From The New York Times: “The annual gathering of the American Psychiatric Association is a dignified and collegial affair, full of scholarly exchanges, polite laughter and polite applause.
So it was a shock, for those who took their seats in Room 1E08 of the Jacob K. Javits Convention Center in Manhattan, to watch a powerfully built 32-year-old man choke back tears as he described being slammed to the floor and cuffed to a stretcher in a psychiatric unit.
Because the man, Matthew Tuleja, had been a Division I football player, he had a certain way of describing the circle of bodies that closed around him, the grabbing and grappling and the sensation of being dominated, pinned and helpless.
He was on the ground in a small room filled with pepper spray. Then his wrists and ankles were cuffed to the sides of a stretcher, and his pants were yanked down. They gave him injections of Haldol, an antipsychotic medication he had repeatedly tried to refuse, as he howled in protest.
Forcible restraints are routine events in American hospitals. One recent study, using 2017 data from the Centers for Medicare and Medicaid Services, estimated the number of restraints per year at more than 44,000.
But it is rare to hear a first-person account of the experience, because it tends to happen to people who do not have a platform. Researchers who surveyed patients about restraint and seclusion have found that a large portion, 25 to 47 percent , met criteria for post-traumatic stress disorder.
Listening, rapt, to Mr. Tuleja was a roomful of psychiatrists. It was a younger crowd — people who had entered the field at the time of the Black Lives Matter protests. Many of them lined up to speak to him afterward. ‘I still can’t forget the first time I saw someone restrained,’ one doctor told him. ‘You don’t forget that.’
In study after study, hospitals have proved that it is possible to reduce the use of coercive force in psychiatry. But it requires sustained effort. It also means balancing patient welfare against the safety concerns of nurses, who are frequently injured in psychiatric settings. De-escalation takes time, and when systems are understaffed, they may default to force as a matter of efficiency.
Dr. Samuel W. Jackson, one of the panel’s hosts, said he hoped that his generation of psychiatrists would usher in change around the practice.
‘I believe that Matt, in telling his story, puts a mirror in front of all of us, allowing us to focus on some of the ugliest aspects of our work,’ said Dr. Jackson, the co-director of Public Psychiatry Education at SUNY Downstate Health Sciences University.
‘Hearing this story, I was initially disturbed, and then at one point, if I’m being honest, a bit defensive,’ he said. ‘However, eventually — and I think that’s where I am now, thinking about this story — I started questioning this idea that putting people in restraint and seclusion is just part of the job.'”
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