The Hat

One of the best interventions I witnessed over the years.

A creative physician assessing an actively psychotic, hallucinating and escalating pt brought in by EMS would successfully stop the process by asking "Did you have the hat on"? It always seemed to cause the pt to tune in and say "What hat"? The physician would calmly explain "The tin foil hat. If you make a hat out of tin foil and wear it when they start to communicate, they can't get through to you and your safe". Escalating psychotic patients would stop, look up and say "I didn't know that". No more problem, they had a plan now. They settled down, were admitted to the psych unit without the whole explosion, restraints fiasco. As they left for the floor one of us would always say "Good luck. Next time, remember the hat".