Pervaiz Akhter.
ASH primary attending
psychiatrist 1996-2015.

Shocking Irony Personified (2016 Update). A discussion of the relationship between the underlying causation of major depressive disorder and the grossly abusive and substandard conditions at The Arizona State Hospital. 

(2016 NOTE: Again, it is the attention now drawn to this article, originally published in 2013, that has compelled the staff of PJ Reed The Arizona State Hospital and Patient Abuse to rerun a slightly revised version of the original at this time. In the last 8-10 days, this article has been visited no less then 75 times. And indeed, as described in the following content, I found it ironic (to put it nicely), and still today am perplexed by the fact that a facility obligated by law to provide optimum mental health care, safe conditions, and reasonably humane staff- ASH- was (and is) in fact far more dangerous then any other realm I have ever experienced, in each area of concern mentioned at the outset of this sentence. And as I have stated before now, the danger posed upon me at ASH had little to nothing to do with the ASH patients in themselves. The danger arose due to the abusive nature of a marked proportion of ASH staff, namely but not limited to staff technicians and charge nurses, who have the most extensive 1:1 contact/interaction with ASH patients on a daily basis;  the grossly negligent character of ASH psychiatrists, including the Hospital's Chief Medical Officer, upon whom each and every ASH patient rely on in terms of ensuring that the flow of care is consistent with established medical standards and fundamental health care as well civil and human rights law; and the abject corruption present in the Hospital's administrative offices, corruption which we all know is also omnipresent in the highest level offices of the Arizona Department of Health Services, right on up to the Director of ADHS in him or herself. It was that bad when I was an ASH patient, circa 2011-12, as personified by the 2015 firing of former and current ASH CEOs, and no less then 6 other administrative state employees associated with the operation of ASH. And as emerging evidence now emerging in Phoenix area media has indicated, ABC Ch15 specifically speaking, the issues most at stake are still ongoing despite the hiring of new Hospital and ADHS administrators, all of whom have promised to clear these matters up once and for all. Which is to say: It is that bad.)    

--------------------------------------------------------

Wherein, I illustrate the fact that the psychological, emotional, and in at least two events, physical abuse that I experienced  while hospitalized in the state of Arizona's sole long term public mental heath facility not only triggered my most deep set memories of abuse that I suffered as a child (and did in fact trigger/worsen acute suicidal ideation that had effectively begun ebbing somewhat- until that point in time that I was admitted to ASH); but went even further in terms of me recalling my most heartfelt concerns for any person(s) affected by clear and potentially harmful disadvantage. As in the "weak", or otherwise at-risk human beings, who I- as an abused child- realized the hard way are  perpetually in need of protection from individuals capable of abusive behavior, as described herein. Concerns that I came to understand well before adulthood, in relation to my learned recognition of how damaging such abuse is, in fact. It took licensed medical practitioners working at The Arizona State Hospital who are willing to flaunt their disregard of civility and established heath care standards, in language that was tantamount to "This is how it is, and there it nothing you can do about it", all of it 100% on point with how I was treated as an abused child. Ironic, to say that least, that being reminded of these things serves as the basis of my work today, specific to doing all that I can to show those wrongdoers that there is, in fact, quite a bit I can do in order to bring about the due oversight and accountability in this context.  

