Dear Will Humble: Herein, I again seek an opportunity to openly communicate with the Director of the Arizona Department of Health Services about the out of control conditions and substandard care practices at The Arizona State Hospital.

     Below is my latest submitted comment(s) to Will Humble's official blog site, written in response to an article that he published in his blog just yesterday, September 11, 2012. The article, which I have also included below, is entitled Arizona's New Chronic Disease Strategic Plan, and specifically emphasizes the creation of  a "new guiding document for chronic disease prevention and health promotion…. (that) will be used by ADHS, county health departments, and community partners to advance chronic disease policies, systems and environmental change in the areas of where we work, live, learn, and get care…. and (which) identifies ways in which our partners can maximize the impact in the areas of heart disease, cancer, diabetes, obesity and tobacco."  
     I think that Mr. Humble has a lot of nerve espousing his commitment to prevention of chronic diseases, particularly with respect for heart disease and tobacco related disease, given the very real fact that at The Arizona State Hospital, staff brazenly smuggle and traffic in tobacco and other illicit substances, which they sell to the highly vulnerable patents there at ASH at  exorbitantly high profit. Please see my June 9, 2012, article, Highly Illegal Tobacco Sales by Staff, for a more thorough description of this issue as it stands at this time, to the best of my knowledge. 
     "To the best of my knowledge" is important in this context, because I am hopeful that someone has, by now, gone about formally addressing this problem; be it the department of health themselves, of any other like internal action, or even the intervention of an outside agency, etc., I do not really care. All I know and care about is the fact that the willingness of ASH staff to illegally provide the most singularly deadly form of substance to the patients at ASH is sickening to the core. In any case, I do know from my records that the article(s) I have thus far written about the issue of highly tobacco sales by ASH staff have garnered as much if not more attention than any other(s), so I am willing to both hope as well as suspect that steps may have been to address this matter and bring the activity to a halt. 

(These are my comments to WILL HUMBLE'S September 10, 2012, article)
Dear Mr. Humble: I am curious about whether your office has taken any steps to address the insidious problem of illegal tobacco smuggling and trafficking at the Arizona State Hospital, a problem that begins with ASH staff's willingness to illegally provide tobacco and other illicit substances to patients, and the final consequences of which fall directly on the heads (in the lungs) of ASH patients. ASH is a hospital. ADHS is "proud" of its' smoke free policies. Nicotine related deaths rate among the highest form of preventable chronic illness in history. The patients at ASH are highly vulnerable to abuse, and the staff endorsement of patients' addiction(s) to tobacco and other illicit substances is abominable, to say the least. I look forward to seeing your response soon. Thank you.    

(This is the article itself, written and published by WILL HUMBLE on Sept. 10, 2012. The article can be viewed at http:// directorsblog.health.azadhs.gov)

Arizona’s New Chronic Disease Strategic Plan

September 10th, 2012 by Will HumbleLeave a reply »

I’m happy to share our new Arizona Chronic Disease Strategic Plan.  This past year, our team from the Bureau of Tobacco & Chronic Disease worked with community partners from across the state on a new guiding document for chronic disease prevention and health promotion.  This strategic plan will be used by ADHS, county health departments, and community partners to advance chronic disease policies, systems and environmental change in the areas of where we work, live, learn, and get care.  At the same time, this plan will also help align activities around the CDC’s Chronic Disease Prevention and Health Promotion Four Domains.  

Funded through the CDC Coordinated Chronic Disease Program- the new plan identifies ways in which our partners can maximize the impact in the areas of heart disease, cancer, diabetes, obesity and tobacco.  The strategic plan includes a matrix of evidence-based strategies which can be used by the public health community..  and it provides clear direction for advancing nationally recognized recommended or promising evidence-based practices.  Congratulations and thank you to the many community partners and health department staff who contributed to the development of new plan.

     In several very recent articles, I have made clear the fact that Will Humble, Director of the Arizona Department of Heath Services, has refused to take notice of any of my good faith requests for input from his office in terms of clearly established problems at The Arizona State Hospital. I have also made clear, to Mr. Humble himself, that his unwillingness to establish transparency when it comes to such communications from a person such as myself, who is a tax paying citizen as well as a former patient at ASH, is illustrative of undue censorship that somewhat clearly proves my contention(s) that the highest ranking officials directly responsible for protecting the needs and interests of Arizona's most vulnerable institutionalized adults citizens are maintaining substandard care and practices with no worry whatsoever of accountability or consumer based oversight. But Humble refuses to relent and cease with this blatant exercise of ill conceived misconduct. It is atrocious. 

