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6 Year Anniversary of Involuntary Commitment June 23, 2014

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Today is the 6 year anniversary of the day I was released from Fairfax Hospital after spending over 3 weeks involuntarily committed there. A lot has changed.

Fairfax Hospital
Before I was committed, I had only vaguely heard about mental illness. I knew one person who claimed to have bipolar disorder, but I had no idea what that phrase even meant. The guy with that diagnosis was emotionally unstable, and made poor decisions in his work life and especially his personal life. I attributed his poor decisions to a lack of moral character rather than to any mental illness he might have been suffering from.
As a large portion of society does, I classified depression as something other than a mental illness. My mother and sister both suffered from depression, and it seemed like a lack of moral fiber rather than something they had no control over. I considered them weak because they took medication to ally some of the symptoms.
When I woke up in the hospital, I had no idea where I was. I had never heard of Fairfax and never in a million years would I have guessed such a place could exist a mere 5 miles from where I used to live. Mental illness was invisible to me.
Like many other people, I only heard about schizophrenia as it relates to someone’s bizarre and dangerous behavior in the news, never having knowingly met someone suffering from that illness. I thought all of those people should be locked away somewhere in an insane asylum where they couldn’t harm anyone.
As a productive, innovative, and intelligent member of the working world, I was used to calling the shots, in both my personal and professional life. I had money to spend however I saw fit. That all changed once I was released from the confines of the mental hospital.
While hospitalized, I wanted my family to tell everyone where I was. I was so psychotic I didn’t fully realize the ramifications of my incarceration on the social fabric that was our life. Only weeks later, after the medication started to take effect, did I have to come face to face with the stigma of having a mental illness. In fact, I thought it was all a giant mistake. I couldn’t possibly have a mental illness. I was too intelligent and too stable to have such a weakness.
With time came the realization that I do indeed have a mental illness. It’s not my fault. It’s not my family’s fault. And there are things I can do to mitigate its effect on my personal life, although there is no hope at this point of mitigating its effect on my now non-existent professional life.
I have come to terms with my new existence. Although I don’t suffer from depression, I have come to accept that depression is a chemical imbalance of the brain, just like bipolar disorder and schizophrenia. I even learned there is such a thing as schizoaffective disorder, which is now my latest diagnosis.
My world is much smaller now, but I’m relatively happy in my new existence.

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My Civil Right to Own A Gun May 31, 2014

