The tragic case of Dr. Bello illustrates the current “revolving door” of processing emotionally disturbed persons.
Crazed persons, often with massive histories of severe and violent mental illness, striking out wildly, belligerently and randomly, are transported to a hospital which will then go through the motions of an evaluation and then discharge the patient within a day or two or even within hours. They cannot be kept against their will for more than an abbreviated stay.
Although the psychiatrists at our large city public hospitals, those cauldrons of incompetence and indifference, obey that law with what seems to be gratuitous relish, they are not to blame for the restraints under which they struggle. Understandably, very rare is the physician who has the courage to stand up for life when the cost could be the repossession of their child’s Lexus.
Hospitals subdue emotionally disturbed patients by making them involuntarily compliant just enough to make them say what they need to say and act as they need to act to qualify for prompt release. They are administered psychotropic drugs to chemically lobotomize them to make them amenable to manipulation. This ensures that when asked whether they are a danger to themselves or to others, they will say “no”, whether or not they actually believe it, thereby springing them back to the streets, the subways, the parks or their homes.
Thus the medical “professionals” have covered themselves, come what may. Many of these patients, unfortunate souls, have been through this game many times and know the drill.
Usually the immediate aftermath of a patient’s discharge is not so dire as a jump from a bridge, a shove of a stranger onto subway tracks or assassination of a police officer. Sometimes that proves to have only been a matter of time. At the very least, a fleeting and vital chance and duty to save a vulnerable person has been abrogated, not out of ignorance but out of callous legalistic restrictions.
In rare instances, a supervisory psychiatrist may wish, against a patient’s will, to detain them beyond the ridiculously brief period allowed. That requires a superhuman expenditure of time and energy and involves satisfying a high judicial standard of burden of proof and the consent of an often skittish and defensive hospital administration.
The court will almost always side with the patient, even when they are incapable of recognizing or acting in their own interest or when they expressly desire not to do so.
Police Officer Familia would very likely be alive today if the legal/medical/ institutional complex were empowered and willing to do what clearly needed to be done to prevent Dr. Bello’s horror.