Police using the term "good for health" and mental subjects

[rolypolyman]

I'm in an east Texas city and monitor my police dispatch frequency regularly. I keep hear dispatch using the term "good for health" about 10% of the time when they're running records on a suspect. A conversation will sound something like this:

"Your subject Bob Smith is eligible, clear, and is good for health."

About the only thing I can find on this is that the state uses mental health warrants. If so, they don't use that term on the radio, and they don't always detain or arrest someone who comes up as "good for health". I'm wondering if they're referring to a warrant specifically, or if this is a code word for someone flagged as mentally unstable. I've only heard the 10-96 code used once in tons of radio traffic.

So how does your city code this kind of thing?

 

[rolypolyman]

An update, I'm finding that they use 2 terms that are similar:

"Good for health"

"Good for safety"

I'm assuming "good for health" means a mental health warrant of some kind and "good for safety" means a concealed carry permit.

 

[Ensnared]

In this part of Texas, most of the time, the dispatch will relay a history of behavior to the officer. Since I wrote a lengthy post on this topic, it is highly improper to identify the type of mental illness since LE cannot diagnose or properly respond to said person with a diagnosis. I have never ever heard the terms you are reporting.

On the other hand, I don't have any problem with the officer simply describing the behavior they are observing. For instance, I once heard, "this person hears voices of dead relatives, believes special messages are coming through the television, meant for them, etc."

I am vehemently opposed to sharing a person's mental condition such as "schizophrenia" or "bipolar" since a significant number of folks do NOT know the difference between the two. What really annoys me is when they say, "the subject is schizophrenic and bipolar." These are mutually exclusive terms.

In TDCJ, a person had to be "medically cleared" in order for some transfers to occur. 10-96 is still being used as well.

 

[6079smithw]

Here in N. NV some agencies use the term "altered consciousness" and/or the 10-96 APCO code in the call.

 

[trentbob]

So in my County, Bucks County PA we use the term 10-96. A typical call will be female says people are following her and she is afraid and she thinks someone's in the house. Car will respond okay and then the sergeant will come on and say she's a 96, frequent flyer. Stop by and check her out but let her know that's it for tonight we are not coming back.

A voluntary self commitment it's called a 201 where someone volunteers to go in and an ambulance will take them to the hospital and maybe the crisis worker will accept them or they won't but a 302 is a warrant. It's a mental health warrant that says the person is a danger to themselves or others and the police have to have a copy of the original warrant before they will apprehend and detain someone and haul them off to the hospital. That's at least a 30-day commitment. That warrant doesn't go into ncic but it does go into the county list. Very rarely are there outstanding 302 warrants because the cops always get their man because the warrant is generated right before they are going to pick the person up. Once in awhile someone runs away but they catch them except for that one guy that jumped out of the back of the ambulance while it was moving rolled and ran. He was in his underwear and socks but he did get away.

We have an awful large amount of 96s in my area.

Altered mental status in my County means the person is having a stroke but they don't dispatch it as a stroke usually because they're never really sure but it is the code for a stroke.

When they run somebody in my County on a car stop they just reply by saying... good, clear ncic, clear County, subject does have a license to carry, or they say suspended for DUI. Before they let the cop know the person has a warrant or is 10-99 they asked the cop first is your radio secure so they're not standing right next to the 10-99 suspect. After a few minutes you will hear, 1 in custody, mileage is XXX and we'll need a tow here.

In some areas of my County just about every car stop results in a 10-99, tremendous amount of outstanding warrants, mostly traffic. Often a car wreck will result in one or both of the subjects running because they don't have a license or insurance. We also have a very large number of Concealed Carry Permits issued as the county district attorney encourages it. The county sheriff makes the process very convenient for people but they still have to apply for and be cleared for the permit.

All the counties in the country are different

 

[DomW]

One night I heard the officer say "She doesn't need a cop, she needs an exorcist." I guess he meant she was 10-96. I've heard them dispatch a car for a person that's hearing voices and another officer will come on with info on the subject and what to expect as they are familiar with them. I have also heard them talk about "mental hygiene".

