TODAY (2013), AT THE ARIZONA STATE HOSPITAL, THERE IS NO ON-SITE PATIENT ADVOCATE WHATSOEVER. ZILCH. NIET. NADA. NOT ONE STAFF PERSON READILY AVAILABLE AND SPECIFICALLY TRAINED/APPOINTED TO RESPOND WHEN ANY PATIENT FINDS HIS OR HER SELF IN NEED OF JUSTIFIED SUPPORT IN THIS CONTEXT. IN NO UNCERTAIN TERMS, THE ARIZONA STATE HOSPITAL IS OPERATING FAR LESS LIKE A MEDICAL FACILITY THAN IT IS A PRISON, CIRCA THE LATE 19TH CENTURY.
THIS IS JUST ONE MORE EXAMPLE OF CURRENT AZ BEHAVIORAL HEALTH SERVICES DIRECTOR CORY NELSON, THE MAN CENTRALLY RESPONSIBLE FOR THE SUBSTANDARD MEDICAL-MENTAL HEALTH CARE AND PRATICES AT ASH FOR THE LAST 24 OR SO MONTHS. I'LL JUST SAY IT:
FUCKING UNBELIEVABLE.
The Role Of The State Ombudsman At The Arizona State Hospital: Herein, the typically mismanaged evolution of a patient grievance report at The Arizona State Hospital.
TITLE 9. HEALTH SERVICES
C. A client has the following rights:
IN MY LEARNED OPINION, THE PATIENT ADVOCATE AT THE ARIZONA STATE HOSPITAL IS A FRAUD. SHE KNOWINGLY COMPROMISES THE FUNDAMENTAL RIGHTS AND PROTECTIONS OF PATIENTS BY SYSTEMATICALLY REJECTING THE DEEPER IMPLICATIONS OF REPORTED STAFF MISCONDUCT AND RELATED PATIENT ABUSE AT ASH IN ORDER TO PRESERVE HER STAFF POSITION. AS SUCH, THE PATIENT ADVOCATE AT ASH IS MORE CONCERNED WITH PROTECTING HERSELF AND HER BOSSES FROM OVERSIGHT AND ACCOUNTABILITY THAN SHE IS ABOUT THE WELFARE OF THE PATIENTS. THIS IS IN DIRECT DEFIANCE OF HER OBLIGATIONS TO THE PERSONS SHE SERVES, AND IT NEEDS TO BE ADDRESSED IN PARITY WITH THE GENERAL OVERALL CRIMINAL CONDUCT OF ALL/ANY ADMINISTRATIVE STAFF AT ASH.
Hundreds of ASH patients, one contact person, very limited availability.
If you do successfully get through to Sonya Serda immediately following an incident involving abuse by staff, the matter passes directly into her scope of authority, for it is she alone who has the power to grant the report its first actual breath of life. Conversely, Sonya Serda has the power to nix any report that comes her way at that point in time, too. Very real power, of the sort that society typically restricts to persons of high education and related qualification, as well proven ethical standing flowing from clearly established work history. And if, in fact, the given report is not handled right or otherwise not advanced/accepted by Sonya Serda at that specific point in the process, the chances are pretty freaking high that the report will die then and there, and the abuse itself will effectively be condoned because the majority of staff at ASH are only as competent as the system that they operate under is.
Given this reality, as the only person at ASH assigned to overseeing each and every patient complaint, Sonya Serda plays an irrationally critical role in terms of any/all ASH patients' fundamental rights and protections in the context of abuse. A person would have to either be crazy in their own right (or so utterly thick skinned that they probably sleep underground at night) to actually believe in any sense of the word that they can meaningfully serve the needs of each and every patient at ASH. As stated already, there are several hundred patients at ASH, but only one patient advocate assigned the task of responding to each and every patient complaint or grievance.
Herein, another dangerously systemic gap (gulf) in the context of legally required administrative procedures that are explicitly designed to protect the rights of Arizona's highly vulnerable mentally disabled patient-clients. Inserting only one short sighted and arguably under qualified citizen into a position with as much responsibility as Sonya Serda has is tantamount to granting the administrators, clinicians, and lower level staff at ASH free license in terms of the exact substandard medical-mental health care practices that state facilities such as ASH are famous for.