I spent the first five months of my total time at The Arizona State Hospital on the Palo Verde (east) unit, as per the direction of my referring psychiatrist in Tucson, Dr. Stoker (University of Arizona Medical Center), who specifically requested that I be placed and treated in the most peaceful and reasonably safe setting at ASH, this as per my personal history, related diagnosis and behavioral characteristics; including the simple fact that I was physically and psychologically abused as a child, and the attendant fact that I have no history of engaging in violent are aberrant behavior (outside of suicidal ideation). In the eight months that I spent in Tucson areas mental health facilities (pre-ASH), these aspects of my history and related behavioral characteristics had been clearly established, and included as such in my various pre-ASH hospital records. While on the Palo Verde unit, I experienced an immediate form of psychological abuse (ridicule in relation to reasonable worry that I about other ASH patients), imparted by a virtually ancient charge nurse named Peggy (you know, the white haired war horse with the east coast accent who literally never gets up from her chair), that was on point with the abuse I suffered as a boy (ridicule, neglect, and related abuse imparted on me by a parent). This particular incident included me being ridiculed (by her) because I was basically spooked by the atmosphere at ASH, again, in my first few days in a full on insane asylum, for the first time in my then 49 year old life. I had requested the option to remain on the Palo Verde unit for dinner, rather than having ot go into the outside grounds of ASH where a common cafeteria exists, simply because I was not yet familiar with ASH and had very real worry about the possible hazards; and this craggy old white haired nurse, Peggy, literally expressed sarcastic comments that I know were designed to antagonize, shame, and/or otherwise make me feel as though my concerns were not deserving of basic respect. At the time, I was downright shocked by this woman's attitude, for it was clear to me that she intended to harm whatever sense of safety I actually had at the time, presuming as I did that should I be afraid of venturing out into the wider patient community at ASH, staff would respect me, and grant me the simple request to remain on the unit at that time. ASH patients do as a matter of fact have the option and right to eat either on their assigned unit, or in the common cafeteria setting. But as I learned, this nurse shared the some willingness to psychologically abuse her patients that many of the nursing and technician staff at ASH possess. I attest to witnessing and experiencing her ineptitude and arguable cruelty on regular basis. It is that bad. 

Not long after that, another Palo Verde (east) charge nurse named Mary Ann literally screamed at me because I sought to be given a sleeping medication immediately before actually going to bed, which is precisely when the medication in this case is designed to be taken. This nurse was anxious to get out the door, and my request to take this medication arose about 10-15 minutes before her shift end (10:45 p.m.). Rather than calmly state her wishes in that context, this particular charge nurse exploded in a fit of rage, screaming at the top of her lungs "You have too too much nerve! How dare you make me do this right before I get off! You are going to learn to take direction!" This exhibition of violent behavior basically freaked me out, and in the ensuing hour or so, as I went to bed, I experienced the same physiological responses that I experienced when, as a young boy, one of my parents fell into a pattern psychological (screaming, threatening), emotional (ridiculing, threatening), and at times physical abuse. This may sound a bit dramatic in terms of the effects of such experience, but the simple fact is, these types of psychological abuse underlie the causations of depression, PTSD, and other like forms of mental disorder and illness.

Along with one incident of sexual abuse when I was 6 year old, these elements of my personal history have everything to do with the manifestation of major depressive disorder in my psychological condition, including my deeply embedded suicidal ideation. This was not the only time that the nurse Mary Ann blew her lid in this manner (but to memory, it was the first such event in her specific case); and as time passed, she was actually reprimanded at one point (in tandem with the aforementioned Peggy) in direct relation to a violation of my fundamental civil rights (to contact a state patient rights' advocacy office via telephone at anytime, versus arguably unreasonable rules and restrictions on phone use); following my having reported this violation of my civil rights, ASH staff were ordered to post signs above the patient telephones that state the legally based fact that any ASH patient has the unalienable right to contact legal or advocacy based agencies/individuals at any point in time they so wish. I attest to this, and I have the data to prove it.  

IRONY PERSONIFIED.

I mention these two simple examples (above) of staff misconduct at ASH for the following reason: 

My motivation to take on the task of addressing and exposing the substandard conditions at ASH arose at the virtual outset of my admission to ASH in January, 20122, directly out of my being triggered by this abuse, as it relates to abuse in my childhood which is known today as underlying my symptoms specific to major depressive disorder, and associated traits, including mild to moderate PTSD, and acute/chronic suicidal ideation. The irony herein is clear, for it took me being abused again- just as I was as a young child- for me to attain a basic understanding of this very detail of my state of mind and emotions, in the context of my very real diagnosis and related mental health treatment needs today. And much as I recognized as a boy, the deeply unjust and harmful impacts of these forms of grossly unjust such abuse (which did in fact lead me to seriously consider suicide at the age of thirteen), I again sensed this while at ASH, where the abuse I experienced in these sorts of instances triggered the same neurological disturbances that arose when my older family members abused me well over 40 years ago. This realization taught me the hard way how damaging such mistreatment is, but it took being subjected to such abuse as an adult patient in Arizona's sole long term public mental health hospital to see this, in fact. Ironically indeed, unexpectedly and undesirably (quite frankly), as I struggled to understand my own personal needs in the context of my mental health, these patterns of abuse at ASH led me straight into my work today, as it stands. For I know today that the highest ranking clinical staff at ASH willfully abuse the emotional and psychological challenges that all ASH patients have to live with day in and day out, and this abuse occurs with direct complicity of ASH's administrative staff. In my own case, during my time at ASH, I did consider a means to take my life on the basis of my feeling as though the greater world around me has no interest in whether I live or die, and there is no more clear evidence specific to my thinking then, than the grossly depraved misconduct of ASH staff, as it arises on a daily level, and as illustrated in these 2 basic examples. Suffice it to say, my records and overall writing to date is rife with such examples, including names and dates. Herein the identifiable crisis that I am seeking to resolve.

