Fundamental Fact #2: Of Laxman Patel, a case study. Wherein, a fundamental inquiry into the causes underlying the substandard care at The Arizona State Hospital offers insight that can hopefully contribute to redress and resolution. 

"I do not care where you are from, what your educational or professional history looks like, or what your stinking title is. If you are up to no good, we will expose for just what and who you are. I will leave it at that.

I only hope, for the good of the patients at ASH, that Bowen and Christ are getting the idea by now. I could really care less about them, they being at no risk of any harm caused by anyone other then by they, themselves." (See below.)

"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 operatinASH 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. 

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

Mahesh "Mike" Patel. (Tucson Citizen. July 09, 2010). A Friend.

Mahesh "Mike" Patel 9/16/1955 - 7/5/2010 was tragically taken from us by a vicious and senseless act of violence on July, 5, 2010, though we know his soul has been freed into heaven. He was born on September 16, 1955 in Ahmedabad, India, where he grew up, married and raised his family. He worked at the Ahmedabad Electric City Co. for 15 years. He was an outgoing and respected member of his community. Proof of his devotion to family took the form of 15 immediate and extended family members living in one household under one roof. In 1998 he left India to join his brothers in Tucson to run Catalina Market. Mike's friendly and very personal style of doing business included greeting customers by name, assuring their unique needs were met, and caring enough to listen to their issues and stories. His infectious sense of humor and joyful laughter made it a pleasure to be in his store and turned loyal customers into friends. The generous and trusting character of Mike and the Patel family helped create a bond of community in the neighborhood-a rare achievement. For those who have known and loved him, we mourn the loss of a genuinely good and decent human being. But Mahesh Patel, a devout and principled man, would want us to rise above our deep sorrow and despair (like the kites he loved so much) and keep aloft in our lives the legacy of his beautiful spirit through kind and unselfish actions each and every day. He is survived by his loving wife, Jaxaben; daughter, Swetal; son, Adil; brothers, Jayntibhai (Jay), Bhupendrabhai (Peter); sister, Shardaben.

                                                                                          

(Originally published April 05, 2012)

THE FIRST TIME I FORMALLY MET MY FIRST PRIMARY CARE PHYSICIAN AT THE ARIZONA STATE HOSPITAL, PSYCHIATRIST LAXMAN PATEL, I ED THE RECENT DEATH OF A FRIEND IN TUCSON WITH THE SAME LAST NAME, PATEL, A FRIEND WHO HAD TRAGICALLY LOST HIS LIFE DURING MY FIRST 8 MONTHS OF RESIDENTIAL MENTAL HEALTH TREATMENT IN A TUCSON AREA HOSPITAL (PRE-ASH). DR. PATEL RESPONDED TO MY SHARING OF THIS DETAIL ABOUT THE MAN'S LIFE AND TRAGIC DEATH BY STATING:

                        "Oh, yes, another convenience store worker. Many Indian people who came here do work like that, in the convenience stores, motels, and so on. But I came here to help people. Which is why I work here at ASH.” 

THAT IS VERBATIM, AS STATED BY A HIGHLY ENTRUSTED EMPLOYEE OF THE STATE OF ARIZONA. I WROTE PATEL’S STATEMENT DOWN AS SOON AS OUR CONVERSATION CONCLUDED THAT DAY, MY FIRST FULL DAY AT ASH. SUFFICE IT TO SAY THAT ON THIS SIMPLE BASIS, I HAD A BIT OF A BAD FEELING ABOUT DR. LAXMAN P. PATEL FROM THE GET GO, PURELY DUE TO HIS CRASS AND SELF AGGRANDIZING DISRESPECT FOR MY FRIEND, MAHESH PATEL, AS ILLUSTRATED ABOVE.

BUT I AM NOT ONE TO JUMP TO CONCLUSIONS, AND MY BASIC RESPECT FOR PERSONS OF OTHER CULTURES DISALLOWED ME AT THE TIME FROM TAKING MY OWN INTUITION TO HEART. IN THIS SENSE, I GAVE LAXMAN P. PATEL EVERY OPPORTUNITY TO DO HIS JOB WITH DIRECT RESPECT FOR ESTABLISHED HEALTH CARE STANDARDS AND ASSOCIATED LEGAL REGULATIONS AS APPLICABLE TO MY CARE NEEDS, AND THOSE OF MY PATIENT-PEERS AT ASH. I ALSO ASKED FOR NOTHING MORE THAN THAT FROM HIM AND AND HIS ASSOCIATES THERE AT ASH, INCLUDING HOSPITAL ADMINISTRATORS AND OFFICIALS WORKING IN THE ARIZONA DEPARTMENT OF HEALTH SERVICES, FOR THE ENTIRETY OF MY THIRTEEN LONG MONTHS AS A CLIENT-CONSUMER THERE. MOST SPECIFICALLY, I ASKED FOR THIS THROUGH VERBAL REPORTS TO EACH OF THE FOUR PSYCHIATRISTS WHO I HAD TO DEAL WITH AT ASH, (LAXMAN PATEL, PERVAIZ AKHTER, BETH LYDON, SYLVIA DY), THROUGH FORMAL GRIEVANCE REPORTS I SUBMITTED TO THE HOSPITAL’S PATIENT ADVOCATE (SONYA SERDA), AND APPEALS SUBMITTED  TO  THE ADHS OFFICE OF APPEALS AND GRIEVANCES (MARGERY AULT).  

TOPIC: Negligence (clinical, administrative).

ISSUE: How/why is it that senior ranking clinical staff at Arizona State Hospital and entrusted officials in the department of health  willfully condone the abusive misconduct of lower ranking staff in so abjectly and unabated a fashion? This misconduct was condoned, as such, in spite of the fact that I openly reported such misconduct for the entirety of my 13 full months at ASH, reports made as per protocol to each and every state (employed) entity directly associated with the operation of ASH was unable to make so much as a dent in the situation.

ANSWER: Deceit, dereliction of duty, ineptitude, and discriminative disregard for the care needs and rights of individuals disabled by serious mental illness. The central cause  for this crisis lies in the fact that the senior clinical staff at The Arizona State Hospital are lacking in the fundamental skills/qualifications specific to the full breadth of responsibilities required in settings such as ASH.

I realize that it is arguably arrogant for someone like myself to express a bottom-line claim to this effect, but again, as I have stated at length in previous essays and articles, obvious deficiencies in character and related intelligence specific to the established responsibilities of ASH's senior clinical staff has everything to do with how and why the conditions there are so graphically substandard.

In contemporary America, anytime an individual reports abusive staff conduct in a health care facility to their primary care provider (doctor), that doctor is strictly required to directly respond to and address the matter, including in terms of sharing such reports with all/any related administrative staff, state operated facility licensing bureaus, and so on. This is not the case ASH, however. 

