Tag Archives: Mental Health treatment

March 7, 2009 · 10:18 pm

Mad Poetry from the Asylum

Introductionwish

Poems are by JN- a patient in the 50 building on Ward F. Printed with his permission but anonymous because he didn’t want to mess with all the written approval red tape- which has to be approved by the hospital and somethings just don’t find there way through the process.

JN is a big man- over 6’6″ I think. He wears suspenders and has very broad shoulders. My first impression on meeting him was “Paul Bunyan”. He never hurts anyone- no record of him assaulting staff or patients that I could find.

(JN has published a book of poetry. He has no copy but knows some libraries where it is available. He wrote it in the 1990’s.)

Still, staff are afraid of him. Especially small, female staff. He has a temper and when he’s angry he raises his voice. Usually, it’s over some small issue of arbitrary rule compliance.

Example: the soda machine in the hall outside the ward was out of product in the morning at 10 a.m. when it is on the ward schedule that they can go in the hallway with staff to get a soda from the machine. The machine was filled by noon. At 2 :00 p.m. JN asked to be able to go out to the hallway (6 feet from the ward door) with staff to buy a soda. He was told “No. The time for buying soda is 10 a.m.” JN said, “But the soda machine was empty. We didn’t get our soda at 10 a.m. Why can’t we get something now?” Staff: “That’s the rule. You know the rule. No soda. Wait until tomorrow.” JN raises his voice, red n the face, pointing his finger at the staff person,  one more minor indignity piled on top of so many others, “I am so sick of your rules! I’m sick of being treated like a child!” Staff: “That was a verbal threat. I’m putting it in your chart that you threatened me.”

Being charted as making a verbal threat means that he will have no privileges- sometimes it can mean “ward restriction”- meaning that even some of the small spaces available to sit with others or by yourself, are off limits. Sometimes it means they won’t let you go with other patients to the “yard” for fresh air. There are levels of privilege given within the confines of what is already an extremely restricted space. Level zero is the worst.

JN has not been above level zero in the year or so he has been locked up this time around. He does not expect to ever be above level zero. He has at least 8 more years in the hospital as assigned by the PSRB (the Psychiatric Security Review Board- an agency of the state courts).

Sometime I’ll post JN’s description of how he ended up in the hospital- it will blow you away. It started with a psychotic break, being told what to do by voices. No one was harmed.

BTW- not all of JN’s poetry is as heartbreaking as this- some is inspiring. You know how great it is when you are dreaming and find out you can fly? Sometimes reading his poems I feel like crying and flying at the same time.

I will be posting more of JN’s work over time. Maybe we’ll get permission to show his name- he’d like that. The guy that does the hospital newsletter (which never has patient-produced content since I’ve worked there) says he will print one of JN’s poems in next month’s edition. I’ll be waiting.

love_heart1Girlfriend

written 2/21/09 6:25 p.m.


We watched a butterfly be born into the world

Held hands at a scary film

Thought silly jokes were funny

Smiled with our eyes

I love you was spoken a lot

Mingled with other couples

Broke up once or twice

People talked about our relationship

She wrote when I was gone in jail

This is where we failed

My time was longer than her love

Have a picture of her I can’t tear up

It looks like she is shaking her finger at me in the picture

Wish I wouldn’t have made my mistake

Stakes were too high for me

Alone again with 40 men

Contemplation

written 2/21/09, 5:30 p.m.

The sentences flowed with suicide contempt

Depression is in the suggestion note

He was a perfectionist in writing what was said

It started with “To Whom it may concern”

It was the sadness in-between that will catch your heart

It wasn’t his dear concern that frightened me

It was the truth of his light that shined through

He was the only one feeling

Feeling like life wasn’t much living worth

More of his emotional turmoil churning the past

At last he was drained and insane

Mentally whipped- to no return to serenity

This is was his suggestion

Void was full of that dark stuff

Nothing to carry him to the next moment

At this second he was dead

lotus

All blessings to you, JN, with your deep compassion for the pain of others, your courage in the face of utter dark, with your warrior spirit-heart that lets loose the birds of language you call poems.

I love that you have new poetry for me every time I see you in your prison even though you hadn’t written in years before we met.

