Mental Health and Competency Restoration in Washington January 29, 2013Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital.
Tags: Involuntary Committment, Mental Hospitals
Imagine having a mental health crisis and finding yourself in a county jail, with little or no mental health treatment, isolated with no direct human contact, in a cell with no toilet or furniture for 23-24 hours a day, wearing only a smock, as days become weeks, then months, all while the symptoms of your mental illness get worse.
According to a report, released today by Disability Rights Washington (DRW), this is a recurring problem in local jails across Washington State. Over the last few years, people with mental illness, intellectual disabilities, and traumatic brain injuries have had to wait for several weeks or even months to get an evaluation to see whether or not they are competent to stand trial. If they are found incompetent to stand trial, they often wait additional weeks or months to get services at the state hospital where there is mental health treatment designed to restore competency to stand trial. While they wait in jail, they are held with little or no mental or behavioral health treatment, often under severe punitive conditions for disability-related behavior. This includes being held in isolation, where their mental health often deteriorates.
Individuals may be held for low-level infractions, like trespassing or vagrancy, often because mental health services were unavailable. “It is unacceptable that people end up in jail facing criminal charges simply because they cannot obtain the mental health services they need in the community. We are turning these individuals into prisoners when they should be patients,” said Emily Cooper, attorney with DRW.
“Jail is the worst possible place for people struggling with serious mental illness. As a society, we need to stop the pattern of unnecessary incarceration of people with mental illness,” said Gordon Bopp, President of the Washington Chapter of the National Alliance on Mental Illness (NAMI). “They are not criminals. Nobody chooses to have a mental illness, and therefore nobody should be jailed for having one. Instead, they should be offered treatment,” Bopp said.
Along with sheriffs, mental health providers, judges, prosecutors, defense attorneys, and disability advocates, DRW has worked on this issue through multiple legislative sessions. Last year, the Legislature adopted an aspirational, seven-day performance target for the completion of competency evaluations and state hospital admission for restoration services. The Joint Legislative Audit Review Committee confirmed in a report issued last month that the state hospitals are failing to meet this target, and the time people spend in jail awaiting evaluation and treatment is growing.
“The longer a person with a mental health crisis spends in jail, the more devastating and long-lasting the consequence,” said David Lord, DRW Director of Public Policy. “Eliminating the excessive time these individuals spend in deplorable jail conditions must be one of the highest priorities of the legislature,” Lord said.
From January 25, 2013 report from Disability Rights Washington “Lost and Forgotten: Conditions of Confinement While Waiting for Competency Evaluation and Restoration”
Mental Illness and Smoking November 16, 2012Posted by Crazy Mermaid in Anxiety, Involuntary Committment, Smoking and Mental Illness.
Tags: Anxiety, Involuntary Committment
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Not a smoker myself, I had the luxury of watching the etiquette of cigarette smoking unveiled right before my very eyes as I roamed the small courtyard at our 15 minute cigarette breaks during my three week stay at the mental hospital.
Without the luxury of time afforded their rich brethren with their ready-made cigarettes like Camel and Virginia Slims, the homeless patients- who comprised more than half the mental hospital population- managed to use their ingenuity and creativity to make cigarette rolling into an art form, combining speed and efficiency. It was fascinating to watch a patient impress his rolling technique with his own personality. Some rollers – mostly men- fancied thick, squatty joint-looking rolls. Others- mostly women- preferred thinner, more ladylike cigarettes. Each cigarette had its own distinct look. It was amazing how much variety could be squeezed out of the same ingredients. Who knew that tobacco and rolling paper could be formed into so many individual shapes while still retaining their purpose?
As a nonsmoker, I was initially offended by this dichotomy: serving cancer sticks to the ill seemed morally bankrupt. Later on, I came to understand the stabilizing influence of tobacco. Its anti-anxiety effect became crystal clear to me as I watched the nicotine-deprived mentally ill patients visibly calm down after the administration of a cigarette or two. Forcing a psychotic patient to suddenly stop smoking was not good medicine, I came to realize. Besides, if the nicotine was looked upon as an anti-anxiety drug, then its administration to a suicidal patient became an action similar to administration of morphine to a cancer patient. Side effects, in other words, are relative.