 

[trentbob]

One night I heard the officer say "She doesn't need a cop, she needs an exorcist." I guess he meant she was 10-96. I've heard them dispatch a car for a person that's hearing voices and another officer will come on with info on the subject and what to expect as they are familiar with them. I have also heard them talk about "mental hygiene".

This is certainly an unusual but interesting thread and subject.

At one time many of the state facilities were part of the State's Department of Mental Hygiene. When all this crazy PC nonsense started they had to change the names to the Department of Mental Health.

 

[Ensnared]

This is certainly an unusual but interesting thread and subject.

At one time many of the state facilities were part of the State's Department of Mental Hygiene. When all this crazy PC nonsense started they had to change the names to the Department of Mental Health.

Mental hygiene? Holy Jesus that term is rather several decades old. Altered Mental State or 10-96 is best. Of course, telling the officer about the suspect having "command type hallucinations" can be highly critical and very dangerous if they are holding a weapon. Classic positive symptoms of psychosis are known to many.

 

[trentbob]

Mental hygiene? Holy Jesus that term is rather several decades old. Altered Mental State or 10-96 is best. Of course, telling the officer about the suspect having "command type hallucinations" can be highly critical and very dangerous if they are holding a weapon. Classic positive symptoms of psychosis are known to many.

Responding to internal stimuli is a more accurate statement.

 

[Ensnared]

This is a difficult one. When you have a suspected 10-96, it would be wise to pay attention to those who talk about things "outside of their head", not "inside of their head." Generally speaking, auditory hallucinations that occur outside of the head are more consistent with some form of psychosis. One of the leading experts on feigned mental illness discusses this here: How to distinguish between malingering, genuine psychosis

When a person describes what the person is saying and doing, it allows professional staff to differentiate between potential psychiatric disorders.
Here is another article. Malingering: Key Points in Assessment

From my long history working in mental health, the ones that bear watching the most are those responding to things "outside" of their head. Typically, command type hallucinations fit into this category.

There are specific malingering tests that illustrate those who feign. One of the questions I loved asking about less frequently occurring perceptual disturbances was that of visual hallucinations. I would ask them, "what happens to the image when you close your eyes." The answer that follows can help narrow down BS from real. Also, folks should at least learn what they might be encountering when working with mental illness by reading as much as possible about the subject. They ain't going away.

The ones I used to watch the most: a) those who refuse to take their medications, often anti-psychotics; b) those who are responding to voices from outside their head telling them to do things, most don't act on these command type hallucination, but some do; c) those who show obvious signs of negative symptoms such as not bathing for extended periods of time. Often, you experience all these conditions on the street, particularly if they are noncompliant with their medication or they are mixing such with recreational drugs.

Faking it: How to detect malingered psychosis

Feigned schizophrenia symptoms usually won’t deceive the clinician who watches for clues and is skilled in recognizing the real thing.

www.mdedge.com

 

[trentbob]

Interesting, I didn't mention this much but I have talked about it a little bit on RR especially with regards to UPMan and his long-term serious illness.

I am a registered nurse in addition to being a retired newspaper man. I worked mostly in medical-surgical but did some stints in psychiatric nursing. Mostly in locked acute units where most of the hardball stuff goes on.

Most of the time the police just want to hand off a problem subject who is overtly mentally ill and it's causing problems for merchants by yelling at their customers and chasing people in parking lots, wondering in traffic or a suicidal subject wondering up on the high-speed rail road tracks causing interruption in service. They also have to deal with people who are temporarily psychotic due to certain drug overdoses. My co-workers and I were the ones they loved to just take off the cuffs hand the patient off to.

They don't care what the symptoms are or the diagnosis they just know they're backed up on calls and they need to move on. The Chronic out patients who are just calling on the phone to the dispatcher all the time with one delusion or another, they just ignore.

