Systemic Discrimination Against the Mentally Ill In State Managed Mental Hospitals of all places. Wherein, not only are many of the lowest ranking, least educated Hospital ignorant to a point of utter discord, but so are at least some if not all of the ones entrusted run such facilities. 

              "Numerous state psychiatric hospitals have recently been exposed for violations and/or deficiencies in patient care and safety, including several that have come under U.S. Department of Justice (DOJ) investigation. The reports show that these facilities are not safe, sanitary or rehabilitative places." (S. Wagner, Director of Litigation and Prosecution, The Citizens Commission on Human Rights. November 24, 2007)

"What do you expect? This is the state hospital." Dr Laxman Patel, January 19, 2011, after I (for the second time) attempted to compel him to meaningfully respond to my concerns about patient abuse and staff misconduct.

                

"You, Dr. Cara Christ , are 100% responsible for doing the right thing today. So do it, already." 

Dr. Cara Christ.
Director, Arizona Dept. of Health Services
2015-the present. 

Since her appointment to the highest ranking position in Arizona’s public health care system in 2015, Arizona Department of Health Director Dr. Cara Christ has repeatedly stated that there have been “great improvements” in the state’s sole long term public mental health care facility, Arizona State Hospital (ASH). To date however, January 2018, Dr. Christ has never provided any evidence or information about just what these “improvements” at ASH are, in fact. This is of very real concern to the staff of this publication, given that Dr. Christ’s immediate predecessor (Will Humble ADHS Director 2009-2015) willfully relied upon producing a pattern of overt and untruthful propaganda that served to delay a subsequent process of critically needed oversight and accountability at ASH. Propaganda that defied the realities specific to the ASH operation, including but not limited to preventable patient deaths, the tragic murder of a young Phoenix woman, and a wide range of patient generated concerns expressed in grievance submissions; and as such, granted the former administrators of ASH further opportunity to continue operating ASH in a manner deeply harmful to the welfare of the Hospital’s patient community. These issues have been exemplified by the information provided in this blog since 2012, as well as in a number of scathing investigative findings of the staff of ABC Ch15 circa 2013-2015; (As reported previously in this publication, at least three preventable deaths occurred due to this fact). 

The following article was originally published sometime in the first twelve months of the life of this blog, PJ Reed The Arizona State Hospital Patient Abuse. We are republishing this information as one means to remind our readers of how dismally substandard the operation at ASH was circa 2010-2012, and in order to raise consideration as to whether in fact any legitimate improvements have in fact come about since Dr. Christ was granted directorship over Arizona’s public health care system.

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Voices Of the Unempowered: Wherein An Aggrieved Former Patient Of The Arizona State Hospital Shares His Sense of Purpose And Cause With Other Civilly Dedicated Members Of The Community.

(Originally published April 28, 2012)

INTRODUCTION: I am currently reading a comical surrealist novel, "The Master and Margarita," (completed in 1939, published in english  for the first time in 1967), which was written by the late Russian playwright Mikhail Bulgakov (1894-1940), who actively wrote during the Stalinist regime in the first half of the twentieth century, and whose work was banned because of its controversial criticisms of over authoritative government and related corruption, remaining unpublished for the most part, until well after his death . Bulgakov's story depicts the appearance of Satan in 1920s Moscow, and the following passage caught my attention just last night. In it, the devil has inadvertently drawn the company of a young poet who has until that moment spent a number of years hospitalized in relation to uncontrollable fear that arose in his conscious thoughts as a consequence of belligerently tyrannical publishing houses:

"That's better," said Woland (Satan) with a slight frown . "Now      

 we can talk. Who are you?"

  

"I am no one," replied the young man with a lopsided smile. "Where have you come from?"

"From the madhouse. I am a mental patient," replied the visitor.

And while this not the first opportunity I’ve had through literature to consider what it might be like to be affected my mental illness, it’s quite apropos in my life today, for it directly highlights what many persons in state managed mental hospitals think about themselves. They do not necessarily acquire such thinking independently. This is particularly true when it comes to the impacts of being a “mental patient” residing for some degree of time in state managed hospitals of this sort.  It is the abject refusal of some staff in these places to provide basic respect for their patient clientele that feeds into feelings of unworthiness and self loathing. As described in prior articles, in my first few hours after admission to Arizona State Hospital, I witnessed an aging (and seemingly well beyond her the point of reasonable retirement) named Peggy literally bring a patient to tears by brutally demeaning his given sense of worth and character. It shocked my to no end, and compelled me then and there to state to that nurse:

“If this is how you do things around here

you’re not going like me one bit.”

