Category Archives: Prisons

Breaking Icons

My second human sculpture, Dr John Jumoke, holds a prescription pad that reads,

Rx: Art, Poetry, and Music.20121223-000808.jpg

I think that is a pretty good first line defense for much of what ails the human condition. That and a good dose of empathic understanding from people who eschew employing violence, sarcasm and undermining skepticism in their efforts to help others. Too often people who are diagnosed, as I was, and still am, with “schizophrenia” are rushed into treatment that degrades and humiliates, even as it inflicts terrible effects, not to mention side effects…all without curing the so-called illness. I am not convinced that a person with “schizophrenia,” given the simple luxury of TIME, and a safe place with really good, caring, kind and intelligent people who know how to help without hurting her or him, would not heal better and more effectively than with any of all the so-called miracle anti-psychotic drugs our billion dollar medico-pharma industry has foisted on us. And I say this even though I still feel that Zyprexa was a “miracle drug” for me, once upon a time, (though also the miracle drug from hell…) and that it gave me a life I had never known before. I say this even though I take Abilify and Geodon and do more art and writing than I ever have…I say this even though I am better now than I have been in decades. I think the drugs are only fixing problems that the system largely caused. And had I had the chance, way back when, I wish I had had the chance to fight back without them…

If I could do anything to fix the mental health system, in Connecticut or this country or the world, one small thing, it would be to end ALL use of seclusion and restraints, period. Violence begets violence, in all cases. In ALL cases. In fact, get this, I would change the prison system as well, so that punishment qua punishment would be a thing of the past. Punishment is only a form of revenge and it does nothing to change a person or make them better. It only makes society feel better the way a bully feels better when he or she smacks a victim upside the head for smiling lopsidedly. I mean this. Sure, people can do very bad things. Yes. And certain people may be so damaged that they are too dangerous  to safely release into “normal” society. (I maintain that this is largely because of how we, as a society, treated them, either at large or in prison.) But prisons and penitentiaries, especially in America, should be seen as an abomination on God’s green earth.

They say a society is judged by how it treats its dead? Well, I think we are judged by how we treat our prisoners, and if so, we will be judged poorly indeed for we treat our prisoners like hated animals…Not like cats and dogs that is for certain, nor even like horses…No, because we generally treat cats, dogs and horses well. Rather, we treat prisoners like vermin, like roaches…and then we blame them when they behave like the vermin they have become!

Have I gotten off the subject? Well, some mental institutions are largely prisons to their populations of involuntary or coerced patients, and most patients, involuntary or not, are cowed into doing as they are told for fear of the consequences. So to a degree the prison metaphor is valid. But if you have been restrained and secluded, brutally, and for hours upon hours, for many days, as I have been, the notion that you are a prisoner becomes more reasonable. That said, I will advance yet another idea: that bad behavior should be treated, not punished. Yes, I mean that. We should treat the person guilty of repeated criminal offenses as if he or she has a treatable behavioral disorder, and not punish them.

I know this will earn me some outrage. But think about it. What good does it do to punish a person repeatedly? Does it do anyone any good to torture that person with “the hole” or with repeated cell extractions and mace in the face? Clearly it doesn’t rehabilitate them or teach them the ways of kindness. It only makes them worse, and in our system an in-prison offense can add years to what started as a short sentence. So we create hardened criminals inside our prisons. I ask again, what good did it do?

But if instead we took that person, guilty of an offense and treated them as if they needed help — help learning how to behave better — and all that might entail, perhaps we might end up not only with someone ready to leave the institution at the end of the shorter stay, but someone ready to stay out afterwards! It only makes sense to treat everyone, including prisoners, with kindness and understanding and education, and if you don’t believe this, you should for one reason only: it would cost less money. (Of course, the owners of the private prisons don’t want you to know this, because they MAKE money on all the prisoners who keep coming back or who never get out, in fact there is a whole industry based on keeping as many people in prison, their private prisons, as possible…)

But I don’t believe in prisons either. I think the institution is a nightmare. You put bad people together with one another and what do you get but people learning how to behave worse together! It is a truly ridiculous idea. Analogous to the hospital, which is currently the worst and most dangerous place to go when you get ill (because that is where the most dangerous infections are and are often out of control). In the “old days” prisons were merely waiting stations. Penalties were sure and swift, and brutal. But no one waited for decades in a crowded prison with society pretending that it was humane. Now, we pretend it is..I dunno. Do we pretend anything, or just not care?

Do we care at all that we warehouse so many millions in dead-end lives that only get worse by the day, and then deprive them the more if they manage to leave prison eventually and not return? Oh, we have three strikes laws to put a person in prison for life, but no one gives a damn that there are three strikes against any person who actually earns his or her way OUT of prison. Nowhere to live, no job, no money, and no safety net whatsoever. (Unless you happen to be a former governor of Connecticut, and then you have it made in the shade.)

Enough for now.

Monet or Moi?

Monet or me? Well, okay, I am no Monet and this time I didn’t copy him… I painted this, with oil pastels, my second imagined seascape. mostly from memory. © Pamela Spiro Wagner All Rights Reserved

Better version of the above photo of my art piece is below this post (I managed to capture the entire picture finally and didn’t cut off most of the sky…)

I have just given a speech that I want either to record for putting up here, once I upgrade to Pro, or if it gets published as an Op-ed somewhere I will point you to it. But for now, let it only be a hint of things to come…

Otherwise, exhausted, I don’t have a great deal to say today except to point people to an article that I found in Science Daily, an article that I found both obvious in the extreme, and yet which I believe most people desperately need to read. If it isn’t time now to stop incarcerating people of color, for NO reason other than the color of their skin, then I dunno what time will be right for it.

