(9-12-16) Distraught, a Fairfax County resident threatening suicide seeks help. Nearly four hours later – after being told no bed has yet been found – the resident is asked if he/she still feels suicidal. When the resident replies “no,” the resident is told that he/she could elect to go home or continue to wait until a bed can be found.
The resident leaves.
The family is frustrated. It wanted the resident to get help, not be sent home untreated. The resident (whose privacy I am respecting) had finally hit rock bottom and reached a point where he/she appeared willing to seek and accept help.
But that opportunity was lost.
After the tragic death of Virginia state Sen. Creigh Deeds’ son, Gus, who was sent home untreated because no local bed was available, the state created a bed registry that could be used to locate where beds were available. Since its creation, I have been assured that Virginia has sufficient beds. In fact, I was recently told that there are nights when there are empty beds.
But as this Fairfax example shows, people in need of treatment are still not being readily admitted. Based on emails and telephone calls that I have received, this seems especially true if an individual arrives at a mental health facility or hospital voluntarily seeking help and not because of a detention order issued by a magistrate that requires the local community service board to find a hospital bed.
Having patients wait for hours is one way to discourage them from being hospitalized. It also is a way to avoid admitting someone by declaring that a patient sitting in a waiting room no longer poses a risk and, therefore, doesn’t need to be admitted.
Because there is no data readily available that would show how many residents simply give up and leave after waiting for hours, it is impossible to identify who these patients are. But I suspect that many of them are much like the resident whose case I have cited above and verified. They are poor and seriously mentally ill, which makes treating them difficult. Some are intoxicated or high, compounding the problem. They are potentially troublesome patients who, more than likely, will end up costing a hospital money and/or depleting scarce county and state services. Many of them are “high utilizers,” which means they are in-and-out of emergency rooms and crisis centers several times a year.
This incident, with the suicidal Fairfax resident, made me suspicious about the death of Giovanny Martinez, the 29-year-old, who last month was fatally shot by a Fairfax County Sheriff’s Deputy outside the Inova Fairfax Hospital. The Washington Post’s Justin Jouvenal and Antonio Olivo have been pursuing that story despite the hospital’s refusal to answer questions — questions that the community deserves to have answered.
According to information provided to the newspaper by the Fairfax County Police Department, Martinez approached a police cruiser parked outside a gas station on the Little River Turnpike shortly before 2 p.m. on August 15th and stated that he wanted to take pills and die. Sensing that Martinez was experiencing some sort of mental problem, the officer called first responders who also evaluated Martinez and agreed that he needed to be taken to the hospital. The officer drove with the ambulance to Inova Fairfax so that he could be available in case doctors in the emergency room decided that Martinez needed to be transported to the Crisis Response Center at the Merrifield Center.
It is important to note that Inova Fairfax has a psychiatric unit in its hospital. This was not an instance of a hospital being unfamiliar with psychiatric emergencies. It is also worth remembering that a police officer and EMTs both judged that Martinez was having a mental crisis.
According to the police report, the medical staff informed the officer shortly before 4 p.m. –nearly two hours later — that Martinez was not in mental distress so the officer left the hospital. Sometime after that, Martinez was escorted by hospital security officers to a bus stop on the Inova campus. At 10 p.m., hospital security guards called 911 to report that a person at the bus stop had swung a sign post at a security guard.
A sheriff’s deputy, who happened to be at the hospital guarding a patient, heard the call and went outside where he confronted Martinez. The deputy ordered Martinez to drop the sign and when he refused and approached the officer, the deputy drew his gun and fatally shot Martinez.
Here we have a troubling tragedy. A man seeking help from the police and treatment in a hospital instead is fatally shot.
Citing federal health privacy laws (HIPAA), Inova Fairfax spokeswoman Tracy J. Connell has declined to answer repeated questions, according to the newspaper. She has refused to explain what happened while Martinez was inside the hospital or why it was necessary for security guards to escort him to a bus stop.
In an interview with the newspaper, Martinez family members explained that Martinez began telling relatives that he felt depressed in June and that he had gone to an Inova hospital “two or three” times seeking help before the shooting. The family did not know if he received any sort of care or medication during this visits.
“He didn’t have to die in that way,” Martinez’s cousin, Orlando Lemus Garcia, told the Post. His mother and relatives learned about Martinez’s death two days after the shooting when the police identified him by showing photos to workers at a restaurant where he was a dishwasher.
Would it be fair to wonder if the fact that Martinez was a poor, Hispanic dishwasher from Honduras, lessened his chances of being admitted into the Inova hospital for treatment?
Because the hospital is citing HIPAA to avoid answering questions, we can only speculate.