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Earlier today, I enjoyed the privilege of presenting my concerns about patient abuse at the Arizona state Hospital at a very impressive Human Rights Rally at Wheeler Park in Flagstaff. This gathering was organized by the friendly folks from the Indigenous Resistance.org network, and sponsored (in part) by The Flagstaff Action Network, Outta' Your Backpack Media, The Arizona Center for Biological Diversity, and the Shanker Law Firm. As I spoke, I found myself thinking of my friend Thomas, who has been hospitalized at the Arizona State Hospital (ASH) for 8-9 years and is likely not going anywhere soon, and who- due to having made at least one attempt to rely upon the hospital and state grievance and appeals representatives as a matter of speaking up in defense of his rights as a human being- is today little different from a shaking leaf in a desert windstorm, his fear of ASH staff and administration so deep, that he would literally shudder whenever I shared with him my own strongly felt desire to speak out against abuse at ASH.

I did not know whether to estimate Thomas' fears as irrational, at first, but beyond getting to know him as I also grew familiar with the rampant patient abuse at ASH, I also had an opportunity to speak with a human rights advocate who tried to assist Thomas in at least one situation, and I learned from her that Thomas had been subjected to administrative retaliation almost identical to the retaliatory transfer that I later came to experience in early September, 2011.

Thomas is a peaceful and amicable man, through and through, and he too had at one time verb  unduly placed on a very dangerous unit after questioning certain issues at ASH, where he is constantly subjected to violence imparted on him by much more aggressive mentally ill adults. But even with these seemingly volatile circumstances, the ongoing elbow to elbow presence in his daily life of violent paranoid schizophrenics, and so on, it was Thomas who first said to me:

"I am terrified of staff!" He then vainly tried to warn me, in his kindhearted way, explaining to me that "It's best to just let these people do things the way do them, and get out of here as soon as you can."

    Indeed, the problems at ASH are with staff, and not the patients.

THERE WERE AT LEAST 200 PEOPLE AT TODAY'S HUMAN RIGHTS RALLY. 

    I HANDED OUT 42 OF THESE TO ATTENDEES.

I ONLY REGRET NOT BRINGING MORE

(PREPAREDNESS IS THE CARDINAL RULE OF ANY GOOD BOY SCOUT)

As I spoke today, I thought about how essentially unjust it is that  Thomas and countless other individuals that I got to know at ASH don't have the basic freedom that I have today to speak out against the wrongdoing at ASH. And I fear even now, as I write, that my message today will not carry far beyond the impromptu stage that I orated from. I am no sort of pulpit speaker, and I do not like asking others for help; while the range of issues by other speakers today had to do with equally imperative aspects of human rights issues in contemporary society and culture.

But my voice, coming as I am from that place, ASH, where patients are laughed at by staff, and scorned by certain of the other patients who staff have wrapped around their dirty fingers, whenever they advocate on behalf of their own fundamental human rights, may be the only voice from ASH to hit this part of the state for the next millennium. Such is the state of mental health care and related advocacy concerns in the human community, not so much a case of deaf ears as it is a case of hollow voices, the stigma and related discrimination's against mentally ill persons being the standard for more Americans than any sort of poll will ever tell us.

I know what it is to discriminate. Not so long ago, I would effectively cross any given street if and when I came upon a man on a sidewalk yelling at the sky, and so on. Today, via my very real experience over the last 25 months, I know what it is to accept mentally ill persons for who they are, no less human then anyone else, and therein  deserving of love, compassion, and respect equal to that of anyone else. Which is to say, I have a learned and sincere understanding of both the discomfort (or worse) that many citizens experience when faced with issues specific to the mentally ill; as well, today, a far more equitable understanding of what it is to be, in fact, affected by mental illness, and subjected on that basis to discrimination and abuse. 

