After burning my face with cigars and cigarettes, in response to command hallucinations, I spent the last month in Connecticut’s well-known Institute of Living (yeah the dangerous 6th month was JANUARY not February but nobody thought to check my math) being beaten up and trussed like a pig in four-point restraints almost daily for many many hours. Why did they deal me this sort of treatment? Why? Because “You do not follow directions”.
I DID NOT FOLLOW DIRECTIONS so they beat me up (despite my policy of non-resistance) and tied me, shackled me with leather and metal cuffs to a bed for dozens upon dozens of hours.! Time after time I had to defecate in my own clothing, because they would not even give me bathroom breaks. Get that? I was disobedient, so they shackled me to a bed as an excuse for treatment!
After this experience, I LOST ALL FAITH in the ability of any institution to do anyone any good who has a mental illness or sickness of the mind, or any emotional disorder or whatever you wish to call it. I GIVE UP! I will kill myself if anyone ever tries to send me back to such a cesspit of a place. I do not care if it is appointed like the Taj Mahal. NO ONE who works there is uncontaminated by the evil infecting such places. I may be the devil but I never wanted to be evil while they are ALL EVIL EVERY SINGLE ONE. I have NEVER been to a hospital where the people are kind and well meaning and where the treatment is actually kind and decent. Once in a while a single person, such as the Middlesex Hospital occupational therapist Christobelle Payne, may stand out in memory as being a rare human being of warmth and dignity and caring, but otherwise, they all to a one fail the test of being decent human specimens and all fail royally to be even normally humanly responsive to suffering persons. They are in it for the money and a cushy job, and don’t you forget it if you go into a psycho hospital, DO not expect to get well there. Expect deadening dulling drugs that never worked and the research tells so, and directions (ie ORDERS) that you HAVE To follow or ELSE.
Get out of there as quickly as possible, because your life depends on it. I am serious. DO NOT LINGER expecting care and treatment or to feel better no matter how helpful you might want it to be.
Furthermore. if you are a young person, do not listen to the sweet seductive advice that some may give you that you woul do well to go for “disability” and social security payments. THAT Is a load of total crapola and the worst thing anyone could tell anyone under the age of 40. Too many young people are being 1) told as children that they have Oppositional Defiant Disorder or ADHD, both of which are adults’ and psychiatrists’ ways of saying, “You don’t as we tell you to huh? Okay, then, we will label you mentally ill in retaliation!” But that is not the worst because they then “medicate” you young children or adolescents with Ritalin or SSRIs and if those cause the anticipated problems of irritability and anger management problems, and outburts and moodswings (!!!), then “add on” atypical antipsychotic drugs (and who would not think to themselves, in momentary awe and self-pity, “OOOh, I must really be Mentally Ill if I take an ANTI-PSYCHOTIC drug, right???”)
The thing is, they will justify these drugs with another label, a label imposed because you now have an IATROGENIC or doctor-induced, medication-caused illness, like some version of “bipolar”, or if they really dislike you, the untreatable Borderline Personality Disorder, which only means largely that you are youngish, female and emotional and angry and don’t shut up when they want you do. (Test: Do they want you in DBT classes? Then you have the BPD diagnosis, trust me. Dialectical behavioral therapy is FOR “borderlines” no matter how hard they argue that it is open all…)
NEITHER of these labels reflect your or anyone else’s REALITY, mind you, they are ONLY labels, and neither Bipolar nor borderline have ever ever been shown to be real bona fide physiological illnesses or even (for all the talk) genetic diseases. What is a “real mental illness” anyway? No one agrees on the diagnosis, in any one person, and no one can find any chemical test or neurotransmitter than it out of balance or even an anatomic difference between the ill and the well. They only have the person’s words and the doctors opinions… If you disagree, prove what you what to argue. Do not tell me, well Manic depression “runs in the family” because that is horseshit. Messiness and not making beds can seem to run in a family, you know why? Because NO ONE breaks the cycle and teaches the kids the value of neatness and making beds every morning. It matter where and how and WITH whom you grow up, and the myths you grow up with matter just as much. The notion that Manic-depression runs in your family is only that. A MYTH. but that doesn’t mean you cannot induce it or see it and make it real in your kids or yourself if you try hard enough.Lord knows teenaged angst these days is frequently dx’d as bipolar so jump on that bandwagon by bringing your child to a psychiatrist and they will be happy to oblige!
But do not think that your label of “Borderline” is something elevated and “nearly psychotic” as if that itself is anything superior to other MIs. Trust me, when someone else calls you Borderline it is shorthand for MANIPULATIVE, DRAMATIC, attention-seeking, devious, lying…if you like those words, go ahead and claim the diagnosis for yourself, but i doubt you will. So why do you vaunt it, and flaunt it? Do you not understand that the hospital and therapists actually hate your guts? Get a hold of your chart and READ IT. it is YOUR right and it might open your eyes to what those people REALLY think of you…It won’t be pretty or nice at all, but it will be instructive, and maybe you won’t want to be Mentally Ill with Borderline Personality Disorder any longer, hey?
Another few words as to young people going for social Security Diabilty: Someone asked me about this and my response is unequivocal. It is the very same trap that Welfare was for young mothers with too many children years ago…It had positives to it, but it ended up trapping many and many generations in poverty of the most extreme sport for, well, generations. Speaking just for myself, IF anyone had had the time to find out where my talents lay, in art and writing, and had been able to provide the community and home supports for me that I truly needed, rather than funding my rent and hospital stays largely, plus a visiting nurses visit to bring me medications. I might have blossomed and never ended up recurrently in the hospital for decades. I mean this from the depths of my broken heart. I was always an extraordinarily talented and intelligent person, and everyone knew it. At the same time, I had very real problems. But no one ever said, LET’S NOT FOCUS ON YOUR PROBLEMS. LET’S SEE HOW FAR YOUR STRENGTHS CAN TAKE YOU!
You know, I still cannot socialize or be away from home for long, and I cannot tolerate any 4- hour work day, far less an 8-hour work day…I do not have ordinary or “normal” stamina in any fashion. Narcolepsy is partly to blame and probably the mental issues and whatever else is at fault, I cannot say. But an extreme lack of stamina that eating well and exercise daily does nothing to help is a FACT of my existence. Nevertheless, I do not believe that I had to stay on Disability and “relief” all my life and be a leech on society…No, i just had no one from the ADA or any social services (god forbid a family member or friend) looking at my individual needs and assessing what I could do to earn a living and helping me, in deep and truly helpful way.,..I believe that my life might have been very different and more productive had the AMERICAN system not dumped me onto antipsychotic drugs and social security and essentially thrown me away…
But it will do it to you too, and you are assenting to it, if you go for disability at at young age. DO NOT DO IT. You will NEVER get free from those checks. NO ONE EVER DOES, unless they marry or get rich some other way…It is the worse decision you will ever make. I know that some living situations demand a check for rent, but don’t assent to their demands, make a radical decision to take charge of your own life, CHALLENGE the psychiatrist’s diagnosis. How long have they known you for anyhow???? Challenge the pills, or at least the dosage. DO YOU FUNCTION BETTER NOW???? that is the only question that matters. If not, the pills do not help. PERIOD. NEVER take any pill on a “For the rest of my life basis!”
Oh, I am so angry and broken at the moment that I cannot speak more. But if I can later on, I will say more to explain. At the moment, I have to attend to too many PHYSICAL bruises and to find a way back to sanity on my own, having been driven to the brink of near extinction by one of the best known hospitals in this state. At the moment I am both rigid with rage and so confused and broken that I scarcely know how to continue, or whether I even want to. Why bother? Why bother? How can people be such monsters, and in such monstrously powerful places and ways. I hurt so deeply and feel I will never trust an single person ever again when they say, “Come let us help you. You need our help.” YOUR help? Like being raped, I need your F—ing help!