Posted by Crazy Mermaid in Involuntary Committment, mental illness.
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With the latest killing spree in California, there is renewed discussion of keeping guns out of the hands of the mentally ill.
I am a hunter, but one of the things I had to give up in order to be released from the mental hospital was the right to bear arms. I’m not sure how, but the State managed to take away my right under the constitution. If I try to purchase a gun, I am supposed to be prevented from doing so. I haven’t tried to buy a gun to see if they really stop me, but I can tell you that I legally purchased a handgun prior to my involuntary commitment, and no one has tried to take it away from me. I don’t know whether they would stop me from getting a hunting license. I am tempted to try, but haven’t done so.
Yesterday was the 6th anniversary of the day I got involuntarily committed to a mental hospital for throwing some furniture at a wall in a hospital emergency room and taking off my clothes there as well. It is also the 6th anniversary of the day my civil rights were violated when I lost my ability to own a gun. Although I am no longer involuntarily committed to a mental hospital, my civil rights continue to be violated. Despite the fact that I was never arrested, I am being denied my right to own a gun. Simply being involuntarily committed by the State of Washington resulted in my loss of the right to bear arms, which is supposed to be a constitutional right.
According to my attorney in the mental hospital, once I’ve been out of the mental hospital and stable for about 7 years (her number), I can go before a judge and request my constitutional right to own a gun be restored to me. I plan to go before a judge to make that request next year.
Can the government eliminate a civil right because I threw some furniture at a wall in an emergency room? Was being diagnosed with a mental illness reason enough to take away my civil rights?
Politicians will tell you the right of society to live in a safe environment trumps my civil right. Is having a mental illness a good enough reason for the government to take away my civil rights? Apparently so.
I realize there will be some anti-gun people out there who don’t believe anyone has a right to bear arms under any circumstances, so I discount those people because they don’t believe anyone should have that civil right. I am more interested in the people who believe everyone (except the mentally ill) should be able to own as many weapons as they want, with no restrictions. They want to give everyone carte blanch to own anything- unless you happen to have a mental illness. They even want to reach a little further and “catch” those people who appear to be unstable, and take away their right to own a gun too.
Civil rights are, by definition, supposed to be universal. Everyone is supposed to have the right to speak their mind without fear of incarceration. And everyone is supposed to be able to own a gun. And yet some conservatives, who are overwhelmingly for the 2nd Amendment, are probably the first people who don’t think I should be able to own a firearm because of what I might do with it. Do the reasons for violation of civil rights matter? They say they do.
I have been told that guns are dangerous for people with a mental illness. They say people with a mental illness are more likely to use a gun on themselves or others. People with a mental illness, they say, are too unstable to own a gun.
In fact, with the latest round of murders in California, there is the usual talk of not allowing people with a mental illness access to guns. But the problem is that, once again, the guy they want to prevent from having a gun is the guy without a diagnosis. And if you take away the right of people with a mental illness to own a gun, nobody will want to get diagnosed. Besides, how do we find those people? By the way they act? Is it going to become easy to get someone diagnosed against their will with a mental illness?
What is the solution to the problem of preservation of civil rights and making sure society stays safe? Is there a balance?
The solution lies in making it socially acceptable to seek a mental health diagnosis, and in making it easier to get people help. The parents of the kid who went on the latest killing spree tried to get him help, but they failed. The system failed them. So now people think the answer is to keep people who they suspect as being unstable from being able to exercise their constitutional right to own a gun. But is it legal to prevent someone from owning a gun because of what they might do with it? I say no. It is a slippery slope, and we need to be careful. Pistol

National Alliance on Mental Illness (NAMI) Walk May 5, 2014

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Back on May 28, 2008, I was locked up at a psych ward in a mental hospital  and stripped of my civil rights. All the doors were locked, and no one would tell me what I had to do in order to leave. My stay centered on how long a particular psychiatrist, Dr. Suh, thought I needed to stay. What I needed to do in order to get released was a mystery that no one explained. After a few weeks of being locked up, I came to believe that my husband was the source of my problems. I was sure he had me locked up because he was sleeping with my sister, and he didn’t want me in the way of their budding romance. I explained my theory to Dr. Suh, but he didn’t believe me and wasn’t about to release me. This scene played out for three long, agonizing weeks. Each day Dr. Suh asked me stupid questions, and each day I gave him my answers. But they were the wrong answers, because he never would tell me that I was free to go.
Finally, after three weeks, my court appointed attorney, whom I hadn’t seen since my commitment hearing three weeks prior, showed up and told me I was being released the following day. Since Dr. Suh had just indicated hours earlier that he wasn’t going to release me, I didn’t know whom to believe. Was Danica, my attorne,y right and I was being released, or was Dr. Suh right and I was staying? I planned for the worst but hoped for the best.
The following morning, my caseworker, Michelle, summoned me to a stifling little room and told me I was leaving. She had me sign some paperwork (I actually was unable to write my name but that didn’t seem to matter) and then brought my husband into the room. At that time, she told me I should go to a support group sponsored by National Alliance on Mental Illness (NAMI). She said it was a group therapy kind of environment, and that only people with a mental illness could go. She indicated that attending that group would help me stay out of the mental hospital. I was all ears.
I was indeed released that day, and reveled in the freedom of not being locked up with no end in sight. I took Michelle’s advice and attended the support group, called NAMI Connections. My husband had to drive me to the meeting, which was held at Crossroads Mall in Bellevue, WA, because I was physically unable to drive because of all the drugs they had pumped into me at the hospital.
Once we arrived at the meeting, he left me at the door and Victoria, the co-facilitator, took me in hand. For reasons unknown to me at the time (but subsequently realized were induced by my medication), I started crying hysterically and couldn’t stop. Once the group started, Victoria led me out of the room and stayed with me while I tried to get control of my crying. The meeting only lasted 90 minutes, and I took up about half an hour of it with my crying jag. Finally, I got control of myself and we returned to the group. Once there, I was surprised at the number of people who had spent time at a mental hospital. In that environment, it wasn’t unusual at all. Many of the attendees could relate to my three weeks of being locked up. I felt good knowing that there were people in that room who understood what I had gone through. I felt a comradeship with them.
Once my medication started to kick in, my psychosis left me for the most part (I still hear voices when I get under stress), but I have continued to attend these support groups because of the fact that there are others like me there, dealing with the same problems I have. I don’t feel alone.
As I got better, I started getting more involved with NAMI. Now, I run a Connections support group and speak at colleges, hospitals, and police stations to audiences about what it’s like to live with a mental illness on a daily basis. That program is called, appropriately for me, In Our Own Voice, and it helps to put a face to mental illness in order to break down some of the stigma surrounding mental illness.
All of NAMI’s programs are free, but it takes money to run them. NAMI Washington’s only fundraiser is a Walk designed to raise money and awareness on Saturday May 17th. My team is called Merry Mermaids and Mermen, and this is a request for donations for my team. If you want to donate, any amount will help. The link is: https://securewalks.nami.org/registrant/LoginRegister.aspx?eventid=132532&langpref=en-CA&Referrer=direct%2fnone. Feel free to donate to either my team or me personally. Thank you for your consideration. Kathy ChilesNAMI Walk of Washington in Kirkland, 2011.

