Falling Down (1)

Section 5150 is a section of the California Welfare and Institutions Code (WIC) (in particular, the LantermanPetris–Short Act or “LPS”) which authorizes a qualified officer or clinician to involuntarily confine a person suspected to have a mental disorder that makes them a danger to themselves, a danger to others, and/or gravely disabled. A qualified officer, which includes any California peace officer, as well as any specifically-designated county clinician, can request the confinement after signing a written declaration stating the psychiatric diagnosis that the diagnosing medical professional believes to be the cause or reason why they believe the patient to be “a danger to themselves or others” or the psychiatric disorder that has rendered the patient incapable of making their own medical treatment decisions.

 – Description of the 5150 Involuntary Psychiatric Hold

Intake

+00:02

He sat in what they referred to as the “security room” – a room with three chairs and nothing more.  There was a guard at the door.  The room didn’t offer any sense of security, safety, calm, peace, relaxation, or surcease of unease.  It looked and felt like a very small unused office or a place where copy machines or supplies might be kept.  It lacked even motivational posters on the walls to provide a visual break from the bland paint and stark corners.

Thirty-five minute ago he had met with his psychiatrist.  Forty-five minutes ago he had filled out a one-page form rating various aspects of his mental state on a scale from 0-3.  He was depressed.  He was struggling.  He needed help.  That’s why he was meeting with his psychiatrist.  To get help.

“I don’t think I have a choice,” she had told him.

He had thought, had feared that this might happen.

His wife joined him in the security room.  They sat and waited and said little.  Time passed.   The security guard joked with other security guards and greeted staff members as they went back and forth in the corridor.  The room did not become more comforting.

Eventually two paramedics showed up with a gurney.

I can walk, he thought.  “I can walk”, he told them.  They smiled and nodded, clearly familiar with the routine and prepared for their reply.  “It’s just policy,” they said.  They started strapping him down as one guard briefed another “Just walk him as far as the elevator.  Once there meet with building security and make sure he gets into the elevator.  Once he’s in, he’s not our responsibility anymore.”

The last of the straps clicked into place and the paramedics wheeled him out.  His wife headed for their car to meet them at the hospital.  He was alone with two strangers, tied to a board.  They took him down in a freight elevator and wheeled him out the back of the building to a waiting ambulance for the short ride to the hospital emergency room.

At the emergency room he traded his real-person cloths for a set of green paper scrubs and was examined for physical problems.  He had to be healthy before he could be transferred because he wasn’t going to a medical hospital, and the facility didn’t want any surprise physical problems to deal with.  It seemed crazy, taking up a bed in the emergency room – he didn’t feel like an emergency.  Certainly not like the other patients there.  The ER staff did their examination, declared his blood sugar high (not surprising) and his blood pressure high (certainly not surprising) and then pretty much left him alone, except for his wife and a guard.  Time continued to pass.  Eventually it started getting late.  Eventually he was informed that he would be spending the night in the ER.  Eventually he was informed that they were having a hard time finding him a bed.  Eventually his wife had to go home.  She took with her almost all of his real-people possessions – clothes, shoes, wallet, keys – leaving only his iPhone, which was threatening to die.  He hadn’t brought the charger because even though he had some concerns in his heart he had thought it would only be a half-hour appointment.

There was nothing to do.

The guards changed shifts around once an hour.  From what he overheard guarding him was considered to be tedious and boring duty and nobody wanted to do it for very long.  There were frequent discussions of swapping duties over the radio.  One guard, however, started a conversation, and discovered he was from Oroville.  The guard became enthusiastic and animated.  Oroville, he said, was a place that he badly wanted to visit.  Oroville had something that he was very interested in.  Oroville had a Shakeys Pizza – the closest Shakey’s Pizza to the Bay Area as it turned out, and the guard really wanted to try Shakey’s.

Looking it up on his iPhone, he discovered that it was true – the town where he grew up did, in fact, contain the Shakey’s closest to the Bay Area – the only Shakey’s in Northern California.  The Shakey’s he had been in many times growing up, and was not far from his childhood home.  The incident was so bizarre that it made him, for the first time that day, actually question his sanity.  What were the chances of meeting a security guard in an emergency room who had a dream of driving to your home town and eating at a restaurant you went to all the time as a teen?  It just seemed to defy belief – like seeing angels or ghosts.

Sleeping in the Emergency Room was impossible.  He was lying on a glorified gurney with one thin blanket.  Just outside the area where he was being – what?  Housed?  Secured?  Stored?  – the ER continued about it’s business.  As the night grew later and turned into very early morning, there was a constant stream of patients into the ER – accident victims, a drug overdose, a woman moaning continuously from some abdominal distress, a man found unconscious and naked in a parking lot.  All during this time he continued to take up a spot in the ER, and the guard continued to wait just outside the door.

The guard also had to follow him to the bathroom when he peed, which he had to do a lot because they kept giving him fluids.  Some guards were circumspect about it, and simply admonished him to keep the door unlocked when he peed.  Others insisted on standing in the doorway, though they turned their backs (which was understandable – there are few who actually enjoy watching people pee).

A nurse took pity on him and charged his iPhone in the staff break room, and he whiled away a bit of time sending messages to some people and forwarding the occasional Facebook funny.

Then two more paramedics showed up with another gurney.  The hospital had located a bed at a mental health facility that was an hour away.  Again he was strapped down and carried towards a waiting ambulance.  But the hospital doors leading to the ambulance parking jammed and no one seemed to know how to open them, so eventually he had to be wheeled out through the waiting room, past family and friends of the other ER patients, waiting for news about their loved ones.

It had been eighteen hours.  Aside from a very brief explanation to his psychiatrist that amounted to no more than a general outline, no one had yet asked him why he was depressed.

Continued in “Falling Down” (2)

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