We arrived in the late hours of a Friday night. Out the front of the slightly run down house, illuminated by the dull glow of an old street lamp awaited a policeman. With a cheerful greeting, and a brief introduction he handed us his tablet; a list of cases awaited on the screen.
“As you can see here, she’s a right proper fruit loop”, he said. “Last time I saw her she’d got her hands on a speargun, the time before that she assaulted someone with a pipe” he continued. “I don’t know why they keep letting her out again”.
Ignoring the political incorrectness of his statement, we quickly perused the case summaries in front of us. Sporadically interrupted by suicide attempts and assaults, there was at least a page of previous acute psychiatric episodes.
It seemed that our patient had a range of mental health conditions including schizophrenia and bi-polar depression. Involuntary admissions to the local psych ward were frequent, but no effective community mental health care seemed to be in place. Worse still, despite her mother being a known major antagonist, our patient’s psychiatrist had thought it a good idea to make the patient spend several evenings a week at her elderly mother’s home. This had been going on for more than two months, with increasingly worse outcomes each time the patient left. Tonight she’d refused to leave, and so the police had been called.
The result of this was now a very agitated and frustrated 40 something year old woman, pacing around the house and chain smoking, muttering curses under her breath and making all on scene more than a little concerned.
With a few subtle suggestions and perhaps a little coercion, my partner successfully managed to talk the woman into coming outside. The two police remained close, and the five of us stood on the stairs and landing in the cold night air, each trying to work out what was about happen next.
“It sounds like you’ve been having some problems lately” my partner asked with as much empathy as she could muster. “Would you like to tell us what’s been going on?”
Her response came with a flat, emotionless tone. “It’s Mum and me”, our patient said. “We don’t get on….. it doesn’t work and ah! It just makes me mad. One of us has to go.” With increasing concern, my partner prompted further: “Has to go? What does that mean?”
The unfortunate reply rolled forward without hesitation: “Y’know, die. Her or me. Yeah…. it’s gotta be soon”
We could all sense that things weren’t going well. Our patient began to shift uneasily on the landing of the stairs. Without apprehension, my partner rattled off the next questions; “are you planning to hurt yourself or someone else? Are you planning to kill yourself or someone else?
The thoughts had already entered our patient’s mind. She remained flat, and without responding drew long pulls on the cigarette in her mouth. We could see her mind ticking over.
Quickly, my partner tried to shift the topic; “can you hear any voices other than yours and mine at the moment? She asked.”
But it was too late. After another few moments of intense thought our patient nonchalantly pushed herself off the rail, turned herself gently towards the nearest police officer and as pleasantly as you like queried “do you mind if I borrow your gun”. As quickly as she could reach for it the officer responded, firmly he grabbed her arm and with measured force placed it behind her.
Unfortunately, she would be coming to hospital in handcuffs.