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Mental Health Triage Facility June 12, 2011

Posted by Crazy Mermaid in Mental Hospital, mental illness.
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I like to share good ideas  in the hope that they can be successfully replicated elsewhere.  This is one of the better ideas I have come across, and it just happens to be in my own county (Snohomish WA, USA):

(Reprinted from An Editorial published  May 10, 2011 in The Herald, Everett WA)

The news is a constant reminder that our prisons are overcrowded, as are our emergency rooms, and that the state doesn’t have the means or infrastructure to deal with all the mentally ill people who need help.

These are monster social problems, all related, for which there is no single fix. So when a good idea emerges, it’s important to add it to the social services/law enforcement toolkit. Which is what happened when a “triage facility” bill, originating from a pioneering Snohomish County (WA) program, was signed into law at the end of April.

The law allows counties to operate triage facilities as a cost-effective alternative to jails and emergency rooms for evaluating mentally ill people and those needing substance-abuse treatment who have been arrested for non-felony crimes. In March, Snohomish County began a successful test run of such a facility at the Bailey Center in Everett (WA); it’s operated by North Sound Mental Health Administration and Compass Health.

The law allows persons to be held involuntarily at a triage center for a maximum of 12 hours, while they stabilized and evaluated for treatment and the appropriate course of action. Before, people arrested for non-felony crimes could only be held involuntarily at jails or hospital emergency rooms.

The creation of the triage center came out of the (Snohomish)County Council’s 2008 adoption of a tenth of a cent increase in the sales tax for mental health and chemical dependency services, as allowed by state law. The center is funded through a partnership with the county and North Sound Mental Health Administration.

Approximately 24 percent of the people booked into the Snohomish County Jail have mental health issues and about 6 percent have a serious and persistent mental illness, Snohomish County Human Services Director Ken Stark told Herald reporter Diana Hefley in the 2009 article, “Mentally ill often adrift in the criminal justice system.” About 70 percent of the people booked into the jail have a drug or alcohol addiction, Stark said.

Tom Sebastian, Compass Health CEO and president, said the new program is cost effective because most people in crisis are not in need of acute medical services, saving the costly trip to the emergency room. The triage center is staffed with peer counselors, mental health technicians, clinicians and nursing staff.

Snohomish County officials, mental health workers, law enforcement and legislators made this smart step happen after creatively trying to come up with way to help the mentally ill and/or drug addicts, and save money at the same time. Now the rest of the state can benefit, too.

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Reluctant Gertie: Unwanted Medication February 3, 2011

Posted by Crazy Mermaid in Involuntary Committment, Mental Hospital, mental illness.
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“NO!”

“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)

Driving and Mental Illness November 22, 2010

Posted by Crazy Mermaid in Medication, Mental Hospital, mental illness.
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When I first began driving, I was a teenage girl living in Kihei, Maui, Hawaii. My dad was Project Manager for a mid-sized construction company named Red-Samm/General, a joint venture between two fairly large construction companies.  He was in charge of putting together a seven mile long sewer line through downtown Kihei.  In fact, I tell my friends that if they’re staying in Kihei and flush the toilet, they can thank my dad.

In those days, my dad came home from an extremely stressful job and started  “driving school for Kathy”. Things were different in those days.  There was no Driver’s Ed on Maui.

After working late, he drank a few beers and then threw me the car keys, saying “Let’s go”.  I climbed behind the wheel of a manual four wheel drive Jeep pickup truck, and he climbed in the passenger seat. As I learned where the gas and more to the point brakes were on that manual transmission, he sat in the passenger seat, holding on for dear life.  Anyone who has ever sat in that passenger seat can tell you it’s no picnic.  Around the Island we drove (it’s a 50 mile trip around the whole thing), driving on two lane roads out in the country lanes.

As I got older, I learned to drive other vehicles, eventually even owning a few of my own. Like my father, I taught my two boys how to drive (with the help of Driver’s Ed).  I became comfortable (and so did they) in my role as Driver Instructor.

