We were saddened by the death of Dr. Wayne Fenton, as noted in the October
6, 2006,issue in the article "Patient Charged With Murder of
Schizophrenia Expert." We appreciate the discussion regarding
psychiatrists often having to make difficult clinical decisions relating to a
lack of inpatient facilities, concerns about the efficacy of a referral to the
local emergency room, as well as the best way to treat a patient while
maintaining appropriate boundaries. However, the topic of defending oneself
needs some additional recommendations.
First, many facilities offer courses on nonviolent negotiation techniques
and nonaggressive forms of escaping a violent situation. This training should
be included in every psychiatry residency, as it is just as important as
education relating to business management, malpractice insurance, and CPR.
Unfortunately, simple avoidance of an aggressive act may not inhibit the
patient-turned-perpetrator from continuing his or her assault. Therefore, we
would encourage psychiatrists to consider taking some form of minimal
self-defense training. Without a doubt, the initial goal even for those with a
martial arts background is prevention and escape. If this option is not
possible, however, the ability to utilize a few self-defense techniques may
serve as an additional deterrent and possibly be life saving.
The suggestion to learn some self-defense techniques may appear alarmist
and controversial. We do not intend to perpetuate the myth that mental health
patients are more dangerous than the general public. Our experience suggests,
however, that as a profession, we are woefully unprepared regarding this