I've been active with human rights advocacy for about three decades, the focus issues of important to people with psychiatric diagnoses and physical disabilities.
Two different yet overlying "camps" of people, as it were.
It is clear that at some point we friended one another on FB; looking at what you have been writing - and of the breadth of issues touched upon, I am glad we did.
Currently I work as an advocate "within" one part of the huge dysfunctional system that is mental health services in the USA. I harbor no illusions about "fixing" that system from within, yet also recognize that without dedicated folks working in it, then those without voice who are in it, are at even greater risk for being further victimized by abusers - be they power-hungry shrinks or family members distraught that they cannot control their unruly kinfolk.
Advocating within a system - as I see it - basically follows two different (though overlapping) paths:
1- Advocacy: that is, speaking up for the improvement of living conditions; making incremental changes in how everything from treatment team planning is conducted (including making sure the client/patient/inmate's voice is not only heard but heeded); to speaking out for the reduction and eventual elimination of seclusion and restraints (including chemical restraints) as well as being a watchful eye and ear close-up-and-personal of the staff; and providing empathy, compassion and offering options to those most in need - i.e. the folks caught up in the system as clients (whether inpatient or out).
2- Abuse and Grievance investigations: Here, working inside the system is necessary, for the investigator has to have access to records (both patient as well as employee performance), policies, incident reports and given the authority to hand down decisions and rulings (don't use this term w/the treatment folks or employee unions - they'll have a bird !) well, findings and recommendations, then. on how to implement corrective measures to ensure abuse is discontinued, employees disciplined (or fired, depending on the seriousness of the findings) and to watchdog the time line for corrective measures to be put into action.
And another thread: "Not Guilty by Reason of Insanity" and "competency" issues: I'm impressed! Few people in the psyche survivor "movement" (as it were) ever seem to touch upon these matters. BOTH are crucial and warrant a much closer review of how these concepts impinge on civil liberties as well as feed into the media and pro-forced treatment zealots intentional deceptions about "The Mentally Ill" (picture that last quote as bold faced, italicized and underlined). The "not competent" legal status is - and always has been - a clear violation of a person's right to a speedy trial. The NGRI issue is a HUGE whale of injustice against people who have committed crimes while in states of extreme distress. NGRI "acquitees" - across the nation - spend 2 to 3 times longer incarcerated (often in "hospitals") than they would have for their crimes if they plead guilty. NGRI is also a convenient vehicle (as you have noted) for folks who - quite in touch with their motives and purposes - attempt to use the NGRI designation to not be held accountable for their actions - often heinous and inhumane - crimes
I could go on, which would be unfair; since I am writing you unsolicited with my opinions.
So I shall tarry no longer, and step down from the soapbox.
Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts
26 February 2012
22 February 2012
websites of interest
Pushed to the Left and Loving It: A self-described grandmother from Canada, her blog profile states: "I am a Baby Boomer, having grown up through many periods of social upheaval. However, I believe that as a nation we have moved forward and I can no longer simply sit back and watch it be destroyed."
Her site has won recognition, as she opines about politics, health care, the environment and how powerful extremist neo-cons in the USA and elsewhere subvert the principles of democracy.
Although it has been a very long time since I lived up by the fluid border that is the boundary between Canada and the USA, I make no secret (while at the same time not much talking about it) that I find myself more culturally Canadian than American.
She also writes about Victoriana, Women in Canada and dolls. I'm proud to post a link to her informative site.
Mental Floss:
This archival edition focuses on four mental/medical experiments gone awry. Three are no doubt clear examples of torture; two of the three are conducted on other mammals than human beings (dolphins and fighting bulls). One is self-inflicted.
The dolphin experiments conducted by none other than psychedelic researcher John Lilly, presumably before he had an epiphany that what he was doing to cetaceans was clearly wrong.
The human "study", conducted by social psychologist Milton Rokeach wanted to test the strength of self-delusion. So, he gathered three patients, all of whom identified themselves as Jesus Christ, and made them live together in the same mental hospital in Michigan for two years. He wrote a book about it, The Three Christs of Ypsilanti [later made into a film]. Twenty years later, Rokeach renounced his methods, writing, “I really had no right, even in the name of science, to play God and interfere around the clock with their daily lives.”