My thanks, my prayers for your trust and faith.

kerouac-quote

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March 7, 2009 · 8:50 am

New Song

Inspired by a patient (or 2 or 10 or 600) at OSH- poorly performed, sadly pathetic production values, my voice doesn’t work, the words are after- here it is:

robert3609

My name is Robert

I live in Oregon State Hospital in building 35

I can’t say much about my live before this place

I’ve been locked up 40 years, don’t know if I’ll get out alive

You may think worse of me to know I hear spirits in the night

As they walk the narrow halls I hear them cry

Nameless Men and Women who lived out their days in here

Maybe I will join them by and by

—

Chorus:

Me, I get up early every single day

Look out on the ward and wish that I was far away

But if my life has been wasted you don’t need to see

The only one who knows I’m here is me

—

When I was young my life here was a nightmare

I was raped by other patients and tied down by MHTs

[Mental Health Technicians- the bottom rung of ward staff]

Then left in the seclusion room while staff would sit outside

Catching up on their reading, just as distant as you please

It’s not so bad here for me now it’s just an awful boring place

We go to groups, the same day after day

And if staff don’t give a damn they mostly leave us all alone

Sometimes we get good ones, they won’t stay

—

Chorus

—

I don’t just sit around all day

I’d go crazy if I did, I’ve seen it happen to a few

I used to work on grounds but now we’re locked down pretty tight

It seems as though there never is enough for me to do

My IDT gave me my Treatment Plan last week

[Interdisciplinary Treatment Team- the primary instruments of Ward Rule]

All my goals right there for me to read

It always just amazes me they know me so damn well

Without ever asking what I need

—

Chorus

*

I’ll put this on the music page later- after I do a better recording of it.

eegah

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May 7, 2008 · 7:11 pm

More Mental Health nik-naks

From: David Oaks <oaks@mindfreedom.org>
Subject: Re: [OCSC-talk] dialogue with office of Governor
To: Oregon Consumer/Survivor Coalition <ocsc-talk@intenex.net>
Thanks Dave R.

I’m thinking about the times we testified and met with legislators
about bills.

I’ve been visiting the legislature for about 20 years.

In the early years we were mainly just stopping bad bills. That’s it.
And it was uphill.

It just seems more and more legislators are supportive of mental
health consumer/psychiatric survivor voice, involvement, etc.

Enough? No not enough. But more and more.

Plus there are more consumer/survivors speaking out!

Here’s a photo of two OCSC group representatives (Marie Parcell of
BEARS and Rick Snook of EI) testifying during the last legislative
session:

http://www.mindfreedom.org/as/act/us/or/sb363-364

Here are more photos:

http://www.mindfreedom.org/as/act/us/or/sb363-364/photos-sb363-sb364/

A number of people who showed up had to do so on very last minute
notice, fairly early in the morning, and wait through a lot of other
bills. And thank much to folks like Drake, Beckie and others who have
helped promote these bills. (And thanks to ADAPT trainers who came in
for a state-wide brainstorming session a few years ago that helped
get these bills started.)

True, we won one bill, lost the other… but we’re finally taking the
initiative, filing a bill, and winning.

And yes we have a long way to go, but my point is about the RECEPTION
we had from some legislators. Quite a few know us, support us, etc.

As one legislator passionately put it to us, “You are preaching to
the choir.”

Enough? Not enough. But a bit of hope.

Maybe people could post some of their “legislators who give us hope”
who might support us… that is, elected state legislators who know
some of us personally, who seem to get some of our issues, who
express warm support.

Again, I’m not saying it’s enough, some have a lot to learn.

A few from my point of view from Lane County: Sen. Prozanski, Sen.
Morrisette, Rep. Holvey,

Others?