That said, I can and do attest to the fact that the representative patient advocate at The Arizona State Hospital, Sonya Serda, neglects her express obligations to the patients there as a matter of standard practice. On a number of occasions during my thirteen (13) months of hospitalization at ASH, I relied upon the patient advocate in good faith and on a basis of civil trust. I came to her with nothing more than the basic expectation that she could be trusted, but in time, I learned the hard way that Sonya Serda cannot be trusted, and that in terms of clear obligations to the patient-clients at ASH, she is little different form any of the other ASH administrators. I learned the hard way that she couldn't be trusted to fulfill her most basic obligations, thus forcing me in my own right to recognize Sonya Serda for who she really is. That said, my generally negative experiences at ASH (and my associated records to the effect) most definitely include the willful refusal of the ASH patient advocate, Sonya Serda, to apply herself as fully as possible to the responsibilities assigned her to as a state employee working in a public facility; and while it somewhat sucks to have to pin the issue of negligence specific to first responder concerns on one person, it is also critically important for this aspect of the substandard conditions at ASH to be revealed at his time.
Patient abuse at ASH is ongoing, this is certain, and short of meaningful oversight in this specific case, the patients at ASH will continue to experience abject negligence and directly related clinical and administrative abuse of authority. The patient advocate functions as the central hinging point at which the worst staff misconduct at ASH nears exposure, and the patients at ASH rely on Sonya Serda to protect them during (and after) their most critical periods of abuse driven crisis. It is unacceptable for a person in her position to do anything less than the utmost that she possibly can, in all senses
I will now lay out the basic process that patients go through when they contact Sonya Serda in order to report abuse and staff misconduct. Keep in mind that for many of the patients at ASH, this with due respect for the vast amount of varied mental disabilities present in the patient community at ASH, it is very difficult to cope the basic stress of needing to cry out for help, and much more so to be limited in this capacity to the supposed support of only one ASH employee whose very presence is represented by a phone number when the phones at ASH are so typically unavailable for patient use. These basic elements of the patient experience are something that ASH administrators seemingly can't comprehend, not to mention the experiences of being physically, emotionally and psychologically abused by ASH staff.
I will now lay out the basic process that patients go through when they contact Sonya Serda in order to report abuse and staff misconduct. Keep in mind that for many of the patients at ASH, this with due respect for the vast amount of varied mental disabilities present in the patient community at ASH, it is very difficult to cope the basic stress of needing to cry out for help, and much more so to be limited in this capacity to the supposed support of only one ASH employee whose very presence is represented by a phone number when the phones at ASH are so typically unavailable for patient use. These basic elements of the patient experience are something that ASH administrators seemingly can't comprehend, not to mention the experiences of being physically, emotionally and psychologically abused by ASH staff.
1) The first best thing for any patient to do when they are subjected to abuse is cry out in as loud a voice as possible for help. There's really very little chance that other staff will respond in such instances, but if nothing else, the abused patient may succeed in drawing enough attention that the abuse stops, for the given moment. Which is better than nothing. Ideally.
2) The next best thing for the abused ASH patient to do presuming it doesn't occur after hours or on the weekend or on a holiday (which is when the bulk of the worst abuse occurs), is to call the patient advocate, Sonya Serda, in person. Patients have limited access to telephones, but there are rules by which any patient seeking to contact an advocate of any kind (in theory), and although these rules were not very clear to ASH staff when I first arrived, I fairly well prevailed in establishing clarification of the issue (following months of repeated complaints specific to that matter alone). So, in general, presuming staff is willing to follow there rules, it is best to pick up the phone and call the patient advocate in person, if possible, even if only to leave a message, should the abuse occur after hours or on the weekend or on a holiday (which is when the bulk of the worst abuse occurs) (I already said that, didn't I?)
3) Once the initial phone call to Sonya Serda has been made, the next best thing for the abused patient to do is put the report in writing. In fact, the patient advocate will require any abused or aggrieved patient to put their allegations into writing, for this is the policy. Standard ADHS/ASH grievance and complaint forms are somewhat readily available for patients to complete. All it takes is a simple request to staff right there on the patient units. The same staff, in essence, that very possibly played a role in the abuse itself. Staff, who by and large watch each others backs. State employees, subject to all of the infamously shortcomings of state agencies and government employment, including peer pressure and systematic retaliation for making waves of any kind. Etc. Consequently, and regardless of the various assurances patients may hear in terms of state protections against abuse of any kind, some patients are terrified of staff there at ASH, because they well know the risks associated with reporting staff misconduct. I heard about this early on in my time at ASH from one my peers there, as follows:
"I am offering you my friendly advice. You report this shit about staff misconduct to the higher-ups, and more likely than not, it will came to bite you in the ass." (August, 2011, T., Arizona State Hospital)
This man, T., has been at ASH for at least 7 years. He is one of the nicest individuals I met there in the patient community, a man virtually incapable of bearing undue ill will towards anyone, including ASH staff. But in how own right, early on in his time as an ASH patient, he was compelled to seek assistance from the state of Arizona's Office of Human Rights; for this, he was not only neglected by that office in terms of the issues that he sought to raise, he was also and immediately subjected to gross retaliation, including being relocated from the Hospital's most reasonably peaceful patient unit, to one of the most violent.
