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Racial disparities persist in how emergency rooms use restraints. Police transport may play a role

NEW YORK - SEPTEMBER 5: A handcuffed suspect is watched over by a police officer in the emergency room at Coney Island Hospital September 5, 2002 in the Brooklyn borough of New York City. The public hospital serves a large multi-ethnic patient population including many Russians, Pakistanis and Central Americans residing in the South Brooklyn area. The emergency room receives approximately 60,000 patients each year. (Photo by Mario Tama/Getty Images)
Mario Tama
Getty Images
A handcuffed suspect is watched over by a police officer in the emergency room at Coney Island Hospital September 5, 2002 in the Brooklyn borough of New York City.

How a patient arrives at a hospital emergency room may influence whether or not they are physically restrained when they get there, according to a new study from the Yale School of Medicine and Duke University.

Researchers have already observed that Black patients are more likely than whites to be restrained in hospital emergency rooms. The racial disparity persists even among patients from similar medical and demographic backgrounds, researchers say.

But what’s driving that disparity is still unclear.

While the use of physical restraint is relatively uncommon in ERs, when restraints are used, researchers questioned if police transport played a role in that decision.

To examine that, Yale and Duke researchers looked at more than 4 million ER visits at hospitals across eastern United States over several years.

Writing in the journal of the American Medical Association, the team found that when a patient was transported to a hospital emergency room by police, they were more likely to be restrained — a staggering 550% more likely — than patients arriving by other means.

The research also found Black patients were transported by police to ERs more than white patients, a statistic that remains consistent with past research.

Researchers say that disparity may influence why Black patients are restrained at a higher rate than whites in emergency rooms — 33% higher.

In both Connecticut and North Carolina — home to Yale and Duke — police officers can escort patients against their will to the ER for clinical evaluation of their mental health.

The researchers say that in both states, and in most of America, patients brought to the ER by law enforcement are often restricted to a locked unit, confined to their rooms, surveilled and denied their belongings, such as their clothes, cell phones and shoes.

One solution, researchers say, is to limit law enforcement from transporting patients with mental health emergencies to reduce bias.

Yale currently has a pilot program where people with lived experiences of mental illness assist in the ER to help de-escalate interactions.

Sujata Srinivasan is Connecticut Public Radio’s senior health reporter. Prior to that, she was a senior producer for Where We Live, a newsroom editor, and from 2010-2014, a business reporter for the station.