IN CLOSING: Herein, I again attest to the basic fact that this entire situation is 100% unacceptable to me and any number of reasonably intelligent persons that I have yet to speak to since my discharge from ASH, including at least two state representatives, and one former chief justice of the AZ Supreme Court (amongst others). As such, these matters are beyond my comprehension in terms of the privileges granted to individuals such as Mr. Humble in the context of this situation as it stands today. But I am content with the realization that these matters are "incomprehensible" to me in this context, for therein, I feel I can rest assured that my ethical awareness of fundamental American principles are intact. 

     Patient abuse at public mental hospitals is arguably the most graphically sickening dirty secret in the entire world of behavioral health care and treatment. In fact, at least one very active and experienced legal professional in the state of Arizona has made this statement to me, in no uncertain terms: "The bullshit that goes on at The Arizona State Hospital is our state's deepest, dirtiest secret. Beyond that, you do not even want to get me started on ASH! I know what you are doing and why, and I support you wholeheartedly, and I agree entirely with your approach." I attest to the fact that this was stated to me while I was still hospitalized at ASH.  Things at ASH really are this bad. The Arizona State Hospital is operating at a level of dismally substandard mental-medical health care and practice and they are getting away with it lock-stock- and barrel. Please visit my April 30, 2012, Resources Ideas article, and determine how you can best become involved in defending the rights of ASH patients today. 

paoloreed@gmail.com

Prose

        where the dead go to die

a lost tree,
a leaning tree
arched like grandmother
over the water
with falling leaves 
and falling ants
that crawl on my legs,

all an invitation 
to join a river. 




look at that thing, 
that water, that river
as though my table
a place for elbows
a surface to reflect
to be reflected, for

the things these waters have seen
it is a lifeline stretching eternally.   

irish girls, scottish boys
resolute and somewhat angry:
   "the water is dead
    it lies facing upward
    in a funeral home
    already powdered 
    for burial."   

no getting away from it
heritage and blessings. 

piece of wood
thunder, rain, disappointment
no relief in sight,
let it rain, then,

one turtle stretching
like a swan, on a log.

    a floating piece of wood
    on a river that extends 
    to the bottom of the world
    all things go, as all things grow, in time,

in time there is salvation
in salvation there is love.


out there in that desert
like a turtle on a rock
bearing itself in defiance
of a river dried like brick
telling itself something vain
is that godforsaken rathole
and the declaration:
   i am a god
   i am beyond reproach
   i am no turtle after all. 

where the dead go to die
there are buried 
behind the eyes of them
the onus of life recaptured
as in birth itself, 

herein such dead will revive, 
                                              resuscitate them. 

But the dead never die
in places like ASH- 
   misery too painful is undying,
   hear all our mothers' crying
   tears in a river, knowing
   that in order to die 
   there must be life.  

                      pj reed 2012


paoloreed@gmail.com

Will Humble: A Recap Relating The Director of Arizona's Department Of Health Services Unwillingness To Openly Respond To Good Faith Client Based Inquiries And Expressions Of Concern. 

"It reminds me of Stalinism."

Readers, 
     I invite you to submit comments to Arizona Department of Heath Services Director Will Humble's official blog site, which can be found at http:// directorsblog.health.azadhs.gov, in relation to the following:  In good faith, I submitted no less than three (3) direct inquiries to ADHS Director Will Humble's official website blog concerning the following three articles that he posted on that blog, but he and his staff have refused to respond to my concerns in kind. They have, in fact, refused to even divulge my comments and share them with the greater public. In my humble opinion, this is a blatant exhibition of undue censorship that clearly illustrates abuse of administrative responsibility and falls nothing short of criminal concealment in terms of the public's constitutional right to full disclosure about the utilization and management of a critical public resource.  


Health Disparities
July 27th, 2012 by Will HumbleNo comments »

Lots of risk factors contribute to health disparities…  and many of the risk factors are called “social determinants of health.” A couple of months ago we (with our community partners), launched the Social Determinants of Health educational series to boost professional development and program planning so Arizona’s public health team can better address health equity and improve health status for vulnerable populations in Arizona.

     With this one, I asked Mr. Humble to respond to my concern about the fact that Caucasians and other non-African American persons are provided treatment at The Arizona State Hospital at 10-12 times the rate that African Americans are. It has been at least six weeks since I submitted my comments on this matter, which illustrates the fact that the No comments indicated above is patently untrue. 