The "self-inflicted" experiment is the tale of a man, Michel Siffre, a 23-year-old French geologist, who chose to sequester himself in an ice cave, conducting an experiment on himself. For two months in 1962, Siffre lived in total isolation, buried 375 feet inside a subterranean glacier in the French-Italian Maritime Alps, with no clocks or daylight to mark time.
Siffre later re-conducted this experiment in 1972, and again, in the year 2000, when he was 62 years of age.
Science Codex:
ARTICLE ~ How the brain encodes memory.
Senior author Kenneth S. Kosik, co-director and Harriman Chair in Neuroscience Research, at UCSB's Neuroscience Research Institute. Kosik is a leading researcher in the area of Alzheimer's disease.
"One of the most important processes is that the synapses –– which cement those memories into place –– have to be strengthened," said Kosik. "In strengthening a synapse you build a connection, and certain synapses are encoding a memory.
"Those synapses have to be strengthened so that memory is in place and stays there. Strengthening synapses is a very important part of learning. What we have found appears to be one part of how that happens."
IMAGE CREDITS: 1- Ninjamatics' Canadian Web Awards; 2- Self-phofo of Michael Siffre, from Cabinet Magazine; 3- Sourav Banerjee, posted on Science Codex
Her site has won recognition, as she opines about politics, health care, the environment and how powerful extremist neo-cons in the USA and elsewhere subvert the principles of democracy.
Although it has been a very long time since I lived up by the fluid border that is the boundary between Canada and the USA, I make no secret (while at the same time not much talking about it) that I find myself more culturally Canadian than American.
She also writes about Victoriana, Women in Canada and dolls. I'm proud to post a link to her informative site.
Mental Floss:
This archival edition focuses on four mental/medical experiments gone awry. Three are no doubt clear examples of torture; two of the three are conducted on other mammals than human beings (dolphins and fighting bulls). One is self-inflicted.
The dolphin experiments conducted by none other than psychedelic researcher John Lilly, presumably before he had an epiphany that what he was doing to cetaceans was clearly wrong.
The human "study", conducted by social psychologist Milton Rokeach wanted to test the strength of self-delusion. So, he gathered three patients, all of whom identified themselves as Jesus Christ, and made them live together in the same mental hospital in Michigan for two years. He wrote a book about it, The Three Christs of Ypsilanti [later made into a film]. Twenty years later, Rokeach renounced his methods, writing, “I really had no right, even in the name of science, to play God and interfere around the clock with their daily lives.”
The "self-inflicted" experiment is the tale of a man, Michel Siffre, a 23-year-old French geologist, who chose to sequester himself in an ice cave, conducting an experiment on himself. For two months in 1962, Siffre lived in total isolation, buried 375 feet inside a subterranean glacier in the French-Italian Maritime Alps, with no clocks or daylight to mark time.
Siffre later re-conducted this experiment in 1972, and again, in the year 2000, when he was 62 years of age.
Science Codex:
ARTICLE ~ How the brain encodes memory.
Senior author Kenneth S. Kosik, co-director and Harriman Chair in Neuroscience Research, at UCSB's Neuroscience Research Institute. Kosik is a leading researcher in the area of Alzheimer's disease.
"One of the most important processes is that the synapses –– which cement those memories into place –– have to be strengthened," said Kosik. "In strengthening a synapse you build a connection, and certain synapses are encoding a memory.
"Those synapses have to be strengthened so that memory is in place and stays there. Strengthening synapses is a very important part of learning. What we have found appears to be one part of how that happens."