When going for my BSN in the third year of school you were allowed to apply for an LPN license and then on graduation after the fourth year you got your RN. When I started in psychiatric nursing in the early mid-70s we would use huge doses of medication like Thorazine 100 mg 4 times a day and patients were I guess you could call it, managed.

Dosages of antipsychotics are greatly reduced now secondary to a condition called tardive dyskinesia. It started around ten years After phenothiazines began to be used.

Patients lived in large institutions where they served a purpose and had a job working in the kitchen, laundry, Farm, maintenance and housekeeping. They rather enjoyed this as many of them felt they served a purpose.

They changed the laws and no longer allowed the patients to work and they all went to the wards again, I lived on the grounds of the hospital in a staff dorm at that time for free and we had a houseboy, a very nice 60 year old man who took great care of us, we took care of him too. When he had to return to the wards and could no longer be around us he passed within 2 months.

Then we had deinstitutionalization where all the state hospitals were emptied out into the community with very inadequate follow up, hence you have today's Mental Health crisis in the United States. I speak from experience as I was a state community mental health nurse and went into the community doing crisis and follow up the very best I could in my brand new 1974 Ford with state seals and plates. Despite my efforts and others the plan was a total flop and communities were inundated with chronic seriously ill mental patients and hospitals were emptied that at one time had a census of 30,000 patients. It destroyed many a community across the United States as the mall's became the center of shopping.

It's my opinion that not so much progress has been made in the last 40 some-odd years.

When I was working we had the DSM 3 but I can assure you that diagnosis de jour have changed over the years, then we had hebephrenic psychosis now called hypomanic or affective disorder psychosis, we had neurotic personality which is now called a borderline personality. Mentally ill people often pass back and forth in between different symptomology and exhibit different Behavior. A bipolar manic depressive could be very depressed and suicidal and then become very psychotic and aggressive.

I guess the point of all this was to try to share some of my experience over a long period Of time.

The way Mental Health Management and treatment that was once considered inhumane was actually the most humane way of dealing with it and what has happened today and what our police and local emergency rooms, not to mention society in general has to deal with is unfair and has cost a huge toll on the unfortunate mentally ill and Society in general.

Just my two cents LOL.

 

[Ensnared]

I could not agree more.

I started in 1981 working with ID, then moved to another ID unit near Houston. I was an Associate Clinical Psychologist. This system was a behavioral, not medical model of treatment. I was involved in some rather intrusive operant conditioning treatment methods that required approval at a state and local level, particularly the use of faradic stimulation.

I never used this method, but Richard Foxx, Ph.D., one of the leading behaviorist used this method on the following client as a function of the intensity of his behavior. This person functioned in the profound range. He was also legally blind. Hence, as a form of self-stimulation, he continually did isometric exercises to the point of having a "six pack." He was stout. When he became aggressive, the consequences were rather grim. He bit a huge chunk of flesh from one of the older and very frail Registered Nurses. Eventually, the program allowed him to deliver mail on the Richmond State Living Center. Despite decades of scrutiny, state-run disability residences still can't pass muster

In 1987, I started working in TDCJ-ID and worked outpatient until 1993 until working in psychiatric inpatient at the Jester IV in Richmond, Texas.

However, when managed care entered the picture in 1996, all four services, (Medical, Nursing, Social Work, and Psychology) which were all independent departments under The Texas Department of Criminal Justice-Institutional Division fell under the University of Texas Medical Branch, Correctional Managed Care. This remains to be a joke to this very day. Profit margins and treatment do not mix.

I agree with you regarding where to house patients. There are those who benefit from properly-run institutions with adequate funding and quality professional staff.

The bottom line? After retiring from a long career in 2009, I returned to work at a privately owned and state-funded MHMR center. For several years, we worked under the old school method of "taking care of patients" instead of “wrangling encounters” for those who love beans. It was downhill from there.

Profits are mental/medical health treatment should not sleep together. If you invest in "quality treatment" where people are listened to instead of handing out CBT aggression dyscontrol handouts to people and expect any significant change, the taxpayer needs to fork it up.

