Psychiatric patients restrained at sky-high rates at this LA hospital
LOS ANGELES — When he came home from the hospital, Marcelus Laidler began to wet the bed. His mother noticed he seemed leery, questioning everything she did.
His ankles and wrists bore scars — the result, he said, of repeatedly being strapped to a bed with restraints at Los Angeles General Medical Center.
“I have nightmares I’m being restrained,” said Laidler, who has schizophrenia and bipolar disorder. “That hospital is like one bad dream after another.”
Hospitals are forbidden under federal law from restraining psychiatric patients except to prevent them from harming themselves or others. Restraints can be used only when other steps have failed and are widely discouraged by psychiatric professionals, seen as a measure of last resort that frays trust and can traumatize patients.
At L.A. General — a public hospital serving some of the poorest and most vulnerable people in the nation’s most populous county — the psychiatric inpatient unit has restrained patients at a higher rate than in any other in California, a Times analysis has found.
Federal records show that over a recent four-year period, L.A. General’s Augustus F. Hawkins Mental Health Center has reported a restraint rate more than 50 times higher than the national average for inpatient psychiatric facilities, ranking it among the highest in the country.
Those numbers doubled between 2020 and 2021 — the latest figures publicly available — even as the statewide average for other inpatient facilities barely increased.
L.A. General staff have reported 200 cases in which psychiatric inpatients were restrained for a total of 24 hours or more within a month, records dating from 2018 show. Nearly 40 of them were restrained for the equivalent of one week or more, including a woman who spent an entire month in restraints.
Patients are always restrained when transported between the Hawkins psychiatric unit in South L.A. and the hospital’s main Boyle Heights campus, a drive of more than 15 miles, according to county officials. Hundreds of such trips happen each year. County health officials said the restraints are necessary to prevent patients from jumping out of moving vehicles or assaulting staff.
Some psychiatric care experts decried the blanket practice for not distinguishing between patients who might be dangerous and those who aren’t. Even accounting for those transit hours, the restraint rate at L.A. General far exceeded the national average in recent years.
L.A. General officials said they turn to restraints as a “last resort intervention” for combative patients in the face of roughly two dozen physical assaults annually on Hawkins staff. A handful of extremely violent patients has inflated its restraint rate, hospital officials said.
L.A. County officials said that the hospital has received more patients with violent criminal histories in recent years and that Hawkins has “become a sort of pseudo psychiatric jail ward.” Exacerbating the problem, they argued, are long waits for patients who should be transferred to state hospitals or other facilities for longer-term care but instead remain at L.A. General.
“We have not been prepared to handle people at this level of violence,” said Dr. Brad Spellberg, L.A. General’s chief medical officer. He
