First Article As Written. April 02, 2012, Flagstaff, AZ.




Pervaiz Akhter. Punjab, Pakistan.
Primary attending ASH psychiatrist.
1996-2015

PJ Reed. Flagstaff, AZ.
April, 2012.

The Arizona State
Hospital and
Patient Abuse.

(As written. Typos included.)






Hello. My name is PJ Reed. April 2, 2012.

paoloreed@gmail.com
  

I have little to fall upon in trying to introduce this blog beyond my immediate past history. But I will state here and now, that this is about the radically dismal state of affairs at the Arizona State Hospital, where doctors, nurses and technicians alike act in unison on a daily basis in abusing the fundamental human rights of patients in a manner and to a degree that is undeniably beyond acceptability in this day in age; and Hospital administrators, as well as Arizona Department of Health Services representatives go out of their way to both distort the truth about this matter as well as effectively condone the misconduct via their egregious unwillingness to do anything about it. I very recently discharged from the Arizona State Hospital (ASH), and I attest to these things. My accounting of my experiences while at ASH is drawn from pure and straight forward, simple fact(s), and I am willing to publicize the very most private aspects of my life story as it stands today simply because the patient abuse at ASH has to stop. ASH administrative officers and clinical staff are currently working in clear complicity with state officials in order to allow ASH to operate at a level of sub-standard mental health care, and they are getting away with it. Somebody has to do something about it, bottom line, and this single reality is what compels me today to introduce this blog to the publics' eye.    

                       My story in relation to ASH began as follows:

Tuscon Mountains, Pima County, AZ

In May, 2010, I awoke at approximately 9:30 a.m. from my fourth attempt to commit suicide on a hillside overlooking the west side of Tucson, Arizona. The early summer sun already had the temperature somewhere in the high 90s. I was dehydrated and extremely tired after having ingested a full bottle of Ibuprofen and three full 40 oz. bottles of cheap, high octane beer. I had about $13 in my pocket; and I had to make a choice of whether or not to walk back down into the city and re-up on my supplies in order to give it one last go (knowing for the first time that I should definitely should have purchased and used Tylenol PM, rather than trying to get a good deal by purchasing Ibuprofen, which had been on sale the previous day...Idiot!), or to go about looking into other options given my very limited circumstances. I had left all of my belongings behind (but for one large backpack of clothing that was stolen from me approximately 36 hours before by two guys at a bus stop), and beyond the dust in my nostrils and hair, I had only the clothing on my back, in essence. 

As I walked out of the cactus and brush filled desert hills, I was sick with dehydration and general weariness caused by the effect(s) of overdose; and it occurred to me that were I to re-up on my basic supplies, with the idea of another attempt in mind, I would have to turn right around and hoof it back up into the mountains, with the attendant realization to I simply wasn't up to it. So I pondered that option, and as I did, my thoughts were drawn to a conversation I had with a man in a bar, perhaps 6 weeks prior. It was, at the time, my favorite bar, and this man- a stranger- was at least 15 years older than I, an obvious long time alcoholic who had likely been well 'round the mountain and back in his own personal life. Over our beers, I informed the man that I was contemplating suicide, a statement I was willing to make because I sensed that he and I shared the same open-mindedness in terms of matters relating to life and death, a maturity of sorts that comes with the disease known as chronic alcoholism. And as expected, my drinking partner that day barely flinched when I told him this; after a moment of basic silence, he did ask, however, if I had ever sought professional help, in any capacity. 

And while I had done that, in a fashion, on at least 3 occasions in my recent history, I realized while pondering my options in early May, 2012, that I had never sought such help in anything resembling sincere desire; instead, I had taken myself to hospital ERs while drunkenly awash in suicidal ideation, and therein admitted to staff that I was thinking these things; but each time, as soon as I sobered up, I decided I did need to be there. At which point I would leave, and before long fall back into my willful desire to die. Walking down from the hills that day, it occurred to me that perhaps I should heed that good man's most basic feedback, and at least try to do so in reasonably good fashion. Once I entered that process in good faith on my own part, and maintained my openness to the best of my ability with my Tucson area caregivers, I came to learn that I was needful and deserving of far more than I had ever comprehended, and made the decision to stick it out; knowing that I could, at virtually anytime, request to be discharged, and go back to my original intentions. And that was the beginning of 21 full months of hospitalization.

