Tuesday, April 03, 2012

Strip Search

A while back, one of our readers wrote a comment discussing the distress of being strip searched upon admission to a psychiatric facility. The reader felt this was particularly egregious because she had been a victim of sexual abuse and this insensitive treatment, unnecessary in her case, caused her to relive the distress of past sexual abuse and psychiatry should be about healing, not opening wounds and causing pain and suffering.

I felt badly for our reader.  In fact, I felt badly for anyone put through such a practice, but I suppose I understand that outrageous and dangerous things happen in psychiatric hospitals and this could be a no win situation: what about the person who is assaulted by a patient who had a razor taped to their inner thigh that went undetected...wouldn't that patient feel it was awful that no one had searched the perpetrator?  And staff on psychiatric units are not uncommonly assaulted, shouldn't they have the right to do what's necessary to protect themselves?  I'm not sure that includes strip searches, but I suppose if there's a couple of stories of contraband or weapons or drugs being sneaked in, then policies change.  One guy has an explosive in his sneakers 9 years ago, and millions of people are taking off their flip-flops every day in airports.  I can't say that particular practice ever made me feel safer.

Okay, I also didn't know that psychiatric units strip search patients.  I haven't worked on an inpatient unit in many years, and if this occurred, I imagine it was done by the nurses, if at all.  Back then, I never heard a patient complain about this or even mention it, and in the years since, I've never had a patient mention being strip searched during an admission.  I'm guessing that it's not a universal phenomena?  Actually, I'm guessing that most hospitals don't strip search psychiatric patients, and really, if they do, I'd be pressed to know why just psychiatric patients, many people in hospitals have histories of unsavory behavior.  

Okay, so just in case I'm not appalled enough, yesterday the Supreme Court, in  Florence v. Bd. of Chosen Freeholders  voted that anyone who is arrested, for even the most minor of crimes-- walking your dog without a leash,  jay-walking, you name it--can be strip searched before being placed in jail.  The court says that even minor violators can be dangerous, and note that Timothy McVeigh was arrested for driving without a license and one of the 9/11 terrorists was stopped for a traffic violation.  Would strip searching them have stopped their terrorist attacks or prevented any future bad events?  As doctors, we think in terms of risk, evidence-based medicine, best practices, statistical events, not anecdote, but I'm convinced that anecdote is much more powerful than science.  And I don't think this supreme court decision bodes well for treating psychiatric patients any more humanely-- if it's no big deal to strip someone who didn't pay a traffic fine (for example, Mr. Florence in the above named case, but oops, he actually did pay the fine years earlier and there was a computer error, oh my), then I can't see why there would be sympathy for the dignity of anyone else.