Thank you for Ken Stanton's "Treating Mental Illness in the ED" (Viewpoint, December 2005). As many mental health care providers can attest, the substandard care and intolerance psychiatric patients receive are not confined to EDs.

Caregivers should remember that even patients who are homeless, drug addicted, personality disordered, malingering, or schizophrenic can tell their own stories. Their behavioral problems, irrespective of diagnosis, are often driven by fear, powerlessness, and low self-esteem-exacerbated by intolerance and indifference when they most need compassion. A little understanding in an initial interaction can mitigate behavioral problems, save time, and ensure the good nursing care that all patients deserve.

Jeffrey J. Drury, RN

Johnston, RI