I attest to the fact that, in the first 3-4 weeks following my January 11, 2011, admission to ASH, I witnessed and was personally subjected to a range of clearly unreasonable behavior carried out by various ASH staff, namely (at that point in my treatment at ASH) some members of both nursing staff as well as technicians; these are the staff whom all patients spend the most direct time with, day in day, day out, 365 days a year. At several points during that period of time, I shared details specific to staff misconduct with my primary psychiatric ASH physician, DR. LAXMAN PATEL. These interactions occurred both in one-on-one meetings Dr. Patel, as well as in full meetings of my inpatient treatment team. Dr. Patel's responses to my reports fell far short of standard care and treatment, and I made close and careful notes of his statements at the time. 

“What do you expect? This is the state hospital.”  (Patel, January 21, 2011.)

“I prefer not to micromanage the affairs of lower ranking staff. It causes more complications than anything else." (Patel, Feb. 03, 2011)

”You should not be concerned about things going on with the other patients. You need to focus on your own treatment." (Patel, Feb. 22, 2011 

"I am not in a position to question the flow of treatment when it comes to patients not in my care, and it is none of your business, either. I have already told you, focus on your treatment, and don't worry about the patients around you." (Patel, late March 2011)

"What? Do you think you can change the system." (Patel, April 5 2011)

These conversations specific to my reporting staff misconduct, including graphic patient abuse, occurred over a period of time in spring, 2011, which represents my first 90 or so days at ASH. And I cannot easily imagine anything more definitive than these sorts of statements in terms of recognizing administrative and clinical negligence when it occurs during any residential hospital patient's process of medical treatment. Now, one can safely assume that Dr. Patel will flatly deny these facts (they all deny the merits of anything even slightly out of line as a matter of standard practice- all of them), but I have scads of irrefutable evidence in support of my claims in this context.

The significance of this evidence is illustrated by the heinously inaccurate and well documented statements that Patel made specific to my formal Psychiatric Admission Assessment. In such assessments, a patient is asked to share as much personal information as possible, including but one’s personal history, in as thorough a fashion as possible. Doing so enables psychological and psychiatrist professionals to provide their patients reasonably optimum quality of care. As such, personal histories in this type of process often includes experiences of extremely private nature, including in many cases childhood abuse, which does, is at least some occasions, include sexual abuse.

Sexual abuse, and incest in particular, is known to have deep harmful impacts of the emotional and mental health of any involved victims; and given the horrific nature of such experiences, these details can also be very difficult to share. By the time I arrived at ASH, I had become somewhat comfortable with describing my own personal history, including the fact that I was sexually abused at the age of seven, by my older sister, Sharon, who was nineteen at the time. It should be noted, however, that my comfort level in this context came about through the trust I had acquired in my primary psychiatric care providers prior to arriving at ASH.

As such, I felt no reason to distrust Dr. Patel upon my initial interactions with him. I had learned by then, as described above, that my best hope of recovery from my own given struggles with mental illness heavily depends on my ability to be open about my personal history. This, in my case, is of crucial importance on the basis of my actual primary diagnosis, major depressive disorder and associated (childhood abuse caused) PTSD.

Therein, and 100% based upon my willingness to trust Patel, I did openly share the all details about the sexual abuse that I suffered as a young boy. Only to have him utterly skew the bottom-line fact that I was sexually abused as a young boy, abuse that has caused my ongoing PTSD and related challenges specific to having intimate, trust based  relations with women since I was an adolescent, and beyond into my marriage. As documented in Patel'sn own notes from our meeting, instead of accurately documenting those critically important details, this highly entrusted, state employed psychiatrist, produced this record:

          “At the age of seven or so, the patient’s older sister allowed him to fondle her.”

To allege that I sought to fondle my nineteen year old sister is shocking to the core. How or why in the hell would any licensed psychiatric professional mischaracterize the significance of sexual abuse in this manner, other then- perhaps- because he was raised and educated in a culture and society where sexual abuse is all but openly condoned. India, that is, where in recent years reports of gang rape and other like issues have been reported in international news, issues that, as per such reports, are far too often suppressed and/or ignored by authorities in that specific nation.

This statement is radically inconsistent with the actual incident, and as importantly, absolutely inaccurate specific to the information I was willing to share with Patel. By characterizing my experience in this manner, Patel, effectively made me the perpetrator, as it were, denying that I was in fact victimized and subject to incest by an adult member of my family. As such, degrading the reality, and distorting my history in such a way that there was no hope of this doctor doing me any good.

I did not have an opportunity to review the record produced by Patel specific to this first formal assessment interview until I had discharged from ASH thirteen long months later. But I know about it now, and that said, there is utterly no logic in granting Patel any degree of trust. Like most of ASH's authoritative staff, this so called medical professional has the character of a back alley abortionist, and by the time I left ASH, it had become clear to me that this is anything but unusual at ASH. I attest to the fact that in at least three other very specific cases, Patel lied, and/or flatly denied a number of things that he had stated to me and my treatment team; doing so at later times in front of myself, as well as that same team, by repeatedly stating:

"You only hear want you want to hear." 

In prior articles, I have described the fact that upon my admission to ASH on January 11, 2011, some of my personal property was immediately stolen (medication) by ASH staff, presumably security staff; and that within 24-36 hours I had encountered at least on highly abusive staff nurse (Peggy) on the Palo Verde East unit. I thus had immediate concerns about such issues, concern to greatly increased as my first months as an ASH patient played out. Nonetheless, during those initial months, I somewhat took for granted that I could rely on Patel, my primary care physician, to hear me out and at least look into these things, on my behalf as well as on that of the patient community at ASH in general. But instead of doing this, the current Chief Medical Officer at ASH (PATEL) deliberately avoided responding to my reports, as illustrated above, in a series of discussions wherein he exhibited undeniably gross ineptitude in terms of his critical responsibilities as one of ASH's most experienced psychiatrists.   

By the time the above statement alleging that I only “hear what (I) want to hear” had become a pattern, my relationship with Laxman P. Patel had so soured that he initiated the process by which to transfer my care to another ASH psychiatrist. This occurred no less then three times at ASH, and I contend that it happened because of the discomfort these people experienced when they each realized that I was not going to back off or in any way stop openly reporting abuses of ASH patients, including but not limited- over time- to reporting those issues to both state as well as federal authorities.

By the time we actually parted ways, as it were, I had come to the realization that Dr. Patel was way out of touch with the established standards of care that apply today in hospitals of any kind. His reference to my concerns as an attempt to "change the system”, and his obvious cynicism in context,  is a clear both an indication of his mot being raised and educated in a democratic nation; and a shining illustration, as well, of how distorted the flow of patient care at ASH really is. There is arguably no more critical aspect of a long term mental health patient's than his or her basic safety, and the primary care physicians in such facilities have the most ability and directly related responsibility in terms of protecting such patients from abuse and anther like forms of staff misconduct.  

