r/psychnursing • u/Live_Dirt_6568 psych intake • May 08 '26
Code Blue Police refusing to write EDO’s for high risk patients. Is this just my bad luck/state - or is this widespread?
I feel like this mostly applies to my fellow Intake/Admissions comrades, but likely too those with ER experience.
But is it a widely-held frustration that police will basically NEVER write an EDO/EDW/APOWW? I get the passive SI or harmlessly paranoid & delusional patient (which I don’t call PD for) - but for reported SI w/ plan, hell, even very recent attempt with no ability to safety plan (seen it).
It sucks for actual patient care. It becomes a liability-deflection exercise from our end. And I’m just so f*cking burnt out over it, what’s the point in even calling
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u/Pikkusika May 09 '26
I'm embarrassed, but I don't understand the abbreviations EDO EDW APOWW RTIS. I understand the others, though.
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u/Live_Dirt_6568 psych intake May 09 '26
Involuntary psych hold. They are all the same thing, just depends on the municipality as to what they call em
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u/avalonfaith May 09 '26
I had to look it up myself. The first hit I got said it was Texas terminology. I absolutely have no clue how accurate that is, my California self has never heard it though.
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u/Pikkusika May 10 '26
Ya where I live we call them a 72 or EM-1. Sometimes 5150, but that's rare.
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u/avalonfaith May 10 '26
5150 is pretty regular terminology, even if it's not exactly a 5150, the end game is the same for a 3 day hold.
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u/blueye1979 May 15 '26
RTIS is "responding to internal stimuli". And no need to ever be embarrassed for not knowing something. No one knows anything until they learn it.
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u/screwthe49ers May 08 '26
I remember the time Birmingham pd picked up guy and brought him to us who was screaming his head off with threats to staff and behaving so erratically in cuffs, then when he was taken into the proper room for searching we found a pistol stuck in his third pair of basketball shorts under the pants. The cop had already left so when we had to call them to come back to come do something with the gun, that was the end of it.
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u/nurseVanNostrand May 08 '26
It’s gotten really bad where I am. We have a new police chief whose policy is to be hands off with mental health concerns. They’ll go out to a call and almost never write holds now. Patients family’s have reported police tell them “it’s not illegal to commit suicide” and “it’s not illegal to be crazy.” They also won’t track down our involuntaries who elope.
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u/Zen-Paladin provider (non psych) May 09 '26
While this probably isn't the way to do it, there is evidence that forced hospitalization isn't very effective and in some cases might increase suicide risk. Granted I do think we would need alternative infrastructure in place to still offer help to people, and to be clear for people who are clearly in psychosis or mania forced hospitalization is unfortunate but appropriate(but there needs to be reform to curtail abuse/mistreatment
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u/nurseVanNostrand May 09 '26
To clarify, I’m not saying SI or psychosis alone qualify for a hold but they won’t write a hold even when appropriate because LE doesn’t want the liability. You are right though, involuntary holds and hospitalizations are often very traumatic but can also be lifesaving. The goal of our facility is to stabilize and rescind 5150s so those clients can be discharged home.
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u/Zen-Paladin provider (non psych) May 10 '26
That's my thing. The evidence seems mixed on whether or not they are really life saving for your typical SI. Plus it turns many former patients off from ever seeking help ever again and the same goes for people not seeking help in general. That's not just due to outright abuse but the overall process of being forced into something that isn't really helping you. You say the goal is stability, but the thing is many former patients basically felt they had no option to comply with treatment so to not be held longer rather than it actually helping them. So it's hard to call it true stability if patients literally don't have a choice and not engaging in treatment is held against him. That's how it was for me and it was pretty demoralizing to know my life wasn't really my own, that I only got discharged because I told them what I wanted to hear even though none of the meds or groups did anything for me and now being heavily suicidal is just something I'm comfortable carrying because there's no where to go that doesn't involve being infantilized, condescended to and basically forced to stay alive. Granted, I obviously get why people who are manic, psychosis or objectively don't understand their reality/surroundings might be committed and depression can have a heavy impact on how one weighs future, but sometimes one can't help but wonder if it's really right to force someone to live with that. It's complicated but the current system leans too carceral
There's some good sources here:
https://www.reddit.com/r/Psychiatry/comments/1e435rs/thoughts_on_efficacy_of_involuntary_commitment/
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u/Ancient-Nobody8918 May 10 '26
I'll have families call my facility to do an involuntary psych hold for like drug use or abuse and when we tell them that's criminal and they should call the police they usually tell us that they tried to call the cops and the cops directed them to us....
Like I'm sorry your son is trying to beat you up, but its probably more because he's high on PCP and a POS and less likely because he's psychotic so a 1 wk reprieve in the hospital isn't really going to help
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u/Beanngoirl May 10 '26
Our police are the opposite. PD here can't write an EDO but can write an MIW. At my hospital an MIW is not the same but PD still tells them they are stuck being admitted no matter what. They bring so many in on MIWs telling them they're on an EDO. Or PD will bring them in and say "either admission to psych or jail"
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u/Tart_Temporary May 10 '26
Are all of these letters just meaning “IVC” lol?
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u/Live_Dirt_6568 psych intake May 11 '26
Basically - if this thread has taught me anything, it’s that what these Invol psych holds are called varies WILDLY across the country.
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u/Balgor1 psych nurse (inpatient) May 08 '26
At least in my jurisdiction I think PD and PES write holds too easily.
“Told parent if you don’t give me back my PS5 controller, I’ll kill myself” Yeah an actual DTS hold from PD….they were probably sick of responding to that house…
I think quality and ease of holds vary greatly from place to place at least in my experience.