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This is very true. In some ways, we used to. Now many mental health patients get dumped on the ED for "medical clearance" and then the ED ends up boarding these patients until an appropriate bed opens up. The ED is a HORRIBLE place for mental health patients.
People that get very loud and aggressive do often end up being sedated and/or restrained. Most patients of mine do OK as I make it clear that it is THEIR behavior that drives how they are treated. If you're being restrained and your my patient, it is because you are a current and continuing danger to yourself or to others because of the things you are doing. If you're just being loud, I don't really care about that until you start escalating beyond that.
Agreed. Patients can be as loud as they want provided they are not disturbing or upsetting other patients. As security, patient care was not our focus. Staff and patient safety was. This would occasionally cause problems with staff in the unit because we handled issues in a different manner than what they wanted. Our response always was, "Well you're process wasn't working, so you had to call us. Why should we do the same thing that you've already tried and that didn't work?"