In his Patel’s case, I fully attribute such thinking to his cultural background (he was raised and educated in India). Patel left India sometime in the 1970s, at a time when that specific third world nation was experiencing very tumultuous civil upheavals ("democratization"), and the associated violence and corruption directly underlying that history is well known to anyone possessing basic familiarity with that era. It is also known that many of the most privileged members of India's rigid caste system (people who have long engaged in graphic prejudice and associated hate towards persons of lesser caste) turned a blind eye to the needs of their society and culture as this process was occurring, and fled with their resources to places where they would not be held accountable for the endemic injustices specific to India's history. I contend with relative certainty that Laxman Patel is just such a person. Leaving his home nation during such crises was an undeniably selfish course of action to take if you compare it to the ideals of many, if not most Americans.

Herein, we can readily identify clear causation for how and why the senior clinical staff at ASH willfully condone the abusive misconduct of lower ranking staff; and it has everything to obvious deficiencies in ethical character and related intelligence specific to the established responsibilities of such psychiatric staff, several of whom come from other home nations with societal histories as deplorable as India’s.

Meanwhile: 

LAXMAN PATEL IS NOW THE CHIEF MEDICAL OFFICER AT THE ARIZONA STATE HOSPITAL!

Laxman P. Patel is one of the most experienced psychiatrists at ASH, and has worked there for something like 3 decades, and is as such part of the "old guard" at ASH, this with respect for the fact that he was a member of ASH's senior clinical staff during the 1990s and the early 2000s, when ASH was subject to series of intensive federal investigations specific to the substandard care practices at ASH.

While during my time at ASH, January, 2011-February, 2012, Patel’s flagrant refusal(s) to respond to my reports about patient abuse stands as a central feature of ASH's overall shortcomings as taxpayer supported hospital that is expected to optimally treat and care for some of Arizona’s most vulnerable adults. Knowing as we do today that PATEL IS NOW THE CHIEF MEDICAL OFFICER AT ASH, one can directly refer to this thirty year record as a bright line point of reference to the still ongoing substandard conditions and practices at ASH. There’s simply no way that Patel wasn’t party to those matters when they were occurring, and you can bet your ass that he wasn't the one to blow the whistle on any of those issues prior to the aforementioned federal interventions.

As such, Patel's abject failure to meet his various responsibilities has been going on for decades, and his just-as clear inability to learn and grow (evolve for the better) in relation to ASH's history serves as just one glaring example of the utter turpitude underlying the depraved care paretics at ASH. Because, if not Patel, who may better have played a role in bringing ASH up to speed over these last 20-30 years than he?

ASH. It really is that bad.  

The fact is, in terms of contemporary health care, medical patients are strongly advised to rely on their primary care physician for all matters relating to their welfare, including their overall flow of treatment in any facility that the patient is receiving services from. At the Arizona State Hospital, however, this specific standard of care simply does not exist. Given Patel's exhibited lack of ethical character and related intelligence, as illustrated here and in my prior article about his role in my specific treatment at ASH (see: Laxman P. Patel: Herein, an introduction to the graphic incompetence of one of the most experienced psychiatrists at The Arizona State Hospital; February 16, 2012), I today find just that much more cause for alarm in terms of the crisis that ASH's patients are experiencing on a day to day basis, now that Patel is ASH's Chief Medical Officer. For it is the Chief Medical Officer who yields the most authority and related responsibility specific to the general flow of actual health care at ASH. This authority extends over that of any other ASH physicians, and directly applies to the needs of each and very ASH patient. 

Given how miserably Patel failed to meet his most fundamental obligations to me, when I was one of his patients, I am sickened to imagine the harm that his status as ASH's CMO might lead to. 

"I CAME HERE TO HELP PEOPLE". YEAH, SURE, A MAN SO DEPRAVED IN CHARACTER IS JUST WHAT PEOPLE LIKE ME, AMERICANS THAT ARE AFFECTED BY SERIOUS MENTAL ILLNESS, NEED TODAY. WHAT A POMPOUS ASS THIS MAN IS. WHAT A FOOL. AND SO ON.

I contend that various medical doctors at ASH today- such as Pervaiz Ahkter, Sylvia Dy, and Ruby Ramos-Roxas (all of whom came to the United states from countries with atrocious human rights records and equally substandard health care) are so lacking in character and qualifications that they would never be able to find work other than in a place like The Arizona State Hospital. On top of that, are actual Americans, be it Dr. Steven Dingle, or CEO Cory Nelson, who willfully condone all elements of these issues, including by employing some of the worst psychiatric professionals in the land.

I further contend that these factors directly contribute to the presence of the most abusive lower ranking employees at ASH, at least some of whom actively seek  to work in places like ASH for this very reason, an opportunity to engage in abusing Hospital patients with no fear of oversight or accountability. In essence, the worst of the worst "health care professionals" in the state of Arizona work at ASH, because they can get away with it. Herein, I attest to witnessing and being personally subjected to staff misbehavior that would absolutely shock the conscience of the public, and in going through that process, I would literally look at these individuals and ask myself: 

”WHERE IN THE HELL DO THESE PEOPLE COME FROM? HOW IN THE HELL DO THESE PEOPLE GET AWAY WITH THIS? WHO ARE THESE PEOPLE!?!” 

Likewise, all the way up the chain of authority there at ASH proper, and on up through the offices of Arizona Department of Health Services/Behavioral Health Services, administrators and managers also turn a blind eye to reports or other evidence to the effect that these substandard conditions exist at ASH with little to worry at all about oversight and accountability. It is, as such, a trickle down effect of undeniably sickening proportion, and the ultimate costs relating to this fact land squarely on the heads of Arizona's most seriously mentally ill and disabled citizens. This is unacceptable. The administrators and senior clinicians at The Arizona State Hospital are engaging in highly illegal and grossly inhumane abuse of their patients, and they are getting away with it lock-stack-and barrel. 

IN CLOSING: That's it. Fundamental Fact(s) #2, merely designed to raise our basic understanding of how and why the patients at The Arizona State Hospital are being subjected to graphically substandard medical-mental care and practice. 

DUE TO CLEAR DEFICIENCIES IN INTELLIGENCE AND RELATED ETHICAL CHARACTER, THE SENIOR CLINICAL STAFF AT THE ARIZONA STATE HOSPITAL WILLFULLY REFUSE TO ADDRESS GRAPHIC PATIENT ABUSE BECAUSE THEY ARE EITHER UNWILLING OR OUTRIGHT INCAPABLE OF ADHERING TO ESTABLISHED HEALTH CARE STANDARDS AND PRACTICE, AND THEY GET AWAY WITH THIS ONLY DUE TO THE FACT THAT THEY WORK THERE- AT ASH. 

SUBSTANDARD MENTAL AND MEDICAL HEALTH CARE, AND THEY ARE GETTING AWAY WITH IT.

This is a process, nothing more, nothing less, and in time the needs of ASH's patients will be respected and their related rights will be honored. All things in their time, and this is merely one more way to move the process along. 

DATELINE 2018:

"Mike's friendly and very personal style of doing business included greeting customers by name, assuring their unique needs were met, and caring enough to listen to their issues and stories. His infectious sense of humor and joyful laughter made it a pleasure to be in his store and turned loyal customers into friends. The generous and trusting character of Mike and the Patel family helped create a bond of community in the neighborhood-a rare achievement."  (As stated by the loving family of my friend, Mahesh Patel, and which I can affirm in all senses.)

