledge on mental disorders. Besides this, the applicant of these legal undertaking should acquire knowledge of mental health and its disorder.
When I was admitted to the state hospital, I had to board a small plane to get there. I had a chain around my waist, which was connected to the handcuffs on my wrists, and shackles on my ankels. I was in scrubs and socks as well. I was no threat to myself or to others, but it was policy. It was a law that all mentally ill will be transported by-way-of chains, just to keep them safe as well as the ones who provide transportation. It was a bit embarrassing, but I got over it. The teenaged boy who rode by my side was chained as well. The restraints were not leather, they were chains.
Hospital? Patient? Treatment?
It's quite obvious once someone has any kind of emotional crisis; they are deemed mentally Ill, labeled, and are deemed dangerous. (no longer a patient, but a risk)
This not some sort of rare occurrence or anomaly..we have a mental unhealth revolving door system that imprisons those deemed mentally unhygienic in America.
Natasha Tracy who lives in Washington State obviously has never been a participant in the county or state mental health system; or she wouldn't be speaking with such blatant ignorance.
Natasha touts her endless foo foo private mental health holy grail shopping & use; without ever opening her eyes to the reality for the vast majority of patients herded through an inhumane & ineffective system that incarcerates first - uses forced drugging without informed consent - releases - and then keeps repeating a futile & horrific failed modality over & over again.
The Tracy's of this world sell repackaged snake oil false hope with complete disregard for the inhumanity, reality, & suffering for the vast majority of patients.
I know an officer who was killed by a patient. The officer was from my hometown. The patient was pleading to be uncuffed (and however else he was bound) because of discomfort.
It is unfortunate that this happens but people need to understand that this is done for the safety of the Officer as well as the patient. As you well know Police use force when needed. A person in handcuffs needs the minimal amount, a person raging out of control can be subjected to Pepper Spray, Tazers and at the most extreme, gunshot. HAving said that handcuffs seem to be the most reasonable approach.
I'm curious as to whether everyone's interpretation of handcuffs and Becky's sentence "a chain around my waist, handcuffed me to the chain, and snapped shackles on my legs" is the same.
Along with the picture provided, I definitely picture Becky's experience where she may have looked like a violent, dangerous criminal. Holly mentioned being handcuffed during transport in an ambulance, and the EMT giving a satisfactory explanation as to why that was the case.
Holly, if you were handcuffed (with the metal and chain type, like in the picture) was a police officer in the ambulance with you? If not, then I'm guessing you were restrained which might have meant having your arms or legs tied together or to the sides of the stretcher with cloth, or by using soft restraints made for the purpose. I'd be shocked to hear that you were handcuffed and transported without police present during the ride. That's against almost all ambulance agency policies.
It's really unfortunate that restraining patients who present with psychiatric issues is the "norm" in a lot of places. I know it's for safety reasons and it's important if there are imminent risks present, but for someone subdued and relatively calm, there needs to be some level of trust established for a successful recovery process to begin, or continue.
I feel fortunate that my hospital admissions have been a calm (or at least outwardly calm) experience and did not involve law enforcement or medical intervention. I can't even imagine the awful experiences you've described and hope it's not something you'll have to go through again. The ways people with mental illness are treated (both medically and socially speaking) in this country needs to change...
We have to remember that there t some very violent MI patients n if it were me transporting I'd def have patient handcuff! Yes it does suck were treated like we r STUPID n CRAZY.... N mayb sometimes in our on p. Episodes we don't recall how frightening we may seem to b to a mentally heathy person. Me too- have been treated like a criminal even with a voluntary comm. N once there u find out that u were told alot of lies. Face it... Once were in there it's what they think n say goes' sorry for ur last experience!!
It might be clear to others, maybe just not me :)
Again, sorry if this is a dumb question, but why does one get transferred from one to another? Aren't they essentially the same?
(We just have the one here. It's a building attached to the hospital so there are no transfers just walks from, say, the ER.)