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Acting Deputy for Behavioral Health

August 5th, 2012 by Will HumbleNo comments »
We’ve already posted the Deputy Director position and have had interviews underway for the Assistant Director position.  I think we’ll move smoothly with filling both of these positions permanently in the near future.  In the interim, I’ve asked Cory Nelson, AZ State Hospital CEO to serve as the Acting Deputy Director- and he’s agreed to help out.  Cory will spend the next three weeks working closely with Dr. Nelson and the rest of the team and should have no problem getting up to speed- as he’s a quick study.  This plan will offer a great opportunity to further strengthen our important link between the Hospital and the community-based behavioral health system.  It’ll also bring in additional people-power to DBHS during this incredibly busy time.  Cory has a great team at the Hospital as well and they’re up to the task of picking up some of Cory’s day-to-day work there.  Donna Noriega will be leading the team at the hospital as Acting CEO and will be working closely with the rest of the leadership team to make sure the great things happening there keep moving forward.

     In reaction to this one, I inquired about whether the fact that Cory Nelson's involvement in the cover up and misrepresentation of the facts surrounding the Jesus Murietta escape and the subsequent brutal murder of April Mott had been considered before granting him this excess of responsibility described in the above article excerpt. I also asked Mr. Humble if the fact that Donna Noriega's recent violations of her licensure had been considered, in combination with her central role in the Jesus Murietta-April Mott scandal, before granting her the excess of responsibility described in the above article excerpt. It has been at least one month since I submitted my comments on this matter, which illustrates the fact that the No comments indicated above is patently untrue. 

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Evidence Based Practice x (Training + Teamwork) = Results

August 17th, 2012 by Will HumbleNo comments »

Good news…  since implementing our Non-Violent Crisis Intervention training we’ve dropped the % of incidents at the Hospital that end up in restraint or seclusion by over 40%.  Equally encouraging is the fact that staff injury has been reduced by nearly the same amount.  Our team at the hospital is doing a great job of using a recovery-based and trauma-informed approach in applying the de-escalation principles that are the key to these results.  You can read more about Non-Violent Crisis Intervention on the Crisis Prevention Institute website.

     In submitting comments to this article, I shared with Mr. Humble the fact that several ASH staff members had posted very clear concerns in absolute contradiction to the information provided in this article, as illustrated in submittals by staff to Cory Nelson's personal website (see: www.crazycorycorner.weebly.com:  2 FRIGTNED 2 SAY 08/18/12                    ASH CLAIMING ON THE NEWS (CHANNEL 3) THAT ASSAULTS HAVE GONE DOWN. LIARS!! WORSE THAN EVER!), and requested a response that might provide me, as a former ASH patient (human being), and current client of the Arizona Department of Health Services (consumer),  and as a citizen of the state of Arizona (tax payer), with some idea of why staff were in agreement with me in terms of knowing, in fact, that the conditions at ASH are anything but stable and in good running condition. It has been 3 full weeks since I submitted my comments on this matter, which illustrates the fact that the No comments indicated above is patently untrue. 
--------------------------------------------------------------------------------

IN CLOSING: Anytime there are problems of this nature at The Arizona State Hospital, which is the only long term public mental health care facility in the state, we can all rest assured that the worst consequences fall directly onto the heads of the patients. That said, even the possibility that such issues exist at ASH demands nothing short of immediate and substantive response and oversight. This is Will Humble's responsibility at this point, because I have made clear to him that nobody in his vast empire of administrative employees and agencies has met their responsibility in this context. The patients at ASH are highly vulnerable and at an extremely high risk of abuse, this is a cardinal reality in public hospital settings of any kind, and it does not take a rocket scientist to recognize the fact that Humble's refusal to respond to my inquiries represents yet another example of maladroit administrative malfunction that extends throughout the entirety of the ADHS Behavioral Health Services network. It does, however, take individuals and a related society of ethically sound minded and compassionately concerned character to meaningfully stand up in support of the patients at ASH. That is all I am striving to establish through my work and this blog, and as a matter of making clear my thoughts about what may be most critically needed in this situation, I'm willing to suggest that it has to start with the people who work at ASH, or somewhere within the realm of the Arizona Department of Health Services. One or more of these people need to put their fears or selfishness aside and step forward on behalf of bringing the truth of these issues to light. 
     In my own case, I am dedicating myself to this cause purely on behalf of the patients at ASH, because I am directly connected to them, and because they are human beings, and because they are deserving of the same respect and overall benefits offered to anyone of American citizenship. I have no intent based on personal gain beyond simple peace of mind; and while I am certain that the nincompoops in the administrative offices at ASH suspect that I am out to create havoc, I need only remind myself, and them, that I have made clear since the first time I filed a formal grievance about the abuse I suffered at ASH, that I seek nothing more than civil redress, as per the applicable protocol. The ball, as it were, has always been in their hands to simply do the right thing, but they have willfully and quite criminally done all they can to avoid the most fundamental intent of applicable codes of conduct and function, which to me is about as boneheaded a way to operate as one might imagine. 
     These people suck, and they need to go. Bottom line.        