The reasonable treatment and related moral support offered me in those Tucson area mental heath facilities afforded me the associated willingness to trust my doctors, and as the possibility of referral and admission to the Arizona State Hospital became a reality, I made the very difficult decision to cooperate to the best of my ability. But I had no idea of what I was getting into.     

"SUBSTANDARD MEDICAL-MENTAL HEALTH CARE AS A MATTER OF STANDARD PRACTICE.
 AND THEY ARE GETTING AWAY WITH IT!"
(Verbatim journal note, March 18, 2011.)

For I learned within a very short time following my admission to ASH, that patients there are routinely abused as a matter of standard practice, and it wasn't long before the abuse fell directly upon me. My story is one which I hope will expose the atrocious wrongdoing that occurs at ASH in a meaningful way, and I intend to share all aspects of my own experiences, including details relating to an ongoing legal process of investigation brought about by my efforts while still at ASH to establish meaningful oversight and accountability specific not only to abuse that I suffered, but also in terms of the Hospital's willingness to carry on its daily operations in direct defiance of common codes of decency and medical ethics.  ch, ASH is a public (health care) entity under federal and state law, and is subject to the principles and provisions of The Americans With Disabilities Act (ADA), The Hospital Information Portability and Protection Act (HIPPA), along with numerous other well established codes of standard and practice. I mention these specific legal standards because as a patient, client/consumer, and human being, I fully expected nothing more or less than reasonable medical care when I came to accept the idea that ASH was the place for me to be as a person affected by a serious mental illness, needing as I did then, formal in-patient care and treatment consistent with what mental health care facilities are obligated to offer as per well established codes of practice and administrative operation.

A bit more history.

As stated already, immediately after that May, 2010 suicide attempt, I spent close to 8 months of treatment at several well operated short term facilities in Tucson; at which time I was then referred to Arizona's sole long term public mental hospital, The Arizona State Hospital. This reference was negotiated via a cooperative civil commitment that I agreed to after long and thoughtful conferencing on the matter with the good doctors at the University of Arizona Medical Center South Campus (formerly Kino-UPH Hospital). It need be said that those first eight months of treatment in Tucson area facilities was not always pleasant, nor free of shortfalls specific to issues that relate to my feelings about The Arizona State Hospital. But this is to be expected, in certain terms, for no residential mental health facility is entirely free of conflict, including in terms of staff behavior and possible misconduct. But I also attest to the fact that at ASH, I encountered conditions so dismally below par in terms of my well learned understand of established health care standards, that there is no comparison, in fact. Going from the the Tucson area hospitals to Arizona's sole long term public mental hospital (ASH, in Phoenix) was very akin leaving the contemporary society that I had lived in for the prior 49 years of my life, and entering a realm inhabited by authorities who exhibit little to no understanding of health care ethics, state/federal law and policy, or commonly recognized civility. 

At the time of my admission to ASH, I was experiencing chronic and ongoing suicidal ideation(s) in direct association with my primary diagnosis of major depression, and as stated above, it was only through a process of mutual trust and good faith planning that any member of my Tucson treatment planning team (including myself) came to consider sending me to ASH with my mental health care needs in mind. I approached the whole concept with an understandable air of trepidation and concern over the conditions at ASH, simply because it is a full blown insane asylum, and I had never personally undergone any sort of planned long term treatment in such a setting (my first meeting of any kind with a psychiatrist occurred in spring, 2010). None of us imagined the sorts of things that I would come to experience at ASH, and I owe my care givers in Tucson nothing short of absolute appreciation, because it is the covert malfeasance of ASH clinicians and administrators that are of issue in this story, and not the well founded expectations of my Tucson doctors, who reasonably presumed that ASH was up to the task of functioning in a manner consistent with the functions of any modern hospital.   

Indeed, none of us could have imagined that over a period 13 months I would come to witness and experience systematic and overtly sanctioned abuse that would, in time, lead me to become an inadvertently dedicated advocate for the rights and wellbeing of all persons associated with ASH, from the patients and their families, as well to the many good people who do, in fact, work at ASH. As stated already, patient abuse at the Arizona State hospital has to stop, and something has to be done to bring this about. This is the purpose of my blog, and I invite anybody of like mind to come aboard, for I can certainly use the support. None of the accounts that I intend to report in this blog are of bad faith intent, and all/any data that I include is factual and truthful to the best of my knowledge.

