Mistakes Common in Confronting Mentally Ill

The Register Guard (Eugene, OR), January 3, 2007 | Go to article overview

Mistakes Common in Confronting Mentally Ill


Byline: GUEST VIEWPOINT By Gary Crum For The Register-Guard

The SCAR/Jasper Mountain treatment facility for disturbed children has received considerable attention after three residents were injured while being physically restrained by staff. My comments, based on experience, are not intended to criticize or defend the Jasper Mountain program, but to promote an understanding what it it like to confront emotionally disturbed and mentally ill persons when they are acting out.

First, residential programs are therapeutic communities designed to offer treatment to very disturbed children. Their over-riding concern is to establish and maintain a safe setting for the residents and staff. Programs must provide immediate and effective intervention when a resident goes ``off the track,'' be it an aggressive tantrum or a full-blown psychotic episode. Such intervention is necessary to protect the resident receiving the intervention, the other residents and the staff, to avoid property damage and, of extreme concern, to maintain the integrity of the therapeutic setting.

These residents often have backgrounds that include physical (and often sexual) abuse and a lifetime spent in chaotic surroundings. Before effective counseling and therapy can occur, the child must feel safe and develop trust in the setting and the staff. Unchecked tantrums and aggressive behavior by residents jeopardize that safe climate for all the residents. Physical intervention, usually in the form of restraint, is simply necessary sometimes - and the more disturbed the client population, the more frequently it may be needed.

However, members of the staff - like police officers - too often make serious mistakes when dealing with the mentally ill. To cite two recent examples: A Jasper Mountain worker was involved in a 12-year-old resident's breaking her arm while he was applying a `walk-along' hold. Recently, Eugene police fatally shot a young man who, in the midst of a psychotic episode, refused to drop a knife when confronted by officers.

Let's look at both of these cases: If you or I were subjected to a `walk-along' hold, we would walk along. We would recognize that the hold could lead to pain and injury if we didn't cooperate. We would make the rational decision that our best interest was served by cooperating. …

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