A man in his 40s with paranoid schizophrenia who had a history of incarcerations for various crimes, including assault, and had been recently released from prison, was admitted involuntarily to the inpatient psychiatric unit after setting a trash can on fire in a store. Because he had auditory hallucinations, the police brought him to the emergency department (ED) instead of jail. He was admitted to a psychiatric hospital and while there, he was discovered hiding in a female patient’s bathroom. Subsequently, he was placed on “aggression observation” status. Several days after admission, he tried to enter a female patient’s room and was diverted by staff back into his own room. He reemerged angrily a few minutes later and when another nurse attempted to calm him, the patient attacked the nurse by beating him in the head and stabbing him with a pen, causing severe injury. Because of the criminal aspects of this event, the police were called but would not take the patient into custody because his primary problem was psychosis.
Roca RP, Charen B, Boronow J. Ensuring Staff Safety When Treating Potentially Violent Patients. JAMA. 2016;316(24):2669-2670. doi:10.1001/jama.2016.18260