GO jump in a lake of snot is what I should say to all of you so called helpers. I’d rather die. Go F— yourself.
NOTE: THIS may be Dr Michael E Balkunas’s forgotten relative, also apparently an MD or he plays one on TV, I dunno! All I know is that the men look amazingly alike! They could be cousins like the twins on that Patty Duke show many many eons ago…What is important to remember is that they DO share a certain number of aberrant genes, and I believe that one of theirs leads to sadism…
(Note that My GOOGLE Review (edited) follows)
In May 2014, Michael E. Balkunas, MD, chief psychiatrist of the W-1 unit of the Hospital of Central Connecticut in New Britain, angered by my rejection of him because I could not speak (he refused me the use of any writing materials) decided to diagnose me with Borderline Personality Disorder despite having asked for in-put from my family and my outside psychiatrists who all stated that no such BPD or any PD symptoms ever existed. He did this despite my having been admitted with a decades-long Axis 1 diagnosis of paranoid schizophrenia (and with PTSD since 2009 due to hospital brutality and abuses).
I believe he added the PD diagnosis in order to justify the implementation of an inhumane Behavioral Treatment Plan which resulted in four-point mechanical restraints and the use of a horrific and freezing seclusion cell. As my Advance Directive stated clearly, even at the time, none of these modes of “treatment” in the past ever led to anything but disaster.
At HOCC I was repeatedly secluded and even restrained, naked in a spread-eagle position, in 4-point leather cuffs for many hours, yet never was this because of any behavior indicating “imminent danger of causing serious bodily harm to self or others” as the Centers for Medicare and Medicaid require. They did this to me always and only because I was too loud, or because I disrupted the unit “milieu.”
Before I was double-locked into one of W-1’s soundproof isolation cells, the nurses might have the male security guards strip me naked “for safety’s sake.” No matter how compliant I was, they always injected me with three “punishment drugs.” Even when I said I would take them orally or offered my arm, they could choose to push me onto my face on a bare mattress, forcibly hold me down until I couldn’t breathe, and administered them in my buttocks.
I informed the guards about CMS rules regarding appropriate uses of seclusion. To their credit they seemed taken aback, but in the end they were always willing to follow orders and to inflict pain in order to ensure my rapid compliance.
Dr. Balkunas insisted again and again on the diagnosis of BPD yet he never treated me with any modality but antipsychotic drugs and never wrote about my exhibiting any BPD symptoms in his notes. In fact his whole stated rationale for starting commitment procedures to the Connecticut Valley State Hospital was that “antipsychotic drugs take time to work.”
The staff of Nurses and Mental Health Technicians at New Britain General Hospital W-1 and most certainly Dr. Michael Edward Balkunas, Adult Psychiatry Unit Chief, must to be re-educated about the evils of employing punishment or torture in mental health care. They should be given, in addition, many hours of intensive in-service training on trauma-informed treatment. But frankly, as a penalty for the extraordinary and sadistic abuses they long inflicted (knowingly with impunity) upon the mentally ill taken into their care, they deserve nothing less than to summarily lose their jobs and their licenses to practice — for good.
The site won’t let me sign up or comment so I am reblogging this and commenting at my site:
This Healthtap App is actually rather useless for those of us in long waiting lists for PCP care. Since you have to have an actual PCP to do Gutman’s virtual Concierge consultation, what good is the health tap app for most of us? Health tap basic refuses to answer any personal questions anyway…And what if this PCP doesn’t have the time to see us virtually at any time of day we demand?? ? Why would they with a flourishing and already busy in-office practice? I think the idea of virtual consultations with available on-line docs and specialists has tremendous potential, and could have safeguards built in, but to demand a prior face to face relationship just ties the hands of anyone who really needs health care. I live in rural Vermont where all the clinics have long waiting lists, one, and two it is very difficult for me, who has difficulty driving distances, to get anywhere…Virtual consults would solve MANY problems, but alas Health Tap’s solution is not there yet (possibly not its fault, but it is not the answer yet, not in its present form).Unfortunately, and I am ordinarily pro-regulation, but maybe not in this case, I think the earlier version of Health-Tap where you could pay a dollar or two to ask more detailed questions of available online docs for the general readership’s benefit, was more effective and helpful, than this trying to do too much that the government at present does not permit. The new Health-tap doesn’t seem to get anything quite right at the moment, alas. I know this will change. But is frustrates anyone wanting to try virtual medicine and being stymied at all corners..
Sitting in the doctor’s waiting room is all about masochism. You’re sick, you’re waiting, and you’re surrounded by people who are hacking and sneezing.
Ron Gutman, CEO of HealthTap, envisions a world where people can meet their doctors from the comfort of their own homes—virtually. Last week, his app, HealthTap, rolled out a new service that lets users consult virtually with doctors for $44 a visit.
Virtual healthcare remains a nascent market. Only 10 million of 1.2 billion annual doctor visits are done virtually, according to research firm IHS. The number of virtual consultations are expected to double by 2018, but that still leaves a lot of room for more. IHS estimates that one-third of all doctor visits could be handled virtually.
When it first launched, HealthTap let patients tap into a network of 60,000 doctors and text them a question for free. A premium subscriber service let…
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If this doesn’t make you happy, I am very sorry…I myself despite a massive migraine and fears of vascular bleeds found mysefl directing a virtual orchestra in the midst of my pain and by the end, PooF! magically it was GONE! Miracle of miracles!
THE POEM THAT CAN FORGET BUT NOT FORGIVE
This poem is afraid
because I am afraid.
This poem is always cold,
and shivering, making my teeth clatter
like cheap tin tableware
on a bare plate.
This poem wants to die,
and be rescued too late
to regret it.
This poem has been all its life scared,
and still is: scared, trembling
on the brink, trembling,
knowing the truth that lies
beyond the lies
told over and over,
though it has never been taken in.
This poem has a voice
small, smoke-rasped, hungry,
and it has much to say
about what really happened
when no one else was there
to stand to protest.
This time it wants to be heard.
This poem wants to be heard!
It will spit and curse and claw
out bejesus if it has to,
this poem means to be heard!
This poem will tattle-tale
sit back and smile smugly.
This poem will wring satisfaction’s neck
and revenge will taste like chocolate.
This poem is sad as water, poor as sand.
This poem wants to live well,
but it doesn’t know how.
© Pamela Spiro Wagner, 2009 (from WE MAD CLIMB SHAKY LADDERS, CavanKerry Press, Fort Lee, NJ)
I may have posted this before but it is especially relevant at the moment because i have been mute for more than 6 weeks now and do not know why it has lasted or what to do about it…
(you’ll need adobe flashplayer to watch this youtube video…)
I would put my entire New Britain General Hospital chart online except that i only have access at this time to a small portion of my MAY–JUNE 2014 record as they decided that 1000 pages was too many to send to my psychiatrist the first time around. She requested the entire chart, but lazily they sent the discharge summary and the ED chart. In the meantime we have put in an immediate request for the rest and they said they are sending those ASAP.