Watching the daily calming influence of nicotine became a siren call for me to take up smoking, much to my husband’s chagrin. His daily visits, usually during smoke breaks, were spent watching me learn to roll cigarettes, and then having to listen to my explanation of why I was going to start smoking. To his credit, he neither discouraged nor encouraged me, sensing that any direction whatsoever to a psychotic mentally ill person- especially his wife- would be useless and even counter-productive.
My announcement to the nursing staff of my intention to start smoking was met with less than enthusiasm. The nursing staff, viewing my intentions as simply another manifestation of my mental illness, did everything they could think of to discourage me from lighting up. But the reality was that the same tobacco and rolling paper the homeless used was also available to anyone who wanted to start smoking. Even me.
My anxiety, from the medications as well as the illness, was enormous. Unbearable, even. It was so awful that I would do anything, try anything, to alleviate as much anxiety as I could. The prospect of dying of lung cancer paled compared to the anxiety of desperately wanting to crawl out of my skin. If smoking would relieve even a small portion of that horrible anxiety, I reasoned, then the price was more than worth it.
While not outrightly engaging in any sort of discriminatory behavior, the nursing staff nevertheless managed to communicate their dislike of smoking, stopping short of suggesting to the smokers that it might be a good time to quit. They realized the very strong stabilizing effect of tobacco on their charges’ psyche. But while they didn’t actively engage in trying to get people to stop smoking, Hell was going to freeze over before they were going to allow a non-smoking patient to take up smoking.
Their first line of defense was to try to reason with me. Didn’t I realize that the reason the drug (tobacco) calmed people down was because it was a “fix” from the habit of smoking? That it really didn’t alleviate anxiety like the anti-anxiety pills did?
But I wasn’t buying any of their bullshit. They were lying to me. I was convinced the drug really was like an extra dose of the anti-anxiety pills. Besides, the doctors limited the number of those pills we could take, but not the number of cigarettes we could smoke. It was, I believed, like getting an extra dose of Klonopin. Besides, all my new friends smoked.
In the end, I couldn’t make my mind up whether to start before I was discharged from the hospital. Once out of the smoking environment, I totally forgot about my desire to take up smoking. Besides, the tools- the tobacco, paper, and rolling machine- were no longer at my fingertips.
M medication is stabilized and I no longer have that incredible surge of anxiety through my system…most of the time. Although I am glad that I never took the habit up, I no longer pass judgment on the smokers of the world.
Murder, Ian Stawicki, and House Bill 3076 June 21, 2012Posted by Crazy Mermaid in Committment Hearing, Involuntary Committment.
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June 21, 2012
Editor, The Seattle Times
Some people blame the City of Seattle for the recent murder of five unsuspecting people by Ian Stawicki. I blame the taxpayers of Washington and the government.
The problem, in a nutshell, is with the mental health system, which was brought on by the State’s refusal to fund a bill that would have had Stawicki involuntarily committed. At the point he was diagnosed as mentally ill (because of the involuntary commitment), he would have been denied the ability to purchase guns as well as been started on a medical treatment for his disorder. Since he was never diagnosed as mentally ill (because House Bill 3076 was never funded), he was not prohibited from possessing a firearm. But because of a lack of funding (and a lack of mental hospital beds), Ian was allowed to roam free, wreaking his havoc among the people in Seattle.
Currently, as the law reads, a person can be involuntarily committed only when a third party, the Designated Mental Health Professional, does an independent assessment of a person who is thought to be an imminent danger to himself or others. This changed with House Bill 3076. In that bill, the DMHP could rely on testimony from friends or family members of those who clearly have a mental illness. As it stands now, input cannot be given by family members or friends of a suspected mentally ill person. But House Bill 3076 changes all of that. With the new bill, however, come costs. The big problem with passing and funding House Bill 3076 is that there aren’t enough hospital beds to take those people who would have been involuntarily committed because of testimony of friends and/or loved ones. So the State acknowledges the need for such a place, but declines to do anything about it.
