‘Thanks for coming,’ he says, rubbing his
chin. ‘Josh’s been staying with us a couple of weeks. He’s just come in and
asked me what he should do about the overdose he’s taken. So of course I say
what overdose and he says a couple of boxes of paracetamol. So I say for a
start I’ll be calling the ambulance. But then he starts getting edgy, saying he
doesn’t want to go to hospital. I explained that I couldn’t let him back in the
hostel after all those pills, but he’s still being difficult. I’m on my own
here tonight. I can’t just let him back to his room and keep an eye on him. It’s
not that kind of place. Anyway - see what you think. He’s in the hallway. I don’t
really know Josh that well. He’s only been here a couple of weeks.’
The wide, black door’s standing half open. Charlie
goes ahead of us.
‘It’s the ambulance, Josh.’
The hallway has been partitioned off, a
security door with meshed glass in front of us controlling access to the rest
of the property, and a double-locked office to our left with a serving hatch
cut into it. Josh is standing in the corner over by the security door. A tall, stringy
kid in his early twenties, he leans up against the wall with his jeans at
half-mast, a track-suit top with the sleeves bunched up at the elbow. His hair
is cut in a feathery black crop, strikingly contrasting with the pallor of his
skin. There’s something curiously inert about him, every aspect; even his clothes
can’t seem to keep a grip.
‘Hi Josh. My name’s Spence. We’ve got Rae
here, too. How are you doing?’
‘What do you mean, how am I doing? I’m
tired and I want to go to bed.’
‘We understand you may have taken an
overdose tonight.’
He doesn’t respond.
‘Some paracetamol? Is that right?’
‘I didn’t call you.’
‘No – I think Charlie did. Charlie called
us because you’d asked him about this overdose, and really – what else can he
do?’
No response.
‘How many paracetamol have you taken, Josh?’
He shrugs. ‘Thirty-four or so. Two packets.
Something like that.’
‘That’s a significant amount, Josh.’
He looks at me, then without any change in
expression, turns to look at Charlie. It’s a strangely absent gesture, his black
eyes flat, without expression.
‘I want to go to bed. Just let me in so I
can go to bed.’
‘Can’t do it, mate. Sorry.’
‘I just want to go to bed.’
‘Sorry.’
I hug my clipboard.
‘Why don’t you come out with us to the
ambulance, Josh? We need to take you up the hospital to get this overdose treated
– and get you someone to talk to you about the reasons why you did it? Yeah?
Come on. Charlie can’t just let you go back to your room, can he? Not after
what you told him.’
‘I just want to go to bed. You have no
legal right to stop me.’
‘Can’t do it, Josh,’ says Charlie.
‘Please.’
‘Sorry.’
‘I’ll sleep rough then.’
Charlie shakes his head. ‘Come on, mate. Please
can you just go with the ambulance people here? It’s the only sensible thing. I
wouldn’t be doing my job if I just said yeah, fine, whatever – would I?’
‘Fine.’
Josh suddenly pushes himself upright and strides
past us out of the lobby, down the steps and out onto the street. Rae goes
after him a little way, but ultimately all we can do is watch him hurry off down
the road.
‘Can I use the phone in your office,
Charlie? Have you got his details? I’ll get the police involved, pass a
description. They should probably be told.’
‘Sure.’
I’m in the office a little while; Rae has
gone back out to the ambulance to sit in the cab and text.
Whilst I’m on the phone to Control telling
them what’s happened, the front door opens again and Josh walks in. Charlie
stands at the door to the office to talk to him. Josh starts shouting,
repeating the same thing over and over again: Let me in. I want to go to bed. Let me in. You have no right.
‘He’s come back,’ I say to Control. ‘As you
can probably hear.’
Charlie tries to reason with him, but Josh
kicks the door.
I’ll
smash it down if you don’t open it. Now!
‘Can we have the police along, please?’ I
ask Control, and ring off.
Rae has followed Josh in. Between us we
have him penned in the corner by the security door. His brief burst of violence
subsides, and he assumes the same position as before.
‘I’ve called the police,’ I say to him.
‘They can’t touch me.’
‘Josh – all we want is for you to be well.
You’ve taken a dangerous overdose of paracetamol. You can’t just go to bed and
forget about it.’
‘Why not? It’s my life.’
‘What sort of people would we be if we just
left you to it?’
No response.
‘Why did you tell Charlie about the
overdose, Josh? You could’ve just stayed in your room, swallowed the pills and
no-one would’ve been any the wiser.’
‘Let me in,’ he says, without looking up. ‘I
want to go to bed.’
‘I think you told Charlie because
unconsciously or not you wanted someone to know and do something about it.
Which is good! That’s a good sign, Josh. That’s why we’re here. To help get
something done.’
‘Let me in. I want to go to bed. You’ve got
no right to stop me.’
‘It’s a significant overdose, Josh. You
could seriously damage your liver. It could kill you.’
‘You’ve got no proof I took anything.’
I step outside. Rae takes my place. Maybe
she can find a way to persuade him.
The police arrive. I explain the situation at
the bottom of the steps.
‘I don’t know there’s much we can do,’ says
the first officer. ‘If he’s competent, he’s within his rights.’