During my career as both an owner of a mid-sized commercial general contracting firm and project manager of commercial buildings, I learned to operate heavy construction equipment, including (bull) dozers, backhoes, dump trucks, and skidders (used for logging operations).  My dad, also a project engineer but for sitework subcontractors until we went into business together, taught me how to operate all of these and more.

If there was any driving to do, I did it. I never let anyone drive if I could help it.

All that changed when I entered Fairfax Mental Hospital.

The initial dose of Lithium (900 mg) knocked me on my ass. I had major coordination problems, including doing what my husband calls the “lithium shuffle” up and down the locked down hallways of the psychiatric ward – where those of us who were involuntarily committed were housed.  I lost my sense of coordination, developed the typical side effects of massive doses of lithium, and lost my desire to drive anywhere.

As the Lithium gave way to Geodon and subsequently ,when Geodon failed to work, Risperdol, I continued to be uncomfortable driving.  In fact, when I got behind the wheel of the car on those rare occasions when I absolutely had to, I had trouble telling how far I was from the car in front of me. I couldn’t tell where the end of the car began.  I had trouble finding the gas and more importantly the brakes.  When I had to go to the local hospital where my gynecologist’s office is, I hit the gas instead of the break when I parked the car. It scared me so badly that I refused to drive myself anywhere for quite some time.

The Risperdol made things better as far as my coordination went, but still I avoided driving at all costs unless I absolutely had to. I felt much safer with someone else being behind the wheel.  I had neither the focus nor physical coordination to drive and I knew it.

Recently, with the switch from Risperdol to Geodon, I finally, two and a half years after my hospitalization, began to feel that I could actually be comfortable driving.  Yesterday, I am proud to say, I volunteered to drive my husband and I to the local Home Depot.  It was the first time in 2 ½ years that he had been in the passenger seat with me.

Everyone around me has been very patient with me, giving me the emotional support I needed to get to this stage.  But I am learning the joys of driving again, albeit slowly and cautiously.  It feels good.

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

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

$58,752 for 18 Days of Involuntary Committment to Mental Hospital August 14, 2010

Posted by Crazy Mermaid in Escalating Healthcare Costs, Health Insurance and Mental Illness, Involuntary Committment, Mental Hospital, mental illness.
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$58,752. Take a good look at this number.  It’s the cost for 18 days of room and board (no additional services like medication and Dr. visits are included) at Fairfax, a private mental hospital in Kirkland, Washington.*, where I was involuntarily committed back in May 2008 to mid June 2008.  That breaks down to $3,900.20 per day for the first 10 days and $2,468.75 for the final 8 days.

At Eastern State Hospital  (WA), a comparative public facility, the average cost per day for a stay there is $524 per day.  My stay there (room and board ONLY) would have cost $9,432. At Western State Hospital  in Lakewood, Washington, also a public facility, the average cost per day is $438.  My cost for 18 days of room and board there would have been $7,884.   Fairfax, a private hospital, charged over six times as much for the identical service.  What’s wrong with this picture?

It gets even better. At these rates, if 25 patients pay $3,900 a day, Fairfax grosses $97,000 a day.  If the beds stay full for a year, Fairfax grosses $35 MILLION dollars.

My family and, by extension, I, had no say in whether I would be involuntarily committed, much less the location or cost of my commitment. The State of Washington made the determination that I would be involuntarily committed.  Because it was an emergency situation, forced on me, my family had no opportunity to explore the various facilities and then do a cost comparison.  Even if we had known the cost, we had no choice. Fairfax was the only mental health hospital in the State with a bed. The State of Washington was forcing me to be involuntarily committed (against my will).  I had to go somewhere, and Fairfax was the only place with a bed. That’s why I went there.  Fairfax had me over a barrel, with no other options.  They took advantage of the situation to make their stockholders a little richer.

