The patient, a 29-year-old man, was in the emergency room—handcuffed, attended by a police officer, and accompanied by his wife, his two older twin brothers, and his grandmother. Earlier that day, the patient, Mr. L, called Jimmy, had shot several newly planted trees in his neighbor's front yard with a BB gun. The neighbor and all of Mr. L's family members had failed to persuade him to stop this irrational behavior. The police were called, and Mr. L was handcuffed and brought to the emergency room. According to the family, there was no precedent for such an action, and Mr. L had no history of psychiatric or substance use conditions. His family history was also negative for psychiatric disorders.