David

On May 4, 2008, at 8:14 PM, David Romprey wrote:
> Excellent thoughts, and ideas to build on, Pat.
> Also, I learned through David Oaks personally that there are some
> very positive updates in our image on Capitol Flats (I say this due
> to there is NO hill around our Oregon Capitol building, and
> actually somehow seems LOWER than most of the city!).
> David Oaks tells me some Coalition members are being much better
> received.  Part of the image problem is simply knowing and learning
> TOGETHER how well we are doing.  I’m happy about the good news, and
> hats off to some intentional relationship work by folks working
> closer to this cause than I am!!
> The best,
> David R.
> On Fri, May 2, 2008 at 2:45 PM, Patricia M DAVIS
> <Patricia.M.Davis@state.or.us> wrote:
> In response to David and Dan’s comments:
>
> Hello OCSC Friends,
> Recovery Thinking and Mutuality filled the halls of the Portland
> State University’s conference center last week, April 24-25, as Dan
> Fisher, M.D., Ph.D., National Empowerment Center Director, person
> in recovery, inspired all in attendance to see dreams become
> reality in taking hold of recovery personally and advancing
> recovery thinking in our society and its systems of care.
>
> That fancy sentence to say, it was an awesome event with Dan and a
> room full of people listening and becoming change agents in their
> own neighborhoods/communities!  People who identified themselves as
> consumers/advocates/patients and x-patients, people who identified
> themselves as family members, people who identified themselves as
> therapists, state hospital employees, people working in provider
> agencies, and people who identified themselves as students.  People
> with all sorts of experience wanting to come together in empowerment!
>
> By the way, Dan’s presentation was a direct result of behavioral
> health workforce development efforts!  PSU asked consumers on the
> BHWD Committee to coach them on new thinking and the consumer/
> recovery movement last year.  As a result, PSU has added an entire
> Behavioral Health Training Series to their Continuing Education
> Department so that the next generation of “helping professionals”
> will be recovery and empowerment minded.
>
> The group of friends of the OCSC instilled such hope in me that all
> of our efforts for change over the years is really making a
> difference.  What a fantastic group!  16 members of the group
> signed up to be “official” friends of the work of the OCSC.  The
> group asked to be formally linked to our OCSC web site and  they
> will also stay in touch with each other to support one another in
> their efforts to support you and transform the part of the system
> they touch.
>
> So group, I’ll create an email group for these change leaders and a
> directory of these friends for you to refer to, but I need to ask
> you about linking them to OCSC.  How would you like this done?
> Should the “friends” nominate someone from their group to get
> connected and be part of the “talk” group, etc.?  A few in the
> group are  in recovery and  working in the system.    Like the
> Oregon Stop Stigma slogan goes…People…JUST People, like you and
> me!
>
> Which leads me to “whole person” thinking and the wellness
> initiative The more we see wellness and illness as a common human
> experience…all of us move up and down on the continuum, that you
> cannot have wellness in our society or in the body without treating
> the whole person (mind, body, spirit)…and that even the people
> serving at the Capitol can and do move along this SAME continuum,
> the more we reduce stigma and discrimination.  When we go to the
> Capitol and speak, or speak individually to Legislators, we speak
> on behalf of “them” as well as “us.”  We become “all” just people
> and the “us” and “them” must disappear!
>
> As to “repairing” our image at the Capitol or anywhere.  (In my
> opinion) It’s all about trust, relationship building, and being the
> strong, brilliant unified voice we have become.  Sticking together,
> presenting concise facts, sharing our stories, working in our own
> communities, finding the leader’s at the Capitol who “get it” and
> following other good civil rights movements like that of the
> physical disabilities movement.
>
> Raising awareness May is Mental Health Awareness Month Educate
> every chance you get!  We are the living evidence!
>
> Happy Friday All,
> Pat
>
> Patricia M. Davis-Salyer, M.Ed.
> Training and Development Specialist
> Addictions and Mental Health Division (AMH)
> Workforce Development Unit
—
Hi,

Can I ask for your help to show there is national and international
concern about the mental health system in the State of Oregon in the
USA?

Oregon’s Governor Kulongoski budgeted zero [0] for the state-wide
voice of Oregon’s mental health clients for five years.

At the same time Oregon is one of the very few USA states building
brand new huge psychiatric institutions.

The Governor found half a billion ($500,000,000) for bricks and
mortar for new psychiatric institutions.

But not a dime for the voice of mental health clients. Again and again.

Please take a moment to show there is international concern.

*BELOW* is a letter to the editor by me that was published today, 6
May 2008, in Eugene, Oregon’s daily newspaper, _The Register-Guard_.

Please read my brief letter.

And then ask Governor Kulongoski in a civil way:

“Why Zero?”