Lest you think I was at Club Med, let me rid you of that misconception. The food was cafeteria-style, brought to us on trays stacked in a three foot high mobile metal tray rack.  Built in the 1960’s, the building has not undergone any visible major or minor remodeling since its inception.  As it is a private hospital, the public information disclosure required by the State hospitals is not required of it. My stay there was not in some kind of padded room.  It was in a plain old regular dorm room, similar to one you’d find at an old college.  Granted, the doors to the outside were locked 24/7, but the facility itself was run-down. Unlike Western and Eastern State Hospitals, there is no website data from Fairfax citing its daily cost.  It’s a private facility.

Oh yeah: one more thing.  Fairfax is owned by Psychiatric Solutions Inc. (PSI). Please join me in congratulating PSI for making Fortune Magazine’s list of Top 100 Fastest-Growing Companies:

FRANKLIN, Tenn., Aug 18, 2009 (BUSINESS WIRE) — For the fourth consecutive year, Psychiatric Solutions, Inc. (”PSI”) (NASDAQ: PSYS) has made Fortune magazine’s list of the Top 100 Fastest-Growing Companies. It is the only Tennessee company to make this year’s list, as it was in 2008 and 2006. https://www.psysolutions.com/facilities/news/fortune-magazine.html

PSI, which is the largest operator of psychiatric inpatient facilities in the country, ranked No. 98 on the list released by the magazine in August 2009, which considers factors such as revenue and earnings per share (EPS) growth rates. Last year, PSI ranked No. 64. In 2007 and 2006, it ranked No. 49 and No. 34, respectively.

How can they get away with this? Simple: There is more demand than supply for short-term mental health care facilities. Solution: build more short-term care facilities.  I think that everyone would agree that $35 Million builds quite a few new facilities.

* Taken from Fairfax’s invoices to my insurance company.

Psychotic Wife Tests Marriage August 5, 2010

Posted by Crazy Mermaid in Bipolar Disorder, Delusions, Hallucinations, Involuntary Committment, Mental Hospital, mental illness.
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My nervous breakdown tested my marriage in a major way.  I’m very lucky that my marriage has survived that horrible ordeal- at least for the present.

From the time the voices started in February to the time I was hospitalized in late May, the voices tried to convince me to divorce my husband of 25 years.

The first reason that the voices told me to divorce him was to protect my newly acquired $1.5 million jewelry collection. This collection included a supposedly “yellow diamond” ring acquired at Target for $20, which the voices assured me was actually a real yellow diamond ring worth a million dollars (not true) and an abalone bracelet that I bought from Goodwill that the voices said was an antique bracelet once owned by my Great-grandmother Mermaid and now worth $500,000 (also not true).

The second reason they said I should divorce him was that he was the real behind-the-scenes person responsible for locking me up in a mental hospital, and he was going to keep me there as long as he legally could (not true) and that my only chance of escape from my “prison” was to divorce him as soon as possible. So the first chance I got at the mental hospital I called my attorney to get the divorce proceedings started.  But as the medication began to take effect, I lost the ability to follow through with my actions because I became lethargic and confused. Finally, as the medication began to cause the delusions and hallucinations to go away, I came to realize that my husband wasn’t really trying to keep me locked up, and that I really didn’t have a $1.5 million jewelry collection for him to go after.

After I returned home and began to realize the magnitude of the damage I inflicted both personally and financially, I became convinced that he was going to divorce me, and that he was just waiting for me to get well enough to divorce him. After all, why would he stay?

Besides the paranoia about what I perceived as my impending divorce, I was undergoing a major medication-induced identity crisis.

The reality was that Bob was free to divorce me at any time, and many less patient men would have simply walked away from me at numerous points. Some husbands would have left back in February or May, when I started talking about wanting a divorce, or in late May when I was spending tens of thousands of dollars. Others would have served me divorce papers in the hospital, as happened to some of my fellow patients.  Still other spouses would have waited until I was on my feet again, able to take care of myself, before cutting the cord.