Obviously, well-funded programs with experienced clinicians costs more money. At MHMR, after completing a battery of psychological tests, I would refer to the treatment floor above. Most of those meant to deliver treatment were interns, not licensed clinicians. They could not interpret the tests because they lacked the training. The Psychiatrists were grateful to get the test results.

In Texas, the state living centers and state hospitals fall under the state. For MHMR, they are privately owned with state funding. There is hardly any quality of care. Hence, they get picked up into the criminal justice systems. They are either moved to ID units or psychiatric inpatient if they are chronic types.

Deinstitutionalization is a vicious buzzword that liberated some and brought some into prison. I can say this without any doubt. I have never ever seen anyone with Down's Syndrome in prison. Typically, most folks understand that they are lacking in skills.

In the end, the cost cuts from these vital programs end up costing significantly more inside a prison. Once patients are released, they are returned to the very environment that failed to keep them stable in the first place. This cycle continues while politicians and laypeople scratch their heads in confusion.

No wonder law enforcement and criminal justice systems are overwhelmed.

 

[trentbob]

I could not agree more.

I started in 1981 working with ID, then moved to another ID unit near Houston. I was an Associate Clinical Psychologist. This system was a behavioral, not medical model of treatment. I was involved in some rather intrusive operant conditioning treatment methods that required approval at a state and local level, particularly the use of faradic stimulation.

I never used this method, but Richard Foxx, Ph.D., one of the leading behaviorist used this method on the following client as a function of the intensity of his behavior. This person functioned in the profound range. He was also legally blind. Hence, as a form of self-stimulation, he continually did isometric exercises to the point of having a "six pack." He was stout. When he became aggressive, the consequences were rather grim. He bit a huge chunk of flesh from one of the older and very frail Registered Nurses. Eventually, the program allowed him to deliver mail on the Richmond State Living Center. Despite decades of scrutiny, state-run disability residences still can't pass muster

In 1987, I started working in TDCJ-ID and worked outpatient until 1993 until working in psychiatric inpatient at the Jester IV in Richmond, Texas.

However, when managed care entered the picture in 1996, all four services, (Medical, Nursing, Social Work, and Psychology) which were all independent departments under The Texas Department of Criminal Justice-Institutional Division fell under the University of Texas Medical Branch, Correctional Managed Care. This remains to be a joke to this very day. Profit margins and treatment do not mix.

I agree with you regarding where to house patients. There are those who benefit from properly-run institutions with adequate funding and quality professional staff.

The bottom line? After retiring from a long career in 2009, I returned to work at a privately owned and state-funded MHMR center. For several years, we worked under the old school method of "taking care of patients" instead of “wrangling encounters” for those who love beans. It was downhill from there.

Profits are mental/medical health treatment should not sleep together. If you invest in "quality treatment" where people are listened to instead of handing out CBT aggression dyscontrol handouts to people and expect any significant change, the taxpayer needs to fork it up.

Obviously, well-funded programs with experienced clinicians costs more money. At MHMR, after completing a battery of psychological tests, I would refer to the treatment floor above. Most of those meant to deliver treatment were interns, not licensed clinicians. They could not interpret the tests because they lacked the training. The Psychiatrists were grateful to get the test results.

In Texas, the state living centers and state hospitals fall under the state. For MHMR, they are privately owned with state funding. There is hardly any quality of care. Hence, they get picked up into the criminal justice systems. They are either moved to ID units or psychiatric inpatient if they are chronic types.

Deinstitutionalization is a vicious buzzword that liberated some and brought some into prison. I can say this without any doubt. I have never ever seen anyone with Down's Syndrome in prison. Typically, most folks understand that they are lacking in skills.

In the end, the cost cuts from these vital programs end up costing significantly more inside a prison. Once patients are released, they are returned to the very environment that failed to keep them stable in the first place. This cycle continues while politicians and laypeople scratch their heads in confusion.