I feel I have made myself clear in terms of bearing no inherent ill-will to persons from literally anywhere in the world. As personified by the graphic differences in character between my friend, Mahesh Patel and the Rat Bastard still working as one of ASH's senior ranking psychiatrists, I know all too well that it is the person who represents good vs. evil, and not the nation that person comes from in itself. 

While on the other hand, some nations today are known for their traditions on the basis of ongoing lack of modernity. Pakistan today,  (Pervaiz Akhter; see this blog, "No Prison Should Be a Prison." January 28, 2018.), has long been known by its neighbors India and Afghanistan, and western nations like USA and the United Kingdom, for its direct involvement in terrorist activities in the region and beyond, and   is also home base today for international terrorist training, including but not limited to members of ISIS, (see "Kabul Faults Pakistan for Terror." Craig Nelson. The Wall Street Journal. January 29, 2018). 

While in the Philippines (ASH Dr. Ruby Ramos-Roxas; see this blog "Of Audrey Peterson. A Friend." January 01, 2018), with a known history of brutal dictatorship, and where even today, slavery and other archaic forms of inhumane practice are still central to the life of less empowered persons not coming from elitist and powerful families. (see "My Family's Slave" Alex Tizon. The Atlantic Magazine. June, 2017.)

As to Laxman Patel's caste oriented snobbery, exemplified by his insulting reference to the role in American society that my late friend Mahesh "Mike" Patel so successfully filled (as per the details included in his obituary),  I can only express- in 2018- my utter disgust over such ugliness of character. But it's really of no surprise, per se'. India, as already described, is not only one of the most horrifically impoverished nations in the world today, with cultural traditions that effectively condone rape and sexual abuse, but is also one of the only- in contemporary terms- countries that still maintains a highly discriminative caste system, whereby persons not born into the right family are subject to hate and murder on the basis of that fact. This specific, India based discrimination is sanctioned by the ruling classes there (of which I feel that Laxman Patel is one), and takes the form of residential segregation, discrimination in labour markets, overt and covert instances of untouchability, deep educational disparities and opportunities, and results in a murder rate that is 100% based upon the presence of this openly sanctioned system of discrimination.  (See "The Ugly Reality of Caste Violence and Discrimination in Urban India." Ashwini Deshpande. The Wire Magazine. November 12, 2017). 

No wonder, then, that Laxman Patel was incapable of understanding the significance of childhood sexual abuse and its direct impacts on any child's emotional and psychological state(s), in graphic defiance of established psychiatric knowledge today. This, from a man recognized as ASH's longest employed senior clinician. Go figure. 

But I really do not care where you are from, what your educational or professional history looks like, or what your stinking title is. If you are up to no good, we will expose for just what and who you are. I will leave it at that.

Back in the proverbial day, I offered Cory Nelson and that whole other pack of Rat Bastards fair warning that did, in fact, begin with good faith, trust based efforts on part to merely ask them to do the right thing, as per their given job descriptions, the place in our society of well established standard of law and policy. As such, I have far less patience today, knowing as I do, how it went the last time. 

I only hope, for the good of the patients at ASH, that Bowen and Christ are getting the idea by now. I could really care less about them, they being at no risk of any harm caused by anyone but by they, themselves. 

I only know what I know. Fair warning.   

paoloreed@gmail.com

Fundamental Fact #1: Of Laxman Patel, a case study. Wherein, a fundamental inquiry into the causes underlying the substandard care at The Arizona State Hospital offers insight that can hopefully contribute to redress and resolution. 

"But the presence of retaliation and other such staff based misconduct  is perhaps not so commonly known when it comes to the operation of state managed mental hospitals. As the attorney who very recently spoke at a meeting of the ASH Human Rights Committee made clear, administrative abuses of authority arise in places like ASH far more regularly then she would have ever imagined prior to her becoming familiar with issues arising there even today. And out of overt resentment towards any threats to the status quo,  these abuses of authority do include, at times, the role of CEO’s such as Aaron Bowen, who may well take action against ADHS employees willing to conscientiously speak out of the patient community, and worse yet, against lawfully established resources of patient advocacy- e.g. ASH’s Human Rights Committee in itself." (This publication, January 26, 2018.)

"Mike's friendly and very personal style of doing business included greeting customers by name, assuring their unique needs were met, and caring enough to listen to their issues and stories. His infectious sense of humor and joyful laughter made it a pleasure to be in his store and turned loyal customers into friends. The generous and trusting character of Mike and the Patel family helped create a bond of community in the neighborhood-a rare achievement." 
     (From the obituary of Mahesh "Mike" Patel. Tucson Citizen, July 09, 2010.)

"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 operatinASH 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. 

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

Of Mahesh "Mike" Patel. A Friend.

(Originally published March 27, 2013)

TOPIC: Substandard Care practices and conditions (across the board).  

ISSUE: How/why is it that the behavior of so many of the nurses and psychiatric physicians at The Arizona State Hospital falls so very very far below the established standards that we the people expect out of licensed medical professionals? 

ANSWER: One reason flows from the fact that psychiatric clinicians at ASH, which is a state managed mental hospital, have no reason at all to concern themselves about customer satisfaction. No worries, as such, about job security, compliments of clientele, threats to the actual licensure, and on the list goes. 

In the public milieu, where we (the patient-client) have the option of considering the quality of care before agreeing to treatment provided health care resources,  professionals of any sort must take into account the quality of their services in order to ensure success. This is a basic as it gets, and a fact that anyone is familiar with. But in places like ASH, the patient-clients have virtually no opportunity to reject the presence of abusive or otherwise substandard behavior and related medical practices. I contend, via my very real experiences throughout the entirety of my 13 full months of hospitalization at ASH, that this has everything to do with why the conditions there are so graphically below par, and it somewhat applies across the board with respect for ASH staff at all levels of employ. All of them, in effect, are in a position to conduct themselves in blatant defiance of commonly established codes of fundamental decency with no worry at all about how their behavior will impact the flow of business that supports their income, and so on. It is that clear. 

I further contend that any number of the most abusive employees at ASH choose to work at ASH for this very reason. I attest to witnessing and being personally subjected to staff misbehavior that would absolutely shock the conscience of the public, and in going through that process, I would literally look at these individuals and ask myself: 

"HOW IN THE HELL DOES THIS PERSON GET AWAY WITH THIS? WHO ARE THESE PEOPLE? WHERE IN TARNATION DO THEY COME FROM?" 

Likewise, all the way up the chain of authority there at ASH proper and on into the offices of Arizona Department of Health Services/Behavioral Health Services, administrators and managers can turn a blind eye to reports or other evidence to the effect that these substandard conditions exist at ASH with little to worry at all about oversight and accountability. It is, as such, a trickle down effect of utterly sickening proportion, and the ultimate costs relating to this fact land squarely on the heads of Arizona's most seriously mentally ill and disabled citizens. This is unacceptable. The administrators and senior clinicians at The Arizona State Hospital are engaging in highly illegal and grossly inhumane abuse of their patients, and they are getting away with it lock-stack-and barrel. 

