Thursday, February 8, 2018

Post Cop Depression

As one who found the Cops at her door early one morning on a wellness check I heard of the story below,  my first  thought:   Well at least they did not kill her.  Most wellness check ends up with the individual dead, which clears that problem up, however.

The week my visit happened a Cop had gone on a suicide call to a woman in a vehicle  who was inebriated, confused and in desperate need of mental health counseling. In the process she released the break and the car rolled into the Cumberland River.  The two Cops were not Seals, nor trained mental health professionals nor even suitably attired  to go into a river that was freezing cold in mid winter and that only certified rescuers should do, jumped in to "save" her.  One died and here we are a year later still mourning his unnecessary death and her being tried for manslaughter. 

Clearly we have a lot of learning to do here about what Cops should and should not do in these situations and yesterday during a Domestic Violence call there was a day long standoff when the individual barricaded himself in the apartment, fired shots and one hit an Officer who thankfully was only  marginally wounded.  This was on the same day that a local foundation/group filed ethic charges on the Mayor as they believe her banging a cop led her  to fail to provide sufficient policies that were with regards to Police oversight.  Ya think?

But needless to say Cops are NOT mental health providers and answering such calls that include Domestic Violence that ends with a SWAT team arriving says that this is not a call one should be making unless they are willing to see bullets fly.

But again when you believe a Nurse would call for Police assistance when they have access to appropriate referrals and  medical professionals available to handle said situation you have this,  a woman forced into mandatory observation and her civil rights taken from her without due process.

I want to say I was surprised but again I was in a medical dental professional building and I was angry and instead of referring to me well someone down the hall, four days later the cops showed. Had I been dead I am unsure how they would know.  Would they then  knock on neighbors doors? Find out where I am employed and call my employer?  Would they bash the door down? Would they get a warrant in which to do so?  No on all of those.  We had such a situation here when a Son called the local Police about his Mother and his concerns that her boyfriend may have done her harm.  The Cops went to the residence knocked, no answer and called the Son and said there seems to be nothing wrong, no one was at home and that was that.  The Son flew out here and went to the residence and found them both dead.  So much for that wellness check, they weren't very well after all.

But again to commit a woman who is expressing depression and who came willingly in for help the best thing to do is get her help.  Locking her up,  confining her and subjecting her to Police does what exactly for her well being?  Again one of the Cops said to me, "You do seem anxious and depressed.' As to my response, "Well let's see I am in my pajamas getting ready for work, I find two Cops at my door asking about my mental health and are you qualified to make said diagnosis and if this does not make someone anxious what does that say about me in another way?" It ended with me getting a dental referral for another Dentist whom I did see and had him review the plan and said his costs would exceed what I was quoted and should pretty much stick with them.  I did not tell him exactly the back story on how I got said referral but the visit was handy as he confirmed the treatment  plan and gave me a solid second opinion.

I want to point out that the woman is on Medicaid and this could be a class issue or one of race but the reality is that women who are poor and of color receive inadequate care and often neglectful care.  This was both.  The reality is we have horrific mental health options for even those insured and the challenges of getting  help regardless is slim to none, particularly for women as the stigma of this issue still exists.  Time's Up.

Nurse Calls Cops After Woman Seeks Help For Postpartum Depression. Right Call?

February 7, 20185:00 AM ET
Heard on All Things Considered
April Dembosky

Jessica Porten went to a doctor's appointment with her daughter, Kira, to get help with postpartum depression. She soon found herself in the company of police who escorted her to a hospital's emergency department.

Four months after having her second baby, Jessica Porten started feeling really irritable. Little things would annoy her, like her glider chair.

"It had started to squeak," she says. "And so when I'm sitting there rocking the baby and it's squeaking, I would just get so angry at that stupid chair."

She read online that irritability could be a symptom of postpartum depression — a condition that affects up to 1 in 7 women during or after pregnancy, according to the American Psychological Association. In California, where Porten lives, those rates are even higher, spurring state lawmakers to introduce a package of bills to improve mental health screening and treatment for new moms.

Porten hopes they help women avoid what she went through.

She went to Capital OB/GYN, a women's clinic in Sacramento that accepts her Medicaid coverage as payment, to talk about medication options and therapy. Porten admitted to the nurse that she was having some violent thoughts.

"I described maybe hitting myself or squeezing the baby too tight," she says. "But I was very adamant through the entire appointment that I was not going to hurt myself and I was not going to hurt my children."

But, Porten says, the nurse's manner toward her changed. "I could see in that moment that she stopped listening to me," Porten says.

The nurse called the police. The police escorted Porten and her baby to the emergency room. Hospital staff made her change into a gown and took her purse, but they let her keep her diaper bag for the baby. They put them both in a room, under constant watch, though the hospital staff was sympathetic, Porten says.

"It's like, everybody knows I'm not crazy," she says. "Everybody knows that this is normal — but they're following protocol."

Finally, at midnight, 10 hours after she first got to the doctor's office, a social worker sent her home. Porten wrote on Facebook that the whole thing made her feel like a criminal.

"It was all legality," Porten says. "Everybody was protecting their own liability instead of thinking of me."

Administrators at Capital OB/GYN declined to comment. Gary Zavoral, a spokesman for Sutter Health, which runs the emergency room where Porten was taken, says that once a patient arrives in the ER for assessment, hospital staff must follow strict protocols.

"The process is to make sure everybody is safe: the individual's safe, the family's safe, the staff is safe," he says. "The process does take some hours, so 10 hours is not unusual."

When patients reference violent thoughts, it forces doctors to think about things in a different way, says Dr. Melanie Thomas, a psychiatrist at the University of California, San Francisco and Zuckerberg San Francisco General Hospital.

California law allows doctors to involuntarily confine a person with a mental disorder if they are a danger to themselves or others. But Thomas says what constitutes imminent danger can be vague.

"You can imagine a provider, a social worker, any number of people might interpret that phrase in different ways, about what is necessary to report and what isn't," she says.

The laws and medical protocols don't always line up, Thomas says. There have been times she felt asked to rely on legal reasoning over her clinical judgment.

"The fragmented aspects of our system of care make it difficult to get women the help that they really want," Thomas says.

That is one reason lawmakers in Sacramento are now introducing a package of bills to specifically address maternal mental health. Assemblyman Brian Maienschein, R-San Diego, is backing two of them. One would require doctors to screen new moms for depression; under current law, it's voluntary.

"The numbers here are so significant that I think it's something that doctors really should understand and should be prepared to both diagnose and treat," he says. Screening, he adds, also "educates a woman in that situation that this is an issue that may impact her."

Maienschein's other bill would direct the state to tap into a new federal pot of money set aside for postpartum programs and awareness campaigns. It was established under the 21 Century Cures Act, which was passed in the final months of the Obama administration.

"Getting federal money is a great thing," Maienschein says. "It's federal money that's available that I'd like to see California have, versus another state."

The legislation has given Jessica Porten a new purpose. People have told her that she should sue Capital OB/GYN for calling the police. But she says no.

"I walk into that waiting room and I see tons of Medi-Cal recipients — so they're all low-income," she says. "If I sue, it's only going to cause monetary damages to a facility that is clearly short on resources."

Instead, Porten says she'll advocate to get the new bills passed in California. She thinks that is the way to help the clinic's physicians and nurses do a better job of helping new moms get the care they need.

"I'm not going to take that away," she says. "I'm going to build it up."

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