No wonder law enforcement and criminal justice systems are overwhelmed.

Not only the criminal justice system is overwhelmed but so are the inner cities as you can see the homeless taking over permissive Sanctuary cities. Mental health has a lot to do with that as it does a lot of violent crime in the news.

Managed care of course is a big problem not only for the mentally ill but for all of us and our health regardless of the BS they try to brainwash us with that it's better.

In my area on the scanner you hear a huge amount of mental health issues on the radio that the police are dealing with that really eats into their crime-fighting abilities and routine assignments. 10 - 96 calls are frequent, the rule around here is if someone isn't bothering anybody it's not illegal to be mentally ill and they don't do very much about loitering because of all the homeless. If a mentally ill person disturbs the public or a business or put themselves or others In Harm's Way and the police have to step in and a call goes out on the radio.

The police will Patrol the all-night Walmarts that have full parking lots of homeless people living in their cars but they don't hassle them as long as they leave in the morning and make room for the customers and don't shoot up in the Walmart bathroom.

It's a big social issue that is not being addressed and hasn't been for a long long time except for lip service.

The cops around here just deal with it the best they can and it is just a daily occurrence on our dispatch channels.

 

[Ensnared]

Not only the criminal justice system is overwhelmed but so are the inner cities as you can see the homeless taking over permissive Sanctuary cities. Mental health has a lot to do with that as it does a lot of violent crime in the news.

Managed care of course is a big problem not only for the mentally ill but for all of us and our health regardless of the BS they try to brainwash us with that it's better.

In my area on the scanner you hear a huge amount of mental health issues on the radio that the police are dealing with that really eats into their crime-fighting abilities and routine assignments. 10 - 96 calls are frequent, the rule around here is if someone isn't bothering anybody it's not illegal to be mentally ill and they don't do very much about loitering because of all the homeless. If a mentally ill person disturbs the public or a business or put themselves or others In Harm's Way and the police have to step in and a call goes out on the radio.

The police will Patrol the all-night Walmarts that have full parking lots of homeless people living in their cars but they don't hassle them as long as they leave in the morning and make room for the customers and don't shoot up in the Walmart bathroom.

It's a big social issue that is not being addressed and hasn't been for a long long time except for lip service.

The cops around here just deal with it the best they can and it is just a daily occurrence on our dispatch channels.

If you did not know this yet, Texas has some of the craziest folks I've ever encountered. Like the rest of the country, law enforcement struggles with the more severe forms of mental illness; however, as you likely know, hospitals and prisons are quickly overwhelmed with Borderlines and Antisocials demanding attention. Some of the craz

 

[Ensnared]

I was commenting about the frequency of occurrence of 10-96 calls here in Central Texas. Bottom line? Despite the infestation of Chip and Joanna, there are some mighty weird folks here in Waco. I have often wanted to call and correct the dispatcher on various psychiatric issues, but I know better. Typically, I shake my head in frustration and move on because the general public does not seem to recognize antecedent conditions leading to a psychiatric incident. I believe the man who shot the capital police in D.C. had been observed talking to satellite dishes two years prior to the shooting.

Typically, those who work in mental health can often see a trail of symptoms and/or antecedent conditions that led up to a psychiatric incident. I must admit, I was wrong about my assessment of the Batman Shooter.

I attended a forensic workshop in Kerrville, Texas. This was the second time I was lucky enough to see the world-renowned Forensic Psychiatrist Phillip Resnick, M.D.

One of his lectures centered on the Batman Shooter. I have this recorded, but have not copied the power point presentation associated with this lecture. I cannot recall the key points Resnick used to refute the contention that his murderous rampage occurred as a function of mental illness. One day, I will work to clean up this recording.

If you are interested, there is a book that became my Bible: Clinical Assessment of Malingering and Deception, Fourth Edition: 9781462533497: Medicine & Health Science Books @ Amazon.com

So, I will continue to sit in bewilderment as the world continues to turn. Since I have retired from practice, for the time being, I will continue to enjoy my solitude. A correctional environment can drain your soul even under the best of conditions.

