Wednesday, March 19, 2014

Police Fear=Psychiatric Patient/Prisoner Injuries and Deaths

How many myths do you believe about persons with psychiatric illnesses? Come on. Just spout them out.  What about these:

1.    They “possess extreme strength”
2.    Well, what about “they will kill you”
3.    You need to get three or four cops to restrain them
4.    You can’t talk to them
5.    They’re really, really dangerous

Others are out there, I’m sure, but I just can’t think of them right now and I do want to finish writing this blog.

If you believe some of these myths, do you suppose it’s just because you’re a “civilian” and not a police officer? Do you think that police personnel have different beliefs about anyone with a psychiatric disorder? If you thought the latter, you’d be wrong. Case in point is probably the recent treatment of a former Marine with psychiatric difficulties who died in an overheated cell on Riker’s Island.

In fact, if you know about that happening and the resulting lawsuit his family is filing, you might also be interested to know that the New York Times (March 18, 2014) ran an article specifically on the increasing violence in New York City Riker’s Island jail. According to the article, there are disturbing increases in violence among prisoners and attacks on the personnel in the prison. The article read in part: Since New Year’s Eve, according to the internal reports, at least 12 inmates have been slashed or stabbed, eight of them in the face or neck. Inmates and correction officers suffered lacerations, concussions, punctured eardrums, and fractures to noses, eye sockets, jaws and hips. In one recent brawl, a chunk of an inmate’s ear was bitten off…

To what do they attribute this increase in violence? Seems the jail is still being run the way it always has been with guards enforcing their power over prisoners and exacting punishments for any infraction of rules. It’s a throwback to a bygone era, as I see it, where muscle will out.

While there is a major problem with this methodology, there is also quite a bit of failure to appreciate the massive changes in the characteristics of the prison population. Rikers has seen impressive increases in the numbers of prisoners with mental disorders and the prison and its personnel appear to be ill prepared to deal with this. Prisons, in fact, have become a place to warehouse psychiatric patients who commit crimes and then there is insufficient treatment for them in those facilities.

One psychiatric hospital I visited reminded me of something out of a Fellini movie. There was a large open area in the center of this wing of the main building and on each side was a row of individual jail cells.  This was a hospital, mind you. Patients waited, hanging onto the bars, as a nurse and a guard rolled a cart around with meds. I couldn’t believe my eyes. It was so cold, so primitive and so cruel. These were people, not animals in a zoo.

Remember those myths? I’ve seen some of this in action at another psychiatric hospital a number of years ago. Now, remember this was at a psychiatric hospital, not a prison. You would think that the officers at the hospital would have had training in how to handle the patients. You would be wrong.

As far as I know, and I was a member of the psychology staff, there was no training for the police and they were scared of the patients who acted out.  Four officers practically tackled a patient, put handcuffs and shackles on him and jammed him into a police car. He was then placed in a special section of the now-closed hospital that was for violent patients. Those cops were frightened and you could see it by their out-of-control actions. In fact, it appeared to me that they actually escalated the fracas.

Police officers, no matter where they work, need training in handling situations that may arise with persons with psychiatric disorders. If they don’t get properly trained, can you expect them to know how to calm their own fears enough to be able to calm the fears the patients/prisoners are experiencing? No, you can’t. And it’s not easy because these officers have little information on psychiatric illness, so what do you expect from them? If their superiors don’t step in and offer training, brutality will out and force will be their only tool. Not acceptable and the resultant injuries or deaths aren’t acceptable, either.

The Rikers staff is rightly alarmed by the 240% increase in violence behavior and the officials of government are rightly alarmed by the abuses reported on the Island. But are they thinking about the psychiatric patients who would appear to have an additional disadvantage because medication can make someone less able to defend themselves and prime for an attack? How are they protected? Isolation and confinement in solitary confinement appear to be one of the practices currently used.

Do you know what confinement in solitary can do to someone, much less someone who already has problems with reality testing? Do you think this would exacerbate their disorder or calm them down? Try putting yourself in an empty room for 24 hours with no access to any interaction with another human being and be sure you don’t have anything else, either. No books, no writing implements, no TV, no radio, not even the ability to shut the light off when you want to sleep. Then know that you are being watched at all times and maybe even videotaped. Forget about your right to privacy. You don’t have one and most of the other rights we normally have aren’t yours, either.

Isolation, in the extreme, can bring on psychosis in someone without a psychiatric disorder, so imagine what it does if you have one. Not a pretty picture.

Who will speak for those who have difficulty putting a coherent sentence together? Who will make sure prisons have treatment and programs and training for personnel? We shouldn’t be modeling the infamous Bedlam in Great Britain.