Psychiatric emergency room doctors at Bellevue Hospital Center routinely forcibly inject newly arrived patients with powerful sedatives, not because the patients are dangerous, but because they refused to have their blood drawn, according to a new report. City Limits reports that Mental Hygiene Legal Services, a public defender organization for psych patients, formally complained to the New York Justice Center for the Protection of People with Special Needs, a state oversight agency, citing eight instances of allegedly unnecessary forced injections.

City Limits investigative reporter Ben Hattem found indications that, in violation of well-established case law and state mental health guidelines, Bellevue doctors have made forced injections of a combination of Haldol and Ativan a standard practice for patients who say no to having their blood drawn. Some medical research indicates that preliminary bloodwork may not even be necessary for screening mental health patients.

The use of force and emergency sedation should be an "absolute last resort" and used only "for someone who is really mentally ill, is really dangerous, and someone who doesn't respond to non-coercive verbal or nonverbal interventions," said Jon Berlin, a doctor and former president of the American Association for Emergency Psychiatry.

Bellevue's psych ward isn't the first in a New York hospital to come under fire over allegations of shooting patients up with tranquilizers against their will. The New York Civil Liberties Union, Mental Hygiene Legal Services, and the firm Kirkland & Ellis sued Kings County Hospital Center in 2007 over conditions in its psych ward, including an alleged pattern of doctors using forced injections as punishment for hard-to-handle patients. The city's Health and Hospitals Corporation settled the suit in 2009 [pdf], agreeing to federal Department of Justice and other monitoring.

Portrait photographer Mike Dote, who suffers from schizophrenia, told City Limits that Bellevue uses injections as a default with stubborn or agitated patients, whereas elsewhere doctors would try to talk them down. He said at Mount Sinai Beth Israel, he was never forcibly injected.

"At Bellevue you just look at someone wrong and they shoot you up with Haldol," he said.

A spokeswoman for the hospital denied breaking state laws pertaining to involuntary medication, but did not respond to detailed questions.