I used to love how many offenders would "attempt" to feign psychotic symptoms in order to escape consequences. Even those with genunie mental illness engage in malingering for possibly different reasons; however, those who are not mentally ill botch it almost every time.

As you know, it is very difficult to fake negative symptoms of psychosis. However, I used to love hearing the bogus accounts of hallucinations. Many folks don't bother to ask if the perceptual disturbance occurred while awakening or going to sleep. Hence, some would go on an put them on medication. But, I have never ever seen anyone capable of sustaining a feigned display of full blown mania. LOL.

So, if the psychiatric/psychological community can have such variance, God help those who have to deal with them on the street.

When I worked at an intake unit in Gatesville, Texas, you never knew what they Hell you would get off the chain bus. Typically, the processing team would receive some kind of notice regarding the bizarre behavior of someone from the county, but not always. You have to be on your toes to spot potential or ongoing offenders close to decompensation.

My former colleague from the TDCJ-ID psychiatric unit, Jester IV, near Houston, called me one day stating that he was the mental health worker who went on runs with Houston PD. I envied his good fortune. Of course, there were some pretty close calls reported.

In other parts of Texas, the MCOT staff have bachelor degrees and that is all. Most of these individuals are clueless particularly when the ID/MH combination is encountered on the street. Texas needs to fork up the money and place licensed clinicians in MCOT positions.

For the moment, I am taking a breather. Glad to have met you. Thanks for sharing your comments.

 

[trentbob]

Nice to have met you also... We probably both approached mental illness in different ways. I have been a RN now for about 45 years now and I did some long stints in acute psychiatric nursing and have my ANA board certification in psychiatry.

As I had mentioned dispatchers and police officers could care less what the diagnosis is or how it started or how it will be treated, they just want to get these people out of the complaints hair and dump the individual on someone else who is more qualified and appropriate to deal with them.

The cops would come in through secure locked doors, they would put their guns in our gun boxes on the wall and we would give them the keys and then they would bring the subject into a more secure area, take the Cuffs off and hand over the individual.

We had the use of straight jackets, four point restraints and adequate chemical restraints. Staff were only the most experienced and qualified and we wouldn't work with anyone who wasn't.

You would be surprised how crazy people are in every community. Sure you have your malingerers and borderlines who are looking for for 3 Hots and a cot and to meet some vulnerable girl but they don't get admitted to acute units anymore. It's not rocket science to discover who a genuine mentally ill person and a malingerer is. The suicidal ticket doesn't work anymore either.

People who are going to commit suicide don't come into crisis with superficial scratches on their wrists and text everybody they know how suicidal they are, people like that are way too narcissistic to harm themselves... real suicidal people are scraped off the front of Amtrak trains and never see the system unless they are lucky enough to get saved.

Don't want to get too much into this on RR but a lot of the people you see in the news who commit these mass murders whether they use a firearm or an ashtray are clearly seriously mentally ill but the answer is of course to take away the implements used and not treat the reason why they were used.

Today I was doing some part-time work, I'm also a longtime newspaper reporter who retired from a seven-day-a-week daily as a department editor and I still do freelance work. The majority of calls I heard today on the police radio on the few zones I was monitoring in the most populated part of the county were primarily 10-96 problems... a total nuisance for the cops who were also dealing with some other serious situations including felony stops and early in the morning a two-state Tri-County Pursuit of a felon. They actually got him in Center City Philly and I give a lot of credit to the New Jersey state troopers who stayed with the pursuit from Central Jersey, joined by at least five bailiwicks and Pennsylvania State Police. LOL.

Keep in mind this is a national problem and there are the craziest people in all areas of the country.

Again thanks for the conversation, something I don't talk about too often but it was a different experience and certainly gives you a certain perspective on life.

Take care... Bob.

 

[Ensnared]

Yes, we had VITEK procedures to compel treatment in those who did not want medication, the ones I used to really watch. My expertise was psychological testing, including both the SIRS and SIRS-2, MMPI-2, and many more.

