LONSBERRY: FAILED MHA SYSTEM HELPED KILL DANIEL PRUDE


The police were looking for Daniel Prude so that they could take him to the hospital.

               Again.

               To get the help he needed.

               Again.

               That’s how this whole tragedy was set up. Less than five hours after being released from the care of Strong Memorial Hospital for psychiatric and drug issues, Daniel Prude was having those issues again, walking down Jefferson Avenue in the dark of a March night, naked and bleeding.

               We know what happened when the police arrived, and in the 10 minutes after. And America is rightly upset.

               But nothing happens in a vacuum, and life isn’t finite blips of edited video, it is a continuum, a series of interrelated and essential events.

               Like the stuff that happened just hours before.

               When the Rochester Police Department took Daniel Pride, at his family’s request, to Strong Memorial Hospital under mental hygiene arrest.

               It’s called an MHA, and is defined in a complex chart in an admissions manual of the state Office of Mental Health. Basically, if someone is out of their mind, or an immediate threat to themselves or others because of mental health issues, they can be taken into custody and delivered by the police to an appropriate hospital, for treatment and possible admission.

               The common understanding is that the person can be held for three days, though they can be committed for longer.

               That’s what’s on paper.

               What’s in reality is very different.

               As the sad story of Daniel Prude illustrates.

               He had been taken in on an MHA the day before the incident that would end his life. That was because his brother felt that Daniel Prude was a danger to himself. Held by the hospital for a period which a nurse told police was “Not very long,” he immediately resumed his troubled behavior – namely, walking down the street, disrobing and punching windows.

               Quite obviously, the emergency psychiatric visit to Strong Memorial Hospital accomplished nothing.

               And that led to his death.

               In the string of failures that killed this man, Strong Memorial Hospital played a crucial role. Or, more correctly, Strong Memorial Hospital failed to perform a crucial role in saving his life.

               It was catch and release, and that led to a fatal outcome.

               Thus far, the hospital has avoided public scrutiny or criticism for that failure. Instead, the university that owns the hospital sent a letter to all its employees bemoaning the death and institutional racism and promising to be even more woke than before.

               Good. Here’s how it can start.

               The University of Rochester, and all hospital owners in New York, should release data on MHAs so that we can get a better view of the problem. How long are people held on average, what are the types of treatments and medications they receive, what are the outcomes, and those things should be broken down separately on the basis of race, gender and insurance carrier.

               For example: How much of what sort of treatment does the average white person with insurance get on an MHA as contrasted with the average black person without insurance?

               Maybe there’s something to learn in those numbers, and maybe there’s not.

               But it would be good to have and track that data, to make sure that race and class don’t factor into the MHA system and into health-care failures like that which befell Daniel Prude.

               It may not be fair to criticize Strong Memorial Hospital in this case.

               People frequently fail when they face an impossibility.

               And fixing, during an emergency visit, the acute psychological problems of a chronically mentally ill person strung out on PCP, or under any other circumstances, is just about impossible. It’s not like getting stitches or having your appendix taken out. There isn’t a procedure or pill that will, presto change-o, make everything all better during a behavioral meltdown. Crisis is crisis, and when someone’s mind has come apart, it is a serious problem for which we have not yet invented a Band-Aid.

               Maybe the premise of an MHA is flawed. Maybe there aren’t enough staffers or dollars, maybe there are too many patients, maybe this is one more symptom of an over-crowded and under-performing mental health system. Maybe it just can’t be done the way it’s set up.

               And that’s where the state government comes in.

               The MHA is a creation of the state. Hospitals are regulated by the state. Police are empowered by the state.

               And this isn’t working.

               Not for Daniel Prude, and not for countless others who spin through the revolving door of New York’s MHA system.

               Is it a help, or is it a hindrance?

               If we’re calling for change, let it begin here.

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