Steven J. Miccio, Executive Director 

Dying for help in the ER

So are we already over it? Many people watched the recent video tape of the Kings County Hospital emergency room and witnessed a woman, Esmin Green, die. However this wasn’t just a woman was it? No, it was a “mentally ill person”.  It was a mentally ill woman that was waiting for nearly 24 hours to be seen for a psychiatric screening and after falling out of her chair was dead within one hour and three minutes. Of course people from across the country are expressing the “shock and horror” but today’s a new day and for most people working in hospitals and in the mental health system and the general public many are most likely back to the daily routines that drive everyone’s lives. Many people are over it.  

I mention Esmin Green’s name because it wasn’t “just” a mentally ill person that died. It was a human being that at some point in her life had a family, friends and interests the same as most people do. Unfortunately most TV and media reports emphasized that Esmin Green was a psychiatric patient and spoke very little of her as a member of our society. De-personalizing a person by emphasizing that he/she was a mental patient kind of takes the edge off of it being a “woman” or being Esmin, doesn’t it? Labeling seems to make it a bit easier to watch a human breathe her last breath. However, we have become a society that has become so desensitized that watching a person die seems to be just another You-Tube moment.

Many Americans watched the horrifying video of Esmin Green fall out of her chair, have a seizure, hit her head and lay on the floor attempting to get up and finally dying. How do we as a community respond and react to such an atrocious event? After seeing this event, does the public care enough care to demand change?  

Try this test. Close your eyes and imagine the scene as it played out on the video and picture the guard sitting in his rolling chair looking at Esmin lying there and how he ignores her. Watch how the life runs out of Esmin. Watch how the hospital staff approach Esmin and how they react to her not breathing in a non-urgent manner. Now picture your mother or your father or husband, wife, partner, son, daughter or loved one lying there in the same position. Does it make you think differently about the event? Does it make you want to do something to change the way people are treated?  

This poor quality of care occurs every single day in emergency rooms across the nation and yet nothing changes. In this case, staff were fired and I guess that’s supposed to be good enough to satisfy the public knowing that the “bad” people no longer work in that hospital. However, firing these people does not guarantee they won’t get jobs in the same field or setting somewhere else in New York or another state.

If the person was one of your loved one’s that died in this manner I would expect that you would have the best lawyers hired to press criminal charges against everyone involved including the hospital and licensing bodies that regulate that hospital. You would do something about it.

This incident received attention because it was video taped and released to the media. What about the incidents that are happening right now in other emergency rooms that aren’t being video taped and reported to the proper authorities? If you followed the story about the documentation being falsified to cover the incident up you can understand how easy it is for hospital staff to falsely “report” serious incidents. If that camera was not on and viewed by the proper people, chances are the falsified report would have been accepted and all of the staff that were fired would be working at that same hospital today. 

The other observation that I want to make is that if most people see a wild animal in our community suffering from an injury or in need of assistance the community seems to think nothing of jumping into action and, at times, going the extra distance to help the animal. People will rally on beaches to save the dolphin or whale. People will stop traffic to allow ducks or confused dogs get across dangerous intersections and yet a woman, a human being, Esmin Green can fall and die in an emergency room with observers and “professionals” standing nearby and in the end we as humans just don’t care.  

I can with clear conscience say that humans don’t care because if they did, if we all did,  there would be change in how people with mental illness and in need of help are cared for. We would have advocates sitting with people in the emergency department listening to the concerns of people in need and assuring people that their physical needs are taken care of while they wait. We would have thoughtful, compassionate and trauma informed hospital staff working to make patients feel at ease knowing that he/she is in good hands. We would end the bureaucratic process of laying blame on the funding sources such as insurance companies, Medicaid or Medicare for poor service delivery due to poor funding issues and we would fix the issue. We would do the right thing.

If humans cared we would fix this discrimination that is so infused in our mental health system and we would do it now. I am angry and frustrated having to hear the many stories from people with mental illness and family members telling of the horrors of the care that they receive. I am angry and tired of hearing professional providers of mental health services talk about how it isn’t “their services” that treat people poorly. This ignorance is unacceptable!

I challenge, no, I demand that every hospital administrator go to a hospital that doesn’t know you as an administrator and present as a person with a mental illness in need of help. While you may get good care because you don’t fit the perceived “discriminating” profile of a mentally ill person (poor and disheveled), observe how people are treated around you. I guarantee that if you sit there long enough you will make some drastic changes in your own hospital and maybe, just maybe you will be the hero that begins to change the discriminatory care that people with mental illness receive all too often. Maybe you will care enough to say “I am responsible and I’m going to fix this.”

As for the general community: find your voice. Write and publicize your experiences in an emergency room. Call the hospital and complain. Call your local legislators and tell them. Call the licensing agencies and tell them. Call the attorney generals office and tell them. Tell anyone that will listen. If need be, march in front of your local hospital and demand change. Hold community meetings and talk about the care that people receive in local hospitals. Do something or we will be reading more stories similar to the one at Kings County Hospital and more people will either die or live with the unspeakable trauma from the atrocious care that has been so dominant in our communities.

Let’s all remember and honor Esmin Green by beginning to work towards developing standards of care that treat people with mental illness well rather than continuing this acceptance of sub-human care for people with mental illness. Let’s do something right for a change.

Steve Miccio

Executive Director

Projects to Empower and Organize

The Psychiatrically Labeled, (PEOPLe) Inc.

Poughkeepsie, NY  

For more information, please contact PEOPLe, Inc. at 845-452-2728 or stevemiccio@projectstoempower.org