IMAGE CREDITS: 1- Ninjamatics' Canadian Web Awards; 2- Self-phofo of Michael Siffre, from Cabinet Magazine; 3- Sourav Banerjee, posted on Science Codex
04 October 2010
mental health - accountability
If we are to accept the spiritual premise that "...the meek shall inherit the earth..." we know that they will not be found amongst the arrogant and vain-glorious poseurs who ~ with pomp and bombast ~ assert themselves as leaders but who are, in truth, just power-lust perverts.In stark contrast are those brave souls who, oppressed and reviled, call for establishing "new traditions" which offer guidance and direction for how leaders ought to manage themselves. Some may scoff at seeking wisdom from madmen but there are times when wisdom is excoriated, and the wise, are in those times, dismissed as delusional and insane. Such as the times we live in now. It behooves us, therefore, to pay heed and listen to the meek ...and the Mad
from the Accountability Caucus
The Accountability Caucus is a group of mental health client activists who are working to upgrade the California clients movement by constructing a new tradition based on accountability. We stand for these objectives/principles as our initial talking points:
1. Constructive activity, not attack politics, based on the recognition that ours arises as a wounded community;
2. Development of an alternative program for client activism that stresses personal responsibility and competence in meeting the challenges of empowerment;
3. Specifically, this alternative is a micro-empowerment program, which strengthens client involvement through:
A. recognizing triggering behavior and upholding suitable ethical standards for such;
B. fighting discrimination by insisting that people treat us like reasonable beings;
C. defending the meaningful role of personal sensitivity and empathy; and
D. opposing an excessively or solely biological approach in favor of a humanistic, spiritual, client-driven model; and
4. Advocacy against the values of tokenism and in favor of the empowerment values which help us hold to account the oppression of the client culture.
We believe that clients are persons of quality whose mental health issues and experiences express both talent and personal challenge. We deserve respect based on our capacities, our resilience, our abilities, and our contributions.
We urge clients who share these principles to join with us and to help re-center client activism in California around the new tradition of accountability. We will organize as a fellowship of involved, reflective, watchful persons seeking serious dialogue with other parts of the clients movement.
First posted at Short Notes on 2005 August 24. For More Info: Accountability Caucus, Social Justice, Andrew Phelps' Accountability Writings and Kenneth J. Gergen's Transformation of Identity Politics |
Labels:
accountabliity,
mental health,
self-determination
15 August 2010
Big Pharma: financial fraud and false claims
"Pharmaceutical fraud is considered one of the top threats in financial fraud"
QUOTE: Sharon Ormsby, FBI Financial Fraud Unit
QUOTE: Sharon Ormsby, FBI Financial Fraud Unit
People & Power investigates fraud and corruption running through the veins of the US pharmaceutical industry.
THANKS TO: Beta Sheep for bringing this to my attention. Too bad we have to look to off-shore news sources for this kind of reportage.
Labels:
big Pharma,
criminal actions,
fraud,
health care,
mental health
18 July 2010
mental health - Toronto "community" to replace old Asylum
A Canadian architect, Frank Lewinberg, and a psychiatrist, Paul Garfinkel, have teamed up and planned for a nice new neighborhood for "the mentally ill". They acknowledge the limits of their vision, writing that “the history of urban planning is littered with idealistic projects that withered in the harsh light of everyday living.”
A recent article in Canadian Architect quotes Garfinkel:
"People need to be treated in a respectful, dignified, holistic manner that sometimes requires them to be confined in a hospital voluntarily or involuntarily. The more we normalize the hospital stay, in keeping with safety and security, the better it is for the person's recovery, and ultimate reintegration. Normalizing starts with an urban village, like the rest of the city, but it gets into the nature of public space, treatment space, what our hospital rooms look like. We want to make [the hospital] a more homelike setting, just as you would want in a normal community."Dr. Garfinkel claims to be especially critical of the "biological reductivism" fashionable in psychiatry for the last 30 years, a theory that lays great emphasis on medication--often, he believes, at the expense of the patient as a whole person, and at the expense of the settings of his treatment.
I have worked with, and on behalf of, people with psychiatric disabilities for over 20 years. I remain skeptical about the plan. This isn't a plan for a new neighborhood, it is adding more office rental space while tossing a few bones to the clients and community.
Not only because the rationale behind building the great Victorian-Era behemoths that housed "the Insane" was based on providing mad people with sylvan settings; but also due to the fact that the plans ~ as extensively described ~ show more effort going into office space for clinicians than to actual housing. That housing seems to be limited to three ""alternative milieu" dwellings: 72 motel-like rooms, with private washrooms and lockable doors, for patients who still need hospital care, but who have progressed beyond the acute stage of their illnesses."
"Housing" people in "motel style" accommodations does little to restore a sense of normalcy to one's life, yet that seems to be the only client housing being given serious consideration in the multi-blocked endeavor.
Moreover, if are planning a community, why is there only circumstantial mention of cultural amenities? Instead "...the exact nature and placement of the non-hospital uses have yet to be determined, a grocery store and health club, scientific institutes and laboratories, cafés and private residences have been mentioned."
