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Eastern State Hospital (WA) and Photovoice August 18, 2010

Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, mental illness.
Tags: , ,

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.



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