Friday, October 11, 2013

PJ Reed: The Arizona State Hospital 
and Patient Abuse (ASH)

NOTE: OVER 85 COPIES OF THIS PERSONAL STATEMENT DOCUMENT WAS DISTRIBUTED IN PRINTED FORM AT NO LESS THAN THREE FORMAL GATHERINGS THIS WEEK IN SANTA FE, NM, ORGANIZED AS PART OF MENTAL HEALTH AWARENESS WEEK, WHICH IS FORMALLY CONCLUDING OVER THE UPCOMING WEEKEND. BUT ON MONDAY OF NEXT WEEK, I WILL BE ATTENDING/PRESENTING AT YET ONE MORE CONFERENCE GATHERING IN THE CONTEXT. SUFFICE IT TO SAY, I HAVE HAD A CAPTIVE AUDIENCE, AND THEN SOME. SO THERE IS MORE TO COME. AS ALWAYS....

Hello. My name is Patrick, aka PJ Reed. I have little to fall back upon in introducing this text beyond my immediate past history. But I will state here and now, that all aspects of this writing directly relates to the drastically substandard conditions, care practices, and overall flow of treatment at The Arizona State Hospital (2500 East Van Buren St., Phoenix, AZ). I can attest  as to the merits of my statement as it stands at this time, because I very recently discharged from ASH (Feb. 2012), following undergoing thirteen full months of abject mistreatment there, in relation to my mental health diagnosis of major depressive disorder and associated traits, including suicidal ideation (and attempts). It is my  express intent to illustrate in full detail the fact that virtually staff psychiatrists at ASH, and a substantial proportion of staff nurses and technicians alike, engage in abuse of the most fundamental rights of ASH patients in a manner and to a degree that is irrefutably beyond acceptance in this day in age. This abuse takes every imaginable form in the context of contemporary health care, and acquires a heightened significance in the context of persons-patients affected by serious mental illness and disability. Hospital administrators and associated Arizona Department of Health/Behavioral Health Services work in unison in order to condone the ongoing violations of patient rights as a matter of standard protocol, and anytime well founded data arises that so much suggests such problems they take this wrongdoing just that much further by both distorting the truth as it emerges, and/or engaging in highly illegal methods of retaliation that cuts to the heart of the public trust in all senses.

All accounts of my experiences are drawn from straight forward  fact(s), accrued during my time at ASH, and detailed in a number of journals and related documented evidence. I have no reason to share my experiences beyond my recognition of how deeply inhumane much of the care and treatment of ASH patients is. If I was in this for personal gain, be it of a financial nature, etc., I would taken any number of other serious action long ago, perhaps in the form of a civil law suit. But I know that if I were to go that route, the issues I most deeply concerned about would not receive the requisite attention that I feel needs to be directed to the broader concerns that I know apply to this crisis, as it stands; and would instead be swept under the rug, which is precisely what each and every individual responsible for this wrongdoing would far prefer. My learned awareness of government and public policy basically demands that I use my full body of acquired skills as a writer and researcher, in direct relation to my status as a one time law student, in order to thoroughly bring the full nature of these issues to light. This level of exposure is critical to the needs and justified expectations of anybody having a vested interest in ASH, including family members, and even those ASH staff who are unable to perform their duties- as per state employment contracts- due to the undeniable willingness of senior clinical and administrative staff to engage in unlawful methods of intimidation and retaliation in terms of job security, on the job safety, and other like forms of employee mismanagement. 

These problems extend well beyond the walls and fence lines of ASH (the facility), for the fact is, high ranking staff in Arizona's behavioral health care system are complicit in condoning or otherwise endorsing a grossly depraved level mental-medical health care. Most specifically, I am very familiar with the fact that staff members in the ADHS/BHS Office of Grievances and Appeals utilize the relative complexity of applicable procedural law in order to stymie any attempts of someone such as myself to bring these issues to light via established protocol. Such protocol, as found in the procedural manuals at ASH, and more importantly, as spelled out in the Arizona Administrative code, has direct bearing on the public trust, but via the willingness of these highly paid state employees to defy such protocol, the public in general has been denied a vast range of due information specific to the realities at ASH. These denials also have very critical significance in terms of patient rights, and the most serious impacts of this misconduct lands squarely on the heads of ASH patients. It is that simple. It is that bad.