During the reconstruction phase, The Workman Theatre, a popular visual and performing arts gathering place, "...a space much loved by local residents and others throughout the city...," operated and managed by people with psychiatric disabilities, [and funded, in part by the Centre for Addiction and Mental Health, Canada's largest mental health and addiction teaching hospital and the agency that stands to benefit from reconstruction] will be demolished.
To destroy the Workman Theatre without having prioritized a replacement structure ~ is patently absurd! It is a popular gathering place, run by clients and former clients of mental health services. Across the continent theatre groups run by ex-patients have shown themselves to helps bolster self-esteem, foster independence and self-determination. Toronto's Centre for Addiction and Mental Health (CAMH) partially funds the theatre group; it is a bafflement that CAMH management would even consider razing a structure so integral to helping mental health service clients in recovering.
That single action alone speaks volumes about the arrogance of clinicians towards the clients the agency supposedly serves, and makes a lie of any claims that CAMH may make about "...advocating for public policies [and practices] that are responsive to the needs of people with addiction and mental health problems." Why eliminate the Workman Theatre, a truly integrated service, that actually provides supportive services that CAMH claims they want to offer?
If Lewinberg and Garfinkel really wanted to help developing a community that helps "normalize" life for people with psychiatric diagnoses, and help folks integrate into the larger society, why then act like just a real estate developer hawking densely packed office buildings? How about affordable housing and street level spaces for small businesses. So much for an clinical commitment to the Recovery Model. And practically nothing to promoting "Community."
IMAGE CREDIT: Rendering of one of the new buildings by Montgomery Sisam Architects
08 July 2010
fitful wanderings from the web
Art House Co-op, in Brooklyn, NY, welcomes art projects for review and possible display.
FROM THEIR WEBSITE: "Art House projects are a way to create a community of artists and give anyone a chance to be part of something creative. We hold an exhibition for most projects at our library in Brooklyn, NY. All of our projects are open for sign ups on a first come first serve basis.
"If you are a professional artist, consider this a unique opportunity to get your work out there and add a show or two to your resume. If you are a first time artist, think of it as a way to inspire you and give you a chance to be in a gallery and see your work on the wall!"
More on the risks and dangers of hydro fracking
Cancer survivor who uses physician prescribed marijuana is fired by WalMart for trying to maintain his health. Is this really about WalMart not wanting to provide adequate health care? Just wondering.
We're in a recession because those already rich demand more and share less with society. Quote that accompanied the picture on the right:
Last September, Judge Nicholas G. Garaufis of United States District Court in Brooklyn found that the state had violated the Americans With Disabilities Act by keeping approximately 4,300 people with mental illness isolated from the outside world in warehouse-like conditions in more than two dozen privately run adult homes. The state pays the homes for their care.
Over the vehement objection of the state and the owners of the homes, Judge Garaufis issued a remedial plan in March.
The plan would give nearly all current and future adult home residents the opportunity to move into supported housing scattered throughout the boroughs, where they would live independently while also receiving assistance like case-management services and visits from psychiatrists and nurses.
FROM THEIR WEBSITE: "Art House projects are a way to create a community of artists and give anyone a chance to be part of something creative. We hold an exhibition for most projects at our library in Brooklyn, NY. All of our projects are open for sign ups on a first come first serve basis.
"If you are a professional artist, consider this a unique opportunity to get your work out there and add a show or two to your resume. If you are a first time artist, think of it as a way to inspire you and give you a chance to be in a gallery and see your work on the wall!"
More on the risks and dangers of hydro fracking
Cancer survivor who uses physician prescribed marijuana is fired by WalMart for trying to maintain his health. Is this really about WalMart not wanting to provide adequate health care? Just wondering. We're in a recession because those already rich demand more and share less with society. Quote that accompanied the picture on the right:
Then Jesus said to his disciples, “Truly I tell you, it will be hard for a rich person to enter the kingdom of heaven. Again I tell you, it is easier for a camel to go through the eye of a needle than for someone who is rich to enter the kingdom of God.” ~ MATTHEW 19:23-24 A Federal Appeals Court has ruled that people with psyche disabilities should be helped to live in their own places not just large, institutional, group homes.