He put up with the trials of living with a woman going through a severe break with reality, including the delusions and paranoia that accompanied the break. He watched helplessly as an out-of-control woman who was legally still his wife but whom he didn’t recognize begin to dismantle his financial future by spending thousands of dollars on clothes and plants and even a $50,000 Lexus convertible.

Then, he suffered through the three weeks I spent at a mental hospital, unable to share that fact with anyone due to the tremendous stigma attached to that fact. As if the fact that I was at a mental hospital wasn’t shocking enough, he found the courage to visit me on a daily basis, despite my less-than-pleasant reception ( I thought he was holding me there on purpose against my will). He didn’t understand what kind of world I inhabited, but realized that I wasn’t really “there” when he visited me, but nevertheless suffered through his daily visits with me anyway. He watched as I tried to take up smoking. He listened when I continued to ask him for a divorce, even listening patienly as I gave him a piece of paper that represented a preliminary breakdown of the assets I planned to receive in our upcoming divorce settlement.

Even when he saw that I was not getting better, and when I ignored him when he visited, he still hung in there. He understood the very real possibility that my mind might be forever locked up in my fantasy world, unable to return to the real world. He realized that he might have to take care of me – what was left of me- alone, might have to raise our kids- alone.

My real road to recovery didn’t begin to materialize until several weeks after I was released.  But as the medication that would bring me back to the real world began to take effect, the side effects from the medication were another nightmare. Depression, suicide thoughts, Parkinson’s disease symptoms, grogginess, fainting, constant crying, weight gain, and a myriad of other medication-induced symptoms became the norm. I couldn’t read, couldn’t drive, could barely walk, had balance problems, couldn’t comb my hair or peel a banana or make my bed. I was anxiety-riddled, having to have my days planned out to the last minute or I’d become miserable. I was almost totally helpless, and there was no guarantee that my physical health would ever return. He supported me through that horrible period without complaint. He was always there for me.

As my side effects slowly began to diminish over time, and as I again returned to the land of the living, some of the pressure is off.  But without the love and support of him and my family, I would still be in the psychotic world, disconnected from reality, for the rest of my life. I’m one of the few lucky ones who has managed to find their way back.

Mental Illness and Smoking July 29, 2010

Posted by Crazy Mermaid in Mental Hospital, mental illness, Mental Illness and Medication, Smoking and Mental Illness, Stress.
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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 “Hotel Fairfax”, 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 looking 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 effects 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 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.

Mental Illness and The Law: How We Got Where We Are June 29, 2010

Posted by Crazy Mermaid in History, Insanity, Involuntary Committment, Mental Hospital, mental illness, Mental Illness and Medication, Psychotic.
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If you want to change things, first you need to understand how they got the way they are.  In the case of mental illness law, politicians and lawyers had the best of intentions, but as with other ventures, the devil was in the details.  The unintended consequences of their actions continue to remain the source of frustration and even danger.

In his 1946 article “Bedlam 1946: Most Mental Hospitals Are A Shame and A Disgrace” http://www.mnddc.org/parallels2/prologue/6a-bedlam/bedlam-life1946.pdf in Life Magazine, Albert Maisel made the case that mental hospitals were terrible institutions.  The final paragraph of his article summarized his point succinctly: “Given the facts…the people of any state will rally… to put an end to concentration camps that masquerade as ( mental) hospitals and to make cure rather than incarceration the goal of their mental institutions.”

While the sentiment is perfectly understandable given the horrific conditions he found when he investigated the state of mental hospitals throughout the United States shortly after the close of World War Two, he threw out the baby with the bath water when he declared, in effect, that nobody should have to be institutionalized.  The wildly popular Life Magazine gave Maisel a platform from which to launch his idea of closing all mental hospitals, also called deinstitutionalizing the mentally ill.

