From conflict to collaboration: psychiatry and the hospital police

Social control is one of the major tasks of the profession of psychiatry (Astrachan, Levinson, and Adler 1976; Adler, Astrachan, and Levinson 1981). The reduction and control of deviant behavior in the community, in the hospital, and on the psychiatric ward are essential, if underappreciated, responsibilities which psychiatrists must negotiate every day. In large urban general hospitals, an increasingly common site for psychiatric programs, deviant behavior derives both from the psychopathology of the patients and from the intrusion of criminal influences from the community. Many urban hospitals have an institutional police force that, like the psychiatry service, is charged with responsibility for managing deviant behavior, albeit through law enforcement methods rather than clinical ones. In recent years law enforcement officers and psychiatrists have increasingly become involved with each other in areas where their social control responsibilities overlap. This increased involvement has often been accompanied by tension, distrust, and, at times, overt antagonism between the two groups. This paper will describe and analyze fundamental sources of this tension and outline one approach to its reduction.