IN CLOSING: That's it. Fundamental Fact(s) #1, merely designed to raise our basic understanding of how and why the patients at The Arizona State Hospital are being subjected to graphically substandard medical-mental care and practice. 

THE STAFF AT ASH ARE NOT ACCOUNTABLE TO THEIR CUSTOMERS, OR ANYONE ELSE, FOR THAT MATTER. THEREIN LEADING TO ALL ELEMENTS OF ISSUES THAT THIS BLOG WILL IN SHORT TIME EXPOSE.

This is a process, nothing more, nothing less, and in time the needs of ASH's patients will be respected and their related rights will be honored. All things in their time, and this is one way to move the process along.

DATELINE 2018: As should be obvious, this 2012 article, and its second part (Fundamental Fact  #2) were oriented towards issues arising due to structural shortfalls at the Arizona State Hospital (as described by the fact that ASH is neither a for profit or a non-state managed health care facility), and the role of medical staff who essentially rely upon this fact in order to so much as find employment. 

I do not prefer, by any means, to criticize any persons nationality, or cultural roots, or race. For most any reason. But for, that is, in circumstances wherein such dynamics contribute to unlawful issues that I know pose harm to vulnerable Americans who have little to no means to defend their interests. And while it is hardly the fault of persons such as Dr. Laxman Patel that they were born and raised in nations lacking in democratic ideals or societal concern for human rights (be it India, Pakistan, or the Philippines), I do feel it is necessary for such individuals to take a good hard look at themselves if and when such issues arise specific to their activities (in America, or anywhere else, for that matter). 

I am of American Indian (Chickasaw) heritage on my father's side, and of Irish-German heritage on my mother's side. As such, I have a reasonably firm idea of what it means to be multi-cultural, which also comes about via my formal education, including my BA in American Studies (UNM 1996), MA in American Indian Studies (UA 1999), and the fact that my scholarship to the University of Arizona College of Law was afforded me through that school's Federal Indian  Law and Policy program (2001-2004). 

As a boy, my parents regularly hosted individuals in our home who haled from various nations throughout the world, individuals who were ambassadorial staff spending time in USA as guests of the New York Office of the United Nations. Such men and women would travel to New Mexico and stay with us for days on end, on the basis of wanting to visit one of the most culturally diverse states in USA. I learned therein that no individual from any part of the world is inherently incapable of being a good person. While also learning, in relation to these experiences, that in some cases, these individuals came from of the most dangerous areas of the world, where even today human rights abuses are standard par to societal and cultural practices. 

Multi-cultural, yes I am, but also 100% American in my specific case, my American Indian father having served as a full  Commander in U.S Navy, and my German-Irish mother having at one time been a regional chairperson in the League of Women Voters and a known advocate for the rights of women in USA and beyond. 

This is all fact, it is who I am first and foremost, and it all compels me today to serve the interests of my peers who, like I, know of what it means to be affected by mentally illness. To be mentally ill, and to have to rely upon the public mental health care system. 

Couldn't make any of it up if I had to. 

paoloreed@gmail.com

No Hospital Should Be A Prison. Wherein, due to appointing individuals who come out of the prison industry into executive positions in state managed mental hospitals, positions which they are not validly qualified for, we discuss one very disturbing aspect of discrimination against the patients in such hospitals.  

"An administration that would, in fact, as recently as only last week, demand that no ASH staff attend any more meetings of the Hospital's Human Rights Committee (HRC), an order that I contend arose on the basis of the knowledge that I am now attending those meetings. Taking close note, as I always have, of all employee statements, particularly those of ASH administrators, persons who have no actual right to privacy so long as they are on the clock, as it were." (From this publication, January 25, 2018.)

"Is it really true that you are not a felon? I can’t believe that.” Dr. Pervaiz Akhter, June, 2011.

Pervais Akhter

Two former South Dakota Officials lose Arizona Jobs. Bob Mercer. June 08, 2015. Rapid City Journal.

“News reports from Arizona show that Cory Nelson and Jeff Bloomberg were placed on leave and then evidently dismissed from their posts in the Arizona Department of Health Services during the past three weeks amid investigations into allegations regarding patient mistreatment, safety violations and sexual abuse at Arizona State Hospital by others during their management.

Donna Noriega, Cory Nelson, Jeff Goldbloom.
All three of whom were fired from
their executive positions at
ASH/ADHS in 2015.

Nelson left South Dakota in 2011 after a dispute over pay for his job as head of the state Human Services Center at Yankton, South Dakota. Nelson originally became acting director at Yankton during the Janklow administration and then received the job on a full basis despite criticism that he didn’t have the proper academic credentials and executive experience. He continued at Yankton through the Rounds administration and left in 2011 as Gov. Dennis Daugaard required pay cuts throughout much of state government’s top levels. He then became the chief executive officer for the Arizona State Hospital.

Bloomberg was state secretary of corrections in South Dakota during the Janklow administration when allegations arose over mistreatment of youth in state custody and the death of a girl at the Plankinton boot camp that was created and later shut down by Janklow. Bloomberg then worked as an attorney in state government for much of the past decade, before leaving for Arizona to work with Nelson. Bloomberg most recently was a top attorney for the Arizona state health department, where he served as manager for the office of administrative counsel and rules.”

"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 operatinASH 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. 

The Status of Mentally Ill Persons In the United States Today.

(Originally published April 10, 2012)

Marginalization and underrepresentation.

Prior to May, 2010, and my first admission to a psychiatric ward of any kind, I had no formal experience in spending time around persons affected by mental illness. I was forty nine years old, had been treated for physical injury and illness more then once in general hospital settings, and had no reason to believe that even today, state managed psychiatric hospitals operate in defiance of established medical standards. I had also worked for a number of years in the 1980s as a EMT, and was married to very competent and ethical nurse for over seven years 1993-2000. But as stated, no aspect of my personal life history had ever included opportunity for me to get a feel for the conditions on psychiatric treatment units, or what persons affected by mental illness might go through in such settings. I was, in no uncertain terms, absolutely unprepared for what I would come to learn over the next 21 full months of hospitalization in Arizona’s public mental health care system.

But central to what I am going to discuss in this article, one very striking feature to the realities on that first psychiatric ward that I all but immediately observed has to do with the fact that many, if not most, persons affected by serious mental illness are grossly underrepresented in terms of acquiring a range of matters specific to their needs.

While I may have thought about this (to some extent) prior to May, 2010, it was there, on the second floor of Kino Hospital in Tucson, AZ (now known as University of Arizona Medical Center, South Campus Psychiatric Hospital), that I saw first hand how difficult it is for some of us, the mentally ill, to represent ourselves in relation to our overall flow of treatment in such facilities.

