Under Their Skin: An Update of Sorts. (RERUN originally published in June 2012).

(Update 2014:  When originally published, this article was intended to encourage anybody with an intimate awareness of the substandard conditions and associated realities at The Arizona State Hospital- e.g. staff- to take action in their own right on behalf of the patient community therein. Since that time, there has been a range of reports emanating from within the fences and walls of ASH, from staff, patients, patients families, and advocates alike; and a consequent heightening of attention to the issues that I have been reporting since the founding of this blog.)

   "Defectors and whistle blowers, as it were, will really help this cause."         

Any writer feels a certain sense of satisfaction when indications appear to the effect that their work is in some way appealing to a reading audience, this in the context of any genre of literature and text. So I cannot deny the simple pleasure that I experience when the reader visits to this blog site spike through the roof whenever I add new material to it. It is, in fact, quite remarkable to observe this as a writer dedicated to disseminating information that is anything but fun to read (I should think). Watching the number of "hits" to the site go from 30, 45, 70 and so on, steadily up through the lunch hour, and then by dinner, to see those numbers transcend into the hundreds, definitely has its positive effect, and I always get a shout out from either my editor in New Orleans, or my publisher in Dallas (or both) whenever this happens, which sort of makes it exciting. But I am compelled to emphasize that my  core objective in terms of this project has little to do with any desire to be noticed as a writer, as it were, for indeed, I have always and continue to be 100% dedicated to the improving the quality of care at ASH on behalf of the patient community. Patient abuse and abject negligence of any form is unconscionable to anyone of reasonable morality, and in graphic violation of state, federal, and international human rights law.

(NOTE: As of September 2014, the total dedicated visits [10 minutes or longer] to this site exceeds 45,000; and indeed, in recent days, there has been yet another surge in such visits, around 75 per day. As I have said before, I must be doing something right.)

Said spike(s) don't come easy, especially given that I don't publish much on here anymore, for it is largely all going into the book. When I do publish something on this blog nowadays, it typically flows directly from news and other like data that emerges through the popular press, as illustrated by the intensity of last weeks investigative articles in Phoenix's major newspaper, the Arizona Republic, feature news reporting specific to the Arizona Department of Health Services (ADHS) repulsive failure(s) to protect juveniles who are undergoing residential mental and behavioral health treatment in ADHS numerous Level I facilities for people in that age group, which are located all around the state. I know that the staff at these media outlets drop in and extract data from my writing, too, but in truth (obviously) I am not a trained journalist, and the basic tone of my voice was honed via my experiences as an abused patient at ASH (versus via standard journalistic investigation, which has its own fundamental requisites); thus, in terms of my most recent blog entries, my gratitude for the work of reporters such as JJ Hensley, Craig Harris, and Rob O'dell (as well as Wendy Halloran at KPNX television, Channel 12 in Phoenix) runs deep, and I owe them far more than they owe me. 

(NOTE: And as of fall 2012, add to that list David Biscobing and the staff at Phoenix Area ABC News affiliate Ch15, who have to date [Sept. 2014] aired no less than 6 investigative news reports on prime time television confirming the fact that ASH administrators are engaging in gross violations of state and federal law; while Scripps Media, Inc.- the parent company of ABC Ch15- very recently filed a lawsuit in Maricopa County Court [Phoenix]  naming ADHS Director Will Humble and all/any involved Hospital officials as defendants, on the basis of the fact that ASH has refused to report graphic reports of sexual assault at ASH to police. This, just one more detail to how deeply distorted the standards of care at ASH are, in fact.) 

It's also somewhat satisfying to know that a marked degree of my "business" (readers) is coming right out from the war zone, as it were, where individuals at the helm of ADHS, as well as administrative staff at The Arizona State Hospital (ASH), are doing whatever they can to deflect attention from the realities of their misconduct. But this satisfaction has no joy to it in the classic sense. It is, rather, a bittersweet experience in all possible ways, because generally speaking, the process that I am engaged in is anything but alluring, and I am only dragged back into the filth characterized by my first person knowledge of how inhumane the conditions at ASH actually are. And while I can only suspect that the wrongdoers at ASH perceive my work to be spiteful and reflective of simple angst, I can attest to the fact I am not compelled to produce data reflecting my experiences and knowledge base in relation to the substandard conditions at ASH by a spirit of actual resentment (towards these rat bastards), nor have I ever been; which is to say that my investment in this matter doesn't flow from a need to impart revenge on anybody. Vengeance, as such, may well have its place in certain processes not unlike this one (particularly given the very real harm that these people have caused in my life), but there is far more at stake than a need to vent my resentment towards anybody, per se'. Indeed, the task at hand is aimed at rooting out the underlying causation(s) by which the graphic discrimination against the seriously mentally ill patients at ASH so vividly occur, for it is undeniably due to this discrimination that the substandard conditions at ASH occur in the first place. This is the case across the board, endemic and unshakeable prejudice that emanates from deeply rooted stigma, and utter disregard for the needs of people as vulnerably needful as the seriously mentally ill. In this sense and this sense only, the ones most centrally responsible for the dismal conditions at ASH occupy executive offices at the facility itself (ASH, 2500 East Van Buren St., Phoenix, AZ, 85008 [602-244-1331] ), as well in the main office of ADHS (150 North 18th Avenue, Phoenix, AZ 85007 [602-542-1025] ); and taking these particular rat bastards to task is just something that has to happen if the far more meaningful redress and reform that I and my supporters are dedicated to can ever come about, for as long as the state of Arizona's most seriously mentally disabled citizens are left in the care of such people, there is no point in advocating for change. 

