So Many Questions
Aug 13th, 2012 | by CareSource
By Jennifer Dozer, RN, Patient Care Coordinator, Behavioral Health
With all the recent news stories about shootings and speculations about whether the alleged gunmen were psychiatrically ill, I’ve had quite a few people say to me, “I’m sure you’re glad you don’t work that job doing home visits anymore – somebody might try to kill you!”
After a few years in group homes and a few years doing home visits with folks who have behavioral health issues, I can honestly say I feared no two things more than bedbugs and drug dealers. Well, maybe lice- my hair used to be down to my waist, after all.
Now, I won’t speculate on whether or not I think an alleged gunman had a psychotic disorder. If I gathered all the tiny bits of information from the news- absent the actual acts – and tried to determine if any of the men met hospital admission criteria right before the events happened, I’d have to stamp that file “insufficient information” and go calling around trying to find more. No judgments will be made here.
What the general public is asking itself now is this:
Aren’t people with psychiatric illness threats?
That’s an easy question to answer. Most violent crimes are not committed by people with a serious mental health diagnosis. Just like in the general population, having an addiction – cocaine, methamphetamines, or the new bath salts – as well as a serious mental health condition is more associated with violence than a mental health diagnosis by itself.
Those of us who have worked in the trenches generally have an interesting story or two about something that happened when a family member or patient became very ill, as we are in frequent contact with the most seriously ill in our communities. The only time I felt my life was in danger, however, was when a drug dealer in a neighborhood broke in through a window while I was visiting a client, threatening both of us. It was another client, the lady next door who had schizophrenia, who called 911 to summon the police. We both made it out alive and unhurt.
There are a few circumstances when hospitalization is necessary because symptoms are severe enough to override judgment and safety.
How could you tell if someone’s behavior actually requires intervention? Here’s a brief checklist:
- First and foremost, are they actually threatening harm to themselves or others? Always take such statements seriously. Don’t be afraid to call the police, who can take them to the hospital to be evaluated. In Ohio, a psychiatrist can put a 72-hour hold on someone suspected to be a danger to themselves or others. Let the professionals decide whether a threat is real or not.
- Keep an eye out for friends and family, especially if you already know they struggle with an illness. If they withdraw suddenly, or have another change from normal behavior, check on them.
- Are they afraid, or thinking someone is out to get them or poisoning their food? Are they becoming aggressive towards other because of this fear?
- Have their hallucinations gone beyond just being present, to actually commanding them to harm themselves or others?
The most important thing to remember, is that your neighbor, or cousin, or brother is most likely not a threat to you, but instead needs your support. Stigmatizing people with mental health issues as violent only makes them less likely to seek treatment.