These basic approaches are about all that the patients at ASH have in terms of defending their rights and demanding due protections against abuse. The phone call to Sonya Serda and the written complaint or grievance report are the only actual tools by which the patients at ASH can even possibly be directly protected from abuse when it occurs, because as a form of documented evidence and data, the reports potentially represent an affirmation of safety and decency in an environment that is often devoid of such.
Ergo, the significance of applicable rules specific to patient rights, such as this one:
A client has the following rights:
In spite of rules such as this, I attest to the fact that at ASH, the integrity of this specific process is corrupted by the basic ineptitude and systematic negligence of ASH administrators (including the patient advocate) as soon as a patient does all that he or she can to report abuse. In essence, Sonya Serda abuses her power over this process in much the same way that the ADHS Office of Grievances and Appeals does, by directly interfering and/or shutting down the flow of relevant information. The following statement relates to a current (ongoing) mishandling of the grievance I filed after ASH nursing staff retaliated against me on the basis of my willingness to complain about staff.
"I am offering you my friendly advice. You report this shit about staff misconduct to the higher-ups, and more likely than not, it will came to bite you in the ass." (August, 2011, T., Arizona State Hospital)
This man, T., has been at ASH for at least 7 years. He is one of the nicest individuals I met there in the patient community, a man virtually incapable of bearing undue ill will towards anyone, including ASH staff. But in how own right, early on in his time as an ASH patient, he was compelled to seek assistance from the state of Arizona's Office of Human Rights; for this, he was not only neglected by that office in terms of the issues that he sought to raise, he was also and immediately subjected to gross retaliation, including being relocated from the Hospital's most reasonably peaceful patient unit, to one of the most violent.
I attest to the fact that I also experienced this specific form of retaliation in my own right, literally on the same day that a formal grievance was submitted by an staff representative of the same state resource, the AZ Dept. of Health/Behavioral Health Services' Office of Human Rights. An action that at the time fully verified the information that my friend T. offered me, offered as such to protect me from such criminal conduct.
These basic approaches are about all that the patients at ASH have in terms of defending their rights and demanding due protections against abuse. The phone call to Sonya Serda and the written complaint or grievance report are the only actual tools by which the patients at ASH can even possibly be directly protected from abuse when it occurs, because as a form of documented evidence and data, the reports potentially represent an affirmation of safety and decency in an environment that is often devoid of such.
Ergo, the significance of applicable rules specific to patient rights, such as this one:
A client has the following rights:
5. To submit grievances to agency staff members and complaints to outside entities and other individuals without constraint or retaliation;
(CHAPTER 20. AZ DEPARTMENT OF HEALTH SERVICES BEHAVIORAL HEALTH SERVICE AGENCIES: LICENSURE TITLE 9. HEALTH SERVICES)
BELOW IS ONE SUCH STANDARD ADHS/ASH COMPLAINT FORM. I PERSONALLY SUBMITTED THIS DOCUMENT TO SONYA SERDA BY HAND ON JANUARY 11, 2012. THE DOCUMENT ITSELF SPECIFICALLY REPRESENTS MY REPORT OF CRIMINALLY DISCRIMINATIVE PRACTICES SUBJECTED TO ME BY CERTAIN ASH NURSING STAFF, (A PALO VERDE EAST CHARGE NURSE NAMED MARY ANNE AND TWO ADMINISTRATIVE NURSING STAFF, BONNIE AND JACKIE) WHO IN THE DAYS FOLLOWING A JULY 07, 2011, STAFF ASSAULT REFUSED TO PROVIDE ME WITH THEIR SERVICES ON THE BASIS THAT I HAD FILED A FORMAL GRIEVANCE COMPLAINT SPECIFIC TO THAT EVENT. MISCONDUCT OF THIS NATURE AMOUNTS TO NOTHING SHORT OF CRIMINAL RETALIATION, AND/OR CONSTRAINT WHICH WAS IMPOSED ON ME BECAUSE I HAD EXERCISED MY RIGHT TO SUBMIT A GRIEVANCE IN RELATION TO THE JULY 07, 2011 STAFF ASSAULT. AS REFLECTED IN THE LANGUAGE OF THE ABOVE STATUTE, STAFF MISCONDUCT OF THIS SORT IS PATENTLY OUTLAWED BY THE STATE ADMINISTRATIVE CODE, WHICH DIRECTLY FLOWS FROM THE AZ AND UNITED STATES CONSTITUTION, AS WELL AS THE PROVISIONS OF THE AMERICANS WITH DISABILITIES ACT. SO I FELT IT DESERVED SOME ATTENTION, AND THUS WENT AHEAD AND FILED A GRIEVANCE REPORT SPECIFIC TO THIS MATTER IN ITSELF.
