THROWBACK TO THE FULL INFORMED CONSENT (Feb. 16, 2023): Visiting the Psychiatric Emergency Room

Full informed consent is essential, especially for marginalized communities who often face unique risks in healthcare. It means understanding all aspects of a decision—benefits, risks, and alternatives—so choices can be made with confidence and care. That’s the heart of The Full Informed Consent, my blog-style newsletter where I unpack the often-overlooked dangers in child mental healthcare and psychiatry. Each post offers practical strategies and actionable tips to help families protect their children, minimize harm, and ensure mental healthcare is truly thoughtful and caring.

Read a bit below. Visit my website for the full article.

“If you or your child is having a psychiatric emergency, please hang up and call 911 or go to your closest emergency room.” Virtually all mental health providers feature this statement in their voicemail recordings. They also recite it when “safety” planning for acute psychiatric emergencies related to suicide, aggression, and other out of control behaviors. Prominent organizations like the National Alliance for Mental Illness and the American Academy of Child and Adolescent Psychiatrists recommend these options as the surest way to promote safety and prevent further harm. But this unanimous messaging betrays the inequitably distributed dangers and harms embedded within the mental health crisis continuum of care.

Calling 911 and going to the closest emergency room pose multiple risks for trauma and oppressive violence from start to finish. Though some communities have the option to contact mental health crisis teams, for many calling 911 means involving police. Police encounters are known to be criminogenic, traumatizing, and otherwise damaging to children’s health wellbeing. The tragic deaths of Daniel Prude and Ma’Khia Bryant demonstrate how police involvement during crises can be fatal, brutalizing Black people for their suffering and distress, insead of offering the succor and support they or their loved ones were seeking. 

The risk of coercion and violence continues when children arrive in the emergency room. When previously working in these settings, I observed that children of color were far more likely to be brought in by paramedics restrained, meaning their arms and legs were physically tied down or they were forcibly injected with sedatives. Paramedics would inevitably adultify children of color, calling them “male” and “female,” rather than “child,” “boy,” or girl.” They were frequently disengaged, surveilling these children rather than reassuring them they would be ok. White children, by contrast, would be brought in unfettered and covered in a warm blanket, engaged in playful banter, described to emergency room staff as “a good kid,” and presented as deserving of care rather than punishment. These observations are not anecdotal. A slew of recent papers indicate that Black children and adults are more likely to be secluded and restrained in various healthcare settings and described using pejorative language that biases their care.

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