How should 911 handle potential suicide victims?
September 16, 2009
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Joseph Hall
HEALTH REPORTER
For Bruce McArthur, frail but feisty at 75 and quite keen to live, the 911 call his daughter made on a warm August night "unleashed the forces of hell."
For Karen Letofsky, head of a Toronto suicide prevention centre, it opened up something quite different: A distressing but opportune chance to educate people about how to deal with someone who may want to end it all.
To be clear, McArthur says his mind wasn't turning in the least that way on the night of Aug. 9. After riding his vintage motorcycle from his daughter's Bolton-area home to his midtown Toronto apartment, his thoughts were on bed.
How he ended up cuffed and bleeding in the grip of two police officers is still a painful mystery.
Earlier he had enjoyed Sunday dinner at his daughter's, and presented a family chronicle he had been working on for a year to his four grandchildren.
"Over the last year or so I started to write out the family history," he said yesterday.
"As I got writing it, I started to put myself into it ... the good, the bad and ugly," says the former commercial real estate manager.
The ugly, he adds, did not include any past psychiatric problems.
But he did ruminate on his death, vowing to avoid the kind of wasting "muscle by muscle" demise that his mother faced years earlier.
"I really want to be in control of the way I go," McArthur says.
"So in this story I wrote, `What do I do?' and (how) maybe what I do is end my own life when I figure there's no future left."
McArthur says he speculated on the means he might use if that time did come – a combination of pills and alcohol, he thought.
He also admits that a recent divorce and stock market battering had left him – "basically an optimistic guy" – feeling depressed.
All of which, when his history was read by the family that evening, led his daughter to seek outside help in fear of a possible suicide attempt.
"Instead of calling me, or getting in the car and coming down and pounding on my door – which is what I would have done – they didn't know what to do and made the 911 call," McArthur says.
And that, concurs Letofsky as executive director of the city-supported Distress Centres, was likely the first and most critical mistake made that night.
"To me that's the missing piece here," says Letofsky.
"I think (family members) were well-intended.
"But if you are concerned an individual is at risk, then the first thing you would do ... is approach that individual."
Letofsky says such a step should be couched as an invitation for the person to share their feelings, while asking directly about thoughts of suicide.
Instead, McArthur says he was called by emergency services, followed by a knock on his door.
"Ah Jesus, I go to my door and it's two ambulance guys with a gurney ... asking, `Can we come in?'"
After a 25-minute chat, McArthur says he convinced the ambulance attendants he was not about to harm himself.
Indeed, he gave one of them a ride around the parking lot in the sidecar of his 1963 BMW motorcycle.
"I take him for a little ride and we come back up and I figure we're past the crisis stage," McArthur recalls. "Two cops walk in and the whole mood changed."
McArthur says the officers, unsmiling and silent, backed him into his bedroom and up against his bed.
"Then they say, `We're taking you into custody and you're going to the hospital,'" McArthur says.
"Well, I said, `Damn it all, I'm not going to the hospital. I'm not sick, I'm not suicidal, I'm not about to hurt anybody ...'"
The officers then grabbed him and put him face down on the bed, says McArthur, whose father and two uncles served for 40 years on the Toronto force.
That's when the cuffs came out, he says. And that's when the bleeding started.
"I'm flailing around," McArthur says, and the police put handcuffs on him. And the thin skin around his wrists, weakened by recent steroid treatments, began to bleed profusely.
With the bed soaked in blood, "they stand me up and march me down the hall with blood dripping, down into the ambulance," he says.
When the ambulance attendants supported his pleas to have the handcuffs removed, police relented. He was taken to St. Michael's Hospital and released hours later after talking to nurses and psychiatrists.
He has since launched a formal complaint against the police, complete with photos of his injured arms.
Toronto police spokesman Mark Pugash wouldn't comment on an active complaint, but did note that McArthur's relatives had apparently called for assistance.
Pugash said officers are told to apply "minimum force" in such situations and are trained to handle various "frames of mind."
Indeed, Letofsky says she feels for the two officers in the case as well as for McArthur – agitated by having his innocent musings misunderstood and his own family bypass him, then having police arrive.
"There is something about this story that seems rather unusual to me. One branch (EMS) saying the person is okay and the other (police) saying they're not okay ... that's rather unusual."
Toronto Star