So when there is a lot of handwringing and rhetoric about the state of the mental health laws, I have little or no sympathy for those doing their handwringing. NAMI (National Alliance on Mental Illness, a grassroots organization for those suffering from mental illness and their friends and loved ones) has testified before Congress at the need for such facilities. But we are always told it is too expensive to fund. This is what happens when needs are ignored. There will be more Ians because of this situation.
Until Congress and the State of Washington take steps to build hospital beds for those people like Ian to go get help, there will be more cases of mental illness-sparked murders. So if we are truly concerned about people like Ian, who clearly have an undiagnosed and untreated mental illness, and his victims, nothing will change.
People on the radio and tv have wrung their hands about people like Ian getting access to firearms. But until House Bill 3076 is funded, there will be no diagnosis of mental illness, and there will be continued access to guns by those with no business owning one.
The Law and Involuntary Commitment January 2, 2012Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, mental illness.
Tags: Involuntary Committment, Mental Hospitals, mental illness
You’d think that once a bill gets passed by the House and Senate and signed by the Governor, there would be no question whether the bill goes into effect. But that’s not true.
Back on March 17, 2010, I posted a blog entry about the passage of House Bill 3076. I was excited because it would no longer required Designated Mental Health Professionals to disregard evidence given by friends and family members of people with severe mental illness in their decision of whether to involuntarily commit a person with severe mental illness. Prior to this law, the Designated Mental Health Professional could not take into account testimony by friends and family members regarding the mental state of their friend or loved one.
Senate House Bill 3076 was a major victory for people with severe mental illness because it enabled them to get much-needed help by enabling their friends or loved ones to give evidence to the Mental Health Professional doing the assessment of the person with severe mental illness to determine whether that person should be involuntarily committed.
“Chapter 280, Laws of 2010 (Second Substitute House Bill 3076) expanded in two ways the factors that Designated Mental Health Professionals and the courts may consider when determining whether to commit a person to involuntary treatment. First, the 2010 law provides that a Designated Mental Health Professional must consider all reasonably available evidence from credible witnesses when determining whether to detain a person. Credible witnesses are defined as family, landlords, neighbors, and others with significant contact and history of involvement with the person. Second, the 2010 law additionally provides that, in determining whether to detain and commit, Designated Mental Health Professionals and the courts may consider symptoms and behavior that, standing alone would not justify commitment, but that show a marked deterioration in the person’s condition and are closely associated with symptoms and behavior that led to past involuntary psychiatric hospitalization or violent acts. The 2010 law set January 1, 2012 as the effective date for both of these changes”
At the time the bill was passed, I assumed that it would become effective immediately. In fact, I assumed this whole time that it was in effect. That assumption was obviously wrong. Had I read the bill more closely, I would have known that the law wouldn’t become effective until January 1, 2011.
I made another assumption as well. I assumed that, once the law came into effect, it would not and could not be revoked. That, too, was an assumption that was wrong.
In fact, another bill, Senate Bill 5987, gutted House Bill 3076. I was shocked at this turn of events.
Basically, the summary of Senate Bill 5987 changed the effective date of the 2010 statuary changes from January 1, 2012 to January 1, 2015.
The reason for the change, said the Staff Summary of Public Testimony, is that there isn’t sufficient treatment capacity to meet current involuntary needs, let alone increased demand. Already, said the new bill, between 25 to 50 percent of all persons involuntarily committed in King County are “boarded” in facilities that are not certified to accept such patients. The legislation, it said, needs to be passed in the special session before the January 1, 2012 effective date of the original legislation. Department of Social and Health Services supports to purpose of the 2010 legislation, but lacks the resources to implement it.
Although it is frustrating that the law is now delayed another three years, the reason it was delayed makes perfect sense. It’s yet another victim of our funding crisis.