“Boarding” the Mentally Ill January 25, 2014

Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital.
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An article Thursday January 23, 2014 about boarding at Evergreen Hospital in Kirkland, WA, gave me hope for the future of treatment of mental illness in hospital emergency rooms. .  http://seattletimes.com/html/localnews/2022721653_boardingupdatexml.html. I had my own horrific boarding experience with this hospital in May of 2008.

Boarding is the practice of “storing” someone in a mental illness crisis at the hospital while waiting for someone with a mental health background to do a diagnosis and  find treatment for the person in crisis. At the time, Evergreen had no one on staff to do the assessment, and it sounds like nothing has changed in the past 5 years.  This lack of staff caused major headache and expense to everyone involved.

When I went to the emergency room at Evergreen, not one person with a psychiatric background, except for the Designated Mental Health Professional (a King County employee) interviewed me during my crisis.  All the hospital personnel did was lock me in a white room by myself for hours.  They kept me locked up alone until the on-call DMHP arrived, which was approximately 7 hours after I got there.

After hours of isolation with no explanation about what was going on, I became more agitated, as anyone in my circumstances, mentally ill or not, would be.  Locked in a room, isolated, with no explanation about what was going on, my delusions and hallucinations got progressively worse. I started to believe they were irradiating me, with the intent of killing me. That was, in my mind, the explanation of why they didn’t feed me during my day-long stay.

After hours of contemplation, I finally thought of a plan to get out.  I got them to allow me to use the restroom, then broke away into the emergency waiting room yelling “fire” in an attempt at escape.  This effort failed miserably.

I understood my rights, and I knew they had no legal basis whatsoever at that point to hold me.  I refused to sign the paperwork that would have checked me into the hospital, and I knew they couldn’t legally check me in.  And yet they locked me in a room.  What was I supposed to do?

At that point, I had done nothing dangerous.  My only “crime” was thinking I was a mermaid, which was not a violent thought at all.  People don’t associate mermaids with aggression, and I didn’t give the hospital staff any reason to consider me dangerous.  Even taking my clothes off in the emergency room didn’t pose a threat to anyone.  It was a sign of poor judgment- nothing more.

It was only after I had been locked in that room for several hours, with no explanation about what was going on, that I decided to throw the furniture at the wall in a misguided attempt to gain my freedom.  Had I been given any kind of explanation by the staff, any communication by them, about what was going on, I probably wouldn’t have thrown the furniture at the wall.

At the point I threw the furniture at the wall, I was declared a danger, which was my ticket to involuntary commitment.  I could likely have avoided involuntary commitment had I been seen by a psychiatrist at the emergency room.  I would at least have had a chance.