Interestingly, the first page of the ED report states that availability of Advance Directive is “unknown.” Nevertheless, the ED triage notes state, with apparent disapproval and resentment, that “pt presents with details instructions [sic] on how to provide her care..” ie the advance directive (which it seems was immediately disregarded as an insult to their knowledge)…
ED Nurses note by “Seneilya… RN Assumed care of patient. Patient arrived via EMS after VNA called for increased anxiety. EMS reports patient refused to speak but wrote down, “Sunglasses block hate. I don’t want to hurt anybody.” On admissions patient refused to speak to this RN. Patient pointed at her head when asked why she was here. Patient nodded “yes” when asked if she was hearing voices but refused to answer other questions. …(next sentence indecipherable)
Report given to Beth RN who assumed care of patient…
At 15:19 Beth RN wrote the following:
“Pt not responding verbally to this nurse, this nurse looked through her art book and placed it back on her stretcher then pt picked it up and slammed it down on the stretcher and pointed her finger at the book. Unable to get pt to communicate. Pt pulled sheets over her head. Pt still in street clothes, will pt [sic] as is until examined by MD.”
What is not said here is that this nurse, “Beth” never asked me whether she might look at my artbook. She simply took it as her right to look at it, and then did so. She refused to allow me any means of communication, however, but demanded that I speak to her. When I was unable to do this, she did not inquire in any fashion as to why I was not speaking nor apparently make any inquiries from anyone else as to why this was so. If she had provided me with means to write I might have been able to tell her what had happened in the previous two weeks at home. Instead, she was so furious at my lack of speech that she belligerently refused to permit any other mode of communication but made assumptions that were extremely detrimental.
I was later given a hospital gown and told to dress myself or I would be forcibly assisted in doing so.
This is what Beth RN records what happened after I was provided with a meal that I could not eat because it was not vegetarian. Note that before this, I had begged gesturally for a means to communicate and all such implements had been outright refused me. This had led to my slamming the artbook on the stretcher in frustration and pulling the sheets over my eyes, effectively silenced.
Now with my meal, I at last had a means to write.
“Pt ate nothing,” Beth RN reports, “[but she] wrote messages with ketchup and French fries, ‘I need a crayon.” This nurse told pt she needs to speak because she can, pt threw everything on her table on the floor, food juice, etc. Pt then picked up fries from the floor and started eating them and gathered more and putting them in the bed with her and kicked the other food away in the OBS area.”
“Pt went to the BR, seen coming from the BR with paper towels then pt observed writing with her finger on a paper towel with something, first thinking it must be ketchup, then maybe jelly, then this nurse go up to check and pt found to be writing with her own feces, some paper was able to be removed, other paper with large piece of BM pt through at this nurse. Pt moved to room 42 [seclusion] then pt got OOB and snuck around corner and tried to attack this nurse from behind, public safety was able to get to pt first, pt to be medicated and restrained. Pt licking feces off fingers, would not let nurse wash her hands…”
Now I want to tell my side of this story because they invented this story out of whole cloth. Yes, parts of it are true, but out of order and not the way Beth related it. This is important because the way she wrote it makes me seem like I spontaneously attacked her out of the blue, which never happened. However, I was also privy to a conversation by the so called Public Safety officers, AKA Guards, who in front of me decided to create this story in order to justify restraining me, because they simply wanted an excuse.
What really happened was that due to my needing to communicate, I wrote my needs with ketchup on the paper box the meal came in, but that was taken away from me, and Beth, rather than telling/asking me to speak came up to me with a NOTE she had written to me (the irony of this is beyond belief except that it is true!) saying, “I will not speak to you or give you anything to write with until you start speaking to me…” Oh GOD! It was incredible. At this point, I was livid and also desperate to write so I had no choice but to use my own feces, which didn’t strike me as awful as it might have…What other choices did I have???? None at all.
So I did as she wrote and I tried to write journal entries about what was happening to me on paper towels with my own fecal material. This of course did not go over too well. However, I never snuck up behind Beth and tried to assault her. What happened was what I wrote in the second rap song. She snuck up on me and simply SNATCHED my artwork book out from under me and raced away with it, holding it up in triumph. I was so furious, without even a thought as to any possible consequences, that I raced behind her intending only to snatch it back. That was all. I never assaulted her, I never so much as touched her. I only grabbed for the book that she had not asked for from me. PERIOD.
That was when they dragged me to “Room 42” and when the guards, holding me down, decided they wanted an excuse to restrain me, and though one of them cautioned that they really had no reason to do so, the other told him not to worry, “we’ll find a reason.” And as I learned shortly thereafter from accusations made by Dr Balkunas, they did so.
But an accusation made isn’t necessarily true, as we all know, and just because Dr Balkunas accused me of LYING or of making up a story doesn’t mean that was true either. He never asked me what did happen. He never tried to find out the real events of that evening, he simply designated me as manipulative and “volitional” essentially a prime-time liar…Which meant that this started a snowball of a disaster in the making. Because by the time he finally saw me on the W-1 Psych Unit the next day, he had already made the decision not to let me communicate by writing and therefore he meant not to let me tell him what was going on from the first. He had decided not to recognize the extreme state of desperation and frustration this induced, but to see only violence and willfulness and to deal with this by punishing me with torture. PERIOD.
But I am getting ahead of myself. Michael E Balkunas, MD , the self- proclaimed god of W-1, claimed to have been there when this happened, when the guards said that I just shot up off the gurney and attacked Beth, the nurse, from behind. But the record does not bear this out. In fact, he never saw me at all until the next day and all the orders were written by other physicians. Dr Balkunas’s name is not even mentioned until the afternoon of May 13 when it says only that he was at my bedside to evaluate me. Even then, from what I recall, I was so sedated after multiple forced meds that I was unable to answer any question. I was unable to speak in any event, so given the face that he refused me the tools to write with, this was as unproductive an evaluation as possible.
I was to be admitted to W-1 on the basis of his snap judgments from that evaluation,: from which he drew the diagnosis that I had a probable “borderline personality disorder.”
How could he possibly diagnose a personality disorder, something that takes time to discern in a person, after seeing me after such an extremely traumatic circumstance, for less than three minutes? In point of fact, what likely happened was that he took an immediate disliking to me, and decided to diagnose me with something that in his mind justified his egregious treatment of me as well as his immediately not allowing me to write instead of speaking. I cannot otherwise explain his behavior . Nor can I understand his apparent surprise at mine when I did not respond to him as he expected. Why did he think I would respond positively when he refused to speak to me unless I was verbal? Why did he think that coercion would bring about a positive reaction? Did he truly think this would be helpful and restorative? I doubt it. I think he just didn’t like me and so he opted as most men do to abuse and punishe me out of rage. Because he was fed up, he lost his temper with me from the get-go…
I recall thinking about the rage in his voice and how out of control he sounded as he sent me to “Seclusion! Seclusion! “ He actually screamed this directive to the guards as they deliberately grabbed my torn rotator cuff which they had been told about in the emergency room (so they would use it to their advantage) propelling me headlong down the hallway. “Restraints! Restraints!” he shouted in a shrill and angry voice.This was retributive and nothing else. He was furious and I was going to learn not to fuck with Michael Edward Balkunas, head of the W-I general psychiatry unit in the Hospital of Central Connecticut in New Britain or he would know the reason why!
But don’t let me put words in Dr. Michael Edward Balkunas’s mouth. Here is what he wrote, in his words. He wrote, surprise, surprise that “while in seclusion I would often scream” . Yet he states with apparent resentment that I had brought items with me “such as a large advanced directive” The nursing notes repeat this as if this is an evil thing, and proceed to disregard every item on it with relish. Not only that but Balkunas from the first accuses me of behaving with “volition” although he does not actually adduce any facts or observations to back up this thinking, except that I brought with me the large advance directive and a published book of the art work I had done.