You see, after a comprehensive evaluation, I would follow it with objective personality testing. Validity indices helped define those who were full of it. However, one must rule out reading difficulties, etc. The fun began when I reviewed the "critical items" from the tests. One fool completed half of the 463 items on the MMPI-2 with only one of two cassettes. When I asked him how he completed the rest of the tape without the other questions, he could not give a tenable answer. If they hesitated before answering a question they endorsed, it was a red flag.

I will have to disagree with you on one point. It is untrue that those who engage in self-cutting don't eventually kill themselves. There are certainly exceptions. My biological mother used to cut herself. In her case, it was really hesitation marks. She was practicing. In 2002, she did it right and followed the guidelines in the book, "The Final Exit." She knew how to do it and now she is gone. She stopped her heart with the recommended brew for death.

In TDCJ-ID, my job was to supply the testing results to discharge them from one of a few air-conditioned units in TDCJ-ID. The focus was to identify those who feigned and not discharge those who really needed help. The intake numbers at one of the female units amounted to 170 bodies per week, using three intake clinicians.

At the state living center for ID, we used contingent restraint since it was behavioral intervention and not a medical order.

I have been working in this field since 1981.

Glad we crossed paths. I still think Texas has more nutcases, LOL.

Again, it is easy to see why law enforcement tends to be baffled by diagnoses. To me, it is better to just describe what they are saying and doing.

 

[trentbob]

yes just to clarify what you pointed out as not agreeing with I do see your point. Making superficial scratches as a gesture is not the same as what you're talking about, perhaps a deeper cut what you refer to as practice but not achieving the goal, I'm sorry to hear about your mother.

Then you also have a cutter which is a whole different story. I would often see a cutter make very deep and severe Cuts in their arms not near arteries or veins for the pleasure of it and the pleasure of the pain but not to kill themselves, I've watched people take a lit cigarette and burn a hole right to their bone achieving tremendous satisfaction before I could get at them to stop it.

One thing I forgot to mention that takes a lot of time away from our police and this type of call is dispatched all day everyday, that is an overdose of heroin that people use to replace narcotics that have been restricted in Pennsylvania because of a Statewide computer system.

Believe it or not the police here all carry Narcan injections, they administer it all day long. State grants had to be obtained by our Police Department's to pay for it as it is so expensive and they inject so much of it every single day. Police here make sure they have Narcan injections the same way they make sure they have ammunition.

We have more people in their 20s and 30s in the obituaries than people in their 70s and 80s.

The police take that radio call very seriously and respond promptly before the squad gets there. They don't save everybody, they usually stop after two injections. In my County that's called a class 5 and the coroner gets a call, again it happens all day everyday.

When that happens there is a protocol the police have to follow regarding the paraphernalia and the baggies Etc and any markings on the bag. It all gets forwarded to the narcotics Squad.

I guess this is a pretty morbid thread but it is a slice of life and I hear it on the radio every day between the 10-96 and the overdose calls.

 

[Ensnared]

I also worked on a Safekeeping Unit that housed homosexual offenders, cops, building tenders (turn key) and some clergy. We had one fool who was attempting to get off the unit. He emitted one of the most brutal methods of getting admitted. He actually cut one of his testicles out of his scrotum and threw it on the run. That will surely get the attention of the Warden. Our Acute Care Treatment Team sent him back to his unit of assignment with BPD.

I would sometimes wait until the 4th time they sliced and diced. The more dramatic ones would attempt to smear the blood and squirt it in their hair to look more serious. Then we had one sex offender who looked like a Rand-McNally road map from deep lateral cutting. He went really deep. When he went to get stitched up, I told the nurses not to engage him in conversation. Fix and go. I did not want to inadvertently reinforce his SIB.

I used to sit on the QC review committee in Huntsville. We reviewed the suicides. We had one fellow who managed to hang himself beneath the mattress frame, within 11 inches of the floor. I don't know how in the Hell he did this, but this was in the Psychiatric Unit. Some of our officers were rather lax in their interval recording.