Hopefully, with the changes Evergreen is being forced by the Federal Government to make, they will have a psychiatrist on staff to interview people in the middle of a psychotic episode, and treat them more humanely.

After the DMHP declared that I was to be involuntarily committed, which was about 6 pm, the hunt for a mental hospital bed was on.  In the meantime, I was kept locked in that white room, with no contact with the outside world, and with no explanation about what was happening.  They should have at least made an attempt to tell me the plan.

At about midnight, three people walked into my locked room with a red four point restraint board and directed me to “hop on”.  There were straps erupting from all directions on that board, and I knew instinctively that they were going to strap me down once my head hit the board.  So I refused to jump aboard.  Upon my refusal, two security guards came at me, one grabbing me by the throat and slamming my head down on the board. He choked me so hard that he cut off my air supply.  I screamed.  The other security guard buckled me into the restraint board.  After he finished, a nurse came at me with a syringe and plunged it into my thigh.

I woke up the following morning in a room with a bed bolted to the middle of the room, and no other furniture.  I had no idea where I was or what had happened.  As it turns out, I had been involuntarily committed to Fairfax Hospital in Kirkland.  Even when I found out where I was, I knew nothing about the hospital or the process of involuntary commitment.

With proper treatment from the emergency room, I believe this whole scenario could have been avoided.  I’m happy to see things might change for the next person having a psychotic break.

New Mental Hospital Beds Coming October 24, 2013

Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, mental illness.
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Finally, things are looking up here in Washington State.  Currently, we are 50th out of 50 in terms of mental hospital beds per capita for the State. Two new mental hospitals are scheduled to be online within the next few years.  A 68 bed facility at Fairfax Hospital, where I was involuntarily committed, broke ground in May of this year.  A 75 bed mental hospital, complete with a 25 bed facility for children, is seeking approval for a location in Smokey Point near Marysville in Snohomish County. Currently, Swedish Hospital in Edmonds, with 23 beds, is the only mental hospital facility in the 733,000 person county.  And it doesn’t handle children.

Bringing these two hospitals online should help reduce or end the practice of “boarding”.  “Boarding” is the act of keeping people housed in regular hospitals while waiting for a bed in a mental hospital to open up.  This is common in King and Snohomish County because there are too few beds. In King County right now, two thirds of all detentions for involuntary commitment end up being “boarded”- sometimes for days, while waiting for a hospital bed to be freed up.

I had my own experience with “boarding” when I was involuntarily committed five years ago.  During my psychotic break with reality, I thought I was a mermaid named Pangaea.  Life was good in the bubble universe I was in.  My friends included Bill and Melinda Gates, Oprah Winfrey, and the Dalai Lama among others.  Bill and Melinda provided me with all the money I needed (in my fantasy world), and everyone hung on my every word, telling me how gorgeous I was.  And I had ESP. This went on for months.

Then things turned nasty.  Zombies showed up, with the intent of capturing me.  It was at that point that I remembered something I learned in grade school:  when your environment isn’t safe, head to a police station or hospital.  So I convinced my husband to drive me to a hospital by telling him I was hearing voices.  Except I didn’t mean it in the traditional way, but I knew he wouldn’t understand that I had ESP.  Feeling my reality dissolving around me, I wanted my husband to take me to the nearest trauma center, Harborview Medical Center in Seattle, but my husband chose Evergreen Hospital in Kirkland instead.

Once we arrived, my friends told me via ESP that the hospital was a trap, and I changed my mind about wanting to be there.  But I had made an error in judgment by telling my unsuspecting husband that I was hearing voices in an attempt to get him to take me to the hospital.  With that confession on his mind, he wasn’t about to let me return home.

Once I displayed my fins to people in the waiting room (I could feel the flap of skin between my toes, since as a mermaid I had fins) and took off my clothes in the emergency room, they locked me in a room for hours as they waited for an overworked County Designated Mental Health Professional to examine me to determine whether to involuntarily commit me.  That was in the late afternoon.  After her examination, she determined that I should be committed (but I didn’t know that).  That’s where the “boarding” came in. She finished her evaluation at around 4 pm, deciding to commit me.  But where? At that point, she started looking for a bed at a mental hospital.  But there weren’t many choices, and they were all full.