Involuntary Commitment in Washington State November 1, 2011Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, mental illness.
Tags: Involuntary Committment, mental illness
Washington State Mental Health System: Involuntary Commitment
At all times in the legal process, patients have the right to agree to entry of a court order detaining them in a facility. Involuntary commitment should not be confused with competency to handle financial and legal affairs. Patients have the right to refuse psychiatric medication 24 hours prior to any court hearing. Patients have the right to have: an attorney to represent them (a public defender if unable to afford private counsel), witnesses to testify for them, to cross-examine witnesses against them, and to present documentary evidence. Patients have the right to testify or to remain silent. The Rules of Evidence apply to these hearings. Patients have the right to view and copy all petitions and reports in the court file as well to have adequate time to prepare for the hearing. Hearings are not closed but the patient has the right to object to the presence of others not involved with the case. The court decides if the hearing should be closed.
Basis for Involuntary Commitment
A person can be detained on any of three grounds: likelihood of serious harm to others; likelihood of serious harm to self; or most commonly, grave disability. Grave disability is defined as a condition in which a person, as a result of a mental disorder (a) is in danger of serious physical harm resulting from a failure to provide for his or her essential human needs of health or safety, or (b) manifests severe deterioration in routine functioning evidenced by repeated and escalating loss of cognitive or volitional control over his or her actions and is not receiving such care as is essential for his or her health or safety.
A person can be detained by a Designated Mental Health Professional for up to 72 hours without a court order. The 72 hours does not include weekends or legal holidays. When being interviewed by the DMHP, the patient has the right to speak to an attorney and the right not to participate in the DMHP’s evaluation. The legal standard for the initial detention is probable cause.
14 Day Hearing
If the patient is not ready for release within the 72 hours, a petition for involuntary treatment is filed seeking detention for up to 14 days (calendar days). If the patient elects to have a contested hearing, then a judicial officer decides the outcome. There is no right to a jury trial. The petitioner cannot request detention for any other period of time (i.e., 9 days or 13 days). Once the court order is entered, the petitioners can release the patient before 14 days is completed if the patient is ready for release. The legal standard is preponderance of the evidence.
90 Day Hearing
If the patient requires treatment beyond 14 days, then a petition seeking detention for up to 90 days (calendar days) is filed. The petitioner cannot file for another 14 days nor for any other number of days. It has to be up to 90 days. The patient has a right to a jury trial (using a jury of 6 or 12 persons) or to have a bench trial as in the 14 day hearing. Jury trials may take up to 20 business days to occur. The patient also has the right to seek a second opinion regarding their mental status as well as the use of a professional such as a social worker to seek less restrictive placement for the patient. There may be a preliminary hearing for the court to formally advise the patient of his/her rights as well as to allow the attorneys and the court to deal with scheduling issues for contested cases. Once the 90 day order is entered, the petitioners can release the patient early if the patient is ready for release. The legal standard is clear, cogent convincing evidence.
180 Day Hearing
If the patient requires treatment beyond 90 days, then a petition for 180 days (calendar days) is filed. The petitioners cannot ask for another 90 days. It has to be 180 days. As with the 90 day hearing, the patient has the right to a jury trial, a second opinion and a preliminary hearing. The legal standard is clear, cogent and convincing evidence. The petitioners can release the patient early if the patient is ready for release.
Less Restrictive Alternatives
At any point the petitioners can ask that the patient be on a Less Restrictive Alternative (LRA), court-ordered treatment outside of the facility. Conditions the patient must comply with include living at a specific address, maintaining compliance with treatment, taking medications as prescribed, refraining from threats or acts of harm to self, others or property, as well as maintaining one’s own health and safety in the community. Possession of firearms is prohibited. Failure to comply with any of the LRA conditions results in being returned to the facility for a revocation hearing. The rights in Step 1 apply to revocation hearings. If the LRA is revoked, the patient is detained at the facility for the remainder of the commitment period (e.g., revoked 30 days into a 90 day LRA = 60 days at the facility). The patient may later be re-released on a new LRA. LRAs can be extended in 180 day increments (they start with 90 or 180 days).
