I’ve posted before that I’m a physician. Specific I’m an emergency medicine physician. The reality is we see individuals in the ED regularly with some sort of mental health condition. Many are regulars. Some have histories of violence. Violence against staff in ED, whether it be techs, nurses, physicians, security, etc is not uncommon. The frequently have to restrain patients (whether physical or chemically) to prevent them from harming staff or themselves.

The reality is, in the past, many of these patients were “institutionalized.” But we’ve moved away from that, in general, so these individuals are often admitted for a week or two, “stabilized,” and then discharged. I’ve literally seen patients who less than a week prior had physically assaulted a staff member.

But I don’t know the answer. Funding is obviously an issue, because there isn’t enough space to hold patients indefinitely. But autonomy is also an issue. If a patient is “stabilized,” if they are calm, without aggressive behaviors, etc, then the question is how long can or should you involuntarily hold them. The reality is, it’s tough to navigate, and as I said, my specialty is not psychiatry, so I’m not going to pretend I have a magic answer.