IN CLOSING: There are many good people working at The Arizona State Hospital (and you know who you are- Jewels in the Desert!). But due to the presence of senior clinical staff who have virtual control/power over the majority of lower ranking staff, and who as exemplified above, are basically accustomed to treating ASH patients like dirt, such "good people" are the minority. I am convinced that the only way to advance in staff hierarchy at ASH is by cooperating with the highly unlawful misconduct of ASH administrators and senior clinical staff. This particular dynamic was exposed by the dishonesty of Hospital administrators such as former ASH supervisor Cory "crazycorycorner" Nelson, exhibited/proven in recent Phoenix ABC Ch15 news reports), wherein it was shown that ASH staff as a whole are threatened by the possibility of being fired, should they raise their voice in terms of speaking out against the deplorable conditions at ASH, whether or not specific to patient needs, of those of ASH staff. In my case, I was initially faced with the illegitimate recommendation of Laxman Patel that I be discharged, in spite of still being acutely suicidal ("This is not the right hospital for you..."; and later, very clear retaliation that was imparted on me by former ASH Chief Medical Officer Dr. Steven Dingle, and Cory Nelson (yet another example of tandem participation in these practices, as illustrated above by the shockingly abusive nature above of two ASH charge nurses). To date,  I think of the better staff at ASH everyday, as I work to maintain a dedication to seeing that the one's most responsible in for these issues be brought to justice, via direct oversight and accountability, as per the letter of law in any modern society. 

In with the good, out with the bad, in other words. 

The fact is, I hold the good people in a state of sincere esteem, appreciation, and at times, outright awe. I could not do what they do. Jewels in the Desert, each and every one of them.   

For, if not for the better staff at ASH (and they know who they are), I might still be mired in the substandard care practices and conditions at ASH. Or, as a matter of fact, dead today. I will never forget that, or them. 

(2016 Update: As I have made clear in recent days, including in the introduction to this 2016 update, there is no evidence to the effect that the most abusive charge nurses, their given supervisors- the psychiatrists- and/or persons such as Chief Medical Officer Dr. Steven Dingle, assistant attorney general Joel Rudd , etc., have been held accountable in terms of their given misconduct. Which only supports the likelihood that substandard health care and practices are still ongoing with respect for persons who have extensive 1:1 contact/interaction  with ASH patients and a day in day out basis.  To the direct detriment of said patients, as described in this article. Likewise, in the administrative offices of ADHS, particularly the ADHS Office of Grievances and Appeals and beyond, persons such as Kara Burke and Margery Ault, etc., are also getting away with the fact that they were 100% complicit in furthering the now proven corruption in the operation of ASH across the board. Each one of the above named individuals were fully involved in allowing for incidents such as the cover of the escape of ASH patient Jesus Murietta, and a far wider presence of grossly unlawful misconduct that I have thus far included in my articles in this BLOG. Whether on the floors of the patient units, in the administrative offices of ASH itself, in the office the assistant attorney general, or farther up the food chain in ADHS/BHS, there are any number of obviously inept and outright malicious individuals who most certainly need to be removed from the picture altogether. I contend that nothing short of such action will serve to bring the operation of ASH up to par with established health care standards, state and federal law, and policy in general. It's that bad, and it has to happen.)

paoloreed@gmail.com