This article was written by Carolyn Annette Elsey.
My experience was very different from the way this article is laid out. The Designated Mental Health Professional that handled my case interviewed me in a local hospital to determine whether I should be put on a 72 hour hold. I entered the local hospital at around 10:00 a.m., and the DMHP finally interviewed me at around 5:30 p.m. She determined that I should be involuntarily committed, and the search was on to find a mental hospital that would take me. It took until midnight for a bed to open up. At that point, I was strapped to a board (a four point restraint system) and loaded into an ambulance for my trip to the mental hospital.
Around 48 hours after I arrived a the mental hospital, the mental hospital presented me with a public defender who was supposed to represent me before a judge to determine whether I was going to be committed for 14 days. Unfortunately for me, that representative took ill the day of my hearing, and I was represented by a different public defender who didn’t know my case. In order to transport five of us to the court, we were loaded onto a van with windows tinted so dark that we couldn’t see out. The interior was outfitted to transport prisoners. We had no idea where we were going, and no one told us anything. When we got there, contrary to what this article says, I was not allowed to say anything to the judge in my defense at my hearing. I sat there in disbelief as the hearing happened right in front of my eyes as if I were a piece of furniture.
As a practical matter, when I was involuntarily committed, I wasn’t privy to the laws, so I didn’t know that my rights had been violated. Besides, who would I, a “crazy mental patient”, complain to?
Close to the end of my 14 day hold, the hospital wasn’t ready to release me, so the original public defender (who had fallen ill before my first hearing) again represented me at my second hearing. But she convinced me not to attend the second hearing. As I hadn’t been involved in the first hearing, I assumed the next hearing would be a duplicate of the first (with no opportunity to speak), so I went along with her recommendation and stayed away.
I was released a week later, which meant I spent 21 days in the mental hospital at a cost of almost $60,000. But it was a conditional release, called Least Restrictive Treatment (LRT) instead of the Less Restrictive Alternative it was called in this article. They pointed out to me that I was still in treatment, and that if I didn’t follow the LRT, I would be re-committed to the mental hospital.
Trapped in Involuntary Commitment May 11, 2011Posted by Crazy Mermaid in Involuntary Committment.
Tags: Involuntary Committment
As I stood outside, I glanced around the small courtyard, taking in my surroundings. A fifteen foot high chain link fence topped with two layers of razor barbed wire surrounded the south and east sides of the compound. The building itself served as a fence on the south side. A six foot high wrought iron fence with a small (locked) gate served as a sentry for the west side of the courtyard. The whole effect made an impermeable barrier from the outside world, discouraging anyone from trying to run away from the mental hospital.
Hours before, I had just learned that I had been involuntarily committed to a mental hospital. As I came to realize the enormity of that fact, a sense of claustrophobia engulfed me. I realized that I had been imprisoned, and there wasn’t a reason why. I had been pulled out of society and stuck in a jail in some god-forsaken place, unable to even learn what city I was in.
They didn’t and wouldn’t call it jail, but that is in effect what involuntary commitment really is. If you can’t leave when you want to, then you’re in jail. If they won’t tell you when (or if) you’re ever going to be released, then you’re in jail.
Some people would argue that being locked up on a psych ward is no different than being on a job that you hate. I argue that in the case of the job, although you might feel trapped, you are in fact free to quit if you want to. You can walk out of your “jail” any time you feel like it. The consequences might be such that you can’t afford to leave, but in fact you are free to walk away at any time and no one can or will stop you.
I, on the other hand, wasn’t being paid to be there. In fact, unbeknownst to me at the time, I was being charged between $2,500 and $3,500 a day to be there.
I have never been one to stay in situations where I felt trapped for very long. If someone tried to hold me down, I would kick and scream and bite until they finally decided that I wasn’t worth the effort.
In the case of hospitalization, no amount of trying would free me from my captors.