I guess I found it so appalling because I've never been dangerous to anyone. I'm just not an aggressive or violent person. But when you say it's for the benefit of both, I can see that. People with a mental illness _are_ wildcards even in the best of scenarios. And no one wants someone running into traffic and hurting themselves when it can be prevented.
I love your blog. Your posts are always so interesting.
I remember being handcuffed during transport once. And yeah, it was a pretty horrible feeling. But in this particular circumstance I was transported by ambulance (paddy wagon? ugh) and one of the EMT's explained why they have to use handcuffs when transporting patients to psychiatric facilities and, quite frankly, it made perfect sense:
People are hospitalized in the US (psychiatric hospitalizations I mean) because they are determined to be a significant danger to themselves or others. That can mean a lot of things. And police officers and EMT's aren't trained mental health professionals. They have to assume, for their safety and ours, that we're potentially dangerous. We're wild cards, you see. They don't know what we're going to do.
- “They do that to everybody,” she said. “Even people we know aren’t dangerous.” -
That's because THEY don't know who is and isn't dangerous. And regardless of how confident that unit director is about her and her hospital's assessment of who is dangerous and who is not, there have been too many tragedies because mental health professionals did not do their jobs and notice the warning signs of impending danger.
As an example of what can happen when transport patients aren't restrained, the EMT told me about a man they were moving who bolted from a prone position, burst through the ambulance doors, and out into oncoming traffic on the highway.
I hate being restrained and I can't promise that, if someone attempts to restrain me again, I won't react very, very badly. But overall, I'd rather patients be handcuffed than kill themselves, and possibly someone else during transport.
That's something I didn't think about--the person doing the restraining explaining why. That would definitely make it easier on patients--showing some respect and explaining the reason behind the policy. No one's ever done that for me or any of the people I've talked to. If there is any, it's just "Sorry, policy."
Most of the police-encounter tragedies I know of were because there were no empty beds in the psych ward or because the crisis counselor didn't call the person back. But that could be another post...
I'm glad you like my work.
I live in NC and voluntarily committed myself. I still was cuffed, walked out in the freezing, wet parking lot in just scrubs and socks and placed in the back of a police car. When I reached the hospital where I was to be committed, suddenly voluntary became involuntary. I was an hour from home, my husband had no idea things had changed. I was lied to and humiliated. I've never so much as had a parking ticket and here I was handcuffed and strolled around like I a convict. Not the greatest first step to recovery. I found out later that the 3 other patients from my county that came in the same night as me did not receive the same treatment, even though they were all involuntary, one was quite dangerous and that "routine" is supposed to be protocol for all transports. Not that I think they should have been treated the same way, but what was it about me that said it was ok to treat me that way? I'm sorry you had such a bad experience, too, especially in my home state. That makes me feel ill.
I'm sorry that happened to you. It is a humiliating experience, no doubt about that, and poor communication and outright lying make things worse. I know of several incidents where things went south because of poor communication--for example, one patient on my unit had the wrong type of commitment and had to go to court all over again.
Another scary incident happened from my first involuntary admission, at a psych ward in Waco, Texas. Two other patients asked me "You were brought here by the police. How come you don't have any bruises?" A little roughing up was routine down there--both patients had been tackled right off the bat instead of approached calmly and given a reason why they needed to come with the police. I dealt with the campus police since I was in college at the time, so the whole thing was handled very professionally. I was treated with respect, responded calmly, and the need for handcuffs was avoided.
Natasha, from over at Breaking Bipolar.
I'm sorry if I missed this, but where were you being transferred from? I don't really know the systems in the States for this sort of thing. Is the fact that it's a State hospital meaningful?
I'm sorry this happened to you. You're right, it is humiliating and it is to be avoided. You're ill, not a criminal.
Sorry if I was unclear--try as I might, I could not get it to sound clear. I was being transferred from the psych ward at a general hospital to the state psychiatric hospital.
I don't know the policies for the other 49 states, but in Indiana all admissions to a state hospital involve handcuffs and shackles. In Indianapolis-Marion County, all involuntary admissions are supposed to be handcuffed, but officers don't always follow that policy.