     The problems described do exist at The Arizona State Hospital, these, and myriad others. It is not a case of basic imperfection, or a matter of understandable ineffectuality. It is substandard mental-medical health care through and through. I attest to this. I witnessed and was personally subjected to every form of patient abuse imaginable short of outright rape, torture, or execution, and it was imparted on me by staff at all levels of employ. Not all staff, for there are many good people at ASH, and they are the ones seeking redress in their own right, but indeed, every existent level of staff person, but for the housekeepers and the gardener. It really is that bad. Patient abuse is inhumane, and any willingness of state employed clinicians, administrators, or officials to turn a blind eye to these issues is criminal. Bottom line. Please do all that you can today to see that the abuse of patients at ASH comes to an end. 
     Today. 

paoloreed@gmail.com

High Staff Turnover: Wherein, a comparative review systemic shortcomings in Arizona's various  public care systems serve as evidence in considering the substandard practices at The Arizona State Hospital, and how such matters can and do directly contribute to harm to the general public.   

     As a matter of exercising my sense of civic duty to my fellow citizens in the state of Arizona, I have gone to great length in trying and alert the public about the ongoing problems at The Arizona State Hospital (ASH) via open and good faith communication with Will Humble, who is the director of Arizona's Department of Health Services (ADHS), as well as by offering my assistance to the employees at ASH who have expressed their concerns about the out of control conditions at ASH through postings submitted to ASH supervisor Cory"crazycorycorner"Nelson's  personal website. There is only so much I can do, however, so I am increasingly relying on other matters that arise in the state in direct relation to my concerns about the endemic failures of ADHS and ASH administrators to meaningfully address the problems at ASH. As such, there is an absolute crisis at this time in the state's Child Protective Services system (CPS), and more than a few similarities can be identified in terms of seeing where the same sorts of shortcomings in ADHS have been arising in CPS; and as direct consequence of these shortcomings, children are dying, on the one hand, while on the other hand, the patients at ASH are continually being subjected to very clear substandard mental-medical health care practices.  

     As part of my investigation into the out of control conditions at ASH, I have been sharing ASH staff postings to Nelson's website with my readers. The results, as far as we can determine, have been mixed (at Best), but that's something. Below I hope to remind you all of this particular staff concern, posted to Nelson's website about 3 weeks ago. 

2 FRIGTNED 2 SAY                           08/18/12

ASH CLAIMING ON THE NEWS (CHANNEL 3) THAT ASSAULTS HAVE GONE DOWN. LIARS!! WORSE THAN EVER! WHY DOESN'T JACO OR MEDICARE LOOK AT EMPLOYEE TURNOVER RATE?

I ask that you pay attention to this staff persons' clearly stated concern over high rate of staff turnover at ASH, and then to consider the following excerpts from very recent articles concerning how this same problem is directly contributing the crises in CPS:

Arizona CPS staffing turmoil is dire: Turnover rampant as foster cases rise. by Mary K. Reinhart - Sept. 6, 2012 11:11 PM The Republic | azcentral.com

•      A record number of child-abuse and neglect cases coupled with high staff turnover are undermining promises to improve Arizona's child-welfare agency and provide better care for the state's most vulnerable kids. After more than a year of efforts to reform the state's Child Protective Services, and despite a governor's task force set up to help find solutions, the overwhelmed agency is falling further behind in attempts to recruit enough caseworkers and significantly reduce the backlog of thousands of cases. CPS is nearly 500 workers short of meeting state and national caseload standards, according to the most recently published state data, in large part due to an unceasing increase in reports of child abuse and neglect. The staff turnover rate at the agency has reached 31 percent, according to a biannual state report released last month, meaning nearly one in three front-line workers has quit his or her job this year. Because child-welfare work is difficult and draining, state agencies typically expect turnover rates that average 20 to 22 percent, said Nancy Dickinson, director of the National Child Welfare Workforce Institute at the University of Maryland's School of Social Work.
• Arizona's turnover is concerning, Dickinson said, and the consequences could be dire as families deal with a parade of new caseworkers.
•       "It's kind of like a snowball effect," she said. "Once turnover rates start increasing, workers don't stay around because their caseloads go up."
•       A California study showed that high turnover rates, considered 30 percent and above, led to higher rates of families coming back into the child-welfare system with new reports, as well as lengthier stays in foster care for children.
• "It really changes the way families are treated," Dickinson said of caseworker turnover.