This artbook, by the way, was was kept from me the entire time I was on the unit on the pretext that it would be very harmful for the other patients if they were to see it.I was led to believe that the mere glimpse of my artwork would hurt them. This was emphasized to me so many times that I felt guilty not only for having brought it with me, but for having drawn the pictures at all. The RNs seemed to enjoy my feeling so bad about it….
Balkunas further claims that he “asked if I would like to speak to him, PLEASE” but what he fails to note is that he refused to permit me any mode of communication other than verbally and that he peremptorily walked out on me when I could not utter a word. He notes that, Yes, I did throw my bed-clothes at him, but does not mention that he would not even look at my gestures in response.. Instead, he stood up in disgust and turned on his heels and strode out.
I admit that having already been so abused in the ED I was hideously upset at being unable to make him stay, unable even to make him HEAR me, that I did the only thing I could do to MAKE ANY NOISE at all, WHICH WAS TO THROW THINGS…
Both my brother and my psychiatrist claim that they told him pointblank not to draw baseless and dangerous conclusions from my traumatized behavior, that he would be making a mistake and would injure me badly if he did so. But he was of course the superman that all in-hospital psychiatrists are, the MR RIGHT that can finally fuck* you and get it right. SO he took one look at me and said, THAT IS OBVIOUSLY A CASE OF BPD if ever I saw one… Of course! And NATURALLY Michael E Balkunas is MR RIGHT, The one who fucks* you and you finally thank him for it, OF COURSE!
So THANK YOU Michael E Balkunas, You FUCKED* me OVER royally and you must have enjoyed it, because you fucked* me up the ass too. And I had to thank you in the end, didn’t I? Thanking you for fucking* me was the only I could earn my way to discharge, You forced* me to bend over and beg you to fuck* me up the ass and then Thank you again for abusing me just like any asshole who abuses women. You murdered* me, and halfway through slicing* my throat you made me beg you to fuck* me, and I did because it was the only hope I had that you might let me off with my life…Finally, with my throat half sliced* and my asshole fucked* wide open, you said, OKAY, now you can leave, you are free, you can go home now. I have had my way with you so go away…
So THANK YOU FOR FUCKING* WITH ME MICHAEL EDWARD BALKUNAS MD, GOD, THANK YOU FOR LETTING ME GO….I owe you my life, because you let me go and you didn’t in fact murder my body, I am still alive, though barely, you only tortured me and you only fucked* me and murdered my soul. You killed my spirit but you did leave my body somewhat intact so I could walk out of there and for that I had to pretend to be grateful and to thank you every day for a week, so I mouthed the words, Thank you Michael Balkunas for fucking* me and letting me leave stll alive….
But I wish you had killed me dead. Instead, you manipulated me into thanking you, for fucking* me over. You didn’t kill me quite. You made me thank you and thank you and thank you…and so now what do I do, you asshole- fucker*, but live with the torture you inflicted and wish you would crawl into your early grave somewhere and explode into a ball of maggotry.
*metaphorically, of course, but in a very real way nonetheless…So I feel it every day and wish I were dead! Note that in every other instance where an * is missing I usually mean my words literally and without any sense of metaphor whatsoever.
NOTE that this is the link to my GOOGLE + review that I posted shortly after my stay at New Britain General Hospital..I think I was rather measured in my appraisal, after all was said and done.
TRAUMA AND ITS SEQUELAE…
Written months after my 4-week admission to the psychiatric unit, W-1, at New Britain General Hospital/ Hospital of Central Connecticut, in 2014 where I was “treated” and abused by Dr. Michael Edward Balkunas, MD
Nine days after your worst hospital stay ever
you are still wearing the shades
that protect others from you
though no one else believes they are in danger
Those staff however wrote you up
as “assaultive” and dangerous to self
and others. But they didn’t mean it the way
you do now and their description of your
behavior was neither accurate nor truthful
Often they lied, as liars do,
just for the sake of convenience.
Now you are a week away from meeting new “cousins”
who await your vacation in northeastern Vermont,
a place magically named the Kingdom
and the recuperation your mind-body badly needs.
Still unable to let go, you perseverate over
the half-nelson grip of sadistic guards
bent on eliciting pain.
What happened to the nurses’
their concern for “the dignity, worth,
and uniqueness of every individual”,
or their “primary commitment
to the patient?”
When the guards forcibly stripped
then four-pointed you to an bare mattress
they were just replaying their favorite rape
yanking each limb wide
to expose, degrade, humiliate.
Never mind the nurses’ vow to protect
the vulnerable. The official hands-off policy
protected only their own asses.
So how do Truth and Forgiveness Programs proceed
when so many refuse to acknowledge wrong?
The hospital broke every humane rule;
they only stopped short of murder
because you submitted,
nick of time. Yet they had the last word:
stuffing your screams
when they muted the intercom
and slammed the door between you
and the mandatory one-to-one observer.
No one ever is there to bear witness, is there?
That point has always been the point,
from Daddy to doctors.
and all the hairdressers and nurses in between.
They’ve made a religion of secrecy
and no one wants to know
what they don’t want to know.
Call it “our family’s business,”
call it “a private cut and shampoo,”
or just call it, discreetly, “treatment”–
but they can always do what they want to, to you. .
When they break you, they declare
you’re just “one of the family,”
no different from anyone else,
now that they’ve finally fixed you for good.
1. CLOSE YOUR MOUTH AND BREATHE THROUGH YOUR NOSE.
This will make you realize you CAN breathe just fine and immediately stop the panic.
2. WHILE BREATHING THROUGH YOUR NOSE, gently try to push the food item back up into your mouth, or swallow it if you can.
I figured this out while living alone. I would panic when I felt myself choking. It works like a miracle, because it is usually a spasm in the upper throat, near your mouth, and not a closed off pharynx that causes coking sensationss. You just have to understand that you CAN still breathe through your nose and that will end the panic. Once the panicky feelings are over, everything is easier to deal with and you can usually spit out the food or even find a way to swallow it. But at least you realize that you are not imminently going to die, which is a good thing to know.
Hope this advice helps someone. If it does, I would love some feedback. I have offered it to friends, and they have loved it, found it useful too, so I know it works.
Best wishes to all,
Actually I “deserved” four-point restraints. I was “violent.”
But I want to explain what “deserving” restraints and being “violent” at New Britain General Hospital (Hospital of Central Connecticut) means in 2014.
I also want to tell you something else even more important: In Connecticut, the staff at almost every psychiatric unit or hospital will insist that “we only use seclusion and restraints when essential, when a patient is absolutely out of control and extremely violent, and cannot be controlled in any other way.”
Trust me, I know, because they have said this to me.
But what you need to know is that they are NOT talking about some 300 pound man hopped up on PCP, waving a machete. For one thing, that person, whom I believe to be largely mythical at least in ordinary psych units, or if real now largely confined to correctional and law enforcement settings, the person they are talking about, the rule, not the exception to the rule of the “extremely violent” person whom they claim must be restrained due to lack of any other method of control, is, to put it grammatically correctly, I.
And let me tell you about me. I will turn 62 years of age in November. I am 5 feet 3 inches tall, weigh, maybe 110 pounds on a good day, and have been consistently described as “poorly muscled.” I am also unable to use my left arm for much of anything, due to injuries sustained at the Institute of Living in 2013, including a small tear in my rotator cuff and possibly more than that– a fact the HOCC nurses/security guards knew and used to their advantage when subduing me. I also want you to know that I am a decades-long vegetarian on the principle of non-violence — to people as well as to animals. I have opposed the death penalty since I was a nine year old child (when I first learned of it) and do not even believe in the principle of prisons, or in treating our convicted “criminals” the way we do now.
