5150

First a little back ground about the 5150 hold. Section 5150 of the California's Welfare and Institutions Code allows people to be placed on an involuntary psychiatric hold to be evaluated at a mental institution. A 5150 hold is placed on people for different reasons:

1.      Danger to self: The person must be an immediate threat to themselves, usually by being suicidal.

2.     Danger to others: The person must be an immediate threat to someone else.

 

5150 calls are common calls for us at NORCAL. Our job is to take these patients from an ER to the Psychiatric hospital where they will be evaluated. You never know what you are going to get on a call like this. Sometimes they are totally cooperative and calm and other times they are combative and require restraints to be transported. Also, depending on the patient there may or may not be an actual need to go to a psych hospital. For a homeless person to get a free meal and a place to sleep for 3 days all they have to say are 5 magic words: "I want to kill myself." This is why we wind up taking the same people over and over and over again. There are those people though who really do need psychiatric help. There are people who hear voices in their heads because of schizophrenia, people who struggle with deep depression who are having suicidal thoughts and then those patients who we tend to say are "just crazy."

 

We get dispatched for a 5150 coming out of San Leandro Hospital going to John George Psychiatric Hospital about a mile away. I go into the room and see a bigger African-American man laying on the hospital bed in 2 point restraints. This means that both his wrists are basically “tied” to the bed. I get all my necessary paperwork and get the story from the nurse. He has no real medical history except for struggling from alcohol abuse for some time. The story of why he was placed on the 5150 hold today was this: he had been drinking early that morning and in his drunken state began “relieving himself”…on other passengers on public transit. Ok, great I say and walk into the room to introduce myself. We get him loaded into the ambulance and I start asking him about why he is in the hospital, if he’s in any pain, if he’s ever been to John George before etc etc. He answers that he has a headache and he has never been to JG. He then proceeds to tell me about 5 times over that he had about 5 beers this morning and a bunch of sake…but its ok because he shared with some homeless guys. We get to JG and wheel him into the triage area where they all look at him and call him by his first name. Never been there before, riiiiight. I tell the nurse the story about why he’s on the hold while the patient listens. He hears that he was urinating on people and he gets really embarrassed and keeps saying “did I really?!” He gets of the gurney and I walk out thinking how glad I am that I wasn’t on his train.