I am more than willing to publicize the most private aspects of my personal life history, as it stands today, because the patient abuse at ASH has to stop.  

My story in relation to the Arizona State Hospital began as follows:

I was formally diagnosed as person affected by serious mental illness for the first time in spring, 2010. I was 49 years old, and the diagnosis arose following my fourth attempt to commit suicide in as many years. At that point in time, I made the conscious choice to seek final resolution to my struggles with depression via the health care system on the outright basis of having not successfully killed myself. I know, this sounds intense, the trying to kill myself, and all. But in fact, it was anything but that, and I experienced all of it as a process. At the time, I had nothing much to gain, and nothing at all to lose. Prior to then, in spite of being affected by depression and suicidal ideation since I was a boy, I had never sought help in terms of addressing these specific facets of my personal state of mind and emotion. The fact is, I did not recognize my very real need, as it were, which may have been a matter of denial, consistent with the fact that I then shared the same well recognized forms of stigma towards mental illness that many Americans exhibit today. But once I did begin the process of seeking such help, I made an associated conscious decision to maintain openness and good faith in my various care givers as they appeared. Therein, during my initial weeks in a Tucson area mental hospital, I came to learn that I was needful and deserving of far more care and treatment than I ever comprehended. At the urging of more than one of these early care givers, I also decided to stick it out, and not follow my often present desire to leave that Tucson hospital in order to go about my business, specific to my long standing intention to commit suicide. That was the beginning of twenty one full months of hospitalization in the Arizona public health care system.

The treatment and care provided me in Tucson was most definitely up to reasonable standard, and afforded me an associated willingness to trust my psychiatrists. No serious issues emerged during that pre-ASH period of my treatment, and as a result, I possessed no predisposition about any aspect of what was coming, as it were. Following a number of months in several Tucson area facilities, during which time my basic lack of interest in life somewhat remained, I made the very difficult decision to cooperate with the idea of being referred to ASH. Misgivings on my part included a very real discomfort with ongoing treatment- at the expense of the public- that did not seem to have much affect on me, in terms of my state of mind and deeper sentiments towards suicide, but one of my caregivers at ASH reassured me that I was deserving of extended treatment at ASH.

It need be said that the provision of mental health care in Tucson has nothing to do with the fact that my state  of mind remained somewhat static during that  time. Likewise, that those first eight months of treatment in Tucson area mental health care facilities was not always pleasant, nor free of problems in terms of staff conduct. On a certain  level, this is to be expected,  for no such  facility functions entirely free of
conflict. However, I fully believe that all members of the medical team that referred me to ASH had no reason to suspect that my treatment at ASH would dive so profoundly below medical-mental health care standards. Indeed, none of us could have imagined that over a period of thirteen full months (at ASH) I would witness and experience systematic and overtly sanctioned wrongdoing, extending as it does well into the highest offices of state health department officials; or that I would thus come to develop into  a dedicated advocate-activist in relation to the rights and well being of all persons associated with ASH, from the ASH patient community and all given family, to the many good people at ASH who, in fact try and serve the needs of ASH pateints. Sadly, at this time, such staff are the minority.

SUBSTANDARD MEDICAL-MENTAL HEALTH CARE AS A MATTER OF STANDARD PRACTICE AND THEY ARE GETTING AWAY WITH IT.

As stated, I spent thirteen full months at ASH, and for the entirety of my time there, I did witness and experience clear and unavoidable violations of established medical-mental health care standards on near daily basis. The attendant stress brought about by being exposed to such a setting was at times traumatic, and directly damaged whatever semblance of emotional and mental stability I had following my initial eight months of treatment in Tucson. And no matter how clearly I made my concerns in this context to each and every senior care provider at ASH, I was met with utter disrespect and patented denial(s), which in time took the form of very real, undeniable retaliation that was imparted upon me by the highest ranking administrative staff at ASH. With my still active suicidal ideation and other diagnostic features in mind, it was all I could do to survive this trauma, at times. In hindsight, I am sincerely concerned about the fact that my experiences at ASH are far from unique. I contend that this applies at ASH, as well as with respect for public mental health care in general. In terms of persons hospitalized in such settings (as I was), the harm is irrefutable and potentially deadly, both in terms of the patent, and the public, albeit shrouded and well off the radar screen of public awareness. No person unfamiliar with the the inner realties of a place like ASH would easily be able to fathom the things I witnessed and experienced there. On the other hand, most anyone having such awareness knows all too well how critical this issue is today.