Yet in every single hospital I have been in since 2000, and of course for years before then (“before they knew better”) I have been brutally secluded and restrained multiple times as “OOC” — out of control — and “violent.” In addition to either physically holding me down by brute force, one person to each limb and one to my torso (this was at the only 2 hospitals that did not actually resort to mechanical four-point restraints– compared to the dozen others that did), they would routinely inject me with one to three drugs as chemical restraints.
I am the rule, not the exception to it, of their supposedly “extremely violent mental patient” who is so OOC — out of control — that Connecticut hospitals refuse to eliminate the use of restraints and seclusion, because they “might need them.” I am the typical example of the person they claim they absolutely must have the right to resort to violence against, for their own safety and mine.
Okay, so am I truly violent? What did I do to deserve their brutality? Or should we say, their “protective measures?” Well, at HOCC, in the Emergency Department, this is what happened, and I kid you not: I came in by ambulance, involuntarily, in the sense that I did not want to go but was brought in by EMTs and given the “either the easy way or the hard way” choice by police. But I did not resist it or fight. I was not restrained in the ambulance. in fact, I was mute and merely handed them my med sheet and my detailed Advanced Directive, on the first 2 pages of which is the important information about my trauma history and the critical need to know points about how to deal with me.
When I arrived I was quickly shunted to the psychiatric crisis section and into a curtained off cubicle. No one took my cell phone from me, or the single book of my artwork that I had managed to bring with me. So I texted everyone I could for as long as I could. For a while I tried to obtain a crayon to communicate with, eventually and in desperation, writing with ketchup on the outer carton of my dinner container, begging for something to write with. Instead of helping me out, the head ER nurse penned me a note saying that I would not get anything to write with, that either I spoke out loud or she would not listen to me. How very odd and evil that she wrote this to me! She didn’t speak to me, she wrote it, as if I were deaf, even while saying that she knew I could speak and would not talk with me unless I did so… The idiocy of that act just sends sparks of rage through my brain even now. She later spied my art book next to me on the gurney, and suddenly rushed me, snatched it out from under my thigh and raced away with it, holding it triumphantly as if she had won a prize. I was incensed. Why hadn’t she just asked me for it? And how did I know what she was going to do with it? Would she keep it safe and sound? Actually, though, I mostly just reacted instinctively: Someone had stolen the only thing I had of my own in my possession, and she had simply snatched it away from me, without a word or even a polite request. So I did as anyone would do, I think. I raced up behind her and snatched it back! Well, that was a mistake. That was bad, that was bad bad bad. I heard people groan and swear. I was grabbed from behind by two security guards and the book was wrenched from me again.
Remember, I was mute so I couldn’t say anything, but I tried to resist, tried to gesture that the book was mine and she had no right too take it from me. Instead of explaining that she would protect it and take care of my things, people started talking about how I had attacked the nurse, had assaulted her…She told them to put me in seclusion. The guards dragged me, resisting in panic, towards this hidden room, and I heard another nurse warn them of my medical history with a torn left rotator cuff. Hearing this, the guard on my left side, grabbed my shoulder and wrenched it higher until I let out a blood curdling scream, wordless but vocal. “Aha! I thought you could make sounds!” he said in triumph, wrenching me again until I sobbed in agony. Then they dumped me in the seclusion room, with only a hospital johnnie on me, and locked the door behind them.
Even though I had no words to speak my rage and panic, I screamed and screamed. They came through the door with needles, held me down and injected me. Then, when in a rage reaction, I disrobed, they decided to four-point restrain me. I heard a guard say, “we really have no reason to restrain her, you know.” But the other said, “It doesn’t matter, we will find a reason.” So they did . Terrified, I did not resist, because they held me down by the left shoulder causing me so much pain I was afraid they would hurt me permanently. I also hoped upon hope that if I didn’t resist, they would let me out quickly. Believe me, I had been through this routine enough to know what to try to do to minimize the consequences and the damage…
Fast forward to my being sent to the psych unit, about which I no longer had any choice, being labelled violent now and OOC as well as mute and schizophrenic (I hate that word but they used it). When the doctor who admitted me, Dr. Michael Balkunas, came to see me the next day, I was still mute. He asked me how I was and I gestured my need for a writing implement to answer his questions. He coldly told me that he would not speak with me if I would not talk out loud. Then he got up and walked out the door, with nothing more to say. I was by then so upset and outraged that I got up off the bed, which was the only furniture in the room, and slammed the door after him. I meant only to make a noise to express my frustration, but unfortunately it caught him in the shoulder. This was not intentional, not that I recall, though I confess I was so enraged by his dismissal of me, especially after the violence inflicted on me not once but twice the night before in the ER on his orders, that it is possible I wanted the door to make contact with him. What I know is that I most certainly did not intend to injure him. I only wanted him to know, before he walked away from me, that I was angry and “speaking” to him the only way I could. Dr. Balkunas’s reaction was itself swift and violent in the extreme, and extremely personal. Enraged, his face beet-red, he bellowed at the nurses to order guards to force me into “Seclusion! Seclusion! Restraints! Restraints!”
Before I could do anything or even assent to walk there, I was bodily dragged down the hall by my injured shoulder, to one of the most horrifying seclusion suites I have ever seen. A set of two cells, each lockable from the outside, completely barren and cold except for a concrete bed set into the concrete wall, with a plastic mattress on it. Nothing else. No commode, no bed pan, nothing but two obvious cameras in the ceiling, but no obvious way for me to communicate with anyone. They locked me in, locked the second door a room away, so I was thoroughly alone and soundproofed from the rest of the unit, and walked away. I panicked immediately, and urinated on the floor in my panic. I took off my clothes. I screamed — wanting someone to talk to me, I wanted warm dry clothing to wear, but there was no response. I screamed and screamed. Nothing. Not a word. I did not even understand at that time that there was an intercom they could hear me through. I thought I was completely alone and abandoned, but for the eye of the camera. So I did what I had to. I KNEW what would happen, I knew this because it was SOP. But I was freezing in there, with the A/C on full bore and at 110 pounds and a history of frost bite I cannot tolerate being cold. I also had NO inkling as to how long they would keep me there, one hour or sixteen. All I knew was that I could not tolerate the isolation, one, and I would not survive the freezing temperature, two.
So I took the urine-wet johnnie I had taken off and I rolled it into a rope and tied it around my neck. I pulled on it as if to strangle myself. It was useless of course, because I couldn’t keep pulling it without letting go and then I would breathe. And I didn’t want to die, I just wanted it to LOOK as if I were strangling myself so someone would come in and I could explain that I was COLD! Well, finally the intercom crackled to life and someone said, “Pamela, take that away from your neck now.” I gestured something that clearly indicated, “I’m freezing cold!” The voice spoke again, “If you don’t remove that from your neck, we will restrain you.” I answered silently but in clear gestures, “I need something warm to wear!” Well, this was a battle I was destined to lose, of course. And eventually but not so quickly as to indicate that they were seriously concerned about my safety, guards and nurses entered the room, along with a gurney, and they did as they had threatened, injuring me in the process. They grabbed me and hoisted me onto the gurney and locked me into leather restraint cuffs, in a painful and illegal spread-eagle position, despite my groans of pain and protest, then they refused even to cover me with a blanket. Someone threw a small towel over my lower torso and that was all. They they positioned an aide at the door and trooped out. I screamed my lungs out, and gestured my desperate need for water and warmth, but the aide simply ignored me, saying she wasn’t permitted to talk to me, and couldn’t get me what I needed. That was how violent I was. And that is how the most violent patients are treated and why they MUST be restrained, for their own safety and the safety of others…Right? NOT! ALL the other times I was secluded it was because i was disturbing the peace of the unit. I was loud and complaining, or simply “agitated” because i walked the halls too much.