Systematic Incarceration of African American Males Is a Wrong, Costly Path

ScienceDaily (Nov. 11, 2012) — Mental health experts from Meharry Medical College School of Medicine have released the first comprehensive report on the correlation between the incarceration of African American males and substance abuse and other health problems in the United States. Published in Frontiers in Psychology on the 12th of November, the report looks at decades of data concerning the African American population rates of incarceration and subsequent health issues. The authors conclude that the moral and economic costs of current racial disparities in the judicial system are fundamentally avoidable, especially if more resources are spent on education and treatment.

“Instead of getting health care and education from civil society, African American males are being funneled into the prison system. Much of this costly practice could be avoided in the long-term by transferring funds away from prisons and into education,” says Dr. William D Richie, assistant professor in the Department of Psychiatry and Behavioral Sciences at Meharry Medical College, lead author of the paper.

Money would be better spent on treatment than on incarceration

The study highlights the fact that with regard to African American males in the prison system, individual States are paying more to lock up non-violent offenders than they are for education, since 60% of incarcerations are due to non-violent, illicit drug-related crimes. The authors also point to a previous study from 2,000 showing that the total cost of substance abuse–be it incarceration, crime or treatment–is over $500 billion per year for the US.

These and other statistics have led the authors–scientific experts often called upon to testify in court–to conclude in the paper that: “Spending money on prevention and intervention of substance abuse treatment programs will yield better results than spending on correctional facilities.”

Need more teachers of color

Even though crime rates have dropped across the country over the past two decades, incarceration rates have continued to skyrocket–with black people accounting for a largely disproportionate 38% of inmates. More alarmingly, incarceration rates for African American males jumped 500% between 1986 and 2004. And while substance abuse increases the chances of individuals’ ending up in prison, those without any previous history of substance abuse have a higher risk of substance abuse once they leave the prison system, and could more easily fall back into the judicial system instead of getting a solid job or education.

According to Richie, much of this disparity is due to a fundamental problem of perception on both sides. For example, negative reinforcement of disruptive behavior is prevalent already in preschool–young children of color are often treated more harshly for behavior similar to their white peers.

“One step in the right direction, would be to have more black teachers during the early stages of development” says Dr. Richie. “From a behavioral scientific perspective, having teachers that look like the students and the parents of students from an early age could go a long way in changing perceptions of authority for black youth.”

Getting more African American teachers means increasing the number of African Americans in the higher education system and getting them out of the incarceration system. In the end, the authors conclude, effective treatment of substance use disorders and alternatives to prison would cost the United States much less and improve the lives of African American males, their families, and the entire country.

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The Original Science Daily article can be accessed here: http://www.sciencedaily.com/releases/2012/11/121112090734.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

And PDF of the original paper (fairly short) can be found at this site:

http://www.frontiersin.org/Forensic_Psychiatry/10.3389/fpsyt.2012.00098/abstract

20121117-041338.jpg

Mental Illness and Authority: Part II

I started the post below as a response to a very kind email from “Mary” but it eventually got so long and involved that it became more of an essay than a letter. I hope she will understand why I put it here, rather than sending it to her alone!

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First, here is her letter to me:


Thanks, Pam.   I learned from your very well written account, “On Psychiatry and Authority.”  I felt like I was in the room with you, it was so descriptive.  I recently had a call from a man who is bipolar.  He said while off his meds, he was in an encounter with his girlfriend and was arrested on domestic violence or disturbing the peace charges.  He told the officers he was a psychiatric patient, but of course, jails have become America’s answer to mental illness.  The police threw him into a cell after booking him, then released a police dog on him in the isolated cell rather than simply locking the door.  He said the dog ravaged his leg, exposing bone, and he was taken to the hospital.  There may have been a time when only black mental patients were treated this badly, but the caller was white.  I wrote about more murders and abuses against mentally challenged people in my blog – Letter to Mary Neal’s Terrorists – http://freespeakblog.blogspot.com/2010/10/letter-to-mary-neals-terrorists.html

I am still undergoing much censorship, Pam, likely because my advocacy to decriminalize mental illness is a threat to the private prison industry.  Over half the inmates in America are mentally ill.  If they are released to community care under AOT programs or treated as hospital inpatients rather than prison inmates, depending on their offenses and functionality, it would not be more expensive for taxpayers, but it would negatively impact prison profits.

As I read about your brutal treatment in the hospital, I was so sad.  Here I am advocating hospitals rather than prison, and you were treated that way by psychiatric professionals.  The only way I can continue after learning what happened to you and others who were in abusive hospital environments is by thinking about people like my caller who was not only tossed in an isolated cell naked, but a vicious dog was sent in to attack him after that.  I also think about my brother Larry who was murdered under secret arrest because police were fed up with being his psychiatric caretakers.  Although hospital care is only marginally more humane than incarceration in some cases, there are fewer permanent physical injuries and murders among hospitalized patients.

Thanks for sharing your experiences.

Mary Neal
Assistance to the Incarcerated Mentally Ill
http://www.Care2.com/c2c/group/AIMI

And my response:

Thanks so much for your email and sympathetic understanding of the traumatic aspects of my so-called “treatment” at Muddlesax Hospital last April. Such treatment was, at other hospitals especially in the 80s and 90s and even in the early 2000s, so much worse — I mean in terms of real physical violence perpetrated against me while being literally, bodily, forced into restraints — that I was almost reluctant to write about such a relatively mild incident. But the humiliation of having to put myself into restraints was almost more unbearable than the, in some sense, honorable freedom to resist! It just riles me completely…How dare they put me in such an untenable position? Then again, I suspect it was intentional.