The daily grind of captivity lasted almost three weeks, and the worst part was that no one could tell me when (or if) I would be released. It was up to my psychiatrist, and he wasn’t willing to let me out until I could comply with a set of criteria that I was not allowed to know about. For obvious reasons, they guarded that criteria from me because they knew that if I found out what that criteria was, I would do my best to trick them into thinking that I had complied in order to get out of “jail”. The object of their game was to get me to fulfill that criteria without a hint from them of what that criteria was. I tried and tried to figure out what that criteria was, but in the end I wasn’t successful. Eventually, as I would later learn, I was released ($60,000 later) when my insurance benefits came to an end.
There is no sweeter feeling than being released from a prison. After 48 years of taking freedom for granted, that three weeks made me realize just how easy it is to get your freedom snatched from you, as you stand helplessly by. I never want to experience that jailed feeling again.
Reluctant Gertie: Unwanted Medication February 3, 2011Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, mental illness.
Tags: Involuntary Committment, Mental Hospitals, mental illness
“You have to.”
“I won’t!” said Gertie, a 350 lb white woman dressed in a hospital gown, squeezed into a chair next to a blood pressure machine at the nurse’s station.
“Please, Gertie. We’ve been through this already.”
“You have no right…”
“We have every right, Gertie,” said Marjorie, the nurse handing out medication. “We’ve already been through this. Don’t you remember what happened before when you refused to take your medication?” She shook the cup of pills at Gertie. “Go ahead and take these.”
“But I don’t like the way they make me feel.”
“I’m sorry, but the doctor said you need to take these.” She rattled the cup again. “Please.”
Gertie shook her head.
“Then I have no choice. We’ll have to give your medication to you intra-muscularly, Gertie. Just like we did before.”
Gertie continued to shake her head. “No.”
“Shall I get the other nurses?” asked a red-headed nurse in a pink tunic.
Nurse Marjorie nodded her head. “I really don’t want to do it this way, Gertie, but you’re giving me no choice.”
“Please don’t do this, Nurse,” begged Gertie.
“I’m sorry, Gertie, but I have no choice in the matter. You know that.”
“Our Father Who Art In Heaven. Please deliver me from having to take these pills,” Gertie prayed.“Please Nurse. Please. Don’t,” begged Gertie.
By this time, three other nurses had arrived
“Please God, save me from these evil nurses and their injection,” prayed Gertie as the nurses positioned themselves strategically around her.
As Nurse Marjorie prepared the syringe, I caught sight of a long needle.
“Please Gertie, don’t make me do this,” she begged.
“PLEASE GOD! DON’T LET THEM!” screamed Gertie.
All at once, the nurses grabbed Gertie, holding her down as Nurse Marjorie plunged the needle deep into Gertie’s thigh.
“NOOOOO!” screamed Gertie. “THEY’RE KILLING ME!”
The injection complete, the nurses released their grip on Gertie.
“There. All done, Gertie,” said Nurse Marjorie, her voice shaking slightly as she fastened a band-aid on the injection site.
By this time, the entire ward was shaken up, having watched this gruesome display.
“I think it’s time for a special Smoke Break,” said Nurse Marjorie. “Everyone outside!”
(Excerpt from my book, I Thought I Was A Mermaid)
A Case for Involuntary Commitment January 1, 2011Posted by Crazy Mermaid in Involuntary Committment, Medication, Mental Hospital, mental illness.
Tags: Delusions, ESP, Involuntary Committment, mental illness
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As part of my psychotic experience, I believed that I had ESP (extra sensory perception). I thought I had famous people as part of my entourage, hanging on every brilliant “word” coming out of my “mouth”. At first, these conversations took place entirely inside my head, without me uttering a single word. However, towards the end of my psychotic experience, my need to talk out loud to them became very strong. Too strong to ignore.
Thanking God for Bluetooth technology, I decided that talking out loud to my friends would be mistaken by everyone who witnessed it as simply conversing on the cell phone, as long as I had my “ear bud” in my ear. So I began wearing my “ear bud” everywhere except to bed.
