Friday, April 06, 2012

Strip Search Survey

Okay, if you've been reading our blog for long, you know that there are some sensitive issues here, and strip searching patients upon admission to psychiatry units is one of them.  I'm a psychiatrist and I didn't know this was routine.  Of course, I assumed it happened if someone was presumed to be dangerous, so if they have a weapon taken from them in the ER, a history of violence, or are being admitted to a locked unit for their own safety.  But grandma with her agitated depression?  Or a high school student with an eating disorder?   One thing that's changed since I was a resident (the last time I worked on an inpatient unit) is that admission criteria has changed significantly.  There are few elective admissions, and pretty much the only way that insurance will pay for admission is if the patient is an imminent danger, so this means that the patients on the inpatient unit are, by definition, more likely to be dangerous and acutely ill.  When I was in medical school, people were admitted for depression for weeks, they'd go out on passes to see how they did at home or away from the unit, and admissions were planned for "next Wednesday."  I remember one patient was admitted for chronic insomnia.  On the Sexual Behaviors unit, people would be admitted for evaluation-- was the old guy who touched his niece when he was drunk a pedophile, or was this an unusual behavior inspired by the fact that he was drunk?  Was he a danger?  And someone could be admitted (electively) for urges to commit sexual offenses.  Things have changed.  So maybe it's not that outrageous to strip search someone who's admitted because they are imminently dangerous, or maybe it is---our readers comment about the trauma of it, how it deters them from being hospitalized when they should be, about feeling violated and having old sexual traumas evoked.  

If hospitals have different policies and they don't have different rates of violence with weapons/ problems with smuggled drugs, then changes should be made.  Some readers have written in about more sensitive means of searching patients, and Clink now thinks hospital should employ trained, cute, dogs to sniff out contraband.  I'm all for it.  What about those with dog allergies?