That was it. That is the rule not the exception, and if you read my posts about my incarceration at the Hartford Hospital Institute of Living in the winter of 2013 you will get a similar picture. I am not the 300 pound crazed man on PCP wielding a weapon, no, I am a small, elderly woman who is non-compliant with the unit milieu and wants only to be warm…that is about it. But each and every hospital claimed that I had to be restrained, that they had NO alternative, that I was so violent that they had no choice, even though it often took only one or two people to do so, because I didn’t resist or say a word, just lay there while they pinioned me to the bed. Now you tell me that restraints and seclusion are necessary ‘modalities of treatment” that cannot be done away with because they might be needed in an emergency. Emergency schmergency. I am that emergency and they were and are NEVER needed, EVER.
TO FORGIVE IS…
To begin and there is so much to forgive
for one, your parents, one and two,
out of whose dim haphazard coupling
you sprang forth roaring, indignantly alive.
For this, whatever else followed,
innocent and guilty, forgive them.
If it is day, forgive the sun its white radiance
blinding the eye;
forgive also the moon for dragging the tides,
for her secrets, her half heart of darkness;
whatever the season, forgive it its various assaults
— floods, gales, storms of ice —
and forgive its changing; for its vanishing act,
stealing what you love and what you hate,
indifferent, forgive time;
and likewise forgive its fickle consort, memory
which fades the photographs of all you can’t remember;
forgive forgetting, which is chaste and kinder
than you know; forgive your age and the age you were when happiness was afire in your blood
and joy sang hymns in the trees;
forgive, too, those trees, which have died;
and forgive death for taking them, inexorable as God; then forgive God His terrible grandeur, His unspeakable Name
forgive, too, the poor devil for a celestial falll no worse than your own.
When you have forgiven whatever is of earth, of sky, of water, whatever is named, whatever remains nameless
forgive, finally, your own sorry self, clothed in temporary flesh,
the breath and blood of you already dying.
Dying, forgiven, now you begin.
by Pamela Spiro Wagner in “We Mad Climb Shaky Ladders” (Cavakerry Press 2009) also featured in “Divided Minds: twin sisters and their Journey through schizophrenia.”
ON NOT SPEAKING
When I went temporarily mute at age sixty,
it sparked no visual wonders.
After decades schooled by dictionaries,
vocabulary categorized the world:
“precipice,” “acrid,” “blanch;”
words even defined my senses.
But one can fall into
speechlessness for reasons
though these may not seem reasonable
to people who believe that only talking things out
or about them makes sense.
Speaking or not, I knew
when silence was less insane
than trying to be heard
by those who would rather hurt me
than pay attention.
But if, as they say, silence is so eloquent,
why couldn’t anyone hear
what I so desperately didn’t say?
I want to reblog this brilliant post by Anne C. Woodlen and then i will add my own editorial comments if i can in a later post or edit. In the meantime, i think it speaks for itself and says just about what i would want to tell a lot of young people newly diagnosed with bpd or did or add or even bipolar disorder and getting on disability, preparing for a life “in the system” – it sucks and it isn’t worth it unless you are floridly psychotic. And even then, don’t believe what they tell you about antipsychotic drugs. There ain’t no such medication, only sedatives that may or may not quiet things down temporarily. The only way out is through, if you can do it with a wise and caring guide and community. Don’t get stuck as i am, on multiple antipsychotic drugs, addicted to them so that getting off them only means you get more psychotic than ever. Psychosis need not be a lifelong problem, but it certainly will be if you keep taking high doses of the drugs and never explore other options.
My name is Dustin and I live in Michigan. When I was seventeen years old my mother put me in a psychiatric hospital called Forest View. The abuse I felt violated me to the core! I felt like I was being raped having to submit to all the rules, the bullying and the emotional abuse. To have your dignity removed when you are an innocent patient and just want genuine, kind, gentle care, and get unprofessional jerks who you can tell are fake and just care about getting paid is a horrible experience. If anything it only caused me more traumas with the trauma that I already had. I am now twenty-two years old and live on disability while also living my life as a hermit because now I am afraid of people due to the awful treatment I endured. I was diagnosed with Borderline Personality Disorder by a REAL…
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As my time here comes to an end, I will miss it and my neighbors terribly., I don’t know what I will do without them, and Lydia my wonderful companion. Returning to Connecticut with its horrible hospitals and indifferent treatment just feels like a disaster waiting to happen. I want to move to Vermont but I don’t know how I can make that happen. I have felt amongst friends everywhere here, but isolated completely for years in CT, despite my lovely dear friends there, I wish I could bring them all up to VT with me!
FROM: THE NEW HAVEN REGISTER May 31, 2014
As Connecticut works to improve its mental health system, new federal data shows that hospitals in the state restrain psychiatric patients at more than double the average national rate, with elderly patients facing restraint at a rate seven times the national average.
In addition, the state lags behind in providing adequate post-discharge continuing care plans for psychiatric patients, especially teens and the elderly. Connecticut’s 28 inpatient psychiatric units and hospitals developed continuing-care plans for fewer than 70 percent of patients they discharged from October 2012 to March 2013 — indicating that thousands of patients may have left facilities without adequate treatment and medication plans.
A C-HIT analysis of the federal data, released by the Centers for Medicare & Medicaid Services for the first time, shows that Connecticut ranks in the top fourth of states (11th highest) in the use of physical restraints in inpatient psychiatric facilities — and is the third highest state in restraining patients 65 and older.
Two psychiatric units — at Bridgeport Hospital and Masonicare Health Center in Wallingford — have the 10th and 12th highest rates of restraint use, respectively, among the 1,753 psychiatric facilities nationwide that are included in the federal reports, which cover October 2012 through March 2013.
State and federal guidelines — tightened over the past 15 years, partly in reaction to deaths in Connecticut facilities — say that restraints should be used only in cases of imminent physical danger to a patient or others. They call for less restrictive interventions when patients are acting out aggressively.
But the data show that Bridgeport Hospital, Masonicare and three other Connecticut hospitals — Waterbury, Hartford, Danbury — restrain patients at more than triple the national rate.
James McGaughey, director of the state Office of Protection and Advocacy for Persons with Disabilities, said he was disturbed by both the high rate of restraint use and the low rate of post-discharge plans.
“The numbers are pretty compelling,” he said. “Some of our hospitals have done a significant amount of work on this, but clearly there’s more to be done.”
He suggested that the Department of Public Health, which oversees hospitals and is charged with reviewing annual reports of restraint and seclusion, should “get a little less timid in looking at this.” Hospitals rarely have been cited or penalized in recent years for improperly using restraints, a review of inspection reports shows.
McGaughey noted that the state-run Connecticut Valley Hospital in Middletown has pursued a reduction in restraints and seclusion that has cut its restraint rate significantly in the last five years. The new data show CVH’s rate at .52 hours per 1,000 patient hours — below the statewide rate of 1 hour per 1,000. The national average is .39.
“It’s ironic that our one remaining large state hospital has done such a good job of reducing restraint and seclusion, but you have some very different results at private institutions,” McGaughey said of CVH, which was cited for excessive restraint use in 2007 by the U.S. Justice Department. “What it shows is that it’s possible to address this issue, but you need leadership to effect this kind of culture change.”
Mental health advocates say seclusion and restraint should be avoided because they are traumatic and dangerous to patients and staff.