(April 02, 2012)

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2016 UPDATE: The above is as a matter of fact the first article produced and published by me since I was discharged from ASH, as written, including typos. Hopefully, the product itself is at least a bit more polished today, thanks in no small part to assistance from a small handful of equally dedicated individuals. But over coffee recently, as the ongoing production of my manuscript (book) advances, me and my pals decided it might be a prime time to share this first article yet again. Why?

SUBSTANDARD MEDICAL-MENTAL HEALTH CARE AS A MATTER OF STANDARD PRACTICE.

AND THEY ARE STILL GETTING AWAY WITH IT.

Since the April 02, 2012, inception of this blog, PJ Reed The Arizona State Hospital and Patient Abuse, we the staff have published 456 online articles specific to the grossly substandard care practices and conditions at Arizona'a sole long term public mental health facility. Since that date, over 100,000 dedicated reader visits have occurred (defined as lasting more then 12 minutes per visit, enough time to read every new article, in essence), the bulk of which only arose after the blog's first 18 months of life, and a number which is still growing at a rate of approximately five hundred per month. But, as our most recent articles illustrate, published in cooperation with the investigative staff of the Phoenix area's ABC news affiliate, ABC Ch15 (KNVX), the current administrators of the ASH operation are yet to bring about meaningful reform, most markedly with respect for the fact that the Hospital is still employing any number of medical and other like staff who are 100% complicit in allowing the presence of patient abuse at ASH to occur. Likewise, I am fully aware that in the AHDS/BHS construct, with specific regard for the ADHS Office of Grievances and Appeals, there are still no less then five highly entrusted officials directly involved in failing to meet their given responsibilities circa 2010-2015 working for that office.  This, despite the associated fact that in spring, 2015, at least seven individuals directly associated with the operation of ASH were summarily fired- including two former ASH CEO's, and one staff attorney from ADHS- an event that only occurred following the hasty resignation of the then Director of ADHS, Will Humble, and the appointment by AZ Governor Doug Ducey of the current ADHS Director, Dr. Cara Christ. 

I must admit in hindsight, that for a moment there, I was willing believe that these developments stood as reasonable evidence to the effect that the issues most at stake at ASH were going to be meaningfully addressed, and that the rampant presence of patient abuse at ASH would be eliminated once and for all. Effectively the same mistake I made when I approached my first ASH physician, Dr. Laxman Patel, in the hope that he would meet his obligation(s) to ensure that such issues would not be permitted or otherwise condoned.

But I know better today. For one thing, the legal process circa 2012-2013 mentioned in my original April 2, 2012, article (above), led to absolutely nowhere in terms of bringing about due attention to the now proven/blatantly unlawful misconduct of ASH administrators; via that process, I came to understand that the entire system, including the role that the Arizona Administrative Court(s) plays in relation to the rights of consumers seeking services from ADHS/BHS, is broken. Indeed, this specific venue is nothing more then a puppet court, wherein the Arizona office of the Attorney General ("AG")- which formally represents the interests of the ASH operation and other like public agencies- has more authority then the Administrative Court itself. Ergo, every time I appeared as a plaintiff seeking nothing more then equitable justice as per procedure at the level of state and federal law, and related constitutional rights (due process, for example), the actual "judges" who sat in the five hearings that I requested in that venue were unable and unwilling to acknowledge any element of my formal statements about the misconduct of ASH's assigned legal counsel, Joel Rudd, who is in fact an acting staff member of the Office of Arizona Attorney General. In each of the these "case proceedings", Rudd  was permitted to engage in abject misconduct as a licensed attorney, exercising distinctly obvious abuse of the legal process in that realm of consumer interests, but when I attempted to compel the assigned "judges" to address this attorney's misconduct, they ALL refused on the basis of the above described authority of the AG. As a former legal professional in my own right, I was nothing less then shocked- even disgusted- by what I experienced each and every time I took my concerns to this court. Because of the basic fact that ASH as an entity has severely disproportionate power over anyone who seeks relief via this court, my good faith attempts to report the substandard care practices and conditions at ASH through the state of Arizona's formal administrative legal system were literally disregarded; representing just one more version of systematic censorship that I contend has allowed ASH to function in gross defiance of law and policy, to the direct detriment of the consumer/client/patients at ASH across the board.    