     Read more: http://www.azcentral.com/news/articles/20120906arizona-cps-staffing-turmoil-dire.html#ixzz25nxZFzrS


   The relevance of these issues in terms of recognizing how critical the problems at The Arizona State Hospital are, with the potential harm posed to the patient community at ASH in mind, simply cannot be denied. It was clear to me as my February 21, 2012, discharge from The Arizona State Hospital approached, that major changes were being implemented in overall structure of staff at ASH, changes that came about due to drastic cuts in Arizona's overall budget specific to public health care (amongst other things, like education, all thanks to Governor Jan Brewer), and which were leading at the time to everything from unanticipated overtime demands, as well as layoffs and other like developments, all of which led many staff to verbally express clear worry over their situation as arguable underpaid employees at Arizona's one and only long term public mental health care facility. It was also stated pretty clearly by several staff members who I interacted with that the hiring of Cory "crazycorycorner" Nelson was largely based upon his qualifications as a skilled budget manager who would be willing to whatever he had to squeeze the operation at ASH into the increasingly narrow parameters of the Arizona health care budget; in other words, Nelson was possibly hired based on his ability save money more that anything else, and given that he came to Arizona from one of the poorest states in the country (South Dakota), this makes sense. High turnover rates are only one specific statistic that I believe will come to stand as evidence of how terribly mismanaged the affairs at ASH are at this time, but until officials such as ADHS Director Will Humble desist in blatantly covering up the problems at ASH, many of these matters will continue unabated, with any amount of possible damage to the patients at ASH.    
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     When I arrived at The Arizona State Hospital on January 11, 2011, some of my property was immediately stolen by somebody working at ASH, most likely security staff, but I never did learn precisely what happened to it, beyond knowing that it disappeared at some point in the first 4-8 following my arrival and admission to ASH. This matter is of particular concern to me because the stolen property was medication, and the implications of the theft are that the ASH staff responsible for the theft stole it in order to sell it on the black market.
Once I was made aware that some of my medication had been stolen, I immediately requested that my primary attending ASH physician at that time, Dr. Laxman Patel, do whatever he needed to in order to see that an reasonable investigation of this matter come about. However, to my knowledge, no such reasonably meaningful investigation ever occurred, and all/any attempts I made to learn about the matter were brushed off or other disregarded by Patel, as well as by the ASH patient advocate, Sonya Serda, and my assigned ASH social worker at the time, Megan Mitscher. I got the same response from each of these people, as follows: 

                            "It has been taken care of." 

    It was clear to me that these individuals felt I was not entitled to know about what had, in fact, happened to my property. 

    The manner in which my good faith desire to learn about what had happened to my stolen property was blatantly disregarded smacked of deceit and impropriety at the time. It was starkly clear to me that no aspect of the wrongdoing that I witnessed and was subjected to while hospitalized at ASH was of sincere concern to my doctor, or any other representative of ASH administrative staff. It is a culture of corruption that extends to the highest ranking members of the ASH staff structure, and on into the offices of ADHS. As such, I feel that it's all a recipe for disaster; a disaster, in fact, that plays out day in and day out within the walls and fences of ASH, but the willingness of the ASH administrators and clinicians (and ADHS' Will Humble, so far as I am concerned) to cloud or utterly cover up the out of control conditions at ASH amounts to nothing short of criminal abuse of authority and medical malpractice. However one looks at it, there is no denying the fact that it all occurs at the direct expense of the highly vulnerable patent community at ASH. 

     Here is another excerpt from a recent article in the AZ Republic concerning the failure of Arizona Child Protective Services to meet their fundamental obligations to their clients, directly contributing to the tragic deaths of Arizona's most at risk children. I include this specific expert because it illustrates the exact same sorts of disregard for wrongdoing that I ran into at ASH whenever I reported patient abuse and requested meaningful response form the one's directly assigned to advocate for patient safety and ell being at ASH. It is sickening.     

CPS hands another young child over to die. by Laurie Roberts, columnist - Aug. 29, 2012 12:00 AM The Republic/  azcentral.com

•     Who knows what she might have become had she been blessed with halfway-decent parents or halfway-competent help from Child Protective Services. 
She would have been 10 months old by now. She would have been sitting up and crawling and laughing, as babies do...
•      It's been four months since we learned of Baby Vanessa's fate and the state's role in dispatching her to the hereafter, so I figured it was time to find out how she went free-falling through the state's safety net.
•      Or not. The matter, I am told, has been taken care of.
•      "The majority of the individuals involved with this case are no longer with the department," Department of Economic Security spokeswoman Tasya Peterson wrote in a statement sent to me on Friday. "Agency officials conducted a thorough investigation in order to determine what happened and has taken appropriate measures to address the issues identified."
• 
  
• What those "appropriate measures" are, we evidently aren't entitled to know. Just as it apparently isn't any of our business what specifically went wrong or how the agency plans to ensure that it doesn't happen again.
•      We can know only that "the majority" of the workers are gone -- though not fired, asthat would be public record -- and that "appropriate measures" have been taken.