The bigger task, then, is to bring Arizona up to speed in terms of participating in a broader national movement that I can only describe as too late and long forgotten, whereby an increasing number of states are recognizing the dysfunction of public mental health care policies that in recent years have directly contributed to our nation's greatest domestic tragedies. There is arguably no state at this time more qualified in the context of illustrating the egregious impacts of these dysfunctional policies than the state of Arizona, and I contend that the Arizona public health care system itself needs to be entirely rebuilt (from the top down), so that the greater public can be assuredly provided with the performance levels expected of such systems. As I have illustrated to date in this blog, those performance levels are the direct responsibility of high ranking state officials such as ADHS director Will Humble, as well as a number other executive and administrative staff in ADHS and at ASH, individuals who have grossly failed in their jobs in direct violation of the public trust, and who consequently need to be removed from this process altogether. Therein, the nature of the "satisfaction" that I feel when I observe the appearance of these sorts of people whenever they visit my blog, straight out of the aforementioned "hornets nest", because I am willing to believe that by making it clear to these people that the time has come for them do the right thing in the greatest possible way specific to the heart of this mission, we may jostle one or two of them out of their roosts there atop the junk pile. Defectors and whistle blowers, as it were, will really help this cause.         

And when I say "almost enjoyable", I mean it in the sense that I and "my people" find satisfaction in knowing that we have caught the attention of such individuals, for only through such success will the requisite wheels begin to turn in direct benefit to the needs and rights of ASH's highly vulnerable and seriously mentally disabled patients. "We" (my people) are not concerned about how well anything I publish sells, per se', because the only market that we are dedicated to targeting at the onset exists in the realms of major health care institutions, including universities, legal forums, and other like havens of scholarship and critical discourse, and that market is a given, for (if nothing else) my publishing house is well established in those realms of intellectual contemplation and discussion. While my editor, meanwhile, has successfully tended to the evolution of a variety of books written by noted medical authorities, including physicians, academics, and public health care officials (including the late C. Everett Koop, who just passed away on Monday of this week). This is why I feel so fortunate to be working with the ones who are supporting my work at this time at the formal editorial and publication level; in our earliest discussions (which occurred following direct references from a good old friend), I quickly learned that they are all dedicated to contributing directly to meaningful resolution of the central issues that I have identified in terms ASH being as graphically substandard as I allege it to be, and the experience of both my editor as well as the management staff at my publishing house is exemplary. Historically, these folks have a long history of briskly stirring the pot in a context specific to medical ethics and commonly recognized sentiments in this sense, and have in their own respective right brought a range of  powerful and invigorating literary supplements to ongoing public health care discourse and debate in the United States, and elsewhere. 

IN CLOSING: And when I say "almost enjoyable", I need to clarify as well that no part of this process is enjoyable, in fact. It is as painful a process as I have ever dedicated myself to and most definitely includes the thirteen long months I spent as an ASH patient; and in this sense, it is equally  nonsensical and seemingly without clear purpose to many of my friends. This is just how it is, though. The state of affairs at The Arizona State Hospital is horrifyingly out of sorts with anything that the high majority of my closest friends could ever imagine. This applies across the board, I feel, with respect for the American public, for nobody of reasonable conscientiousness and related awareness about the world we live in would ever easily believe that a modern health care facility could ever be so dismally mired down in practices that were officially abolished decades ago. As I said, this is just how it is, for I was there, and I saw these things, and I was subjected to these things, and it hurt me and fucked me up in very real ways, and these things only I can I know. Likewise, I mentioned already that my main writing project is being edited by a woman who was for a period of years close to the late C. Everett Koop, and she has done a great job in reminding me that I need to care to my own needs as we go through this process, which will likely take years, and may require the writing and publication of more than one book. She does this because as an experienced professional, she knows that if I am not on top of my game, the primary objective of our working relationship is at risk; she is also a genuinely nice person, in my humble opinion, and the mere presence in her history in association with a individual as esteemed as Koop grants me something beyond simple inspiration, something more akin to reverence for the trade of writing, as it lays before me today. My good friends, meanwhile, are people I have known for up to three or four full decades, and they care for me outright and simply, and they know me to be a fighter, and a survivor, and a good man, so with guarded tones of blessing, they support me. I will cross this puddle, and I will wade out once the crossing is done, and they will still be there, as they are today, and have always been.

paoloreed@gmail.com