It took five police officers, two social workers and a nurse more than an hour in the driving rain recently to move Charles Ford from the heating grate he calls home at 22nd and E streets NW.
Commuter traffic streamed by as Ford, one of the ragged "street people" who wander the city, cursed and fought before finally being forced into a patrol wagon to be hauled off to D.C. General Hospital's emergency room.
Charles Ford may not have known it, but he was the object of an emergency involuntary mental health commitment -- a little known procedure here designed to get unattended persons considered a danger to themselves or others to undergo temporary mental observation and possible treatment.
Only three categories of people can invoke the procedure -- doctors, police officers and specially designated "officer-agents" of the city's Department of Human Services.
Doctors are busy and rarely do it. Police officers must personally witness the behavior justifying emergency commitment and thus rarely do it. That leaves the DHS officer-agents, and today, there is only one of them.
She is Minnie Marie Bingham. Diminutive, soft-spoken, pillar of her Baptist church and a registered nurse, Bingham was the central character in the drama at 22nd and E streets last month and the one who signed the commitment recommendation against Charles Ford.
At 53, Bingham is the last of about a dozen officer-agents appointed by the city in the last 15 years to initiate involuntary commitments in the absence of police and doctors.
While others have retired or dropped out, Bingham continues to do the sometimes dangerous, always difficult, and legally touchy job. The city pays her nothing for the work, beyond the salary she earns already for her regular job as a nursing supervisor at the Area B Community Mental Health Center.
"They never gave them officer-agents any money, never gave a raise, and she's the only one that stuck by it," said James S. Garner, chairman of the D.C. Commission on Mental Health. "She continues because people need help."
According to Garner, about 1,800 persons are involuntarily committed in the District of Columbia each year, most by the more common petition process that can be initiated by a spouse or parent. It requires a hearing before the mental health commission and can take three weeks or longer.
For more urgent cases involving unattended persons such as Ford, city law permits immediate commitment. The process is not simple, and Minnie Bingham has authority only to recommend commitment of the person and take him to the door of a hospital.
There, a medical doctor or psychiatrist must approve the patient's admission. Sometimes they refuse. Even when they permit it, the patient cannot be held more than seven days without a court hearing to determine whether he or she should be held longer. The result is that many patients soon end up back in the street.
Minnie Bingham, interviewed in her Spring Road NW office, said that her emergency commitments "are really, really dangerous now, so the police will either meet me at the scene or come here first to discuss the situation. The clients are younger now and have more access to dangerous weapons."
Bingham recalled a close call that taught her a sobering lesson in caution. She said she had been called to a home by a father whose 25-year-old son was "really out of contact with reality." The son was threatening to kill him and other family members, Bingham said.
"We were all on the porch, and he accused me of being some kind of goddess who wanted to kill him," Bingham said. "He jumped on the policeman's gun. I didn't know what to do but run, because whoever got control of the gun was the one who was going to be alive."
The police won the skirmish and took the man in. No shots were fired. Ever since, Bingham says she always asks for at least two officers if the person is "younger and appears overtly psychotic."
There are cases that bring another kind of pain. Bingham recalled a middle-aged man who had holed himself up in his apartment building to protest its sale. He had both refused to be moved and to eat, she said.
He remained there for several days while various city agencies squabbled over who was responsible for him and whether his problem was physical or mental. When mental health workers eventually went to his room to remove him, he was dead.
Despite such tragedies, Bingham says she persists in her job because "I know what it's like to be poor and be without." The second of 13 children of a West Virginia coal miner, she said it was "always my desire to get out of West Virginia. I didn't want to be a coal miner's wife and end up like my mother, having a lot of kids and not knowing where the next meal was coming from."
To get out of West Virginia, she applied for and passed a mail-in exam to enter nurse's training at the old Freedmen's Hospital here, but did not begin for another seven years because of her father's failing health (he had black lung disease).
Even after coming to Washington, she worked as a maid in the nurses' dormitory and later as a nurse assistant at Walter Reed Army Medical Center during the Korean War before beginning her formal training.
"A lot of people helped me and I just want to help people," she said. "I'm not asking for any glory."
"It takes a special person to do that kind of work," says David Yochim, executive assistant in the city's mental health services administration. He said Bingham is scheduled to become manager of a new crisis resolution center at D.C. General Hospital that will handle some of the cases she now takes in the streets. Yochim said the administration also hopes to train additional qualified city employes and be able to pay them for their work.
In the meantime, there is just Minnie Bingham, on call for the Charles Fords of the city streets.
"Somebody is trying to kill me," Ford, 43, raged last month, as plastic-gloved policemen lifted him from the heating grate at 22nd and E streets, leaving his grocery cart of rain-soaked rags and plastic bottles as a forlorn landmark.
"You understand that when we get him to the hospital and the doctors won't take him, he's a free man," one of the officers called to Bingham, who had come across Ford after a citizen wrote to the mayor about the man's condition.
Ford, weak from lack of food, his hands red and swollen, was delivered to the emergency room at D.C. General for medical treatment. After that, according to Minnie Bingham's plan, he was to be transported to St. Elizabeths Hospital for emergency psychiatric commitment, while she moved on to another commitment case.
That is not quite how things turned out, however. Ford was never admitted because he refused medical treatment at D.C. General, according to Dr. Donald Marshall, who was on duty at the time.
"If the patient was a danger to himself or others, we would have expected him to be escorted by someone who would make sure he received treatment," said Dr. Donald Thomas, director of emergency care at D.C. General. "If the patient was unaccompanied, we have no legal authority to hold him or treat him."
Undaunted and concerned for the man's health, Bingham kept an eye on Ford's heating grate at 22nd and E streets. When he showed up again a few days later, she repeated the process -- and this time accompanied him to the hospital. Ford was admitted and currently is a patient.
"That man was so weak he could hardly stand," Bingham said." . . . There are so many technicalities, that's what's so frustrating."