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Without Psychiatric Beds, Patients and Police Must Wait

Alexandria Tries to Cope With Hospital's Decision to Close Mental Health Unit

By Elaine Rivera
Washington Post Staff Writer
Sunday, September 12, 2004; Page C05

The indigent patient was in need of psychiatric care, and two Alexandria police officers stood by his side at Inova Alexandria Hospital to ensure he didn't hurt himself or others.

When their shift ended, two more officers stepped in to watch the patient. Hours later, two more officers took over. Nearly 24 hours later, the patient, who was waiting for a bed in another jurisdiction, was finally admitted to Inova Mount Vernon Hospital in Fairfax County.

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Deploying the officers to stay with the patient cost approximately $1,680 in salaries and benefits, said Deputy Chief Blaine Corle of the Alexandria Police Department. "They were being paid to be babysitters," he said.

Last month, Inova Alexandria closed its 19-bed psychiatric unit. At the time, police and mental health officials predicted that there would be a drain on resources if they had to place indigent patients at other hospitals in the region.

Now, they say their worries have come to pass.

"We've had two incidents in which we had a prolonged need to commit resources to safeguard patients," Corle said. "We had discussed our concerns for the better part of the year with Inova and they were confident that this would not occur."

Corle said officers and a mental health worker stayed with another patient for 12 hours before he was admitted to Inova Mount Vernon Hospital.

Liz Wixson, director of acute care services for Alexandria's Community Services Board, said it's not just taxing for police and the mental health workers, "it's worse for the patient."

"Anything more than one or two hours is too long. They end up getting medicated more than they should," said Wixson, who added that in the first incident, the therapist called 20 hospitals across the state before the patient was placed.

H. Patrick Walters, a senior vice president at Inova Alexandria, said the incidents were a result of "making adjustments as we're making the service change."

"Our best estimates are that beds will be available as we continue to provide emergency services for any folks who need that in Alexandria," Walters said.

Inova officials decided to close the hospital's psychiatric ward because of low patient numbers and a reduction in full-time specialists.

The decision, however, not only costs the police department in labor, Corle contended, but it also puts officers in a Catch-22. Under state law, for police to hold a person involuntarily, officers must first observe that the person may pose a harm to themselves or others, according to Corle. But officers can hold the patient for only four hours unless a magistrate issues an order for further custody.

Corle argued that if officers have to spend those four hours with the patient while they are trying to have the patient admitted or while driving the patient somewhere outside the city, they may exceed the time limitation.

"It puts these line officers in a precarious situation," he said. "Once the time limit expires, they don't have the real legal authority to hold these people, and at the same time they know it's a recipe for disaster if they walk away. They are not criminals and are not treated as criminals. We hold them against their will until an assessment is made."

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