‘I know,’ I say, glancing up at the door
just to check we’re not being overheard. ‘To be honest, when he absconded I
thought that would be it, but now he’s come back and just keeps saying he wants
to go to bed. Obviously Charlie the warden can’t let him through, so we’re a
bit stuck. He’s already threatened to kick the door down, and I think there’s a
real chance he’ll get violent.’
‘Let’s have a look, then.’
We walk back up the steps together.
The scene is exactly as it was – Josh,
leaning up against the wall, Rae to one side and Charlie to the other.
‘Hello, Josh,’ says the first officer.
Josh folds his arms more tightly. ‘You can’t
lay a finger on me. I know my rights. I didn’t call the ambulance. I don’t want
you here. I’m tired and I want to go to bed.’
The police officer speaks to him patiently,
evenly, each phrase ending with a gentle ok-ay,
and then a pause to judge the effect. The second officer seems edgier, offering
up a tougher kind of logic whenever the moment allows. Between the five of us
we have most angles covered – medical, social, safety, legal – but nothing has
any effect.
‘You can’t touch me,’ says Josh. ‘I haven’t
done anything wrong.’
‘I understand you kicked the door and used
a threat of violence against Charlie here. Is that right?’
‘Let me in. I want to go to bed.’
‘Of all the things that might happen
tonight, that is definitely not one of them,’ says the second officer.
‘Come on,’ says the first. ‘O-kay? Let’s go outside and talk about
it there. You can’t stay here tonight, and we can’t stand here talking to you
all night.’
He puts a hand out to guide Joshua to the
door. Joshua lashes out. The two officers grab his arms and they all wrestle to
the floor.
‘I’m arresting you for breach of the peace,’
says the first officer, struggling to speak whilst he grapples for control of
Josh’s left arm. Despite his slim build, Josh is surprisingly strong. He
screams and swears, kicking his legs, twisting and butting his head – anything to
get a purchase, an angle. Charlie backs away into the office, appalled. In the
confined space of hallway the whole business is lumpen, messy and violent. The three
of them are squashed up in a heap between a radiator and the security door. We
do what we can to help, holding down Josh’s legs, whilst the first officer eventually
manages to free up a hand to put out a call for back-up on his radio.
*
At the hospital, Josh is handcuffed to a
trolley with the two police officers standing right and left. He has resumed
his inert posture again, completely uncooperative, sullen and withdrawn. I can
tell he’ll be refusing any treatment, all the while looking for a chance to
escape.
‘Sorry to bring him in,’ I say to the
charge nurse. But she smiles, seems quite sanguine about it.
‘If he doesn’t want help, we can’t force
him,’ she says.
‘No. I don’t suppose we can.’
‘He’d
have turned up eventually, after a day or so, with the abdo pain, the vomiting,
the jaundice...’
She signs my board with a flourish.
‘Thank you,’ she says.
Whilst I’m in the reception office,
photocopying my sheet, I try to imagine standing in the hallway back at the hostel,
watching Josh wander through the security door and off to bed, sleepily tidying
away the scattered blister packs into the bin.
I drop the copied
sheets into the tray, and head back out to the truck.
4 comments:
Not a lot you could do there Spence.
Strange to think that the only way you could treat him was by having him arrested first.
This whole area of competency / best interest is fraught with difficulty. Apparently, you can't deduce a lack of capacity from someone who's attempted / attempting suicide. If you lay a hand on them, it's assault. But on the other hand, you have a duty of care to make sure that they're being rational, and not acting under the influence of anything they've taken / the stresses of the situation. Which on scene is fairly impossible. In this case, the police arrested Josh for breach of the peace. The only reason they took him to the hospital was because of the overdose - not something they'd be able to do anything about at the custody suite. But then - he'd be quite within his rights to refuse treatment, as he's not under section. At least at the hospital he could be seen by someone from the psych team, who'd have more expertise in the subject.
Difficult and frustrating. All we can do is the best we can, given the circumstances, working in good faith. I'd rather make a technical error like this, than feel guilty that maybe I'd neglected to give someone a chance.
One thing that confuses me, though - at inquests into suicides, they often talk about a person taking their own life 'while the balance of their mind was disturbed' - a retrospective judgement, which seems to suggest that a suicidal act is not the result of a balanced mind, i.e. you could infer mental health issues from the very threat of the act itself.
Like I say - a legal minefield. And out in the real world, not something we have much time to think about.
:/
I would have thought that his clear statement to the warden would satisfy a court that he had suicidal intentions and was a danger to himself.
And I think you nailed it, Spence, when you pointed out that, on some level, he wanted to be rescued. The suicidal brain is irrational.
Absolutely - but as far as capacity goes, I think it's the case that you can't assume a lack of it just because someone has expressed suicidal thoughts / made an attempt. The only grounds for intervening is if you think there's some reason the person isn't able to act rationally - influence of drugs, for example. But I completely agree. All this is fine when you're away from the situation with the luxury of discussing the legal niceties. In the moment, I can't imagine anyone simply standing by and watching as someone attempted to hurt themselves. It just doesn't sound reasonable - or humane!
Thanks v much for the comment, Wynn.
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