Nevertheless, I am very much aware that in Connecticut hospitals way too many people have died while they were in restraints, and this in the not so distant past. In fact it was investigative reporters at the Hartford Courant back in the late 90s —and their article entitled, I believe, Deadly Restraint — that served as a national catalyst in getting hospitals to stop the wholesale use of seclusion and restraints. At the very least it started a national discussion about the use and abuses of force in psychiatric hospitals and (I think) juvenile detention centers. (God forbid anyone at all should care about jails and prisons however…Those people obviously deserve it, they are criminals after all… Right?)

But even though most hospitals in Connecticut claim to have reduced the use of force to the most extreme cases, (they will force medication though, through the use of forced medication hearings) I do not believe that can be so. Because I cannot believe that I alone “deserve” seclusion and restraints and yet I have been subjected to such abuse time and time again. Until 2005, I was put in S + R at least once almost every time I was hospitalized and quite often multiple times, for many long hours. After 2005, I would say the incidence was reduced by about half. That means that half the hospitals still indulged in this abuse, one of them, as I wrote earlier in this blog, employing them almost every day for a week and a half!

Of the hospitals that did not physically restrain me,  most were still abusive, but more subtle about it…For instance, they would put me on Constant Observation, but then tell the “sitter” not to speak to me. Or they would institute the common but for all the commonness of it, still abusive policy, of making the one-to-one person being ignored sleep with her hands and head completely uncovered. Now, all hospitals are freezing these days, I do not know why. But it was well known that you had to bring a sweater or sweatshirt everywhere, because the air-conditioning would be out of control and everyone was too cold no matter the season. So to have to keep your hands exposed all night was cruel. But the reason that they insisted on it clearly had nothing to do with it being “safer” for the patient. No, it was punishment. That is ALL. The whole purpose of one-o-one in those places was punishment. You could not talk to the sitter, one, and the sitter had to follow you even into the toilet. And all the while deliberately ignoring you if you spoke to her..So what was the point, if they kept the close eye on you they were supposed to, they knew you could not hurt yourself.  So the point was simply to humiliate and torment the patient so they would beg for “freedom” and pretend or at least mouth the words “I am safe.” Those magic three words were all that were needed, but you had to say them so that the nurses could hear.

For many years, I believed that this was a hospitals-wide, state-wide, business as usual policy, the no-talking, hands exposed rules, and that it was reasonable. Until I went to Natchaug and Sharon told me that Natchaug didn’t believe that one-to-one should be “punitive” in any way. And by the way, she said that word, “punitive,” not I. Nevertheless, at Natchaug, no one made me sleep with my hands outside of the covers and the sitters freely spoke with me. In fact, once they understood that I needed them not to share their own lives with me, because then I would feel the need to take care of them, something that would not be helpful to me, they wanted to find out specifically how they could help me.

But back to the use of restraints. I am only 5’ 3” and from 2005 until 2010, I weighed between 92-105 pounds. Surely I could not have been that great a threat to anyone. In fact, at one hospital, one I will not name, fearing them so much I wouldn’t put it past them to take revenge, they had a somewhat better policy of dealing with agitated patients.  At a Code Orange, staff members from every unit converged on the “victim” (sorry but that is how it felt) and  “held” her until she could calm herself. Now, this “holding” often consisted of pinning her bodily to the floor, which itself could be anxiety provoking. And at least once, in my case, a male nurse who openly detested me, tried to pin me to the floor on my stomach, which I had read was something to be avoided as people had died when held down prone, as opposed to supine (on the back)! But in general the technique worked, if the victim was held down long enough. Basically, if he fought, there were enough people holding him down to allow him to exhaust himself without doing anyone harm. And then, when exhausted, he would calm down and either take PRN medication, or assure the head nurse that he would be okay now. It worked, though, no matter what I thought about it, or of the people doing it. And it did avoid all use of restraints, though of course by itself it is already a form of restraining people, it just avoided the use of mechanical restraints. That though, still makes a big difference…

Forgive me if I segue again into another digressive subject for a minute or two, but the subject of 2010, which recently turned the decade corner into 2011, brought to mind the fact that having taken Zyprexa (most of the time) since then has caused me to gain a fair amount of weight, another subject that is near if not dear to my heart. Oh, the damage that psychoactive drugs do! How dare doctors blame us, the people with schizophrenia, for it? Don’t we have enough trouble without being blamed for the side effects of the very medications that they prescribe? Do you know that for decades, and sanctified as Truth in psychiatry textbooks, they insisted, without any reason and making less sense, that schizophrenia itself was the cause for so many of us to be obese? That was utter nonsense to my way of thinking. Every single memoir about sz that I ever read revealed that the author had been thin UNTIL she or he was treated with antipsychotic drugs, and then, blammo, food becomes the enemy. Yet the shrinks actually insisted, against all the evidence, that it was the illness and not the drugs that was behind the huge % of patients exhibiting this “signal obesity”.

Well, all along I thought they were full of shit, pardon my french. No, I didn’t just think it, I KNEW it. I had not a doubt in the world. And you know what? I was right. The latest research has borne out precisely what I’d asserted all along: when investigators looked at a population of people with schizophrenia that for one reason or another had never taken antipsychotic drugs, they discovered that this neuroleptic-naive group was thinner than average, and that it was in fact the drugs that had made us obese, sometimes massively so, rather than schizophrenia. And it just infuriates me, not just the obesity, it is not just the weight gain the drugs cause, it is the fact that we patients have been blamed for something that they, the doctors and nurses and their GD drugs, inflicted on us. Maybe it is especially difficult for me, with my history of anorexia and my intense wish simply to disappear, but what about those who will die from drug-induced heart disease or diabetes?