Easy ways to ask the Governor via the web are here:

http://www.mindfreedom.org/zero

Or see links at the bottom of this alert.

~~~~~~~~~~~~~~~~

LETTER TO EDITOR – Published 6 May 2008 in The Register-Guard,
Eugene, Oregon, USA:

The Register-Guard’s recent guest viewpoints and letters about humane
alternatives in mental health are appreciated. This community
dialogue is healing and necessary.

I’ve studied the history of the mental health system over the
centuries. Minor reform is not enough. Reform often results in more
money for more of the same. One step to deeper change is to start to
listen to the diverse perspectives of mental health consumers,
psychiatric survivors and their organizations.

Most of the states support the statewide voice of mental health
clients in some way, even if small. Most states fund an office of
mental health consumer affairs, a statewide conference or a
newsletter to support the empowerment of our citizens who are
diagnosed with psychiatric disabilities. Many leaders in Oregon’s
mental health system and Legislature endorse this common sense idea.

Our advocacy group concludes that a top obstacle to real change in
Oregon’s mental health system is in the office of Gov. Ted Kulongoski.

Since Kulongoski took office, his budget item for the statewide voice
of mental health clients has been eliminated. The governor has
continued to recommend that this funding stay at zero, even while he
raised about half a billion dollars to build huge new psychiatric
institutions.

Now I hear Kulongoski say that as a superdelegate he may override the
majority of Democratic voters in Oregon’s May 20 presidential
primary. Is there a pattern here of the governor squelching the
voices of Oregonians? Let’s all ask him.

David W. Oaks

Executive director

MindFreedom International

Eugene, Oregon, USA

~~~~~~~~~~~~~~~

* ACT NOW * ACT NOW * ACT NOW *

Two easy actions you can take to ask “Why Zero?”

Encourage funding Oregon’s state-wide voice of mental health clients
in your own words!

1) ASK OREGON’S GOVERNOR!

Just use Governor Kulongoski’s web contact page here to send e-mail,
phone or postal mail:

http://www.governor.state.or.us/Gov/contact_us.shtml

2) COMMENT ON OREGON’S BUDGET!

The Governor’s Department of Human Services is asking for public
input *now* about their next budget!

E-mail your comment here:

dhs.budget-input@state.or.us

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May 6, 2008 · 3:49 pm

Mental Health grab bag

An assortment of news and information releases related to the consumer/ survivor movement, broadly:

Mental care – As the nonprofit tries to right itself, critics trace
the crisis to early leadership

by ARTHUR GREGG SULZBERGER

The Oregonian

Even though he moved to France more than two years ago, the chief
information officer at Cascadia Behavioral Healthcare continues to
collect a hefty paycheck as a full-time employee, telecommuting
across many time zones.

Like the other three members of Cascadia’s executive team, Jeff
Poolin worked at the small predecessor organization that aggressively
built itself up into the state’s biggest provider of mental health
services.

Critics say that small team, leading an insular and top-heavy
management, played a big role in steering the massive nonprofit
toward collapse.

The organization has tried to answer its critics and change its
culture with a leadership overhaul that has for the first time
shifted the agency out of the hands of the small group that built it.
Upper managers were cut by 40 percent. Most strikingly, Poolin is the
only longtime executive still there (and he is still in France).

The changing of the guard might help explain why the state and
Multnomah County stepped in this week to ensure that Cascadia could
continue to work with the 23,000 people it serves each year. Their
eleventh-hour $1.5 million cash infusion will keep Cascadia operating
for at least another two weeks.

But how the company will go on after that and in what form are the
complicated questions now facing the governments that send millions
of dollars to the agency to treat their hardest cases.

To explain the current crisis, it makes sense to go back to the
beginning.

How did Cascadia start?

In the 1970s, after years providing mental health services itself,
the county decided to decentralize the local mental health system. It
divided the county into quadrants and contracted with four nonprofit
companies to provide the bulk of care in those areas.

But in the mid- to late 1990s, those agencies and a number of smaller
mental health nonprofits struggled financially. Leslie Ford — the
CEO of Network Behavioral HealthCare in Southeast Portland, one of
the four geographic companies — made a series of aggressive mergers
and acquisitions with the goal of consolidating services under a
single banner.

In 2002, Ford successfully united the companies and called the new
amalgam: Cascadia Behavioral Healthcare.

Cascadia struggled financially from the start, partly because the
merger included the debt-laden nonprofit charged with providing
mental health services for the west side of Portland.

But it has continued to expand. In the five years since its
inception, the company grew an additional 45 percent. It now has an
annual budget of $58 million, with more than 1,000 employees and 90
facilities.

Cascadia provides a full spectrum of mental health care — from
housing to counseling to crisis treatment. The roles include
operating walk-in clinics, crisis response and a network of housing
for low-income people with mental illness. Though the bulk of its
business occurs in Multnomah County, Cascadia also provides services
in Clackamas, Lane, Marion and Washington counties and directly to
the state.

