#3 Of Patient Safety. And/or, the lack thereof in terms of the substandard care practices and conditions at The Arizona State Hospital.

As to the topic of staff sanctioned trafficking of illegal substances at The Arizona State Hospital, and the related issue of retaliatory actions that ASH administrators utilize in order to put certain patients at grave risk of harm should any such patient openly report the substandard medical-mental health care practices at ASH, I offer yet more good faith accounting of my very real experiences as an ASH patient in 2011-2012.

     I did submit more than one heartfelt and well documented report about the presence of illegal substance trafficking at ASH to the Arizona Department of Health Services within 8 weeks of my arrival to ASH. I had by then been exposed to the worst aspects of how this issue affects the experiences of ASH patients across the board. In short, the presence of highly addictive substances- namely tobacco products- that are illegally distributed by a very limited number of staff, with the cooperation of an equally limited number of ASH patients- do create a range of very serious threats to ASH patients in the precise manner that all/any form of street drug dealing does in similarly small/contained settings (apt. complexes, neighborhoods, etc). Not to mention the well recognized lethal hazards of tobacco, and the complications that addiction causes in the context of mental illness. Through basic conversations about this matter with patients who had been at ASH for many years, I learned that one cigarette typically sells for upwards of $5, which translated to close to $1000 per carton, and that the supply of these illicitly  trafficked substances is made available by only a few ASH staff, with the clear involvement of ASH security.  

     This issue is of very common knowledge to anyone with any semblance of experience at ASH, from all ASH staff, to the patients, and even regular visitors to ASH. As stated, I submitted several reports to ADHS in the context, and did in fact acquire the attention of state level ADHS officials. A representative from ADHS  came and spoke with me about this issue in April, 2011 (about 12 weeks after I arrived to ASH), and he did agree to initiate a process whereby ASH administrators would be advised of the fact that such activity at ASH needs to be eliminated, on the basis of applicable law, as well as in the context of how hazardous this matter is, in fact, to the ASH patient community as a whole. 

     In coming to this agreement, I was assured by involved ADHS officials that my identity would remain undisclosed, this in direct relation to the possibility of me subject to potential retaliation from involved staff or patients. However, within a matter of days of my formal meeting with ADHS, several ASH patients (Billy, Joe) made clear to me that they had learned about my participation in this process, and did from that point on continually engage in very serious threats that kept me in a dire state of fear for my safety, and in time led to actual assaults on me  that arose directly in the context of me being labelled as a "snitch." 

     Important to note that none of the involved ASH patients were receiving treatment on the treatment unit that I was initially placed on (Palo Verde east). However, the above mentioned patients (Billy, Joe) were both residents of the very violent unit that I was unlawfully transferred to immediately after the submittal of a formal, AZ Office of  Human Rights grievance report on my behalf (see this blog: "Of Pateint Safety..." Jan. 22, 2014). I then chose to openly divulge these details in the hope that my efforts to report the issue would be acknowledged in good faith,  and made these facts clear to the ASH staff who implemented that transfer, including then ASH Chief Medical Officer Dr. Steven Dingle, my primary attending ASH psychiatrist(s) Dr. Pervaiz Akhter and Dr. Laxman Patel, as well as the ASH patient advocate at the time, Sonya Serda. None of my concerns  in this context were acknowledged, however, and within weeks of being unlawfully transferred, I was as a matter of documented fact  physically attacked by such patients in my new treatment unit. I attest to these facts, and I can prove it. 

     
IN CLOSING: Needless to say, the presence of this issue remained literally unabated for the entirety of my 13 full months as a patient at the Arizona State Hospital. I never witnessed any direct intervention by ASH administrators, and the only response I ever got from my attending doctors amounted to clear indifference, the standard byline being "You need to focus on your own treatment, and not concern yourself with such things." No actual actions beyond, that is, the temporary closing of the only available patient bathrooms on the outside grounds of ASH's civil section in late summer, 2011, an action that was allegedly implemented by ASH security, had no effect on the availability of illicit substances that as a matter of fact are all smuggled into the ASH facility, and only led to the occurrence of defecation on the sidewalks etc. of the grounds themselves. It is clear from this pattern of negligence that ASH administrators and senior level clinicians have little to no understanding of the significance of these issues, or worse (albeit as likely), that at least some of them are involved in profiting from this trafficking. It is that bad. Grossly substandard care practices and highly illegal administrative mismanagement of Arizona's sole long term public mental hospital- and they are getting away with it.    

paoloreed@gmail.com