I know, I know, Mary, you may be on the other side of this argument, or it might appear that way, because you want more treatment to be available, not less. I do in general agree with you: Prisons are overflowing with the mentally ill, who should never have been there in the first place. In fact, I think the prisons are overflowing with an awful lot of people, especially those of a certain darker-hued skin, for little reason more than the very color of their skin! I mean, tell me why Robert Downey Jr and Lindsey Lohan, aside from their celebrity status, get caught again and again with drugs and cocaine etc, yet are sent off to posh rehab centers, with a smile. But should you happen to be an unknown, POOR, god forbid mentally ill person of a darker hued skin (and let’s face it, a light/white South African immigrant would not be treated the same way as a dark-skinned someone with Nigerian roots!) if you are that person and you offend in some way just 3 times, well, then, you are sent away to one of California’s really “posh” ha ha ha penitentiaries FOR LIFE! Things like that just make my blood BOIL. And don’t get me started on the insanity of our drug laws!

But forgive me for going so far astray. It is just that the whole subject of prisons and what we do to people in them is a really sore point with me, and not just how we treat the mentally ill there, though that is about as atrocious as it can get…Need I even mention the “extra beds” in unused supermax prisons being used to house “unruly” MI prisoners? It makes me want to scream and throw up at the same time.

Well, no doubt this “essay” is both incoherent, in the sense that it doesn’t cohere properly, and just plain incoherent! I admit to a bit of laziness, as it is late at night, and i need to take my MEDS and go to bed. So, at the moment, I am not going to polish and fix it. I am going to pretend that since this is “only” a blog I can get away with shoddy ill-organized writing, and call it a night. Which is what I am doing forthwith…Good night, and thanks, Mary N, thanks a million again.

PW

Schizophrenia and Traumatic Treatment: Continued Use of Restraints and Seclusion

Please note: For my final take on what happened at Middlesex, please jump to this link: https://wagblog.wordpress.com/2012/05/15/useless-psychiatric-mediation-and-a-poem/   (added in September 2012)

First, before I start my post today, I wanted to share my newest artwork, which is a colored pencil “painting” of a woman who lives in my building, whom I will call Rose. She did not ask me to paint her; she was simply someone who sits quietly for many hours in the community room, and so was a good subject for a portrait, and a photo. I also happen to find her a very agreeable person, one of the nicer ones here (most are gossips and backbiters, or if not most, then the most vociferous and visible of the residents). I think she will be quite pleased with how it turned out, so long as she does not expect anything but a portrait that is faithful to life, rather than an idealized one. I believe, however, that Rose is very down to earth and knows what she looks like, and will appreciate what I have painted.

Rose, intent on her needlework
Rose intent on rugmaking
Rose comparison of painting with photo

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Now I want to discuss, yet again, the use of restraints in Connecticut psychiatric units, particularly as it pertains to my treatment there. As I recall, I have not gone into much detail about the last hospital stay, back in April and May, largely I think because it again was so traumatic and in many ways similar to the previous one, that I could not bear to contemplate it.

However, as very little as I recall, I do remember more of the stay than the complete amnesia I still experience for the stay in Manchester, back in October or November of 2009. When I say I have a loss of memory with regards to this other hospital stay in the spring of 2010– in Middletown — I meant it more for the specifics of certain episodes. And for any of the people there who staffed the unit. (Except for Christabel the OT).  With regard to much that occurred I believe a lot could be brought back to me, under the right circumstances. I do, for instance, continue to have an overall memory of what the place looks like and where my room was and some details about what happened. What I do not, and did not remember, not even the next day, was most of what precipitated the use of restraints and seclusion during this stay. Or at least, of the two or three incidents of S and R two are jumbled together, so that it takes some mental probing for me to straighten out any of it. but one incident remains too clear in my mind for comfort though even at the time, or immediately afterward, as well as now, I have no idea what was the actual precipitant.

Anyhow, what I recall of  that episode is this: I had been taken off Geodon, which I took regularly with my  Abilify up till then, both in order to boost its antipsychotic properties as well as to temper any Abilify-induced irritability. The irritability was physical as much as mental — and with the resultant tendency to get into verbal fights and arguments with anyone who, as my mother used to put it, looked at me crosswise. I have no idea why they did this, took me off Geodon, given that I know I explained the rationale for the use of two antipsychotics. But many MDs seem to find this objectionable, however effective. Perhaps they considered the 20mg Zyprexa, which they had talked me into taking on an acute basis, would be an adequate substitute for the calming effect of the Geodon. They had wanted to stop the Abilify, too, using Metformin, a diabetes drug, for weight control, but I had insisted on taking it both in an effort to combat Zyprexa’s tendency to cause weight gain, but also because I believe that it is the Abilify that has so massively enhanced my creativity.

So there I was, on Abilify untempered by Geodon, and taking Zyprexa, which induces its own “upsetness” when my weight invariably increases…I assume that I must have been hostile, loud, and disruptive, for I do not know why else they would have made me go into the seclusion room. I do remember that I could not calm down, and that in the flimsy johnnies they had clothed me in, I was freezing, so that even when the nurse doing constant observation told me to lie down and rest, I was unable to do so for all my shivering. I begged for a blanket, but no deal. I pulled the entire bare mattress over me as a covering. Well, this was apparently seen as a self-destructive act, or something, as immediately they pulled it off me and dragged the mattress itself from the room. Now I had nothing for warmth, except my own anger at having been treated  in such a fashion.

