The USA

As resident and attending psychiatrists, our role is to evaluate treat people who require hospitalisation for acute psychiatric conditions. Our primary goal provide these individuals with a safe space heal, offer treatment that can promote recovery. Although this achieved most patients in the unit, not all are afforded such sanctuary. Recently, young man, Mr X, opened eyes mistreatment Black men face within hospital setting. unlike we care for, was escorted, handcuffed, into inpatient psychiatry unit by police officers. Earlier morning, X had been pulled over at routine traffic stop charged possession of marijuana. In context possibility charge might threaten his employment, told officers he would rather die than lose job. The responded charging resisting arrest, placing him on involuntary hold danger self, transferring unit. We were alerted X's arrival an urgent page requesting immediate evaluation patient cooperating staff. expected find agitated patient; instead, saw tearful man far end room, least ten staff members guarding exit. With reassurance, engaged us shared story. He served military and, like so many veterans, long-standing history being vilified persecuted very country risked life for. His sacrifices apparently quickly forgotten return from war. story too familiar: one struggle themselves frequently targeted police, wrestle symptoms depression post-traumatic stress daily. After prolonged period unemployment, left hometown search new start. stated suicidal; main concern potential loss employment. agreed did hospitalisation, but discharge outpatient follow-up appropriate. However, despite efforts reassure colleagues, was, absence, seen again prescribed given intramuscular medication. following months, as nation wrestled questions around social justice equality, reflected facets case how it affected us. initial reaction sadness. Later, feelings evolved include frustration transformed yet another tool oppression. From initiated handcuffed transport, medications received, silenced, stripped rights, further marginalised under auspices receiving care. believe hospitals somehow shielded mistreatment, showed walls easily penetrated racial injustices flood nation. experience has motivated explore systemic scrutinise practices have unquestioned long. since working increase implicit bias training, diversity amongst health-care teams, establish several improvement projects dedicated reducing degree which biases influence clinical judgment. One goals reduce use restraints emergency ensure colour last-resort measures. small steps towards addressing larger issue racism country, hopeful even changes will help protect some vulnerable patients. wounds deep, make difference, however or insignificant may seem, participate its healing. anonymised, details altered preserve confidentiality.