It is that simple. It is that bad.

There is an ongoing national discourse today that has everything to do with the known shortfalls of public mental health care in America, and there is escalating concern in relation to a number of very tragic occurrences, including mass shootings and other like horrors that  may very well may have happened in direct relation to recognized shortfalls in the context. I have included in my documented data more than one specific issue arising at ASH during my time there, that did in fact lead to tragedy well outside of the walls and fence lines of the facility itself, in combination with the ongoing employment of persons who both caused the given tragedy itself, and who still do all they can to deny such truths, no matter how legitimate the basis of such data.

This is where I come in, as a direct line witness to the realities in a modern American state's sole long term public mental health care facility. As such, the whole of my statement has direct bearing on national policy in this context.

The whole of my testimony has to do with safety.

My story is one that can expose the ongoing presence and severe impacts of endemic discrimination, neglect, and outright abuse of seriously mentally ill adults who have nowhere else to turn but our public state hospitals when and if the issue of chronic mental illness is at stake. This applies in the context of the afflicted, as well as in the interests of the public. For if, in these places that all Americans are led to believe seriously mentally ill persons are safe in their own right, the applied standards of care are not up to par with the greater standards in effect outside of such facilities, a radical disconnect will be furthered in terms of a wide range of public interest concerns. This disconnect, in turn, can, will, and has- including in the context of ASH at this time- led to direct negative impacts on the greater good, far too often in the form of avoidable tragedy.  Given my experiences, and the very real presence of such data, I know for a fact that some proportion of America's most seriously mentally ill and disabled adults are being subjected to mistreatment that many Americans presume has been successfully banned and eliminated, this as per well recognized history specific to state mental hospitals, and related improvements in state and federal law that was intended to bring such mistreatment to an end once and for all. And while such mistreatments and related shortfalls in state mental health care have long been banned, in fact, the harsher reality still exists that in places like ASH, highly at risk adults, historically known to be vulnerable to neglect, exploitation, and abuse, are still being subject to sickeningly inhumane care and practice. At ASH, this is a matter of standard practice.

From a legal standpoint:

Under bright line state and federal law, the Arizona State Hospital- and any other like state mental health facility- is a public (health care) entity. Such public entities function under very strict authority, as per the principles and provisions of numerous statutes and  public policy mandates, including but not limited to the Eighth Amendment of the U.S. Constitution, the Bill of Rights (Title V, Section 501 of the Mental Health Systems Act 42 U.S.C.)The Americans With Disabilities Act, and the Hospital Information Portability and Protection Act. Such specific   standards of law bear immediate significance in relation to all/any aspects of ASH's function and actual operation, including in terms of any person(s) directly responsible for abiding law as critical as these. Critical because all persons affected by severe disability in any context are deserving of direct protection on the basis of said disability, this given the known history of shortfalls when it comes to persons who are afflicted, as such; and given this history, we are all (Americans, in effect) well acquainted with the related discriminations of the seriously mentally ill. I mention these specific edicts of common law because as an ASH patient, state citizen (taxpayer and consumer of public services), and human being, I rightfully expected nothing more or less than reasonable medical care when I came to accept the fact that ASH was the place for me to be, as person affected by serious mental illness, needing as I did then, formal long term medical-mental health care. My expectation(s) were 100% consistent with what all/any public mental health care facilities are obligated to provide. Any verifiable evidence to the effect that ASH, or any other like public health care facility across the board- anywhere in the United States today- is failing to abide by such edict is due immediate attention in the form of rigorous oversight and accountability. This is a matter of law, and there is no justified reason for allowing such conditions to exist.