At MHMR in Temple, Texas, we trained the MCOT Deputies to recognize various symptoms they might encounter.

However, I roll my eyes listening to the scanner when I hear some lame self-harming gestures for some type of secondary gain. I refused to call self-cutting or other forms of self-harm as being suicidal. When the Warden attempted to classify this otherwise, I would quickly correct them. I had medical autonomy based on the Ruiz Lawsuit in this state.

Generally speaking, If a person wants to kill themselves, they won't tell a living soul. When death is likely without a chance of rescue (offenders would often tie off their cell to avoid S.O.R.T. entry to save their lives) then the outcome is death.

Furthermore, I have a pet peeve. It is rare for fecal smearing to be associated with mental illness. The old diagnosis of hebephrenic schizophrenia included this behavior on occasion. This is one of the quickest ways for someone to get shipped to inpatient. Wardens don't like poop on their units.

Then, there was this fool. I saw him prior to his debut on the front page of the former Houston Post. Security referred him to us because he cut his scrotum. When I asked him about the extent of his injuries, it was around 1/16h of an inch long and superficial. I have not followed his case, but his attempt to get castrated brought additional charges. He could not keep his mouth shut. Now, I see he is still around. God bless those who are harmed by this maggot. Sex offender who asked state to castrate him after molesting kids released from jail in San Antonio

 

[trentbob]

Oh I could tell you some stories also. I'll spare the RR community as if anyone is actually reading this anyway but you and I. Many stories that probably only you would appreciate.

It does remind me why I went back to medical-surgical nursing LOL

I was always a newspaperman also and had my own darkroom by the time I was at age 16 and that's what I ended up doing full-time, I left nursing all together, when Managed Care came in I was too ethically challenged. I did a stint in utilization and review and that didn't last long, they realized I had far too much Integrity to do that job properly.

Many interesting stories I could tell you that you would relate to. I'll limit it to one and then call it quits LOL. I'll make it as brief as possible. You'll appreciate it.

I was working in a large 800 bed University General Hospital in a large Northeastern city. A 27 bed locked psychiatric unit on the 8th floor. 4 security rooms, or affectionately called rubber rooms. We had an ECT room, 3 beds, no waiting LOL

On the 11 to 7 shift as the charge nurse, 4 RNs and 3 techs... well built unit with all the safeguards.

Looking for an uneventful safe night eating my corn flakes in the kitchen and a Tech comes in with a look of Terror on her face sputtering and pointing, I knew it wasn't good as we are all running down the hall following her. I discovered a 19 year old girl lying in bed both arms completely sliced up one more than the other of course. I said get the crash cart, get me lots of towels and tape and call a surgical code. I asked her are you with me but her pupils were uneven and my assessment was she was Knocking on Heaven's Door.

Lucky for her she was in a large University Hospital. Applied tourniquets and wrapped the arms pretty tight, even though this was 1976 I was qualified in IV line placement and started a line in her leg and dumped 3 units of plasma in her and by that time 2 surgical residents showed up in response to the code. They started clamping off major bleeders. She had basically stopped bleeding anyway because when you go into shock like that all of the blood that's left pools to the organs, my guess is she lost five or six pints at least. Universal precautions were not a big deal as the first cases of HIV were not showing up until 77 and 78. We wore Street clothes.

She went to surgery and survived but of course never had use of her arms and hands again... how did she get the razor, her family brought it in at her request to shave her legs. A regular safety razor with a blade. Stupid family and it got past the staff.

So here's the part that you will understand and appreciate. She was very conflicted about her career and future and at odds with her family about it.

She was a gifted piano player and a standout student at Juilliard.

Well we should stop here as we are way OT now. Appreciate talking with you and these are things I haven't thought about in a long time but talking about all of the mental health issues we hear every day on the radio has led to an interesting discussion.

Thanks again for a unique conversation!!!