This latter understanding came to me via my experiences while being "treated" (for lack of a better word) in Arizona's sole long term public mental health care facility, ASH. Bottom line, hands down, end of story.

I also know today that even in contemporary terms, the presence today of covertly sanctioned patient abuse in state managed hospital facilities such as ASH is a far more insidious state of affairs than outright racism or genocide, because many mentally ill persons do, for the most part, function in their very own, personal worlds on the basis of their given health challenges. Being placed in long term settings where direct, publicly administered oversight is effectively nonexistent, puts vulnerable persons such as the mentally ill at undeniably great risk of abuse and related medical perversion. Based upon my experiences at ASH, I somewhat doubt that the administrators at ASH even comprehend the depths of this risk, but this is no excuse for their systematic rejections of patient voices in terms of alleged staff wrongdoing.

ASH is a place where I might have at one time felt safe in presuming that mentally ill adults would be most protected from outright abuse and medical unlawfulness, but as a patient there, I learned the exact opposite. The plain fact is, as per my learned experiences, state managed mental hospitals offer safe haven for persons with little to no character to engage in rampant from of patient abuse.

Voicelessness is a central theme of mental illness in society today, but not entirely because of the inability and related unwillingness of healthy people to listen. My time in the close company of Arizona's most seriously mentally ill adults taught me that we, the ones effected so strongly by our given mental illness/disorder, experience our illness all but alone. This is true in the sense that only the mentally person experiences the innermost aspects of their own cognitive experiences, and in relation to this, we are often most alone when asked to meaningfully express ourselves. The desire to loudly advertise our struggles to remain lucid is not a given, and far too often, the societal stigmatization of mentally ill persons carries a two fold impact.

I can, in this sense, attest to the fact that most of us, the mentally ill,  undesirably share the same degree of shame and stigmatization that is  assigned to us by supposedly "healthy" people. Further compromising out ability to even accept needed health care in context. 

Early on in my treatment for depression, I shirked the notion that I could somehow be like that, and once I somewhat willingly allowed myself to begin treatment for an identified mental illness, I did so begrudgingly, because I was not certain that I was in any way deserving of exclusive attention derived of my diagnosis as a mentally ill person. As such, my own shortcomings in terms of accepting the fact that at least some degree of my depression based thinking is, at times, distorted, underlies the essential reason that it took  so long (21 full months of continuous inpatient hospitalization) for me to come to terms with my full diagnosis as a seriously mentally ill person. Sadness, per se', is not a mental illness, right? That is what I had told myself since my first encounter with severe depression (at the age of 13 or so). And with my suicidal ideations in mind,  so what if my sadness causes me to discard all notions of taking part in this world as it presents itself to me. 

Right?

But before these factors, there is me, the person, the man; and I am nothing, if I am unable to ascertain the essential bearing of my mental state on some level. All mentally ill persons have moments of reasonable lucidity. and at those times, at that level of their experiential lives, they are at least somewhat aware of their given interactions and related challenges when it comes to connecting with the world around them. This is not always true, but there is as overwhelming belief that the seriously mentally ill do not know that that they are so affected is erroneous. As with myself, I am well aware that major depressive disorder- a known form of serious mental illness- has long negated my life experiences, and that it is only due to my being affected by severe depression- vs. more debilitating forms of mental illness-  that I am able to function with no seeming negation in this sense.

In my case, I have all but always kept my struggles with depression to myself. As a boy, when my depression began manifesting at twelve years old (or so), I was not aware of what I was experiencing, in fact. Likewise, through my teens, and upwards into my thirties, I gave little to no credit to the significance of my depressive breaks. These breaks manifested in me feeling as though I was looking outward at the world around from a bottle, leading me to isolate, often in a state of near catatonia, sitting alone while awash in deep sadness and seeming confusion. And which, at the age of fourteen, very nearly led me to taking my life (for the first time). As such, my depression and the experience in itself is the most devout element of my overall sense of privacy. It is, as such, my private life, and I for the most part not only don’t want anyone “in there” with me, I am further not convinced even today that anyone else should have to worry about me in this context.     