In this section from my memoir (called I Thought I Was A Mermaid), I had just driven to Walmart (really) to go shopping with my (imaginary) friends.
(Note to blog readers: As far as the people with me go, they were a mixed bag. Although I had never met the real Claudia, she was in fact a real person whom I had heard about and wanted to meet. Mike was actually based on my (real) boss at Mortenson, where I was a project manager on a $55 million ice hockey rink under construction. Bill Gates needs no introduction, except to say that although I had never met him in real life, my circle of friends (really) included someone who had (really) worked with he and Melinda Gates, his wife, at Microsoft back in the day.
Rolling into the colossal Walmart parking lot, I turned off the key.
Me: Here we are, everyone!
Claudia: I can’t believe how nice the cars are. I thought they’d be all dumpy and old and stuff. But they’re not too bad. Even a Lexus or two.(Note to blog readers: the people I conversed with could see through my eyes, so they saw exactly what I saw).
Bill Gates: I’ve never been to a Walmart before. But I know someone who has. And she’s dying to meet you. Oprah Winfrey, meet Kathy. Kathy, meet Oprah. I was shocked, to put it mildly.
Me: I never expected to meet you in a million years, Ms. Winfrey.
Oprah: Call me Oprah, Kathy. And it’s very nice to meet you.
Me: It’s nice to meet you also.
Oprah: I’ve been hearing a lot about you, Kathy. Bill and Melinda Gates are friends of mine. When I heard they knew you, I begged them for an introduction. And it’s so funny that I’d meet you here in a Walmart parking lot. I grew up with Walmart.
During my three week involuntary hospitalization (at Fairfax Mental Hospital), I continued to believe that I had ESP. The day I was released from Fairfax, I met my new psychiatrist for the very first time. After my meeting with him, I believed that I talked with him via ESP during my car ride home.
My point is that it took over a month for the medication, initially forced on me during my hospitalization, to finally kick in enough that I no longer believed I had ESP. Without involuntary commitment and its accompanying medication, I would still believe I had ESP and I would still be talking out loud to my imaginary friends. At first I fought tooth and nail, but in the end, involuntary commitment saved my family and I from a terrible fate.
Anatomy of a Breakdown September 23, 2010Posted by Crazy Mermaid in mental illness, Delusions, Hallucinations, Involuntary Committment.
Tags: Delusions, Hallucinations, mental illness
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Looking back at my diaries of 2 years ago, I again became enmeshed in my identity crisis. It reminded me of how difficult it was to lose who I was. And to find out that who I was wasn’t exactly pleasant.
Before I became psychotic, I was Kathy 1. Then, when I became psychotic, so many things about me changed that I lost my identity as Kathy 1. While I was psychotic, this change from Kathy seemed a very natural turn of events, since my delusion had included my belief that I had always been someone else. According to my delusion, I was, and always had been, a mermaid named Pangea. For 48 years I just never knew it.
During my psychotic break, Kathy 1 was no more, wiped out of existence, replaced by an entirely new personality: Pangea the Mermaid. Transfering my identity from Kathy 1 to Pangea was easy. It was an act initiated by me. It was an act controlled by me. I was drawn in gradually over a four month span of time into my new identity as Pangea. My final act of recognition of this sea change was that I planned to change my real legal name to Pangea. But before I could carry out my plan, I was involuntarily committed to a mental hospital.
When I was hospitalized, the staff began the long process of stabilizing me. Part of that process was administration of medication that pushed me out of my delusion that I was Pangea. Logically, removing Pangea from the equation should have left me back at identifying with Kathy 1. Unfortunately (or not), this didn’t happen.”
It’s difficult to put into words, but the person who was Kathy 1 had certain thought patterns, certain ways of doing things, certain tastes in clothing, hair styles, and expressions of who she was, as well as a much faster speed of thinking, and other brain-related characteristics that made up her very soul. Her very existence. Those characteristics are gone.