Helping this idea along was the development of the first generation of antipsychotic drugs in the 1950’s. Used to treat schizophrenia and other psychoses as well as acute mania, agitation and other conditions, their discovery allowed many mentally ill people once hospitalized to return to their families, hopefully with their illness under control and able to function as productive members of society in many cases.  In many cases this was true, but not in all.

The advent of these new antipsychotics lent fuel to the fire of the deinstitutionalization movement, and, combined with the publicity of the atrocities perpetuated in the mental hospitals, served to throw the doors to the mental institutions wide open in the mid-1950’s.

From the mid-1950’s to the mid-1960’s, a small percentage of the eventually deinstitutionalized were released. But from that point forward, the trickle became a flood, culminating in the release of the majority of the mentally ill by the mid-1980’s. And as the mentally ill were released from the hospitals, rather than wait to see whether whether the experiment was going to work, those hospitals were closed down forever, shrinking from a high of around 550,000 beds in the mid-1950’s to around 40,000 today. As this experiment failed,the homeless and prison populations of every major city and State ballooned.

In the meantime, California was the first state to pass the Lanterman-Petris-Short Act in 1967, giving the mentally ill the legal right to avoid treatment for their mental illness, regardless of how damaging that mental illness became. Unless the person was in imminent (immediate) danger of severely harming or killing themselves or someone else, they had the right to be left alone, free to wander the streets, homeless and victimized, eating out of dumpsters, lost in their own world. Other States followed their example, with the former Governor of California, Ronald Reagan, leading the charge on a national level as he ascended the highest office in the land, the Presidency.

The mistakes the do-gooders made in this two-pronged approach of first deinstitutionalizing and then arming the mentally ill with the right to refuse treatment were twofold.  Their first mistake was  in perceiving all hospitalization to be bad hospitalization. Secondly they assumed that anyone who has a mental illness has the presence of mind to know when to seek treatment for that illness.

Treating mental illness like any other illness, disregarding the fact that one of the symptoms of the illness can be a failure to realize they are ill, and denigrating all mental hospitals as evil are poor choices for which we have all paid dearly, in the form of the fallout from our endless supply of suicides, the incarcerated mentally ill population, the homeless population, and mentally ill people who attack and assault others.

Until we realize that mental hospitals can also be used for good, and that mentally ill people can’t always help themselves, nothing will change.

(Note:  Part of my research for this article was done with the help of Dr. E. Fuller Torrey’s book The Insanity Offense. (2008).

Not Guilty By Reason of Insanity May 21, 2010

Posted by Crazy Mermaid in Delusions, Hallucinations, Mental Hospital, mental illness.
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Wednesday’s Everett Herald featured an article about a young man who was acquitted of a first degree murder charge.  Chad Patterson, accused of breaking into the man’s home Sept. 10 and repeatedly trying to stab him with an 8-inch kitchen knife, was acquitted of the charges by Superior Court Judge Ronald Castleberry on Tuesday.  Verdict: Not Guilty By Reason of Insanity.

According to the article, three doctors concluded that at the time of the attack Patterson couldn’t understand that what he was doing was wrong.  The Judge ruled that there was enough evidence to support the defense’s position that Patterson was not guilty of the crime because he was legally insane at the time of the attack. Instead of jail time for a murder conviction, Patterson will be locked up indefinitely at Western State Hospital, receiving treatment for a mental illness.

I can already hear the complaints from the general public about this.  They’ll say the guy scammed the system.  That he got off scot-free. But let’s examine the facts of the case.

In what was said to be his first ever psychotic break with reality, Patterson was out walking his dog when he saw his neighbor watching him, preparing to attack him (so he thought).  Deciding he needed to “take care of” the neighbor, Patterson threw himself through a window to get into the neighbor’s house. Fighting off the teen, the neighbor pushed him outside, only to have Patterson return a second time.  He pushed Patterson out a second time, and Snohomish County sheriff’s deputies arrived as Patterson, bloodied and cut, was trying to get inside the man’s home a third time.