I remember that I was yelling a lot, and that I wouldn’t lie down on the cold linoleum and “calm myself.” No, I wanted to talk, and begged the nurse to do so. Instead, she only turned away and told me again to lie down on the floor. Well, this enraged me, and I went to the door to complain again. She said nothing, only stood in front of the open door so that I could not leave. Finally, getting no response, and still anxious and “het up” I suppose you could say, or over-activated by the Abilify, I tried to push my way through her into the opening. Immediately two “guards” pushed me back into the room. I yelled at them, and pushed back. One of them asked me what was wrong with me, why I didn’t just ask to talk with the nurses instead of resisting physically…I looked at him and said that I did ask to talk, and she refused. He seemed somewhat surprised by that. Nevertheless, he ordered me to go back into the room and lie down.

I was having none of this dictatorial behavior on their part, and as I recall, at one point — no, I do not remember what happened. I only know that suddenly the guards were on top of me, and one had pinned my arms behind my back and was pushing my face into the linoleum floor. It was as if I were a recalcitrant inmate of a prison and this was a cell “take-down.” I was hurt and I was furious.

When they let me up (and why they had pinned me to the ground I have no recollection, only that when they let me up, I was finally allowed to talk to the nurse nad stand out in the hall with her. I heard some talking behind my back and a commotion, followed by feet going down the hall away from us. I had a bad feeling about it, and asked the nurse, “What are they doing?” She responded, ominously, “They are preparing a bed for you.” “a bed? what sort of bed? She remained silent and I understood that they were putting restraints on my bed…”You can’t restrain me, I am out here calmly talking to you. You haven’t even offered me a PRN and I will tell you now that I would be more than willing to take one. But I am NOT a danger to myself or others, and you cannot legally put me in restraints.” The nurse continued to remain silent. My heart began to race. I called down the hall, “I will not let you use restraints on me, I am calm and this is not allowed.”

Some of the staff approached me and told me to come down to my bed room with them. I complied, because I knew that if I didn’t they would have some reason to say I “deserved” to be restrained. When I got to the room,   I found I had been correct: there on my bed were the straps and shackles of four-point restraints, attached to the bed frame.

“I am calm and I am not a danger to myself or others,” I carefully declared. I will take medication and I do not need restraints.”

“Lie down on the bed, Pamela” someone told me. I refused, saying that this was punishment pure and simple and that they had no cause to do this nor any legal right. “I will ask you one more time to lie down on the bed, Pam, or the security team will help you do so.”

At this point, I understood that they were going to use this form of discipline on me no matter what I did. That they were out to get revenge and that they would use any excuse to excuse such measures. So if I “made” them force me into the restraints, that would by itself prove that I “deserved” them. So, more humiliated than I believe I have ever been in my life, I sat down on the bed, then lay down on my back and said out loud, “I am now placing my limbs into four-point restraints, and I want a record of the fact that I am calm and not resisting and that I have asked for a PRN instead.”

It was no use, though, as they went ahead and shackled me, then left me alone in the room, except for a staff member monitoring me through the door, left partially ajar. My heart was racing with rage, and I could feel the pain of such profound humiliation surging through me. But I did and said nothing, I think, because I was going to prove to them that the drastic measures and punishment they had inflicted on me was WRONG. After about an hour and a half someone came back and let me out. I was neither compliant now, nor placated and as soon as I was free and out of that room, I let it be known, loudly  that I intended to file a complaint. But no one said a thing, no even spoke to me the rest of the night…

THAT is what I remain so traumatized by, at least with respect to  this time: the utter humiliation of what you might call “cutting my own switch,” along with the clear understanding — even mutual acknowledgment — that they were punishing me.

This continues to preoccupy me, that is when I allow myself to think about it, or when I continue to try to read the records of that stay, which records I only a week ago obtained (having sent for them many weeks ago…). I cannot help but re-experience the same brutality and the same extreme and exquisite humiliation, and once again it hurts beyond belief. The worst thing perhaps is that when I told my family about what the staff had done to me they didn’t come to my support, they didn’t unconditionally defend me. They didn’t even  seem to care, or to believe, that I had done nothing to “deserve” four-point restraints (as if anyone deserves them). Another family would have automatically come to their member’s defense and declare that NO one deserves such brutality, and that as their family member I should never have been treated that way. Another family would have done  –oh forget it!  No, my family is always so eager to please the staff and to believe that I am in the ‘wrong” at these hospitals, to believe that I am at fault, (this is the story of my life!) that they simply told me I must have caused their use of such brutal methods of control by my own behavior, I surely deserved it, and besides “what else could they do?” Shackling me, calm and rational, me to a bed was clearly the only option and entirely justified…So much for MY family’s loyalty and compassionate support, huh?

Well, bitterness solves nothing, so I won’t dwell on the last subject, but I will say that if I can, I intend to file an unoffical complaint, or barring that, an official one. The problem with the latter is that I will not then be able to confront my persecutors. whereas if I did so unofficially, it might yet be possible, if only to avoid a messy public affair. After all, I could easily write something…No, I won’t go there. For now, I only wanted to describe what continues to occur at Connecticut psychiatric units, despite the regulations and general disavowal of the use of cruelty in the treatment of those with mental illness. It still goes on, it just happens behind the closed doors of the hospital and the continued use pf seclusion and restraints as discipline and as a salve for frustration, depends on the assumption that no patient will bother, after the fact of discharge, to do anything about it, except try to forget.

Things are better than this, but do not feel it!
Note the linoleum and bare mattress. I have never seen a windowed seclusion room!

The Mentally Ill in Prison and Out-patient Commitment Laws

Dear Pam,

Thank you for the link to the Dr. Manny Show. There are indeed many faces of mental illness. Some people have mild cases and are able to work and function at the same level as anyone else.