Serious mental illness, as most anyone might imagine, can be very debilitating; and can, in some cases, make it very difficult for individuals so affected to speak up for themselves, whether that be in relation to their actual health care needs, or in direct relation to their given rights as disabled persons. While I may have thought about this to some extent prior to May, 2010, it was there, on the second floor of Kino Hospital in Tucson, AZ (now known as University of Arizona Medical Center, South Campus Psychiatric Hospital), that I saw first hand how difficult it is for some of us, the mentally ill, to represent ourselves in relation to our overall flow of treatment in such facilities.

Before going much further along, I need to clarify, very happily, that no aspect of the care practices or conditions at Kino Hospital so disturbed me that I ever felt the need to take action in defense of my needs. Indeed, I can report in context that university and other like operated public mental hospitals bear little resemblance with respect to the care practices and conditions in state managed mental hospitals. But that is for another conversation, beyond me needing to clarify that the folks at Kino Hospital impressed as very competent and very ethically inclined medical professionals. 

With reference to my first awarenesses as described above, and with further  regard for my thirteen months in Arizona’s sole long term public mental heath care facility, Arizona State Hospital, I sincerely believe by now (April, 2012) that seriously mentally ill (SMI) persons represent one the most marginalized populations in contemporary American society. I can, in fact, attest that, despite numerous reform movements to the contrary, such persons are still extremely vulnerable to negligence, exploitation, and outright abuse.

Hospitals are not prisons.

In this context, another critical feature to my experience based awarenesses today, relates to the simple fact that mentally ill persons are not inherently criminal by nature; this, at least, in terms of their struggles with mental illness, as may apply. No more inherently criminal by nature then any other human being, as I see it, and no more likely to be identified as persons guilty of crime then anybody else. Unless, that is, you are talking about places like ASH.

Joe Saucedo Gallegos.
At the time of his arrest, 2010,
prior to his admission to ASH.

During the near entirety of my time at ASH, where at least some of trained medical staff far too often treat each and every patient like dirt (and I feel it is safe to presume, as it may be in most all such state managed mental hospitals), as though we the patients are inherently immoral, defective to a point being undesirable, and therein undeserving of the compassionate care that all such public health care facilities are required to provide as per established law and policy. I was, from my first day at ASH, struck by the feeling that I entered some or another third world nation, where it might be taken for granted that deceit and ineptitude are all but the norm. I say this without even needing to go into the theft of some of my personal property as soon as I arrived to ASH, which did occur, and which I will discuss at length in the future. For now, I will continue to focus on the lack of respect directed to persons affected by serious mental illness, and related underrepresentation that has been imposed on state mental hospital patients by just those people who you would expect to know better. Staff psychiatrists, that is.

Case in point #1 (only one of many such examples of my experiences at ASH): In my first formal doctor-patient conversation with Dr. Pervaiz Ahkter, this Pakistani trained medical doctor incredulously stated: 

"Is it really true that you are not a felon? I can’t believe that.”

Akhter posed this question in May, 2011, at which point I had been hospitalized at ASH for over 12 weeks, in spite of the fact that my entire personal records were provided to ASH staff upon my application for admission, as per the civil court order that dictated my right to be provided services at ASH the previous winter. At that point in time, I was yet again floored by the twisted behavioral characteristics of ASH’s psychiatric staff, and it’s worth noting that my first attending psychiatrist at ASH, Dr. Laxman Patel, had already impressed upon me the need to pay serious attention to just how these entrusted medical professionals treated me, in fact (and not solely in a context of actual medical care). But this was a bizarre as hell question in itself, which seemingly came out of nowhere. I well recall sitting there looking at Akhter after I’d quickly responded, “Well, I’m not, and I never will be”, and then taking a moment to more carefully digest the tone of his question; and then, deducing almost as quickly the likelihood that this native of Pakistan was ignorant to a point of ridiculousness. Which I also recognized as a circumstance posing likely threat to my right and need to be treated at ASH with reasonably optimum health care. 

        

I attest to the fact that seriously mentally ill and disabled adults have little to no voice in terms of speaking for themselves, in graphic defiance of the mission of numerous efforts in society today to create avenues of empowerment for mentally ill persons, and that the staff at the Arizona State Hospital capitalize on the their disproportionate power over the patients as a means to preserve egregiously substandard care and practices at ASH. In  public hospitals such as ASH, the stigmatization factor that underlies deeply endemic discrimination against persons affected by serious mental illness and disability is still acutely present; and as per my experiences, behind the fences and doors of the Arizona State Hospital, I further attest to the fact that the most insidious elements of this societal disfunction and related history are still rampantly at work, to the direct and undeniable detriment of all ASH patients, all of it as a matter of standard practice. Many of the most fundamental communications between patients and staff technicians and nurses at ASH are are highlighted by overt prejudices of staff towards the patients, and I literally  encountered staff members at ASH who were willing to treat me like like as something less than human on my first day there. 

In this context, what I also learned during my 13 long months at the Arizona State Hospital is that most of the patients' interests there are managed by guardians (often the state itself) due to the severity of their given mental illness, which means that they have next to no independent voice or immediate recourse if they are in fact abused or otherwise mistreated by ASH staff. As stated, on top of that fact, many of these guardians are state appointed, and as the situation at Arizona Child Protective Services has proven in recent years, the state guardianship program is a disaster, particularly in terms of the at-risk citizens that these agencies are responsible for. 

At ASH, this issue is a double bladed reality, due to the nature of the facility with its high level security status, etc., where no sort of objective oversight is possible, in patent defiance of applicable state and federal laws. The patient advocate at ASH, Sonia Serda, once made it very clear to me that anytime a patient is struck or otherwise abused by ASH staff (this, after I reported having seen two burly male technicians face slam a nonviolent patient, Andy B., into a solid steel door), there is nothing that can be done to address the matter if the patient's guardian doesn't report the incident on that patient's behalf. But these guardians, even in the best of circumstances (if and when the patient has loving family representing them in the context, for example), are not immediately available, this as per very limited phone use restrictions and the willingness of most ASH staff to defer the factual presence of patient abuse to clinical and administrative supervisors who refuse to respond.

All staff members at ASH know these things well, and the majority of them take full advantage it. The fact is, seriously mentally ill adults are extremely vulnerable to abuse, exploitation, and negligence; and in this sense, I was shocked to learn that in a public health setting such as ASH, where one would reasonably expect for the rights and well being of seriously mentally ill persons to be most assuredly preserved, the conditions are in fact in 100% contradiction to any such expectations. Such protections and safety, as per established medical ethics, and rights and liberties provided for via the provisions of the Americans With Disabilities Act [ADA] and the Eighth Amendment of the Constitution, etc., are central to the required obligations of any/all public health care facilities, consistent as well with the actual licensure of such facilities, and that of medically certified caregivers, from the ASH psychiatrists, to senior nursing staff, and so on. It was one of the most frightening aspects of my overall experiences as a patient at ASH to realize that many of the staff there simply suspend the reality that this is the United States, and that the year is 2012, and that they are openly willing to look patients in the eye and say "You don't matter, you can't do anything to protect yourself from me, you are not human.