Alternatives include individualized aggression-management plans, the use of “comfort rooms” or time-out spaces, and one-on-one interventions. Among the innovations at CVH are 22 “comfort rooms,” designed to calm agitated patients, and a reduction in the time interval that a physician’s order of restraint or seclusion can remain in effect, according to a state report.
Yale-New Haven Hospital has a restraint rate of .36 hours per 1,000 patient hours — just below the national average of .39 hours. But its rate of developing care plans for discharged patients is relatively low — 50.36 percent, compared to a national average of 73.5 percent of cases.
Officials at Connecticut hospitals with high rates of restraint say they are working to reduce those incidents, and they stressed that even minimal mobility restrictions, such as soft wrist restraints or brief therapeutic holds, are counted in the federal numbers.
Robert Bernstein, executive director of the Bazelon Center for Mental Health Law, a national advocacy group that successfully sued Connecticut in 2006 to stop housing psychiatric patients in three nursing homes, said he worried that progress made in the early 2000s to reduce restraints might be slipping in some hospitals because of staff shortages and “pushback” from clinicians.
“Some of the procedures put in place may have been weakened, because it’s a lot of work” to use alternative interventions, he said.
Although patients subjected to improper restraint can file complaints, few speak out, Bernstein and others said. Among the exceptions in Connecticut is Pamela Spiro Wagner, a Wethersfield writer and artist with schizophrenia who has cycled in and out hospitals.
In an April “open letter” to the director of a Connecticut psychiatric hospital, Wagner readily conceded that she is a difficult patient — “easily roused to irritability and hostility” — but insisted that her behavior has not warranted her repeatedly being placed in restraints and seclusion, for hours at a time.
“Once you allow staff to use restraints a little, it only takes a little to use them a lot.”
CONNECTICUT VS. THE NATION
Nationally, the states with the highest restraint use are Minnesota, Washington, South Dakota, Tennessee and New Hampshire. For patients 65 and older, only Nevada and New Hampshire have rates higher than Connecticut, which restrains elderly patients at an average of 7.69 hours per 1,000 hours. Thirty-five states have rates of less than 1 per 1,000 hours; the national average is 1.01 hours per 1,000 hours.
The U.S. facility with the highest restraint rate is Park Ridge Health in North Carolina, which reports 722 hours of restraint use per 1,000 patient hours overall. Among facilities that report serving children ages 2 to 12, Lakeland Regional Medical Center in Florida has the highest restraint use, at 200 hours.
The federal data shows Connecticut psychiatric facilities fare well in some categories, including lower-than-average rates of restraint for children and teenagers. Five hospitals reported no use of restraints for any age group: Sharon, MidState Medical Center, Bristol, John Dempsey and Natchaug hospitals.
And Connecticut’s rate of keeping patients in seclusion is lower than the national average, with half of the state’s psychiatric facilities reporting that they did not use seclusion at all. Nationally, South Dakota, Montana and Washington report the highest use of seclusion, defined as involuntary confinement where a patient is prevented from leaving.
But the state’s over-65 restraint rate is fueled by excessive rates at Masonicare (35.99 hours), Bridgeport Hospital (37.92) and Hartford’s Institute of Living (9.19).
Officials at those hospitals say they have taken steps in the year since the data-reporting period ended to reduce restraint use.
This is the first time that quality measures from psychiatric facilities have been made available by CMS. The federal agency does not penalize facilities for high rates of restraint or inadequate discharge plans. Instead, an agency spokeswoman said, the public reporting is intended to encourage quality improvements and help consumers to make informed decisions.
At Bridgeport Hospital, Dr. Ryan O’Connell, vice president for performance and risk management, said the hospital’s geriatric psychiatric unit serves many patients with dementia and behavioral problems that cannot be managed in other facilities. About 18 months ago, he said, the hospital put in place an “action plan” to reduce restraints, including using “comfort” rooms. Also, in January, a new policy was implemented requiring that the nurse manager be called before any patient is restrained.
“We realized we were going in the wrong direction with restraints” and have since seen a “dramatic drop” in their usage, O’Connell said.
Hartford Hospital’s Institute of Living (IOL), which has a geriatric unit for complex dementia patients, has made similar changes over the past few years, nursing director Ellen Blair said. She said restraints are now rarely used, and only for patient safety. The IOL requires that a physician’s restraint order be reviewed every two hours, rather than every four, which is the standard of care.
“We look at our data every single day” to ensure that restraint and seclusion are being used only as “a last resort,” Blair said.
Masonicare’s acute psychiatric unit serves geriatric patients who frequently are referred because of difficult behaviors and aggression, said spokeswoman Margaret Steeves. When restraints are needed, the hospital uses “the least restrictive restraint, which is typically a seat belt,” she said. Masonicare has an interdisciplinary team reviewing restraint use.
Statewide, the Connecticut Hospital Association has been working with the state Department of Public Health to minimize the use of restraints, said Dr. Mary Cooper, the group’s vice president and chief quality officer. She said the new federal data “indicate that there is more work to be done in this area” and will help to identify best practices.
Nationally, the federal government tightened rules on the use of restraints and seclusion between 2001 and 2007, including time limits on physician orders and strict documentation requirements. The changes were prompted by a series in The Hartford Courant, “Deadly Restraint,” which documented restraint-related deaths in psychiatric facilities nationwide.
In 2007, the U.S. Department of Justice cited the state-run CVH for excessive overuse of unnecessary restraint and seclusion. Since then, policy and training initiatives have significantly reduced restraint episodes — from 26,290 hours in 2000, to 529 hours in 2012 — a state report shows.
State DPH spokesman Bill Gerrish said the agency collects restraint and seclusion reports from hospitals and works to “ensure that care is appropriate.”
LAGS IN DISCHARGE PLANNING
McGaughey and Bernstein said they were especially troubled by the failure of many hospitals to develop continuing care plans for discharged patients, and to transmit those plans to the next level of care.
Statewide, Connecticut facilities developed adequate discharge plans 69.4 percent of the time — lower than the national average of 73.5 percent. For teens, hospitals transmitted care plans only 55 percent of the time — lower than the national average of 74 percent — and for seniors, just 42.7 percent of the time, below the national average of 56 percent.
Discharged patients are supposed to receive care plans containing their diagnoses, reasons for hospitalization, medications and treatment recommendations.
The federal data shows that 10 Connecticut hospitals, including Waterbury Hospital, Masonicare and Yale-New Haven Hospital, properly transmitted care plans to the next provider in less than half of cases.
A few hospitals — St. Mary’s, Bristol, Norwalk, Natchaug Hospital and Southwest Connecticut Mental Health — transmitted care plans more than 90 percent of the time.
McGaughey said that without continuing care plans directing further treatment, many discharged patients may languish in nursing homes, shelters or land back in the hospital.
“The lack of continuity of care, to me, is a huge issue,” he said. “It’s a pretty brutal business — insurance companies want you to medicate and discharge as fast as possible. The question is, what happens after they’re out?”
Bernstein said the lack of attention to continuing care plans was “jaw-dropping.”
“Those numbers should be at 100 percent,” Bernstein said. “It’s shameful.”
Hospitals with low rates of discharge care plans blamed much of that lag on their failure to document that the paperwork was done.
At Masonicare, for example, Steeves said the 31.3 percent rate of developing care plans was due to problems with the “tracking of the discharge document . . . not that it wasn’t actually sent.”
This story was reported under a partnership with the Connecticut Health I-Team (www.c-hit.org).
This is the comment that I posted online at the paper a few days after the article was published, (as it happened, while I was a patient being tortured at the former New Britain General Hospital, the present day, Hospital Of Central Connecticut).