During the attack, Patterson said that God told him that the man needed to die. After he was arrested he told deputies that he was their god and demanded to be released from his handcuffs. But that’s not all.

Patterson was convinced someone had implanted a camera into his eye and a microphone into his ear, both likely symptoms of undiagnosed schizophrenia according to expert testimony. At the time of his attack on his neighbor, Patterson hadn’t been diagnosed with a mental illness and wasn’t under the care of a mental health doctor, despite the fact that his mother had been trying to get help for her son.  She was told that until he hurt himself or someone else there wasn’t anything that anyone could do about the situation.

According to Patterson’s defense lawyer, the insanity defense is rarely pursued because it is almost impossible to meet the threshold needed to prove someone is legally insane at the time of the alleged offense.  Adding to this, according to the public defender, is the fact that many offenders refuse to publicly acknowledge they’re living with a mental illness.  They’d rather go to jail than be diagnosed with a mental illness.

Those who think the insanity defense is a cake walk have another think coming. In fact, according to Frontline’s A Crime of Insanity, insanity defense acquittees frequently spend twice as much time institutionalized as defendants convicted of a similar offense spend in correctional facilities. And let us not forget what a mental hospital is really like. Locked doors, razor wire topped barbed wire fences all around the compound, structured days, institutional food.  Just like a jail, except for one added bonus feature you won’t find at a real jail.  In the mental hospital, you’re pumped full of drugs that try to bring your brain as close to “normal” as possible.

So contrary to what the general public thinks, those inhabiting mental hospitals rather than prisons don’t necessarily have it better.

Facts of case excerpted from: http://www.heraldnet.com/article/20100519/NEWS01/705199838

Frontline’s A Crime of Insanity: http://www.pbs.org/wgbh/pages/frontline/shows/crime/trial/faqs.html#gbmi),

Mental Illness and Burger King’s Offensive Ad April 22, 2010

Posted by Crazy Mermaid in Uncategorized.
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In the year 2010, we’re now using mental illness to sell merchandise in the mainstream, mega-bucks fast food industry.  The latest ad by Burger King is the most offensive I’ve ever seen regarding its portrayal of people with mental illness. Although this same company wouldn’t be caught dead denigrating other minority populations, it’s apparently open season on the mentally ill.

Admittedly, the King, of Burger King fame, has always been off the wall in his approach to everything. But this time he’s out-done himself. The beginning of the offending ad has him crashing through an office window, shattering glass and being chased by two people in white uniforms who eventually tackle and restrain him (a la straight jacket) as they shout “The King’s insane!”.  It’s clear that he’s being involuntarily committed to a mental hospital. Right before he’s completely immobilized, he manages to hand a hamburger to an office worker, who then says to the two in white, “You’re the ones who are nuts.”

When I first saw this ad, I was in shock. The ad went by fairly quickly, so I took a deep breath, convincing myself that I must have misunderstood it.  I let it go, until the next time I saw the ad. Then I realized: I hadn’t imagined it.  The King was being  involuntarily committed to a mental hospital. And the situation was being played as a pitch to sell more hamburgers!  Unbelievable!

Mortified,  I expected that somehow someone somewhere, either a whole bunch of private citizens or a national group of some sort, would contact Burger King and convince them to pull the socially unacceptable ad, much like they’d pull an ad were it offensive to any other minority population.

And so I wasn’t surprised to hear that both National Alliance on Mental Illness (NAMI) and Mental Health America, two excellent consortium groups, tried to reason with Burger King, explaining why the ad was offensive and requesting that Burger King pull that ad. Response?

According to the Washington Post , Burger King released the following statement: “The creative concepts used to bring this to life were meant to highlight the king’s unchecked enthusiasm about giving his guests a Steakhouse-quality sandwich at a great price and were not intended to reflect any group or situation.”

Yeah, right.

You can read the entire article (and view the ad) at. http://www.myfoxny.com/dpps/news/dpgoh-burger-king-commerical-insane-or-offensive-fc-20100409_6989888