     Case in point #2: In early April, 2011, my first assigned ASH psychiatrist Laxman Patel, responded to my earliest concerns about patient abuse and staff misconduct at ASH with these exact words:

"What do you expect? This is the state hospital."

Only a few weeks later, out of immature frustration over my continued efforts to get him off his ass and to meet his obligation to address my reports of staff misconduct, Patel went a step further in exhibiting his resentment about my conduct in this context, by stating he would not continue treating me, as follows:

  “Only if you stop with this nitpicking!”

This, from a man who was raised and educated in India, where democratic principles are outside of that nation’s societal and cultural history, and not to mention being devoid of concern for human rights (as illustrated by India’s still in effect caste system); a man who is now (2013-14) filling the crucially important position of ASH's Chief Medical Officer. Patel’s appointment arose after his predecessor, Dr. Steven Dingle, was unreasonably promoted into a executive position in the Arizona Department of Behavioral Health Services, in graphic defiance of his role in the death of April Mott, and a wide range of other like issues that are today subjecting the ASH patient community to substandard care practices and conditions. Indeed, any hospital’s chief executive officer bears the responsibility to ensure that all aspects of clinical operations, which most necessarily requires a degree of character specific to equal ensuring that all patients are provided with optimal quality of care. More specifically, the American Medical Association defines (in part) the job description of chief medical officer as follows (@ ama.org):

“Rather than directly care for patients at the bedside, CMOs act as liaisons between doctors and healthcare executives. It’s the Chief Medical Officer’s duty to ensure patients receive the highest quality treatment possible by hiring, evaluating, and training new physicians. CMOs work to implement cost-effective, efficient medical interventions in nearly all healthcare facilities. Sometimes, CMOs are also hired by government agencies to lead a medical expert team for meeting public health needs on the legislative front. Chief Medical Officers create and enforce the clinical guidelines that make healthcare delivery run more smoothly, and must possess the willingness to adhere to all in-house and legal regulations.

  

2018 NOTE: Who are the criminals at ASH, again? As we all know by now, in the late mid 1990s, Dr. Steven Dingle was identified and disciplined for having engaged in sexual harassment of female residents working under his authority, to a degree that I’m of the opinion that not only does this man lack the character to ensure optimal quality of patient care, but more so, qualifies as one form of sexual predator, wherein via his abuse of authority/power, he willfully took unlawful advantage of women relying on him to advance their medical careers. And as illustrated by the dictate of the AMA, and his role in covering up the escape of Jesus Rincon Murietta in late May, 2011, and consequent death of April Mott, Dingle is quite obviously lacking in a willingness to adhere to all in-house and legal regulations.

As I have already said in this article, this is only one small detail of my overall experiences as a former ASH patient. I attest to the fact that similar exhibitions of grossly substandard practices and related clinical ineptitude arose on a near daily basis throughout the entirety of my 13 long months at ASH, shockingly illegitimate misconduct that intensifies the higher up the ranks of ASH staff you go, extending as such into the executive offices of ADHS/Behavioral Health Services. And no aspect of my efforts to get any member of ASH’s psychiatric staff to step forward on behalf of their patient clientele was responded to in reasonable terms, an abject pattern of negligence that was also exhibited by ASH administrators during my time there, or their given superiors in the department of health.

     

It need be understood that all ASH patients are disabled by virtue of serious mental illness. The willingness of ASH staff to carry on with their systemic abuse of patients day after day is a blatant violation of myriad state and federal laws, and occurs in complicity with various state agencies who are required as per the public trust to protect the rights of all AZ citizens. This misconduct is condoned on the basis of the fact that ASH patients are hindered by disability- which is patently discriminative in all senses- and only occurs due to the fact that, in facilities such as ASH (or places like ASH), all patients are affected by a gravely disabling illness often limiting intellectual function, which effectively rules out the possibility of any patient successfully reporting these issues as they arise.

Only in places like ASH does this sort of abuse so rampantly occur, with the involved staff basically saying in no uncertain terms "You are mentally ill and do not deserve to the same treatment as other people." This is putting it mildly, in terms of how many of the ASH staff act, and in my observations, this was consistently the attitude of the majority of senior ASH nurses, as well as the psychiatric doctors; and once I turned to the administrative staff at ASH, I only learned that much more soundly that abuse(s) of authority and related dereliction of duty is standard practice anytime the needs of seriously mentally ill and disabled citizens are at stake in Arizona's public health care system. 

It's that bad.

IN CLOSING: What will it take to bring about the reform that I contend needs to be implemented if these matters are to be addressed, at the Arizona State Hospital, and beyond in the public state health care system? At a minimum, all concerned persons must openly voice such concern to each and every elected state official in the book, as it may apply. I invite and encourage anybody of like mind to contact me, this in the hope that open and unfettered dialogue can occur on behalf of the seriously mentally ill and disabled patients at The Arizona State Hospital. Well before any such patient was committed to ASH, there were and are still human beings, not inherently criminal or immoral, and deserving of nothing short of all persons' rights in the context of public health care. 

DATELINE 2018: I mention above that I was married to a nurse in 1990s. I only recalled after writing the above 2012 article that she had done a three week rotation in an Albuquerque area, state managed psychiatric facility (Turquoise House) while acquiring her bachelor of science degree; and her informing me that she could not take seriously the idea of ever working in such a setting because of way staff there routinely mistreated their patient-clientele. Likewise, in my first year of law school (2001-2002), during a phase of focus on medical malpractice in Torts One, a visiting attorney stated "You don't even want to get me started on Arizona State Hospital!"; but given that I did not know the actual status of ASH as a public mental hospital, this too I forgot until after my discharge from ASH in 2012. As such, I did have some inking, possibly latent in form, of what to expect my experiences at ASH would be like; in fact, had I known, I most certainly would have resisted the very idea of being committed to ASH, regardless of my attitude about the need to extended treatment in context. 

"I really hope they have something for you up there." Dr. Van Rhodes, who treated me immediately prior to my 2010 commitment to ASH. Since that time, I have spoken with Dr. Van Rhodes about my experiences at ASH, and he has wholeheartedly supported my efforts to advocate on behalf of ASH patients since day one of this blog. 

As discussed in this 2012 article, the role/point of Arizona State Hospital and other like facilities throughout the United States today, is to optimally treat individuals disabled by mental illness. Emphasis here, on illness that is directly associated to the mind (vs. body), which of course underlies why these hospitals exist in the first place; and why any American is, in fact, involuntarily committed to such facilities, on the basis of identified medical need and deserved health care. 

While it may seem silly to even make this point a topic of discussion, it is imperative to consider the fact that such hospitals routinely appoint chief executive officers (and other like administrative staff) who have little if any professional history outside of the corrections industry. State hospitals are hospitals first and foremost, and should not be interpreted as anything else. Having such unqualified persons at the helm of state managed mental hospitals can and does most certainly contribute to the ineptitude of medical staff employed under their authority, including with regard for the willingness of psychiatric physicians to treat their clientele as anything other then and/or less then who those clients are, in fact: Medical patients. 