      Read more: http://www.azcentral.com/arizonarepublic/news/articles/2012/08/28/20120828roberts0829-cps-hands-another-young-child-over-die.html#ixzz25o8dJ9sN

     It may seem to be bait of a stretch for me to directly compare the problems at AZ Child Protection Services with the out of control situation at The Arizona State Hospital and in the ADHS/Behavioral Health Services (BHS) system, but nothing could be farther from the truth. These respective systems share the same sort of functions and directly associated obligations and responsibilities in terms of how they operate. And both CPS and ADHS/BHS manage the care needs of Arizona's most at risk-vulnerable citizens. As with the neglected and abused children flowing out of Arizona's drug addled inner city environments, the patients at ASH exist so out of sight-out of mind from the awarenesses of the greater public, that the clinical and administrative abuse and neglect that I witnessed and experienced during my time at ASH goes entirely unnoticed, other than by arguably incompetent staff who are either too afraid for their jobs or simply too unethical/dense to stand up on the patient community's behalf.
     Therein, the significance of data emanating from research compiled in relation to CPS at this time. It is only a matter of time before yet another headline grabbing incident occurs at ASH, just as it is with CPS. I attest to this as one who has seen and been subjected to the worst health care in America.
I am a member of the mentally ill population, and I know what that means, particularly in regards to the substandard practices at ASH.      

IN CLOSING: Media professionals such Laurie Roberts of the Arizona Republic utilize basic public records requests in establishing the data provided in the above two articles about Arizona's Child Protective Services. Annual, semi-annual, and even monthly reports of various types are prepared and issued by public health care institutions like ASH as a matter of their licensure and function as public entities, and all of it is open to the public. Anything but readily available, for state agencies such as ADHS and facilities such as ASH do not like to be scrutinized. The unwillingness of my clinicians and the administrators at The Arizona State Hospital to provide me with my own personal medical records, including but not limited to nurse's notes and other like details that can serve to represent the flow of "care" provided to me during my 13 long months of mis-treatment at ASH, belies how deeply embedded the corruption there is. They know that I am intelligent enough to prove their wrongdoing via simple oversight/review of my own affairs in the context of that flow of "care", and there is no way in hell they are going to grant my fundamental right to access my own personal records if they can help it. This, just another example of how inept and shortsighted these people are. Because those records are mine, and I will come into possession of them in time. 

     Please visit my April 30, 2012 "Resource Ideas" article today, and decide how you can best act in defense of the patients at The Arizona State Hospital. I cannot emphasize enough how critically we need your help. The abuse of patient at ASH is ongoing, and it is inhumane, criminal, and patently unacceptable. Let's stop it now. 

paoloreed@gmail.com

Random Notes: Readership is now over the 7000 mark, and still growing, a surprise given that I am retaining far more topical data than I am releasing. (I must be doing something right). 

     1) Both of these stern looking fellows are ancestors of mine. The cat on the right is Scottish-Irish, born (1739) and raised in Pennsylvania and South Carolina, and was a decorated officer in the American Revolution, amongst other things; and the dude on the left is Chickasaw, was born (1789) and raised in Mississippi when that region was termed "indian country" by the federal government, and he in time served as the first elected leader of the Chickasaw Nation. As many people know, a number of prominent American citizens of Scottish heritage married into the Cherokee, Chickasaw, and Choctaw tribes following the Revolution, therein lying the early history of my immediate family on the paternal side. 

     2) I had a very interesting and enlightening conversation with 

Debra Rinaudo of the Arizona Board of Behavioral Health Examiners this afternoon. The names of four (4) people who I closely interacted with came up and not even of my behest, individuals who were working in the context of social services at The Arizona State Hospital during my hospitalization there, working as such at a basic level, as well as at the administration level. Encouraging, if nothing else. More later.

paoloreed@gmail.com  

RERUN/REWRITE: This man was my first attending psyche doc at The Arizona State Hospital. LAXMAN PATEL, who has since been promoted, and is now the Chief Medical Officer at the Arizona State Hospital. 

"Doctor." Wherein, formal notes specific to a patient's state of mind and related treatment needs, entered by a senior member of psychiatric staff at The Arizona State Hospital, reveal just one more example the clinical ineptitude that has allowed the substandard care and practices at ASH to exist, to date. 