Not knowing what was going on, I sat in that locked room, for hours.  Finally, around midnight, they showed up with a four point restraint board and expected me to jump on and get buckled in.  I refused, so they grabbed me by the throat and pinned me down and buckled me in, then came at me with a syringe and plunged it into my thigh. I passed out, coming to in a mental hospital.

With new hospital beds on the way, and with some money (thanks to a new tax that goes towards funding for mental illness) to get training for emergency room personnel, the experience I had should become a dim memory.  At least that’s what I hope.

Lock up the Mentally Ill to Prevent Mass Murders September 19, 2013

Posted by Crazy Mermaid in Committment Hearing, Delusions.
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A young woman on Anderson Cooper 360 last night called Aaron Alexis “a crazy schizophrenic” and stopped just short of saying he should have been locked up.  Let’s take a close look at this idea, because it’s going to rear its ugly head.

First of all, Alexis was never diagnosed with a mental illness. So how do we find people like him and lock them up so they don’t kill people?  Let’s lock up anyone we suspect of having a mental illness. That would do the trick.

How do we find those people?

Let’s make the police find them for us.  Any time someone calls the police about someone acting bizarrely, let’s have the police assess that bizarrely acting person.  After all, the police interviewed Alexis when he called them to report someone was “sending microwaves through the wall”.  Anyone who makes bizarre statements like that should be locked up.

What about people who are acting bizarrely because they’re drunk?  Let’s not count those people.

Where should they go to be locked up?  Let’s build more mental hospital beds to house them all. How many beds will they need?  Well, if you count the number of people who want to commit suicide, there probably needs to be four times as many hospital beds as there are now.  Or don’t we want to count those people?  After all, they just want to take their own life- not anyone else’s.   Except for those people who do things like get in bad car accidents, managing to accidentally take the life of others with them.  So we should definitely count the suicidal in our sweeping net.

Should we let the police be the ones to make the official determination, or should we bring in someone trained to handle such a task, like the Designated Mental Health Professional?  That clinician determines whether someone is a danger to themselves or others, the current standard for involuntary commitment.  And that’s what we’re talking about: involuntarily committing anyone who exhibits bizarre behavior. We don’t really need a DHMP because the police already performed that function when they took the police report.

Violating people’s civil rights (which is, when you get down to it, what involuntary commitment is) will become commonplace. I don’t want to live in such a world.

Mental Illness: Worst Disease in the World? March 14, 2013

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As the worst possible disease, mental illness isn’t even on most people’s radar. But consider, for a moment, the facts.

Unlike cancer, mental illness has a lousy public relations campaign. It doesn’t have a public personality attached to it- at least nobody positive. There’s no Lou Gherig or Lance Armstrong or Stephen Hawking to bring a sense of empathy to the masses. Unlike breast cancer, hundreds of millions of dollars aren’t spent on events to publicize mental illness- events like the Susan G. Komen Walk for the Cure – where the color pink has come to symbolize breast cancer in everything from headbands to hand mixers. Unlike Lance Armstrong’s Livestrong cancer campaign, where yellow bracelets signify triumph over cancer, there is no little plastic bracelet color for mental illness awareness. In fact, because of its enormous stigma, you would be hard-pressed to find victims and family members willing to take the spotlight for mental illness.voelker-hospital-bed

Everyone recognizes that the term “cancer” is a blanket term for a multitude of illnesses all sharing the same basic characteristic: improper cell division. Unlike cancer, the general public doesn’t perceive mental illness as a blanket name for illnesses caused by brain chemistry imbalance. Both are breakdowns of normal bodily functions, yet cancer doesn’t have the reputation of being a character flaw or a sign of moral bankruptcy that mental illness does.

Patients with cancer are not embarrassed to tell their friends and family their diagnosis. They aren’t afraid of being thought less of as a person for that diagnosis, that somehow they fell short. But with mental illness, the stigma is so great that the fear of rejection and isolation is a legitimate concern.  You just don’t tell anyone.