Congress passed mental health legislation in 2008 providing for workers who have psychiatric dysfunctions to be covered under their employers’ health insurance at the same rate as employees with physical illness (certain exclusions apply). That was a positive step. However, acute mental patients do not benefit by that law, because severe mental illness is often too debilitating for victims to work, especially without the psychiatric treatment they need. In fact, people with acute schizophrenia, bipolar disorder, PTSD, and other conditions frequently resist treatment even when it is available to them.

Unfortunately, 1.25 million mentally ill Americans are currently imprisoned for offenses ranging from simple vandalism or disturbing the peace to murders. Last January, Rep. Eddie Johnson (D-TX 30) introduced H.R. 619, a congressional bill to resume Medicaid coverage for inpatient psychiatric care for patients in crisis and for people who require long-term containment in a secure treatment environment (such as patients who have done violence).

H.R. 619 is an important bill that deserves our support. It was largely the removal of Medicaid funding several decades ago that led to criminalizing mental illness. That in turn led to many other problems, such as overcrowded prisons and a burdensome prison budget. Hundreds of thousands of acute patients were “de-institutionalized” in the 60’s and 70’s only to become homeless and/or prisoners. Thousands of acute mental patients continue to be dismissed from mental hospitals and prisons without subsistence assistance and provisions for continuous monitoring and treatment under programs like Kendra’s Law.

Assisted Outpatient Programs like Kendra’s Law have been proved to reduce homelessness, arrests, hospitalizations, and incarcerations by up to 85% (among New York participants, compared to their circumstances three years before becoming program participants). The impressive rate of reduced arrests and incarcerations also indicates that community safety was improved significantly as less crime was done, and it also follows that the prison budget was lessened by helping patients with living arrangements and mandating continuous psychiatric care for ex-offenders and former inpatients who often lack the wherewithal to make wise treatment choices and avoid psychiatric crises.

Assistance to the Incarcerated Mentally Ill (AIMI) supports Rep. Johnson’s bill, H.R. 619, as well as NAMI, Treatment Advocacy Center, and many other mental health advocates who believe resuming funding for inpatient treatment is best for patients and for America. In fact, 100% of police officers I polled agree that prison is not the place for severe mental patients, where they comprise 60% of the inmates kept naked in solitary confinement cells.

I solute Congresswoman Johnson, a former psychiatric nurse, for introducing H.R. 619, and I hope everyone who is concerned about human and civil rights will support the bill and end the discriminatory practice of punishing Americans for being sick. I pray for another bill to be introduced to address the second cause of mental illness having been criminalized in America – the lack of continuous care and subsistence assistance for released prisoners and former inpatients. Kendra’s Law should be applied nationwide so that acute mental patients will be treated, not punished, for having a common, treatable health condition that requires monitoring and care just as diabetics and heart patients receive.

Inpatient hospitalization was not included under the national health care plan, so it is very important to pass H.R.619 as a separate bill. Please write an email to your representatives tomorrow and ask them to co-sponsor the resumption of Medicaid for psychiatric hospitalization and to institute Assisted Outpatient Treatment progams, which would not only be more fair and humane to sick people and their families, but would also save taxpayers billions each year as our prison rolls decrease.

Thank you, Pam, for this forum and for the useful information that WagBlog always has. I will share the link to the Dr. Manny Show with many people at my Care2 Sharebook and at FreeSpeakBlog, where we often publish mental health news as well as other matters that have to do with promoting human rights for prisoners.

Mary Neal
Assistance to the Incarcerated Mentally Ill
http://www.Care2.com/c2c/group/AIMI

PS Please VOTE for H.R.619 to replace prisons w/ hospitals for acute mental patients. The link below will take you to OpenCongress.org where you can use your voice to say to our elected officials, “We care about the least of these, His brethren: naked, sick prisoners.” (Matt.25:36) http://www.opencongress.org/bill/111-h619/show

While many Americans celebrate the health care reform bill’s victory, please agree that millions of citizens should not be left imprisoned or live under the threat of prison because their health care needs were omitted. Put the “NATIONAL” into health care reform by supporting H.R.619: Medicaid funding for psychiatric hospitals instead of prison cells for mentally challenged people – a change that will save money and restore lives!

Thanks in advance for voting. Please invite others!

___________________________________________________

Dear Mary

I think you know that I was quite ill until starting in 1996 when Zyprexa came out, but not truly until 2005,  when a complete transformation occurred. However, when I relapse, I “relapse good” — as my medical record from the October hospitalization attests, with nearly constant locked seclusion or restraints for 6-8 days etc. Nevertheless, I am with you, though reluctantly, as I also know how terrible the side effects are of some of the older medications are as well as the newer ones, and the horrible state of affairs when a harried or burned out psychiatrist simply rams them down your throat without consultation at least after the acute psychosis resolves and you are able to discuss such things.

When I was in Manchester Hospital, I begged to be put back on my anti-convulsants and the Abilify/Geodon combination that had served me well for many months, believing, with reason, that I was suffering from a flare-up of my neurological Lyme disease, an illness that had always and invariably produced severe psychiatric symptoms. I needed, I knew, an increase of those drugs rather than a wholesale change to the “old drug” Trilafon. But did the doctor listen to me? No, he did not, despite my  ability to say as much to him, my psychosis consisting not of incoherence but of paranoia and command hallucinations to  harm myself in order to atone for being the Devil…I could and did argue with him, vehemently, and steadfastly, refusing to take the Trilafon, until he instituted a standing restraints order for every time I was non-compliant.