Most "healthy" people see all of this as an affliction, and are made uncomfortable by it, granting mentally ill persons what might be characterized as "their space," or avoiding them entirely. This same basic condition applies to the atmosphere at ASH, and the outright deliberate willingness of the majority of ASH staff to treat the patients there as unequal to themselves directly endorses the fundamental challenges that all mentally ill people have in accepting the full breadth of their given diagnosis.

Let the freaks be, right? Mikhail Bulgakov knew what he was talking about when he portrayed the expressed self identity of his long hospitalized poet in the way that he did:

                                                 "I am no one... I am a mental patient."

Identity is a tricky thing in America today, and perhaps in human experience itself. I know that my father's conflict with self identity flowed in part from his modern "heritage" as an American Indian man, in large part because was an "Oklahoma Indian," a member of the far displaced Chickasaw nation, and a person who grew up in a time when Indian children in Oklahoma were told by their own parents to cloak their indianness because their parents were terrified by what they know about the new blood colonizers.  The depression that my father experienced later in his life was rooted in identity conflicts, I know this much about him, conflicts as deep as the waters of the greatest northern lakes, and as personal as humanely possible. My depression flows from these same elements of self understanding and conflict, albeit in a different form.

But today, with the help of others who understand the graphic fear that comes with believing- for whatever reason-  that you are not worthy of or cut out for life itself, as well as of those who are capable of comprehending the egregious state of human rights issues in the United States and beyond, I may find the means to bring voice to the patients at ASH. Please, whoever you are, become involved in expressing simple, straight forward demands for rigorous investigation and oversight of the atrociously inhumane conditions at the Arizona State Hospital today.

DATELINE 2018: Not only am I able to seemingly function with no legitimate challenges specific to my known diagnosis of major depressive disorder, I am further and more importantly able to speak in defense of my rights and care needs. The ones running state managed hospitals far most often don’t like this, for it poses challenge to the willingness to ignore contemporary health care standards, and other such realities. Just as the current CEO at Arizona State Hospital, Dr. Aaron Bowen, has proven himself unwilling to allow any member of his patient clientele to speak “in public” about the fact that some ASH staff, including the long time chief medical officer, Dr. Steven Dinglle, have depraved or otherwise bottom feeding characters. 

Bowen’s stance on this issue is absurd, even surreal. The rights of persons to express their opinions and concerns is especially preserved when such persons are speaking in a public setting. In considering why this highly entrusted state official possesses such a twisted logic, despite his advanced level of education, I can only suspect that it is Bowen’s own disparate view of the status of persons affected by serious mental illness- his clients, that is- that makes this the case. It is also absurd for him to demand that a very well experiences body of persons serving today on the ASH Human Rights Committee get on board with the notion of statutory duty, this given the fact that Bowen is not a legal expert in the first place, and a man who has proven his obvious lack of awareness specfic to the constitutionally established, statutorial civil rights of his patient clientele. 

It should be no surprise, and yet is is. This is a man running the operation of a facility that has the direct responsibility to ensure that the patients are provided with safe and reasonably optimized treatment. And by treatment, my concern extends beyond simple medical treatment.  I am also referring in this statement to personal treatment with respect for civil and human rights, and basic dignity and respect. The entire population of ASH is greatly at risk due to their given disability of violations and abuses of their rights and discriminative limitations and shortfalls in their given medical care, including but far from limited to negligence in all its insidious forms. There is a very real need for Bowen to ensure that his patient clientele are not only provided with reasonably optimum psychiatric medical care, but also to guarantee that the dynamics underlying historically known abuses of such persons not be present in any hospital setting such as ASH. As such, these are core factors to any mentally ill persons best hope of recovery, and something that any any American of reasonable conscience can understand.

Right?

In closing, yet another plea to ADHS Director Dr. Cara Christ. If there are indeed examples of great improvement at ASH, please present these examples to the public in a detailed manner. (Cease and desist with vaguaires. Please.) 

This is really all it will take to get me to back off… Well, not entirely “back off”, but it will certainly serve in getting me to believe on any level that such improvements are for real. Because to date, I simply do not believe your statements in this context. (How can I?) 

And nor does anyone else with a valid history of following this blog over the years. Said followers most definitely includes some current ASH staff, and employees of your departmental office, well intentioned and equally well qualified individuals who have continually supported this blog since well before your appointment, Dr. Christ. 

paoloreed@gmail.com