Steven Ledwon woke with his arms strapped to a hospital bed.
Police had picked up Ledwon, 55, in late April from a local shelter in Alamosa, Colorado, where he was hallucinating and speaking garbled Spanish. Likely triggered by a change in medication, Ledwon’s psychotic episode was compounded by crippling anxiety. Police dropped him off in the emergency room—common destination for mental-health patients, but one that may cause as much harm as good.
According to the Centers for Disease Control and Prevention, mental disorders like Ledwon’s caused 5.3 million visits to emergency departments nationwide in 2011, 4 percent of all trips. All too often, however, ERs are ill-equipped to handle patients whose illnesses are mental or emotional rather than physical. Not only are ER visits expensive—one industry analysis pegged the median cost at $1,200—they take time and beds from patients who require physical care. The chaotic ER environment, too, is hardly conducive to mental health. During every hospital visit, Ledwon said, the needles, harsh lights, and restraining straps made him feel even more anxious than when he walked in.
Despite the many drawbacks to ER visits, law enforcement often has nowhere else to house people who are clearly experiencing mental-health crises but are not a danger to themselves or others. The emergency room, said Alamosa County Sheriff Robert Jackson, is “our catch-all.” Police here have few other options. The county jail is overcrowded, and just two officers in Alamosa have been trained in crisis intervention, which teaches officers to de-escalate situations involving people in mental-health crisis. Alamosa, a town of 10,000 people that serves as a hub for those seeking social services throughout Colorado’s isolated San Luis Valley, has just nine beds in its ER.