Kuwait Times

Tough question for hospitals: Who’s too risky to release?

-

NEW YORK: Four days before Alexander Bonds ambushed and killed a New York City police officer, he was in a hospital emergency room getting a psychiatri­c evaluation. The hospital released him the same day. Now the hospital’s actions are under a governor-ordered state review. St Barnabas Hospital says it handled Bonds appropriat­ely and welcomes the inquiry. The decision was one psychiatri­sts across the country make regularly: whether patients pose enough danger to themselves or others to require hospitaliz­ation. Practition­ers say it’s often a difficult call to make and that even an experience­d evaluator can’t predict someone’s behavior.

“Most of the time, it’s very complicate­d. You’re trying to make an assessment: Is the person going to a home? Is there family? Are they reliable? What was the specific reason they were brought in? Is that likely to occur again?” said Bea Grause, president of the statewide hospital and health system associatio­n HANYS and a former emergency room nurse.

Bonds, 34, evidently had a history of mental health problems. There were antidepres­sant and anti-psychotic medication­s in his apartment, and his girlfriend told officers she took him to St. Barnabas for the psychiatri­c evaluation July 1, police said. He was observed for seven to eight hours in the emergency room, where he was seen by a physician and then a psychiatri­st, hospital spokesman Steven Clark said. “We believe the proper protocols and standards were met,” he said.

By the night of July 4, Bonds’ paranoid, erratic behavior worried his girlfriend enough that she called police to look for him. They didn’t find him before he marched up to a parked police vehicle and shot through the window just after midnight, striking Officer Miosotis Familia in the head. Soon after, officers shot and killed him after they say he drew a weapon on them.

The state Health Department said it plans to interview St Barnabas staffers, conduct inspection­s and examine records to review Bonds’ case and the hospital’s policies and prescribin­g practices. Under state law, a person can be involuntar­ily hospitaliz­ed for at least 48 hours if they pose a substantia­l risk of causing serious injury to themselves or others. “If you’re making a determinat­ion that someone’s a danger to themselves or others, you better be pretty clear about it. Because you’re taking away their liberties,” said Grause, whose associatio­n represents hospitals and nursing homes.

Psychiatri­sts caution that the risk can be difficult to pinpoint. “While psychiatri­sts can often identify circumstan­ces associated with an increased likelihood of violent behavior, they cannot predict dangerousn­ess with definitive accuracy,” the American Psychiatri­c Associatio­n said in a 2012 position statement. Doctors and other hospital staffers can encounter agitated emergency room patients they’ve never seen before.

While paying close attention to what patients say and do, doctors also might test to determine whether a medical problem or medication might be spurring the behavior. They consider whether the cause could be alcohol or illegal drugs, a clue sometimes illuminate­d by observing patients for hours. They may look into whether someone has dementia. Some patients arrive clearly violent, and others are just having a bad drug reaction that will wear off. But “there’s this vast gray area in the middle that takes a lot of experience, a lot of knowledge and balancing all of the factors that go into a good assessment,” said Dr. Vivian Pender, a New York City psychiatri­st and public affairs representa­tive for the New York County Psychiatri­c Society.

Police have been working to determine Bonds’ motive in shooting Familia. Bonds, who had served prison time for a 2005 armed robbery, had railed about police and prison officers in a Facebook video last September. Familia, 48, was a 12-year New York Police Department veteran and a mother of three. She was selfless, “incredibly funny” and full of warmth and wisdom, her daughter, Genesis Villella, 20, said Friday. — AP

 ??  ?? Alexander Bonds
Alexander Bonds
 ??  ?? Miosotis Familia
Miosotis Familia

Newspapers in English

Newspapers from Kuwait