 A BIT MORE HISTORY:

As stated above, I spent close to eight months undergoing treatment of my mental health needs at several well operated shorter term facilities in Tucson, AZ; at which time, I was referred for continuing treatment to Arizona's sole long term public mental hospital, The Arizona State Hospital, in Phoenix. This referral was implemented via a cooperative process (between myself and my Tucson based care givers) and the terms of a civil commitment, as per applicable Arizona law. In reaching that point, my Tucson caregivers afforded me thoughtful conferencing as matter of reasonable care, and in doing so, I know for a fact that my primary tucson psychiatrist directly consulted with ASH admissions representatives in terms of my specific needs. In short, I went from the conditions of a level one "acute unit"  in Tucson (such units are where the very most unstable patients are referred by police, and so on, markedly volatile, as such), to the conditions at ASH. In theory, one would expect that the professionalism of staff in any state's public mental hospital would be comparable to such cute units, if not better. But I learned the hard way that there is no comparison. It was like night and day, as though I had been transferred from the society I had lived in for close to fifty years to a realm inhabited by licensed practitioners and trusted health care authorities who exhibit little to no understanding of health care ethics, common civility, or state/federal law and policy as it applies in such settings.  I attest to this wholeheartedly.

Via my very real experiences at ASH, I am willing to believe that such conditions also exist in any number of state mental hospitals. This is on point and consistent with the history of such facilities, and while things today may certainly be "better" than they were in the past (?), I contend that the function and operation of such hospitals will, as a matter of undeniable evidence, always require very high degrees of oversight and related accountability. This reality is inherent to such distributions of public resources and related authority, and is especially acute anytime the citizens most at risk are affected by severe disability, in any context.

The untreated impacts of my nearly life long mental illness literally derailed my life over time, in what I can only describe today as a long, at times painful, and very arduous (slow burn) process that began when I was a boy. Following attending and doing very well in college (in my 30s and early 40s), including a BA (UNM 1996, Magna cum laude, Phi Beta Kappa, general honors), an MA (UA 2000), and two full years of achievement based/scholarship supported law school (James Rogers College of Law, UA 2001-2003), I increasingly fell into deep and unrelenting crisis that arose in direct relation to my life long struggle with depression. This directly contributed to my active decision to leave law school when I did, and subsequently led to acute suicidal ideation, on a level I had never experienced it, including attempts. It took five years of this level of struggle before I finally began seeking help in the Arizona public mental health care system.

IN CLOSING   When I agreed to enter into the legal proceeding by which I was referred to ASH, I harbored no predisposition in terms of my expectations as a tax paying citizen of Arizona, and my willingness to take part in that part was 100% of good faith. I was mentally ill, at risk of harming myself, and I knew it. Once at ASH, as the worst affects of my depression somewhat subsided over a period of 3-6 months (far more as the direct consequence of my ongoing medication regimen- drug therapy- and my own self directed physical health activities, than as that of the flow of clinical "treatment" that I experienced at ASH), I found myself taking a renewed interest in my environment, which inadvertently and very unexpectedly led drew me into the process of doing all that I (can) to address the substandard care and practices at ASH. In reaction to this (my efforts in this vein, while actually hospitalized at ASH), I was subjected to very real clinical and administrative retaliation. This described retaliation underscores the extent to which abuses of patient rights exists at ASH at this time. For all I was trying to do, in fact, was exercise my fundamental rights and related responsibility in terms of reporting patient abuse at ASH- or any other like crime, in fact, anywhere in America today. This nature of retribution for doing the right thing is patently unacceptable to anyone of reasonable conscience, and I further contend that there is a very real need for any persons, organizations, or other like entities claiming a good faith interest in the mental health care crisis in America today, to take a heartfelt stand in support of our nation's most seriously mentally ill and disabled adults and children, with particular regard for the deplorably substandard conditions in long term public (state) hospitals such as The Arizona State Hospital. Herein lie the most counter therapeutic forms of malpractice in health care today, with irrefutable impacts that are effecting the well being of the public. Said "public" includes each and every American citizen currently being subjected to mental heath care in such places. Bottom line. 

PJ Reed, author: The Arizona State Hospital and Patient Abuse.

(NOTE: the above material was taken from my first article-
an introduction- as included in this blog, and originally 
published on-line in April, 2012. To date [10/13], I have 
composed andpublished over 270 full blog articles about my experiences and related knowledge specific to The Arizona 
State Hospital. The site has documented well over 20,000 
dedicated visits, and in recent months, is accruing over 
150-300 such visits on almost any given day.)



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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.