Enter "Doctor" Laxman Patel", a man which more accrued experience at ASH than any other doctor there, besides the witch, Ruby Ramos-Roxas.      

     Now for something as deeply personal as I am willing to openly discuss. One of the most traumatic aspects of my childhood relates to incestuous sexual abuse that I was subjected to by my older sister when I was 6-7 years old. Due to the internal confusion and relative trauma that the incident caused me at that age, I have rarely discussed this fact with anyone in my life; and in fact, until being hospitalized in 2010 (following my last suicide attempt), the only persons I had ever even mentioned it to were my wife and my mother. As it turns out, my therapeutic sessions in several hospital settings (including before my admission to ASH, which signifies that this incident etc. was part of my formal medical record at that time that Patel become my primary doctor at ASH) determined that this abuse has played a significantly debilitating role in my overall life, and directly in the medical context of my being affected by major depressive disorder and associated traits. In short, my sisters absolutely sickening abuse of me in this context fucked me up in ways that directly damaged my sense of self esteem and relatedly complicated my interpersonal relationships very difficult since I was an adolescent, including in terms of the relationship between me and my former wife.   

      As a matter of practicality, here is just one formal summary description of the damage caused by incestuous sexual abuse to the abused child's mental and emotional well being: 

Incest is a form of chronic traumatic stress that can lead to a host of initial and long-term effects. Like child sexual abuse in general, it poses a serious mental health risk for many victims. The chronic nature of the abuse, the nature of the family, including its dynamics and defenses, the child's dependence on and entrapment in the family, and his or her loyalty to that family,necessitate using strong defenses to cope. Denial and dissociation (splitting off of normal thought processes from consciousness) allow the victim to discount, minimize, or otherwise suppress memories of abuse. These defenses often persist into adulthood. As a result, survivors may appear asymptomatic and not suffering from long-term effects of the abuse, when in reality they are emotionally constricted due to the trauma. Since incest usually occurs in childhood, it inevitably influences maturation and development. For many survivors, the incest experience, along with its aftermath and coping mechanisms, has greatly influenced and become integrated

into the personality. (Faqs.org//Health 2010)

     Well, as luck would have it, my first primary attending psychiatrist at The Arizona State Hospital happened to be Dr. Laxman Patel, an Indian-American who attended medical school at a non-accredited university in  India and has been working as a doctor at ASH since the early 1990s. In a report compiled by Patel following our first meeting in January, 2011, he stated the following: 

      "Mr. Pickens reports that his older sister let him fondle her    

      when he was 6 years old." 

     I shit you not, oh reader, "…. let him fondle her"!!!! is precisely what this goddamned so called medical professional reported in his records about me! I have that document. It is part of the record. Formal medical interpretation of my statements, by a man raised and educated in India, which today coming to be one of the most filthily societies in the world with the subject of rape, incest, and other like sickening dynamics. Is this why Laxman Patel, the current Chief Medical Officer at ASH, so inaccurately interpreted my history in this context? Does it have to do with the fact that Indian men, and the underlying culture of that particular third world nation, believe that only men have the ability and right to subject others to sexual attack? Here in the United States, virtually all established medical data recognizes the severe damage(s) that incestuous conduct causes, and this particularly significant in terms of anyone claiming to be a qualified mental health physician. 

And yet this man, who now (2013) has more authority over the lives of ASH's seriously mentally ill and disabled patients than anyone else at ASH has, utterly failed to acknowledge this critical aspect of my personal history, as it did and does today affect my sense of self esteem, personal worth, and related major depressive disorder.   

     This, again, a clear example of the substandard mental health care that I experienced while at ASH. And while it may seem reasonable to look at this yahoo's statement as nothing more than a tad bit of miscommunication, I cannot emphasize enough how critically impacting the primary care physician's role is in relation to any patients' treatment needs in a place like ASH.  As I have already stated, these doctors hold the patients very lives in the palm of their hands in terms of everything from the patients' freedoms and privileges there at ASH to the patients grasp of reality in terms of being institutionalized, which extends their given authority far beyond the terms of traditionally accepted patient-doctor relationships; and the directly related power dynamic and reliance of the patient on these doctors dictates all aspects of the patient experience at ASH.