Pamela Spiro Wagner: “As someone who has been subjected to more use of seclusion and four-point restraints over the past “decade of change” than in the two decades previous it boggles my mind that anyone would even dare to state that things are improving in CT mental health care institutions. During my nearly month-long captivity in the winter of 2013, the Institute of Living in Hartford regularly restrained me to a bed for as long as 19 hours at a time, without ever releasing me for so much as a bathroom break — I had to defecate in my clothing. I was not even released to eat. When I was not in four point restraints “for not following directions, I was in seclusion, which they called the “Quiet Room” and not seclusion, but by CMS definitions, it was seclusion as I was separated from the rest of the patient population by force, and was not permitted to leave the room I was isolated in.
The one time I did actually saunter away, walk down the hall to look out the window, and return to my non-seclusion Quiet Room, I was punished with immediate use of four point restraints, into which I was placed without a struggle, hoping that would make it easier to win my freedom. Alas, for me, there was no way to earn freedom from restraints I never “deserved.” The entire point was discipline, and that would last as long as the staff wanted me to be in shackles to learn my lesson. There was literally nothing I could do, –stay calm, sleep, quietly ask for release — nothing, until they were finally satisfied that I was submissive enough to obey their orders, some 6-19 hours later. But I had to cry Uncle, and submit to a set of degrading humiliating “debriefing questions” that assured them that I took responsibility for my own being restrained and that my behavior would henceforth conform to their norms.
I was surprised to see Natchaug Hospital being given good ratings of any sort. One of their chief psychiatrists on the Adult Unit, a longtime presence their Emeritus psychiatrist you might say, was so insouciant about this job as to be nearly incompetent, but probably hard to fire even for negligence. HIs name I will not mention. He routinely did drive-by visits with his patients– a wave in the hallway might not be a completely standard morning meeting, but it happened often enough that peatients knew that would be all of this doctor they would see for the day. He routinely discharged patients with GAF scores at or around 60, the highest “global assessment of functioning” that one can have and still be rated “disabled” — not because he knew this level of functioning to be the case, but because it made him and his psychiatric ministrations at Natchaug look good. After all, if person comes in with a GAF in the 20s, and barely able to function, and you discharge him or her a week or two and some drive-by counseling sessions later with a GAF of 60, you must be doing a terrific job, esp for a 75 year old doctor not too keen on using anything like trauma-informed or patient-centered care. I had never left a hospital before Natchaug with a GAF higher than 40, but suddenly I rated a 60….by a doctor with whom I never spoke.
Natchaug Hospital, when the nursing director was Sharon B Hinton, APRN, was a decent place, because she made certain that abuses like restraints and seclusion rarely to almost never happened under her watch. I know, because I was there about three times during her administration. I also knew her when she was Hartford Hospital’s psychiatric Head Nurse at CB-3, where she and her never failing humanity and respect for the dignity of every patient made all the difference in the world. I might have come from an abusive hospital in the early 90s, like University of Connecticut’s Dempsey Hospital, which in those days four-pointed people to an iron bedstead, by shackling them spreadeagled to the four corners of the bed, a stress position that is not just tantamount to but is in fact torture. But I would be rescued by someone finding me a bed at Hartford Hospital, where Sharon would discover me arriving there in tears and tell me, unfailingly,”Its not you, Pam, you did nothing wrong, It is the hospital that treats you badly…We don’t have any problem with you, because we treat you well and you respond to it. When they treat you with cruelty, you respond badly…That’s very normal.”
But as to Natchaug…Bravo if they have done away with restraints completely. They had not done so when I was there last in 2012. Nor with seclusion, which was imposed in mostly a disciplinary and arbitrary fashion. Largely it was used to force medication on loud obstreperous patients or for angry fed-up senior nurses to take out their peeves on patients they didn’t particularly like (e.g. me). I still remember one APRN demanding that I be dragged to locked seclusion, and left there alone (despite all Sharon’s previous assurances that such would NEVER happen, that someone would ALWAYS remain in that room with me if I ever ended up there.. Alas, Sharon had left by then, so rogue nurses like D could have their way…) and when I peed on the floor in panic, and took off my clothes they rushed in to take them away from me, and inject me with punishment drugs, then made me stay for an hour alone on the pee-soaked mats, freezing cold, pretending to sleep and calm myself just to convince them I could leave and not bother anyone. I managed to do so, or at least the APRN D. got over her fit of pique and finally released me, but I was not really calm, and when they finally draped two johnnies over my naked body so I could decently traverse the distance to my room, I left, disrobing as I went…Who gave a damn about my flabby flat behind? I certainly did not. And it served them right if everyone got an eyeful…served them right..
Natchaug’s biggest problem was and probably still is a lack of staff cohesiveness and bad morale between the staff nurses and the well-educated techs/mental health workers who were all very dedicated college grads but were treated like grunts…The MHW’s did most of the important patient contact, but were not trusted to write patient notes, or the notes they wrote were never read, or accorded any import. This was not just despicable but very unfortunate in more than one instance during my stay, as the notes they took personally might have saved me from some terrible misunderstandings and outrageous misdiagnoses that harmed me terribly..
Most places use techs who are trained by shadowing for a day or two, which means, badly trained, if at all…
You have to take all such in-hospital diagnoses with such a heavy grain of salt, you know, even when they are labeled with the words, “THIS IS A LEGAL DOCUMENT.” Because they get so much of fact-checkable, factual material garbled that you cannot believe a word it says. And as for diagnosis, well it is all of it opinion, one, and two, it depends largely upon whether you are a likable patient or a disliked one, what they finally say about you on any given day. No one should have that sort of power over another human being, frankly. And the idea that they can brand one for life with certain psychiatric diagnoses just sickens me.
Be that as it may, my recent last experience was beyond the beyond, at Hospital of Central Connecticut, The old New Britain General…and I expect to go back to talk to someone there about it. I always do And I have much to say to them, after the pain and rawness have worn off a little. They considered it SOP to strip me naked and leave me alone in a freezing seclusion cell without any access to human contact, unless they chose to speak to me over a loudspeaker hidden in the ceiling. If not, I was utterly abandoned, no contact or even view of another human being for as long as they wanted to keep me secluded. They also restrained me, having male security guards four-point me stark naked to the bed, before they had the decency to cover me with a light sheet, even though I begged for a blanket for warmth. (A nurse manager came in and shivered, saying “Brrr its cold in here!” but did they relent and let me have a blanket…No, clearly I was not human, didn’t need warmth.)
This is just the tip of the SR iceberg in CT in the current years, Remember this is happening right now, not ten years ago, or before the so-called reforms. Nothing is getting better. Things are worse than ever, And when you are a patient in these hospitals, you have no help, no recourse, anything and everything can be done to you and you have no way to refuse or say “no”. No one will help you, or offer assistance. They can just grab you and seclude you or restrain you without your having the power to stop them or any recourse to make them pause and reconsider. You are powerless to stop anything…And so they get away with it every time. And once it is done, who will fight for you? What lawyer will take your case if the guards hurt your shoulder rotator cuff, or bruise you up, or degrade or humiliate you? No one….so you are deprived of your human and civil rights, completely, but the hospital knows that no one cares enough to fight for you, so they get away with it each and every time, and they know this when they do it. They have nothing to worry about,….You are just another mental patient, a nobody, a nothing.
That’s what you are if you are diagnosed with schizophrenia and hospitalized in CT hospitals in 2014. A nobody that the hospitals can abuse with impunity and will. Just wait and see if any of this changes…I doubt it highly. They have no motivation to change. They don’t think they are doing anything wrong now.”