Likewise, I now (2016) recognize the fact that the above described firings of seven individuals working for ADHS/BHS amounts to little more then scapegoating. I have learned this and other things the hard way, through thirteen long months of torment as an ASH patient and over five years of producing data that I compiled while there in this blog, that the primary reason for the ongoing substandard care practices and conditions at ASH has everything to do with the hyper-dysfunctional bureaucracy in the ADHS/BHS construct. Due to a trickle-down effect of this dysfunction, which  lands squarely on the heads of the ASH patient community across the board, some proportion of ASH staff- including still employed primary care ASH physicians who I attest to having willfully turned a blind eye to the presence of patient abuse when I was there- are even today engaging in abject dereliction of duty as "practicing" doctors at ASH. They, all of them, need to go. 

These issues extend from top to bottom with respect to ASH staff in general, and the described role that ADHS/BHS plays in furthering the situation; and they are are occurring with the full support of at least one employee of the Arizona Office the Attorney General, Joel Rudd, who has been ASH's primary legal counsel for over two full decades. 

The barebones fact remains. I have done far more then my share of work in granting persons such as Dr. Cara Christ  an easy avenue by which to begin a legitimate process of reform when it comes to cleaning ASH up. I have, in fact said it before: Until someone in the highest offices of the ADHS/BHS construct has the proverbial balls to thoroughly do the right thing, in cooperation with the Attorney General himself (who needs to prosecute Joel Rudd as a first thing), there is little hope of ensuring that the stake holding client-consumer/patients at ASH are being provided with a requisite level of medical care and related services.

But that has not happened. Neither the new blood in ADHS or at the helm of the Hospital itself (current ASH CEO Dr. Aaron Bloom in particular) have taken action with respect for the fact ASH that physicians  (including and especially longtime ASH Chief Medical Officer Dr. Steven Dingle) were centrally involved in each and every scandal now known to have occurred, this in spite of the plain fact that these doctors are required as per their licensure- and the Hippocratic Oath- to ensure that their given patients are not denied optimum care and treatment across the board. Basic decency aside, these licensed practitioners also bear the legal obligation to respond to any concerns about abuse and other like issues that their given ASH patients bring to them, representing in no uncertain terms the first step in the given food chain when it comes to expressing such concerns, this as per Hospital and ADHS protocol (The ASH patient handbook circa 2011 states "Patients are advised to take any concerns about their provided care at ASH to their treatment team, beginning with their assigned primary psychiatrist.").  

Based on these facts, law and policy demands that each and every ASH physician working at ASH over the last 5-6 years be held accountable for the simple fact that they too refused to do their part in fulfilling their responsibilities, which 100% represents the ongoing substandard care practices at ASH. Anything less is an abject dereliction of duty under the terms of the public trust, for if the ASH doctors are openly willing to ignore staff misconduct and associated patient abuse, what is to deter lower ranking ASH from engaging in such misbehavior?  

The record also proves that longtime ASH legal counsel Joel Rudd (who is in fact an employee of the Arizona Office of the Attorney General) has  directly participated in furthering the unlawful misconduct of ASH administrators for over twenty full years.  This particular Rat Bastard has always been at the table when administrative decisions at ASH have been determined, including but far from limited to the criminal coverup of the 2011 Jesus Murietta escape and the consequent death of an Arizona citizen who had no relationship to the Hospital beyond the coverup itself. April Mott's tragic death only occurred due to the role that each and every one of these people played in that coverup. But even the Attorney General himself (Mark Brnovich) has failed to address the fact that one of his staff is deeply involved in now proven unlawfulness of the ASH operation across the board.

It is that simple. It is that bad. I see this, I attest to it, and I refuse to relent.  
  

CONCLUSION: It will require the authority of federal agencies such as the Department of Justice (who oversee the Americans With Disabilities Act- all ASH patients are disabled under federal law) and the Department of Health and Human Services, if we are ever going to see an eradication of the substandard care practices and conditions at ASH  once and for all. Likewise, as a matter of simple deterrence on behalf of the ASH patients, only direct oversight and full accountability applied to each and every individual even remotely involved in the now proven history in this matter will suffice, as per the strict letter of state and federal law.

Until next time, then. 

paoloreed@gmail.com