Why is Cascadia struggling?

Cascadia has been constantly shadowed by looming financial crisis.
While management decisions and rapid growth played a significant
role, much of the trouble is linked to the thin margins that come
with working in the mental health field, experts say.

Most of the money in Oregon’s mental health system comes from the
state and federal government in the form of Medicaid reimbursements.
That money is passed to counties, which determine how to spend it.
Some counties provide their own services, but most contract with
private nonprofits to provide service.

Because of the dependence on government funding, mental health
providers have coped for years with budget cuts and, more recently,
with mandated changes to how they conduct business. The most
significant is a switch in how they get paid.

Multnomah County and other counties until recently provided up-front
payments to mental health agencies for each client and allowed broad
spending discretion. In 2006, Multnomah County mandated a change:
Agencies now would be reimbursed for specific services after clients
received them. The move was touted as a way to increase fiscal
transparency and ensure that money was going for services rather than
administration.

But Cascadia managers said that while the new system was good at
caring for people with mild or moderate mental illness, it failed to
provide resources to care for the very sickest clients. That’s
because it provides no money to track down and help people too ill to
enter or stay in the system on their own. Cascadia’s success reaching
out to those individuals before they ended up in expensive hospital
beds or jail beds was core to the company’s mission.

In June, a consultant estimated that Cascadia employees spent about
30 percent of their work days providing billable services and would
have to double that ratio to break even. That same consultant warned
about incorrect record-keeping. Months later the state ordered the
nonprofit to pay back $2.7 million because of improper payment
records. Cascadia still owes the money.

What has happened so far?

In recent months, Cascadia has laid off more than 250 staff, or about
of a fifth of its work force. Last week it replaced Ford as CEO with
Dr. Derald Walker, who has worked at the nonprofit for just two months.

County and state officials still refused to bail out the agency by
backing its loans.

On Wednesday, the Capital Pacific Bank drained most of Cascadia’s
cash accounts, saying the company had defaulted on a $2 million loan.
Cascadia was only able to make payroll because the state and county
accelerated a $1.5 million payment for services Cascadia already has
provided.

The company remains deeply in debt and many of its vendors have
stopped providing services unless paid cash in advance.

Nevertheless, Walker said this week that Cascadia’s focus on cutting
staff and increasing productivity are starting to pay off with
growing revenues.

What happens next?

County officials already have spent weeks working with state and
local mental health leaders planning to shift contracts from Cascadia
to smaller providers and have drafted detailed plans for an emergency
partitioning of the rest of the company’s services and assets should
it be forced to declare bankruptcy.

The county will wait until an independent audit of Cascadia’s
finances is completed later this month before making any big decisions.

Arthur Sulzberger: 503-221-8330; arthursulzberger@news.oregonian.com

—
News Release – 3 May 2008

United Nations Treaty on Disability and Human Rights Now in
Effect Globally.

Psychiatric Survivors Play Important Role in Creating the
Legally Binding Treaty.

MindFreedom International (MFI) joins with the international
disability rights community in celebrating the entry into force of
the “United Nations Convention on the Rights of Persons with
Disabilities.” The UN Convention — a type of binding international
treaty — enters into force today, 3 May 2008, after 20 countries
ratified it.

Celia Brown led the MFI UN team of psychiatric survivors inside the
United Nations. “It’s been great to be in the United Nations with
survivors of psychiatric abuse and many international disability
groups from around the world,” said Celia. “We’re all fighting
together for human rights, self-determination and freedom.”

For the full news release — text or PDF — click here:

http://www.mindfreedom.org/campaign/global/disability-convention
or here: http://tinyurl.com/5s5j3k

~~~~~~~~~~~~~~~~~

(2) News Report – 3 May 2008

MindFreedom Ireland Holds Successful Protest of Electroshock

Members of MindFreedom Ireland protested in Cork, Ireland on 3 May
2008 against the use of electroshock as a ‘treatment’ both in Irish
psychiatric institutions and worldwide.

For the brief report of the Cork Ireland protest of electroshock from
Mary Maddock, click here:

http://www.mindfreedom.org/as/act/inter/mfire/ireland-electroshock-
protest
or here: http://tinyurl.com/54pnup

For news of other May electroshock protests and events click here:

http://www.mindfreedom.org/events_sf

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