II: Different Meadow, Same Sheep Shit.

Jay Pottenger
Current CEO
Montana State Hospital

   "Survey faults care for older patients at Montana State Hospital; state says issues fixed." 

   TJ McDermott. Montana Standard. February 12, 2019.

The following text is "PJ Reed The Arizona State Hospital/Montana State Hospital. Montana's Forgotten Suicides' " formal commentary to various Montana news press that covered the above scandal:

"Well, you don't say! Yet another issue 100% consistent for just how and why Montana State Hospital was subjected to federal oversight and sanction in early 2017. Where in all this, then, is attorney Craig Fitch, the so-called longstanding "Patient's Lawyer," who functions on-site five full days a week? And/or the facility's current Chief Executive Officer, Jay Pottenger, who in direct relation to the 2016-17 federal inspection process, exhibited gross ignorance in a formal interview about his given responsibilities, as per his very title? Why should we, the public and the patient community at Montana State Hospital need to rely on outside resources- such as in this case, Montana Disability Rights- to identify the issues at stake when Fitch and company are there on the front line of it all, supposedly in order to preserve/optimize the rights and care needs of the patient-consumers hospitalized there? It is the citizen based taxpayers who pay these people's salary, and as such, suffer the direct impacts of such ineptitude. Unacceptable to the nth degree."

Dr. Steven Dingle
Known sexual predator,
current chief medical officer,
Arizona State Hospital.

Relatedly, at that point in time when I directly reported to the current CEO of Montana State Hospital ("MSH") , Jay Pottenger, the fact that the facility was being operated in violation of very specific staff to patient ratio quotient requirements, AKA staff shortages, his verbatim response was:

"I am obligated to support the governor's budget."

This, in spite of my informing him that this issue puts both staff and patients at risk of harm, negligence and so on. I also emphasized the legal standard in context, that the license of MSH was directly at risk of being sanctioned, if not terminated. I had initially discussed this with the MSH Resident Advisory Committee, suggesting that we contact the governor's office about the matter. At which point, a senior ranking staff member basically insistent that we first discuss this with Pottenger. Which we did, in good faith. but as stated above, the bonehead was more concerned with the state's budget (and, it only follows, his salary) then he was the federally required standards by which MSH operates.

Emphasis herein, again on the basic idea of communication when it comes to bringing about meaningful change. Media is only one route, really, for there are varied ways to get crucial information into the public light. Indeed, it was in fall 2016 that PJ Reed notified two elected state representatives in a detailed letter about the fact that Montana State Hospital, "MSH",  was being operated in violation of the federal standards by which it is licensed. Compelled at that time by a staff technician only 20 years old who expressed grave concern about endemic staff shortages, who stated at the time, "I don't even think this is legal...!"

Which, of course, he was 100% right about. This is an accurate dynamic specific to the substandard conditions in Montana's sole long term public mental health care facility, legality, human rights, and fundamental public policy. This technician's willingness to simply speak up did lead in January, 2017, to the federal Centers for Medicare and Medicaid Services ("CMS") serving a formal Notice of Jeopardy in relation to the Hospital's license to operate. Following two separate CMS inspections beginning in late November, 2017, a final report issued over the 2016-17 holiday season listed one hundred and eleven identified violations of established public health care standards (Yes, you read that right: 111!), all of which the Hospital is required to abide by in order to receive federal insurance funding. And at the head of it all, endemic staff shortages, putting both patients and staff (direct care staff, mind you, and not the imbeciles occupying the administrative offices there) at grave risk of harm.
  

L-R Donna Noreiga, CEO
Cory Nelson, CEO
Jeff Goldbloom, Attorney
All fired, spring 2015
in direct association with
Arizona State Hospital.

All of this, on point, too, precisely one of the same violations of law and policy identified at Arizona State Hospital ("ASH") on no less then three occasions over the last twenty odd years. And as with the situation in Montana at this time, ASH, too, is still being managed in basic violation of the public trust.  As only one bright line example, just last year (2018) a lawsuit was brought against Dr. Cara Christ, director of AZ's Department of Health Services (which is directly responsible for the operation of ASH), filed on behalf of a patient who, due to a lack of sufficient staff, nearly died in 2016 when attacked by another patient. The aggressor in this matter was supposed to be closely monitored on a 24/7 basis. But due to the plain fact that ASH's medical staff failed to maintain this monitoring, yet another ASH patient suffered grave harm due negligence, medical malpractice, and with the responsibilities of ASH's current CEO in mind, Dr. Aaron Bowen, administrative ineptitude. 

All of it that bad.

While, in fact, MSH is also currently subject to several law suits filed on the basis of outright negligence and administrative incompetence. This is nothing unusual, either. We also question the Montana Department of Health's pavlovian response to this issue, seeking to assure the public that it's been "fixed" without providing any firm evidentiary information consistent with this claim. Indeed, circa the 2016-17 period of time, senior ranking executives at MSH fell into the same pattern of smoke screening the truth about substandard conditions and care practices there, 100% on point with what goes in Arizona anytime such issues arise.

Deny, deny, deny.

It takes little in the way of online review to recognize how widely these issues extend in America's overall public mental health care system, but especially in relation to state managed mental hospitals. iAnd yet, there it is, even this day in age. Graphic shortfalls in the care of our one the nation's most vulnerable populations, seriously mentally ill Americans who jut so happen to be hospitalized in state mental hospitals. There is no just cause for this to be the case, or for any state employed health care official to ignore this issue in itself. 

Including persons such as MSH CEO Jay Pottenger,  Dr. Cara Christ, and on that list goes.

In short, smiles simply do not suffice.

Dr. Cara Christ
Current Director
AZ Dept. of Health Services.

IN CLOSING: I will again point out that mental illness in itself does not rule out reasonable intelligence, conscientious awareness, or any other such aspects of human attributes. And that, despite my being affected by serious mental illness, major depressive disorder and associated traits specifically speaking, I and many other such affected persons have the capability to make a difference in American society today. The plain fact is that I am well educated, and was able to succeed in a range of achievements throughout the virtual entirety of my adult life prior to the severe late-onset manifestation of my worst struggles with major depression. I did, as such, deal with undiagnosed-untreated depression since I was an adolescent, in large part as a result of psychological and physical abuse during my earlier childhood; and yet, am in no way unique in terms of my strengths as a human being.

Dr. John Forbes Nash.
Nobel Prize, 1994.

As personified by persons such as Dr. Mark Vonnegut, Dr. John Forbes Nash, and numerous other like individuals of marked character and reasonable intelligence, in defiance of the discriminations against persons affected by serious mental illness. And by no means to blow my own horn, I too am able and willing to contribute to the public good despite my own respective struggles with depression, in patent opposition to the mindset that underlies such discriminations. 

Dr. Mark Vonnegut, and son Oliver.
Pediatrician and author.
"Just like someone without mental illness,
only more so" (2010);
"The Eden Express" (1975).

More then once have I had certain medically licensed professionals, always those working in state managed mental hospitals, question my status as a man affected by mental illness for no reason other then my willingness and ability to clearly speak out about substandard care practices and conditions in state managed mental health care facilities. Particularly in relation to places where I have personally sought treatment over the last nine years, always via involuntary court commitment. It is these such mental health practitioners who directly further the discriminations against the mentally ill in contemporary American culture, employed by any given state's health department, paid by any state's citizens, and entrusted as per the public trust to offer reasonably optimum medical care. 

Paolo Jack Reed.

paoloreed@gmail.com