Friday, June 19, 2020

A New Team of Professional Crisis Workers

 The mayor of Hartford Luke Bronin is proposing “a new team of professional crisis workers who would respond instead of or alongside police to calls involving mental illness, emotional distress, trauma and addiction.”

Hartford mayor commits to creating civilian crisis response team to handle certain emergency calls instead of police

As he says in the article in the Hartford Courant, "police should not be the first or only ones to respond to some calls for help."

Hmmm.

How about EMS?

No, wait, we already do it.

He just didn’t know because of our special powers of invisibility.

Now, to be truthful, here’s how it works in Hartford.

Resources are dispatched depending on the way the call comes in.

Let’s talk about these categories.  EDP (Emotionally disturbed person).  Violent EDP, Overdose, Shooting, Stabbing, Assault.

Many years ago when I started in Hartford, we were sent to these calls and we just went.  In time, we started to do something called staging.  We respond, but wait for the police at a safe distance.  Today, a nonviolent normal EDP, we don’t stage.    We stage for a violent EDP.  We stage for shootings and stabbings.  Sometimes we stage for an assault and sometimes we stage for an overdose.  I understand why they have us stage for a some assaults in case the assailant is still there, and I can see us staging when we are sent for an overdose when the overdose is a large muscled man on PCP climbing naked on cars.  I don’t understand why sometimes they have us stage for an apneic heroin victim, but staging for such calls is rare.

Let’s say the call is a violent EDP.  The police enter and we wait for them to call us in.  Sometimes, they bring the patient out in handcuffs, sometimes they come out and say misunderstanding, but most times we go in, talk to the patient and convince them to come with us to the hospital.  We often do a good guy bad guy routine.  They want to get away from the cops so they go with us.  Sometimes, they are holding the patient down, and we sedate them, and then they help us get them on the stretcher and follow us to the hospital.  Usually, when I sedate a violent EDP, they are snoring by the time we get to the hospital.

On the heroin overdoses, sometimes the cops show up and try to force the patient to go to the hospital when they refuse.  I once had a cop say, “Either you are a victim of a medical illness, in which case you are going to the hospital, or you are a criminal, in which case you are going to jail.”  I am against these forced transports.  If a patient is alert and oriented, I will take a refusal after giving them a full discussion of where they can get help and how to stay safe.  For the most part, the cops will defer to whatever EMS decides is right for the patient.

I have noticed on some overdoses lately harm reduction people have shown up on scenes, often getting there before us.  (They listen to scanners).  They are helpful and never in the way.  I can see how dispatching them formally would be a good thing.  I am also not opposed to mental health professionals going.  This has happened sometimes in the past.  They can be helpful, but they can also just make things worse.  I have waited on scene for extended periods while they have conducted their assessments.  I prefer that we say to the patient, how about we give you a ride to the hospital and you can talk to someone there who can here you out?  That usually works.

I am all for keeping the cops on calls where they are most needed.  Sending them for a violent eight-year old or an apneic heroin overdose or a fifty-year old who told her friend she doesn't want to live anymore might not be the best use, but they do certainly need to still go to the shootings, stabbings and crazed people on PCP.