     As such, communication in terms of the doctor-patient relationship is critical, and there is no excuse whatsoever for this man's ineptitude. I don't know if it was, in fact, a communicative slip on his part (because it certainly was not on my part), or if his given cultural background contributed to this disturbingly gross misinterpretation of my most personal communications with him (perhaps in his native culture, 6-7 year old boys commonly "fondle" their older siblings, e.g.), but whatever the reason for Dr. Laxman Patel's blatant disregard for the significance of this critical point in my personal history, his act remains the same: Psychiatric professionals responsible for this sort of blunder can and do lead to death, injury, and overall harm to the general well being of their patients. It is that clear, and anyone with a basic understanding of psychotherapy in this day in age understands this. I attest to this via my own experiences and the extensive body of literature applicable to the topic, and I look forward to testifying about this matter when the time comes. 

     Do you hear that, Dr. Patel? In this case, you- my singularly most important caregiver, my so called trusted primary care physician- radically mischaracterized the facts of my childhood experiences in such a way that you effectively condoned my sister's  behavior- (over 40 years after the fact, you son of a bitch, you furthered the harm and shame that I experienced in this specific matter, rather than responsibly contributing to my care needs in this very critical context)- and directed the insidiously sickening wrongdoing of the incident onto me. At the age of six, I had no interest in or idea about what sexual conduct is, and I somewhat presume that most 6 year old children are of the same mindset (in my culture, that is). I did recognize that my sister was up to something deeply shameful, however, and I did not willingly participate. I was persuaded through manipulation and clearly veiled threats, and the harm done to me at that time festered and ultimately led me to suicidal ideation. You- Patel- have no excuse for not recognizing this. These are facts that I have always stated in very clear terms to each and every individual I have ever talked about the matter with, including you, Dr. Laxman Patel. 

     Only at The Arizona State Hospital.

     Dr. Laxman Patel exhibited his incompetence in at least five (5) specific cases in direct relation to my being one of his assigned patients at The Arizona State Hospital. He was my first primary attending physicians at ASH, but we had a fall out following a very important inpatient treatment and discharge planning (ITDP) meeting in April, 2011, wherein he exhibited graphic dishonesty that was witnessed by no less than 6 other ASH staff persons, all of whom were also members of my ITDP team at that time. On several occasions during my subjection to this quacks "care", I expressed concern over what I felt were very inconsistent statements that he had made as our relationship evolved during my first three (3)  months at ASH, and in each of these occasions, Patel attempted to deter my feelings about the matter(s) by stating: 

                          "You only hear what you want to hear."     

     He would say this to me as though I were a child, with no respect whatsoever for the fact that I am an honest, well educated, and reasonably ethical man. Experiencing this nature of mistreatment by this man, and in absolute consistency with the majority of the abusive behavior that I had to deal with from ASH staff, caused me to question my self worth, and thus reignited my consideration of taking my life, because I had chosen to trust such personnel to such a degree that I  almost believed everything they would tell me. This particular aspect of my thinking had come about in good faith via my earlier treatment when I was still in Tucson area hospitals, prior to going to ASH in early January, 2o11, directly due to the fact my doctors in those facilities had earned my full confidence in there skills and professionalism. 

The ironic thing about this specific episode is that I did not discover Patel's gross misrepresentation of the childhood sexual abuse I had suffered (as noted by him in his record of out first conversation shortly after I was admitted to ASH) until well after I had been reassigned to another primary care physician at ASH. These notes are definitely of the sort that ASH clinicial staff would never willingly release, be it to the patients themselves, or any other interested party, which is precisely why I am willing to state the the provisions of Hospital Information Portability and Protection Act are willfully violated by the Hospital's senior clinicians and administrators.  Proof in the pudding, all as a matter of standard practice. 

IN CLOSING: This doctor is an insult to commonly established  mental health care today. And yet at this time, at the expense of Arizona's taxpayers, he is being paid an exorbitantly high salary in his position as Chief Medical Officer, at Arizona's sole long term public mental health care facility. As such, the one ASH staff member with more authority over the affairs of each an every ASH patients' flow of treatment is willfully violating his professional requirements, in defiance of the Hippocratic oath, and in brazen disrespect for the needs of his patients.  At ASH, it took me about two months (out of 13 total months at ASH) to realize that the quality of care there was anything but up to current medical standards, and Dr. Laxman Patel's misconduct centrally represents why and/or how I came to realize this at that time. He was my first assigned primary psychiatric caregiver at ASH, and I had nothing but good faith expectations at that time that I initially become his patient. He is arguably one of the most experienced psychiatric representatives at ASH, and yet somehow, he was unable to grasp the significance of my reports to him about staff misconduct at ASH; and subsequently, his ongoing displays of clear disrespect for me as a person, in tandem with his obvious shortcomings as a doctor, caused me to suspect that there are very serious problems with the way patients at ASH are treated. 

paoloreed@gmail.com