There’s a void where my identity is supposed to be. I try to feel a familiar pattern of thinking or feeling or being and there’s no familiarity at all. Zero. I have no idea who I am. It’s as if I woke up in someone else’s brain. I have no reference points. I’m in a strange place and can’t find my way back to who I was before. But then do I really want to return to that person?
Through counseling, I learned to analyze all of the little choices that Kathy 1 made in her life that brought her the total control that she was looking for, which ultimately led to her complete break with reality. Little things and big things loomed in my head. Overall, I realized that my efforts at control not only led to my complete break with reality, but in the process had turned me into what I would term a “flaming bitch”. I had attempted to control virtually every facet of my life down to the last speck of dirt in the house to the greatest extent possible. Everything was always about me. It was embarrassing to come to this realization at the age of 48. How horrible, how narcissistic. It was depressing to consider all of the wasted years, all of the misery, that I had inflicted on people, including those I loved, through the years. Was there anything I could do to make up for my past bad behavior?
I need to find out how to get me back to who I was before- only nicer. And if I can’t do that, then I need to figure out who I am now. For lack of a better word, I’ll call myself Kathy 2. I need help to discover who she is.
Eastern State Hospital (WA) and Photovoice August 18, 2010Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, mental illness.
Tags: mental illness, Mental Hospitals, Insanity
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At a recent NAMI Conference I attended this past weekend, I had the privilege of listening to Dr. Jeff Ramirez and Ms. Elaine Alberti discuss the culture of Eastern State Hospital (http://www.dshs.wa.gov/mhsystems/esh.shtml). Housing involuntarily committed civilly committed patients as well as patients who have been acquitted of committing crimes due to the fact that they were found Not Guilty By Reason of Insanity, the hospital is located in Medicine Lake, a rather isolated part of the State.
Dr. Ramirez and Ms. Alberti brought with them a wonderful Photovoice display, which showcased the work of some of the patients. Bringing the voice of hospitalized patients to the outside world, the powerpoint was a very powerful demonstration of the sometimes-forgotten humanity behind the various incarcerated individuals housed at that facility.
In an experiment designed and conducted by a clinical nurse specialist, a group of patients had the opportunity to participate in photo sessions in which they took pictures every other week. Photos were taken in and around the hospital grounds. Patients were not allowed to leave the grounds in order to take photos.
Taking four photos at each session, those photos were developed for the patients. Then, during group sessions, the photos were handed out to each patient. Patients put meaning and interpretations to their photos, sharing those meanings and interpretations with the group.
The clinical nurse specialist in charge of the program assisted the group in categorizing the narratives into four overarching themes: finding meaning, expressing anger, fighting stigma, and finding hope. Each of the photos were identified as belonging to one of those four groups. The resulting collage of photos were combined and set to music, and the end product was shown to the staff as well as others. Giving voice to the patients, it presented itself as a strategy to help reduce seclusion and restraints. Delivering a powerful message to all who saw the presentation, it resulted in a 96% reduction in restraint use.
Unfortunately, one of the unintended consequences of the escape of Philip Paul, the Eastern State mental patient, included the dissolution of this program. For about 4 months after Philip Paul’s escape, patients were in total and complete lock-down, unable to even get to their treatment mall to receive their medication much less take photographs even inside the hospital grounds.
For those unfamiliar with his story, Philip Paul was incarcerated at Eastern State Hospital in eastern Washington for the death of Ruth Motteley, a woman whom Paul thought was a witch. He said that voices in his head told him to kill her, and he obeyed them. Diagnosed as a paranoid schizophrenic, he was found not guilty by reason of insanity and taken to Eastern State Hospital, where he has been held on and off since April 1987, escaping from a field trip to a fair on September 17, 2009. The history of his incarceration can be found in a September 21, 2009 article in the Spokane Review (http://www.spokesman.com/stories/2009/sep/21/key-developments-pauls-legal-history/).
It’s unfortunate that a program with the success rate of this one has been cast aside because of the behavior of a few.