This article is part of the Here. Now. essay series, which seeks to de-stigmatize mental health treatment, and improve accessibility to treatment and support for teens and parents in metropolitan New York.
Every child throws a tantrum. That doesn’t mean that child gets locked up in a psychiatric hospital, or does it? That’s what happened to one boy named Nicholas from Jacksonville, Florida this past September–all while he was at school. He was at the hospital for three days. Without his parents–or their consent.
According to Buzzfeed, Nicholas was sent to River Point Behavioral Health, which is notoriously a problematic unit of the nation’s largest psychiatric hospital chain, Universal Health Services, as it was recently reported by BuzzFeed News that at least 10 of the company’s hospitals in nine states “were under pressure to fill beds by almost any method and to hold patients until their insurance payments ran out.”
So, what exactly happened?
Nicholas, who is under 4 feet tall and weighs less than 55 pounds, has attention deficit hyperactivity disorder and disruptive mood dysregulation disorder. Because of this, he was seeing a therapist as well as a psychiatrist to treat his conditions, although his parents claim he never showed any suicidal or homicidal behavior.
Like many kids, Nicholas sometimes refused to listen to teachers or do his work at school. Sometimes, he would hit others when frustrated. One day at school, a counselor chose to send the boy to a psychiatric hospital after he had been kicking and biting.
Florida’s commitment law, known as the Baker Act, allows a person to be sent to a psychiatric hospital for an examination if that person appears at risk of causing severe harm to themselves or others. Once patients are sent to a psychiatric hospital, it is the facility’s responsibility to determine if they need to be hospitalized, and they can only hold patients for up to 72 hours. Thus, it must release patients who aren’t likely to inflict “serious bodily harm” on themselves or others. Sounds normal.
However, what isn’t normal is the treatment Nicholas received. His mother, who only knew that he was being transferred from school to the hospital from voicemails that both the school and counselor had left for her, said she declined consent for her son’s treatment, stating:
“It felt like my child had been kidnapped. I didn’t want him to be there at all. I can’t even hug my kid and tell him it’s going to be okay.”
Nicholas’ mom claims she immediately asked the facility to release her son, but was instead told that she would not even be able to see her son until later that evening during visiting hours. When Nicholas’ dad went to visit later that night, he mistakenly signed a form that he thought was just to let the doctors give his son medication, but was actually a consent to hospitalize him.
The real trouble started after his dad left, when Nicholas was given a bloody nose by another child at the hospital, got locked in a “seclusion” room at 3 in the morning, and waited more than 24 hours to see a psychiatrist, according to medical records provided by his parents.
A couple of hours after his dad left, Nicholas was found in a hallway, screaming and crying. When he was transferred to a hospital ER for medical attention, he was still not able to be released, despite his X-rays showing nothing being broken. Naturally, all of the moving around upset Nicholas, which resulted in an outburst.
The morning after the ER incident and outburst, his mother requested that the hospital release her son for the second time–to which she was denied. While the psychiatrist who saw Nicholas that day said he had no suicidal or homicidal thoughts, his stay was estimated to be three to four days, because of his “poor impulse control” and “aggressive behavior,” which seems pretty apt for many kids his age. As if that wasn’t enough, a nurse wrote that Nicholas was on suicide precautions, “but is interacting with peers and staff, is not withdrawn, and is not voicing anything suicidal.” Seems contradictory.
On Nicholas’s third day at the hospital, a petition to commit the 6-year-old landed on the desk of the public defender for the county, Stephanie Jaffe. Nicholas was in apparent need of more treatment, because there was a “substantial likelihood” of “serious bodily harm” to himself or others. Yet there wasn’t really “substantial” evidence. This mean he could be held against his parents’ will for up to 90 days.
Stephen Talmadge, a lawyer and psychologist who reviewed documents from Nicholas’s case, stated how absurd this was:
“The Baker Act is supposed to confine really mentally ill people who are dangerous — and a kid who has a temper tantrum is not a danger to the public… What is the kid going to do, bite a stranger?”
When Nicholas’s parents arrived for visiting hour that third evening, they said he seemed totally different than his usual self:
“It was hard to leave him there — you wanted to just grab him and run out of the facility with him. He was out of his mind, we didn’t recognize him. It was hard to leave him there — you wanted to just grab him and run out of the facility with him.”
His mom noticed new bruises on his legs, and also found out Nicholas had also been bitten by another boy. The next morning, Jaffe petitioned the court to release Nicholas, arguing that Nicholas was not a threat to himself. By 3 p.m. that day, River Point released Nicholas from the facility.
As of now, rightly so, River Point is under criminal investigation for Medicare fraud, and Federal regulators are investigating whether River Point violated Florida’s involuntary commitment laws to hold patients at the hospital who did not need treatment. Clearly, Nicholas’ case backs this up–and one case mishandled is one too many.
This post is part of the Here.Now series, which seeks to destigmatize mental health,
and is made possible by UJA-Federation of New York and The Jewish Board.
You can find other educational mental health resources here.