Because their loved one’s illness isn’t associated with moral bankruptcy and character flaws, friends and relatives of cancer victims don’t have the same incentives to keep anyone from knowing their loved one has cancer. Protecting themselves from the unspoken charge of moral bankruptcy by association isn’t a top concern of the families of cancer patients, so they get emotional support from those around them.

Other diseases, like cancer or ALS or a stroke, don’t cause its victims to commit heinous crimes.  You don’t see a breast cancer victim as the lead-in story on the nightly news because she murdered a bunch of school children. You don’t hear about a stroke victim trying to assassinate the President. A lung cancer victim doesn’t jump off a bridge to get away from the horrible voices in his head. And yet the connection between these types of actions and mental illness, if the news media even bothers to make one, is voyeuristic rather than sympathetic.

No legitimate insurance company would dare decline to authorize or pay  for mainstream treatment of a cancer victim, but up until a very recent change in the law, insurance companies had little or no such coverage for mainstream treatment of mental illness, reasoning that it wasn’t, after all, a real physical illness. When they do cover it, it’s under a separate policy from “physical” health, called “Behavioral Mental Health”.  We don’t see major insurance companies splitting off cancer from a list of diseases, calling it “Cell Divisional Health”, severely restricting its access, and farming out its administration to an entirely separate company.

When it comes time for hospitalization, there isn’t a question of whether a cancer victim or stroke victim even needs to go to a hospital. If they’re seriously ill, a cancer patient doesn’t have to be at death’s door before he’s admitted to the hospital. But a mentally ill victim has to either be about to hurt or kill himself or others (as determined by a third party) or needs to have tried (and failed) to kill himself before a mental hospital will consider admitting him.

If they’re hemorrhaging, but not near death, a cancer patient isn’t turned away for lack of space. Cancer patients don’t have to wait until there’s room for them at a hospital. Unlike hospital space for the mentally ill, hospital space for cancer victims hasn’t decreased over the past 20 years.

Alzheimer’s patients aren’t routinely discharged from hospitals onto the streets, left to fend for themselves. Cancer patients aren’t routinely discharged before they are stabilized. And yet the mentally ill are routinely discharged out onto the streets before they’re ready all of the time.

The cancer patient doesn’t have to give up his civil rights in order to be treated. He can leave the hospital whenever he wants. But in order for a mentally ill patient to be treated, he has to give up his civil rights. Mental patients are locked in, physically unable to leave the hospital until someone else- the attending psychiatrist- says they can go- however long that takes.

Once in a hospital, a cancer patient has the option to discontinue medication at any time.   Mentally ill patients who have been involuntarily committed, on the other hand, must leave their civil rights at the door when they enter a mental hospital. Whether they want to or not, they are forced to continue medication while they are hospitalized.

Comparing the physical pain of the cancer or the effects of cancer treatment with the effects of mental illness is in some ways like comparing apples to oranges.  Whereas the cancer victim fights for her life, the severely depressed victim fights to die.  Is the physical pain of cancer worse than the emotional pain of continually hearing horrible voices in your head nonstop? Is radiation sickness worse than lithium side effects?  Is prostate cancer preferable to schizophrenia?

I’m not trying in any way to minimize the pain and suffering that these diseases engender. My point is that each of these diseases –all of them- including mental illness-engenders tremendous pain and suffering. None of them- including mental illness- is any less severe than any other.

For too long, mental illness has been a quiet disease. Quietly terrible, but still quiet.  This is a disease- or a family of diseases- on par with cancer and ALS and strokes, and yet there is a huge vacuum out there. Nobody even thinks about mental illness as a true physical disease. It’s not even on the radar. This needs to change. We need to raise people’s consciousness about mental illness, and give it the parity it deserves.  We’ll know we’ve done our job when “mental illness” takes its rightful place on the list of Terrible Diseases in the public consciousness.

Mental Health and Competency Restoration in Washington January 29, 2013

Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital.
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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 Health Courts January 17, 2013

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Mental health courts link offenders who would ordinarily be prison-bound to long-term community-based treatment. They rely on mental health assessments, individualized treatment plans, and ongoing judicial monitoring to address both the mental health needs of offenders and public safety concerns of communities. 