These are the sorts of things that trouble me about  forced treatment and/or outpatient commitment laws. It is not that I think people suffering from severe psychiatric illness do not need or deserve treatment, only that the treatments available are not always effective or tolerable. And until they are, I am not sure that the only way to go is only to force medication on everyone willy-nilly, not, at least against their protestations of extreme discomfort. At the very least every effort must be made to find a medication or medication combo that keep the psychosis at bay while making the person as comfortable as is humanely possible…which is difficult when a psychiatrist is saddled with a hundred patients to see in a week. It took Dr O and me six years or more to find  the right combination of drugs, and to titrate them precisely enough to treat my symptoms,  reducing them significantly while keeping unpleasant side effects to a minimum.

There is much about the treatment of the mentally ill that is so disgusting I cannot begin to cover them all here, though your comment is very thorough, which is why I have put it up  as a regular post. I appreciate your links to sites that do so as well. You did not mention one horrific situation: where under-utilized supermax prisons now house “uncooperative mentally ill prisoners” whose lack of compliance or cooperation is due solely to their illness. Though it is well-known that such brutal conditions drive “normal” or reasonably sane prisoners to insanity, can you imagine the brutality of forcing a psychotic individual to reside in such isolation? (Note however that in years past, as you know, isolation and seclusion of disruptive patients in hospitals was also the norm, since “overstimulation” from the outside world was considered to cause their agitation…I have been in hospitals where, in bare seclusion rooms, I was not permitted access to letters or phone calls, visitors or even reading material. As for restraints, they too were inhumane as I was shackled SPREAD- EAGLE, to the four corners of the bed and not, as even then was considered proper, with my legs straight and my arms in position by my side. This treatment moreover was considered normative for agitated psychotic patients rather than cruel in the extreme  as recently as the 1980s in some municipal hospitals in Connecticut.

I  recommend the book, THE DAY THE VOICES STOPPED, by the late Ken Steele, who wrote of his experience as a 14 year old with the savage isolation policies in NY hospitals in the 60s and 70s,  treatment that today seems literally incredible.

Well, I thank you for your contribution to my blog, Mary. You are welcome here at any time. I will post as many of your comments as I can.

Sincerely,

Pam W

Poem: Life without Hope of Parole…

STATE PROPERTY

The Walls: what prisoners call the Washington State Penitentiary at Walla Walla

Freeworld: everything beyond the Walls

For A.

You’ve been owned by the State

since you can’t remember when,

body, mind and what’s left of your spirit

shackled to a prison more shattering

than the Walls, where at 18 you ended your life

in the freeworld. Hadn’t the big house

always beckoned, ever since the first time

you entered a home and found it

no refuge but a place of pain

and abuse, of neglect so battering

you ran straight into the arms

of a detention center

where at least no one pretended to care?

Who cared anyway about just another

juvenile delinquent with a mouth

to feed? It was hard to say

when mere delinquency — a word

that meant only that you’d left,

that you’d “left completely”

but left what was left to the imagination,

left home, left hope behind, left off caring —

turned from trying to survive to the criminal.

Homeless, hungry, no better educated

than an arrested ten-year-old,  you

stole bread, stole something middle class

and valuable and we, a nation

of Javerts, were too righteous to split hairs

and see you. But somehow an innocent

was killed and now you are up against the wall

in Walla Walla, amidst the teem

and clangor of that crazy

noise-filled space, with no hope, no hope

of freedom and even if it kills you

this time you swear you will redeem yourself,

reclaim and save yourself from the death

of that which still remains humane

in you. One aching brick at a time,

some walls are built, others torn down.

Outside the canteen window,

snowy egrets build their nests,

a beaver slaps the water with its tail.

I don’t remember exactly what happened to place Andy (not his real name)  and his sister in the care of the State, but I know that certain authorities found them huddled in the bathroom of their house or apartment, hungry and dirty and frightened, and from then on nothing was the same. They were separated, for one thing, and Andy lost track of his sister for years. Foster care was a travesty. Though there are, I know, many good foster families and truly giving and loving people who do fostering out of the goodness of their hearts,  Andy did not meet those. Most of the time his  foster parents only wanted the extra cash and he was lucky if he was fed adequately and had a bed of his own. He was often beaten and had to work for his food. Desperate, he made the first mistake, but one that probably set him on the road towards the situation he is in today. He ran away. But for a foster child, a ward of the State, running away is truancy, a juvenile offense and several such episodes, he was considered incorrigible and sent to reform school, where he learned only more survival tactics and more violence.

You see where I am going with this? It may be true that some boys rise above this, some boys find it within themselves to turn their lives around and make something of themselves…But I do not believe that they do it themselves. I believe that some caring adult, someone, anyone, steps in and makes them believe in themselves. Andy never had that. He knew only abuse and more abuse, in the many homes he resided in and later in the various juvenile  centers to which he was sent.

Finally, in a home as a teenager, he turned 16 and , he was an adult in the eyes of the state, no longer their problem, and he was turned out onto the street, unceremoniously, with no skills, no money, voila, no — nothing, but the clothes on his back and was told to get a job and make a life…This is crazy of course. Totally and completely crazy. But that is what happens, at least in Andy’s state, and I suspect in more states than I want to know about. Where do you go when, on your 16th birthday, your foster family wakes you early in the morning, and instead of presenting you with a special birthday breakfast and a birthday present, tells you to dress and get lost, get going, you’re an adult now and not worth anything to them anymore? I cannot imagine what on earth I would do.