IN KEEPING WITH STANDARD PROCEDURE AS AN ABUSED ASH PATIENT, I PERSONALLY SUBMITTED THIS DOCUMENT BY HAND TO THE ARIZONA STATE HOSPITAL PATIENT ADVOCATE, SONYA SERDA, ON JANUARY 11, 2012. TWO MONTHS LATER, I FOLLOWED UP MY INITIAL REPORT UP WITH A MARCH 15, 2012, LETTER OF INQUIRY TO SONYA SERDA, WHEREIN I STATED MY CLEAR DESIRE TO BE FULLY INFORMED ABOUT THE STATUS OF THIS REPORT AS SOON AS POSSIBLE, AS FOLLOWS:
PJ Reed
c/o The Guidance Center
2697 E. Industrial Way
Flagstaff, AZ 86004
ATT: Recovery Unit
TO: Sonya Serda
Arizona State Hospital
2500 E. Van Buren St.
Phoenix, AZ 85007
March 15, 2012
RE: January 10, 2012 GR DOC 071011
Dear Ms. Serda,
I am writing out today in order to inquire about the above ADHS/ASH grievance report document (GR DOC 071011), which I personally submitted to you on January 11, 2011. I am at this time requesting a reasonably full report as to the status of this matter as soon as possible. Given that the central issues that I reported in this document occurred almost eight full months ago, as well as the fact that I included the details of this specific misconduct in my original grievance report in mid July, 2011, I feel the need to point out that I was due information specific to this matter at least 30-45 days ago, as per AAC R9-21-312 and 410, in terms of both your own investigation as well as any subsequent response from ADHS/BHS.
Please do what you can to see that I am provided with an update in relation to the status of this matter as soon as you can. I know that you are very busy. Any information that you can provide me with at this time will be greatly appreciated.
Sincerely.... (Etc.)
(END OF LETTER)
IT IS NOW JUNE 06, 2012. TO DATE, I HAVE HEARD NOTHING AT ALL ABOUT THE STATUS OF THIS ISSUE FROM THE ASH PATIENT ADVOCATE, SONYA SERDA, OR FROM THE OFFICE OF GRIEVANCES AND APPEALS AT THE ARIZONA DEPARTMENT OF HEALTH SERVICES. THIS IS STANDARD PROCEDURE AT ASH, AND FLIES IN THE FACE OF APPLICABLE LAW AND POLICY, AS FOLLOWS:
A client has the following rights:
6. To have grievances considered by a licensee in a fair, timely, and impartial manner;
(CHAPTER 20. AZ DEPARTMENT OF HEALTH SERVICES BEHAVIORAL HEALTH SERVICE AGENCIES: LICENSURE TITLE 9. HEALTH SERVICES)
I WILL FOLLOW UP THIS ARTICLE WITH ONE LAST DIRECT COMMUNICATION TO SONYA SERDA ON THE MATTER, AFTER WHICH I WILL IMMEDIATELY SUBMIT A FORMAL MOTION TO THE ARIZONA OFFICE OF ADMINISTRATIVE HEARINGS, WHEREBY THIS PARTICULAR OCCURRENCE OF CRIMINAL NEGLIGENCE IS OFFICIALLY DOCUMENTED IN THE RECORD.