Mental health courts share characteristics with Crisis Intervention Training (CIT), jail diversion programs, specialized probation and parole caseloads, and a host of other collaborative initiatives intended to address the significant over-representation of people with mental illness in the criminal justice system.

In the early 1980s, Judge Evan Dee Goodman helped establish a court exclusively to deal with mental health matters at Wishard Memorial Hospital in Indianapolis. This court was a dual purpose court. It to handled the probate court needs of people needing to be on a civil commitment for psychiatric treatment and it established a docket to deal with cases of the mentally ill offender who had been arrested on minor charges. This was necessary as the mentally ill were frequently arrested and had charges pending when the treatment providers sought a civil commitment to send their patient for long term psychiatric treatment. Judge Goodman’s court at Wishard Hospital could serve both purposes. The probate part of the mental health court would handle the civil commitment. The criminal docket of the mental health court could handle the arrest charges. The criminal charges could be put on diversion, or hold, allowing the patient’s release from jail custody. The civil commitment would then become effective and the patient could be sent to a state hospital for treatment. Judge Goodman would schedule periodic hearings to learn of the patient’s progress. If warranted, the criminal charges were dismissed, but the patient still had obligations to the civil commitment.

In addition to arranging inpatient treatment, Judge Goodman often put defendants on diversion, or on an outpatient commitment, and ordered them into outpatient treatment. Judge Goodman would have periodic hearings to determine the patient’s compliance with the treatment plan. Patients who did not follow the treatment plan faced sanctions, a modification of the plan, or if they were on diversion their original charge could be set for trial.

Judge Goodman’s concept and the original mental health court were dissolved in the early 1990s.

In the mid-1990s, many of the professional mental health workers who had worked with Judge Goodman sought to re-establish a mental health court in Indianapolis. Representatives of the county’s mental health service providers and other stake holders began meeting weekly. After a couple years of lobbying local authorities the in Marion County, Indiana, the mental health court began as a formal program in 1996. Many consider this to be the nation’s first mental-health court in this second wave of mental health court initiatives. Since the PAIR Program did not operate with any new funds, there was not much scholarly research and therefore the accomplishments of Judge Goodman and the PAIR Program are frequently overlooked. The current PAIR Program is a comprehensive pretrial, post-booking diversion system for mentally ill offenders. A program launched in Broward County, Florida was the first court, to be recognized and published as a specialized mental-health court. Overseen by Judge Ginger Lerner-Wren, the Broward County Mental Health Court was launched in 1997, partially in response to a series of suicides of people with mental illness in the county jail.

Shortly after the establishment of the Broward County Mental Health Court, other mental health courts began to open in jurisdictions around the U.S., launched by practitioners who believed that standard punishments were ineffective when applied to the mentally ill.  In Alaska, for example, the state’s first mental health court (established in Anchorage in 1998) was spearheaded by Judge Stephanie Rhoades, who felt probation alone was inadequate. “I started seeing a lot of people in criminal misdemeanors who were cycling through the system and who simply did not understand their probation conditions or what they were doing in jail. I saw police arresting people in order to get them help. I felt there had to be a better solution,” she explained in an interview. Mental health courts were also inspired by the movement to develop other problem-solving courts, such as drug courts, domestic violence courts, community courts and parole reentry courts. The overarching motivation behind the development of these courts was rising caseloads and increasing frustration — both among the public and among system players — with the standard approach to case processing and case outcomes in state courts. In February 2001, the first juvenile mental-health court opened in Santa Clara, California.

Since 2000, the number of mental health courts has expanded rapidly. There are an estimated 150 courts in the U.S. I was “processed” through my involuntary commitment through King County’s (Washington State) court, one of the first in the nation. Snohomish County (my county in Washington State) just opened theirs in October 2012.

(From Wikipedia)

Mental Illness and Smoking November 16, 2012

Posted by Crazy Mermaid in Anxiety, Involuntary Committment, Smoking and Mental Illness.
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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.