Andy fell back on the skills he learned in reform school, like petty thievery (how else was he to get food?) and lying. And he ran with a crowd doing much the same thing. I do not know where or how he coped otherwise, nor where he slept, whether it was indoors or out of doors, nor for how long. I only know that at one point things escalated, and there was a gun involved, or perhaps it was a knife, but in any event, an innocent person was stabbed, or shot, and of the entire group only Andy was apprehended. But Andy was no snitch, and so he said nothing when pressed to tell who his “accomplices” had been, not even when threatened with a life sentence. which is what, in the end he received: Life without HOPE of parole. At age 18. Life without HOPE…

What does that sort of sentence mean, precisely? Well, for one, it means Maximum Security, because all long sentences are put into Max, esp lifers. It also means that at least in Andy’s prison, they wouldn’t bother to educate him or allow him to study for his GED, let alone a college degree. Why waste the money or the time on someone who was never getting out, never returning to the freeworld? It meant a lot of things, but mostly it meant hopelessness. And that was the hardest thing to deal with. That and the fact that you owned nothing, that you could count on keeping nothing, that nothing was yours. At any moment, everything you had in your possession could be confiscated, trashed during a cell search or simply ruined by flooding of the tier by prisoners protesting various atrocious conditions of their incarceration.

Andy knew that if he was to survive, he had to give up all attachment to things, to  everything outside himself, and to know that he was himself, a person, and that no one could take that away from him. He had to know that he could rely on himself alone, and to trust that, no matter what they did to him. And they did plenty. You can read about the Hole, but what really happens there, and even beforehand is truly an abomination. During a cell extraction for instance,  the squad, preparing to overpower the resistant convict, terrifies by virtue of their appearance and their “firepower.” To say that pepper spray is used is to deliberately mislead the public into thinking that the procedures are relatively harmless. A huge blast in the face of a chemical that makes one feel as if one is suffocating and cannot see is applied through the door window, until the convict is gasping and on his knees. Then the real extraction occurs, with an entire team subduing the prisoner, hogtying him in some instances, and removing him from the cell, which will later be trashed during a search.

People are disappeared, people are beat up, people die during a cell extraction, or simply when the guards are angry or sick of someone they can’t easily control and the death is hushed up. People die and nothing is said when a new prisoner is shown to the bunk they once occupied…

Andy has written a book length manuscript about his experience in the worst prison in his state, and  the entire book follows a prisoner through one day in the life of the main character. I think it is magnificent. Andy went from a 7th grade education to writing like a college grad, teaching Spanish, and many other accomplishments, including authoring two book-length manuscripts and a full-length play. I am hoping to find a publisher to take a look at his novel/ memoir. If you know of anyone who might be interested, would you please get in touch with me?

Prison Abuse: A letter etc.

Edited from a letter to a friend: 


I sent the following message to the White House website — the Office of Public Liaison. It is the beginning of a snail mail campaign (insofar as I am able), geared directly at President Obama asking for a prison and “juvy” reform agenda. So far as I can tell, he has nothing  of the sort at this point and we need one.

 

This is the very least I can do as I have decided that while I write this blog and books on behalf of my own issues around schizophrenia and mental illness, my political writings and action will be on behalf of a prisoner I am acquainted with who is sentenced to “life without hope of parole.” (I ask you is there a more fiendish mode of inducing despair, desolation and desperation in a soul than such a sentence?)



But my question  submitted on the form available was as follows: “Is there any Obama agenda for humanizing juvenile detention centers and for prison reform?  Abu Ghraib, Guantanamo and other foreign-soil prison abuses  did not come out of nowhere. Abuse and yes, torture of prisoners in “juvy” and US prisons are practices both brutal and common that serve no purpose except to create more violent convicts. Most will one day be released – to no one’s benefit, least of all  society’s. NO ONE CARES about them. They have been forgotten, lost, abandoned. PLEASE help.”



 

I was limited to 500 words so this had to be very carefully crafted and I wanted to get in some of the most important points. I dunno now about the comment about Abu Ghraib, but it seemed to me to be the important name to cite — an accurate reference for all that, according to my source– to draw attention then to the equation with US maximum/moderate  security prisons.

 

Anyhow, I don’t expect much of an answer (though the website implies the promise of something along those lines) but it was mostly to introduce the subject, into which I plan to go in greater detail in later letters.  


 


Towards the same ends, I am reading Christian Parenti’s 1999 book on US prisons and the “correctional system” in general, Lockdown America. I have had the book for years but have never been able to read it, though I wanted to. Now, suddenly, due to interest in this prisoner’s plight, I am slowly plowing through it. I admit it is difficult to get myself to sit down and read, but I really want to and so I persist.

 

My eyes, I think, continue to rebel. I have found that recently I have had to continually wipe my glasses clean in order to see better, or felt that I had to, without real relief. I am not sure what is going on, though. I believe I can still see 3-D okay. I just feel as if there is a scrim of something, a veil between me and the world…But it is more that than anything, and my usual narcoleptic sleepiness that prevents me from reading. Certainly not lack of interest and dedication. Still it remains very frustrating to me that getting through an entire book takes such a long time while writing is so easy (This is due in large part to my antipsychotic medication, Abilify, which I strongly believe facilitates putting words on paper, if insuring nothing at all about the quality of their ordering).

 

————————————————————————

 


Anyhow, truth to tell? The times are grave…I am attempting to work on a poem about Obama as Messiah and the concomitant end of the world. At the same time, I want to move to higher ground as I wrote in the earlier post, as soon as I get a spot in some other complex out of the Valley. That, however, could take years, I am told, as I am low on the waiting list, being disabled not a senior (I’m 56 and need to be 62 to be so classified, though the cut-off may be 65 by now)…

 

I do not know if the six years till then will be soon enough, and too, why continue to live if there will be social chaos and a catastrophic flood, famine and widespread panic, the predictable breakdown in all civil order…? I’d rather die, and by my own hand than survive to have to worry about being murdered by –

Argh, you don’t need to hear this, I think. But people are already  filling my head if not the halls with screaming and gnashing of teeth. I fear I may need to barricade the door…