BEYOND THAT, AS I HAVE ALREADY STATED IN SEVERAL OF MY PREVIOUS ARTICLES, NONE OF THE MANAGERIAL STAFF AT ASH OR AT THE STATE AGENCY LEVEL EVER FOLLOW THE WELL ESTABLISHED RULES OF PROCEDURE WHEN IT COMES TO THESE PROCESSES. THS HAS BEEN MY EXPERIENCE TO DATE. THE RESPECTIVE EVOLUTIONS OF VIRTUALLY EVERY GOOD FAITH COMPLAINT OR GRIEVANCE REPORT THAT I EVER SUBMITTED DURING THE ENTIRETY OF MY THIRTEEN NERVE WRACKING MONTHS OF HOSPITALIZATION AT ASH WENT JUST LIKE THIS. OVER AND OVER AGAIN. IT IS ABSOLUTE DERELICTION OF DUTY IN THE CASE OF SONYA SERDA AND HER VARIOUS SUPERVISORS. MEANWHILE, I KNOW AS WELL THAT THE CRIMINAL MISBEHAVIOR OF THE SPECIFIC ASH NURSING STAFF WHO GROSSLY ABRIDGED MY RIGHTS AWAY BACK IN JULY, 2011, (ALL THREE OF WHOM ARE SENIOR LEVEL NURSING STAFF) WAS NOT EFFECTED ONE IOTA BY MY GOOD FAITH COMMUNICATIONS WITH SONYA SERDA. THUS AND THEREIN, EVEN AS I WRITE THIS TODAY, THE STAFF AT ASH HAVE YET AGAIN BEEN ASSURED BY THE VIVID INEPTITUDE OF ADMINISTRATION THAT THEY NEED FEAR NO RETRIBUTION WHATSOEVER IN TERMS OF OVERSIGHT OR ACCOUNTABILITY, EVEN IN THE CASE(S) OF THEIR WORST BEHAVIOR. THE ABUSE IS ONGOING, OF THIS WE CAN ALL BE SURE, AND THIS IS ONLY ONE WAY THAT IT MANIFESTS.
IN CLOSING: As with anybody, the patients at the Arizona State Hospital rely upon their fellow citizens when it comes to maintaining the commonly shared rights and protections that are afforded by the United States Constitution and other like mandates of American law and policy. The patients at ASH, however, are uniquely dependent on ASH staff when it comes to these fundamental aspects of contemporary life today. Knowing as I do today, via my own very real experiences at ASH, that even at the most rudimentary stage of attempting to speak out in defense of their rights, the patients at ASH have little to no reliable support from Sonya Serda and other like administrative staff, leads me to state that much more strongly the dire need for federal intervention on behalf of the seriously mentally ill and disabled patents at ASH. Nothing short of deep reform within and throughout the entire Arizona behavioral health care system is going to address these issues; this much is clear, and until people at the highest level of authority in the state system are directed by the citizens of Arizona to establish such reform, mentally disabled adults here are going to suffer interminable degrees of abuse and mistreatment.
Patient abuse is inhumane and 100% unacceptable. Bottom line. Please take the time to contact your elected state representatives today on behalf of the patients at The Arizona State Hospital. The Tucson office of former state representative Gabrielle Giffords also has a dedicated and vested interest in supporting the sorts of behavioral health care system reform that I am talking about, and there are several federal agencies (The Department of Justice Office of Civil Rights, for example) that are obligated to respond to comprehensive reports by citizens such as any one of us, should we present them with a well founded concern about patient abuse in public state facilities such as ASH. I implore you to review my April 2012 "Resource Ideas" article, where I have provided at least a few resources in this context, and to go from there.
(June 6, 2012)
UPDATE AUGUST 5, 2013: I have no actual idea of what happened to Sonya Serda, although I have heard rumors ranging from health problems to outright resignation compelled for no clear reason. In spot of my deep discontent over her conduct, as spelled out above, I do with her well, for as a matter of fact she too is effected by mental illness. Likewise, a state appointed on-site grievance investigator (VICKY FOX) who was on staff when I was at The Arizona State Hospital lost her job not long before I discharged in Feb., 2012. As I understood it at the time, she was fired for speaking on behalf of my advocacy at the time. I attest to this today. In general, the safety and wellbeing of ASH patients has deteriorated since I left there, and this leaves me no option other than to continue my work, as it stands today. Believe me when I say, there is more than enough material for only one book, at this time, and I more than willing to compile the data. This, for my many friends at ASH, and in support of those ASH staff who do- in fact- try their best to serve the needs of ASH patients in spite of the twisted power dynamics at ASH, dynamics kept alive by individuals at the very top of Arizona's food chain.
YOU KNOW WHO YOU ARE. BE AFRAID.
I AND MY WRITING ARE GOING NOWHERE.
paoloreed@gmail.com
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I would really love input of any kind from anybody with any interest whatsoever in the issues that I am sharing in this blog. I mean it, anybody, for I will be the first one to admit that I may be inaccurately depicting certain aspects of the conditions
at ASH, and anonymous comments are fine. In any case, I am more than willing to value anybody's feelings about my writing, and I assure you that I will not intentionally exploit or otherwise abuse your right to express yourself as you deem fit. This topic is far, far too important for anything less. Thank you, whoever you are. Peace and Frogs.