The underlying fact for why state managed mental hospitals have such horrific histories in terms of patient abuse has everything to do with patient underrepresentation, as that arises specific to the debilitating affects of serious mental illness. It was only after I witnessed (and reported) technician staff on Palo Verde east physically assault my then roommate and friend Andy H., that I learned from then patient advocate, Sonya Serda, about the inability for her to advocate on his behalf until she was granted opportunity to do so by Andy’s guardians (his parents, who resided in Minnesota).    

While it is true that some number of patients in these type of hospitals do have criminal histories, often rather serious- as in felonious- records of outright shocking “criminal” acts that would typically require extended terms in the corrections industry. But no such state hospital patient winds up in these medical facilities without first being processed through the given legal system’s criminal court, be it at the level of state or federal authority, anywhere in the U.S. today. 

There are variations from one state to the next in terms of the findings of prosecutors and judicial authorities in relation to mental illness, this, with regard for persons found “guilty but insane”, or “not guilty by reason of insanity”, and so on. But regardless of these variations, the bottom line in such findings directly relates to the fact individuals experiencing acute or persistent psychiatric disease at the time of the actual criminal act in question are not responsible for those acts. It should be noted that some states, including Arizona, have guidelines by which some criminal defendants found guilty but insane at the time of the act in question shall be treated in state managed psychiatric facilities until such a time that the individual has been “restored to competency”; wherein the individual shall be referred back to the involved criminal court, and again be indicted for the criminal act in question at the original trial proceeding wherein the defense of guilty but insane granted such individuals the right to receive medical care in state managed medical facilities. 

Joe Saucedo Gallegos
March 2012. After that
point in time that he was deemed
"restored to competency," discharged
from ASH, and retried for having
killed two young boys
in 2010.

In my time at ASH, I came to know (not always pleasantly) a patient named Joe Saucedo Gallegos. I did not know at the time that Gallegos had bludgeoned two little boys to death with a baseball bat in 2010, or that he was a candidate for future indictment and prosecution on the basis of (possibly) being restored to competency. It was only after I left ASH in February, 2012, that I became aware of Gallegos history in this context; and it was only a few months after then that Gallegos was, in fact, deemed restored to competency by the medical staff at ASH, and thus, retried- and convicted- for the original crime in question. Subsequently, Gallegos was sentenced to two separate life sentences in prison with no opportunity of early release. 

As always, and despite my at times negative interactions with Joe Gallegos, I wish him and his family well; and while it is doubtful, I also sincerely hope that he is being reasonably treated for his known psychiatric care needs in Arizona’s state prison system. 

This concern also applies to the fact that Jesus Rincon Murietta is also an inmate in Arizona’s prison system today, a man also affected by serious mental illness, who in all senses should have been returned to ASH prior to the brutal murder of April Mott. This would not be the case, if only Dr. Steven Dingle and virtually all other members of ASH’s medical staff had met their obligations to the public trust in association with Duty to Warn, and openly reported Jesus Rincon Murietta’s escape and presence in Phoenix’s public community. 

Herein again, the fact some state mental hospital patients have very disturbing histories in terms of criminal conduct. But this does not justify any physician or other like medical staff in state mental hospitals to put aside their obligations as per the Hippocratic Oath, etc., in favor of focussing attention on any patients personal history unrelated to identified health care needs. As such, regardless of the whether such individuals have criminal records, it is responsibility of state managed mental hospitals to prioritize the health care needs of each and every patient committed to these facilities, and again, with no emphasis or attention upon issues specific to the legal system. 

As illustrated at the beginning of today’s article, former-since fired ASH CEO Cory Nelson, and his compatriot Jeff Bloomberg, a former-since fired attorney who worked as a “rules expert” for the Arizona Department of Health Services during Nelson’s tenure at ASH, both came to Arizona with far more experience in corrections then anywhere else (Nelson, in fact, left South Dakota under a cloud of fiscal scandal). 

I graphically came to understand how and why the presence of such individuals in executive positions in health care poses threat to the welfare of Hospital patients at that point in time when I had to deal with Nelson on a personal basis, in direct relation to his willingness to overtly retaliate against me on the basis of my openly reporting unlawful staff misconduct to the state’s Office of Human Rights; retaliation that long time ASH chief medical officer Dr. Steven Dingle was 100% complicit in allowing for (he and Nelson both and oh-so foolishly signed the document whereby this retaliation occurred.)

Specifically speaking, no aspect of Hospital protocol was followed when, with no formal notice at all and one business day following the submission of a grievance that had been prepared on my behalf by staff of the Office of Human Rights, I was summarily relocated from ASH’s most peaceful treatment unit, Palo Verde east, to one of the most violent, Desert Sage east (which is where, not so coincidentally, I encountered Joe Saucedo Gallegos). Likewise, with direct reference to Nelson’s role in the death of April Mott in late August, and the related cover-up of Jesus Rincon Murietta’s escape three months earlier, I came to the conclusion that the one person most entrusted to oversee the ASH operation was arguably devoid of understudying the rights and care needs of his patient-clientele at ASH.  

Not that I agree with it, retaliation is an issue well known to the operation of state prisons, and one does not have to be corrections official of inmate to recognize this. “Snitches”, staff associated coercion and intimidation, punitive actions on the basis of inmate complaints, and other such issues are common place in virtually all corrections institutions today, as they long have been. 

But the presence of retaliation and other such staff based misconduct  is perhaps not so commonly known when it comes to the operation of state managed mental hospitals. As the attorney who very recently spoke at a meeting of the ASH Human Rights Committee made clear, administrative abuses of authority arise in places like ASH far more regularly then she would have ever imagined prior to her becoming familiar with issues arising there even today. And out of overt resentment towards any threats to the status quo,  these abuses of authority do include, at times, the role of CEO’s such as Aaron Bowen, who may well take action against employed individuals willing to conscientiously speak out of the patient community,  and/or bodies of patient advocacy- e.g. ASH’s Human Rights Committee.

This is precisely why persons trained and most experienced in the prison industry should not be granted the responsibility of overseeing the operation of state managed mental health care  facilities. The risk of furthering known violations of law and policy when such individuals are appointed to such positions is far too great, and I contend that persons such as Dr. Cara Christ (who appointed Bowen as ASH’s current CEO) should know this. As should have her predecessor, Will Humble, who hired and appointed former-since fired Cory Nelson and Jeff Goldbloom in 2011.

Until these highly entrusted health care officials get up to speed with the overall realities specific to mental health, and the needs and rights of persons affected by mental illness who just so happen to wind up in ASH, I can all but guarantee that we will yet again see the need for the federal government to directly intervene; and can guarantee, in fact, that PJ Reed The Arizona State Hospital and Patient Abuse will continue to expose any/all known violations of patient rights and related shortfalls in patient care there. 

paoloreed@gmail.com