Last September, Judge Nicholas G. Garaufis of United States District Court in Brooklyn found that the state had violated the Americans With Disabilities Act by keeping approximately 4,300 people with mental illness isolated from the outside world in warehouse-like conditions in more than two dozen privately run adult homes. The state pays the homes for their care.
Over the vehement objection of the state and the owners of the homes, Judge Garaufis issued a remedial plan in March.
The plan would give nearly all current and future adult home residents the opportunity to move into supported housing scattered throughout the boroughs, where they would live independently while also receiving assistance like case-management services and visits from psychiatrists and nurses.
IMAGE CREDIT: Dwelling in the Word
28 June 2010
dark side - addictions
"Addicts tend to dwell in the ecstasy of ignition, that moment when endorphins are first beckoned and the show begins, but in a more sober, retrospective light, the fact remains that addiction's primary aspect is boredom - the getting and using of the same substance over and over until death, jail or recovery intervenes."
David Carr
I did not select the quote above; a friend who admits he has a problem with addictions, did. When I went to visit him he excitedly pulled our Mr. Carr's article for me to read. "Isn't he so right when he speaks of boredom.?" I mentioned that (in relation to the endorphin kick) my friend has often referenced going on with alcohol use until he got "that click!" I further responded that I wasn't really sure - being addicted to substances has never been my demon. Besides - I rarely find myself bored. David Carr
My friend momentary looked perplexed, then made an "aha" look, acknowledging he finds himself bored quite a lot. Then he agreed (with himself as much as with me) that he needed to do something about this. I found myself agreeing.
Now, the boredom, and repetitive substance abuse, and that search for the "snap" is a bit what the film "Still Life", posted here, is about. Grim, but it seemed an apt feature to put with the quote about addictions.
QUOTE FROM: Mr. Carr's review of a book, "Portrait of an Addict as a Young Man" by Bill Clegg; the film short, Still Life, was produced by Brookstreet Pictures.
27 June 2010
psyche/mental health issues - Side effects of psychiatric drugs
FROM THE Citizens Commission on Human Rights (CCHR) WEBSITE:
But being critical of Big Pharma's own historic negligence at owning up to adverse side effects of psychiatric medications does not make one either a Scientologist or anti-psychiatry. Just stating the facts.
CLARIFICATION: * CCHR is the Citizen Commission on Human Rights International. It was co-founded in 1969 by members of the Church of Scientology
and Professor of Psychiatry Emeritus Dr. Thomas Szasz at a time when patients were being warehoused in institutions and stripped of all constitutional, civil and human rights.
Psychiatric drugs including antidepressants, antipsychotics and stimulants have serious, life threatening side effects and patient’s are rarely warned about the full risks of these drugs.NOTE: I'm often wary of sourcing CCHR* for its critiques, because of their historic ties to both the Church of Scientology and the disparaging label of "anti-psychiatry". However, this is a good video with a punch based on facts, not advertising bromides.
International drug regulatory agencies including the U.S. FDA warn that commonly prescribed psychiatric drugs can and do cause worsening depression, mania, aggression, psychosis, depersonalization, diabetes, hallucinations, suicidal and homicidal thoughts, heart attack, stroke and sudden death. And what’s worse, these are drugs commonly being prescribed to children and even infants.
CCHR has long fought for full disclosure of psychiatric drug risks, and was one of the first organizations to expose the suicidal and violent inducing effects of antidepressants as far back as 1991, calling on the FDA to take action and issue public warnings.
It would take the FDA 13 years to finally issue black box warnings on antidepressants causing suicidal ideation.
But being critical of Big Pharma's own historic negligence at owning up to adverse side effects of psychiatric medications does not make one either a Scientologist or anti-psychiatry. Just stating the facts.
CLARIFICATION: * CCHR is the Citizen Commission on Human Rights International. It was co-founded in 1969 by members of the Church of Scientology
and Professor of Psychiatry Emeritus Dr. Thomas Szasz at a time when patients were being warehoused in institutions and stripped of all constitutional, civil and human rights.
poetry - What is his Axis One?
WHAT IS HIS AXIS ONE?
The smartly dressed psychiatrist
Practically yelled across the room.
WHAT IS HIS AXIS ONE?
She cried out, the sharp glint in her eyes
almost bouncing light off her
Severe
designer earrings.
WITHOUT KNOWING HIS AXIS ONE
I’m not certain we can treat him
There are, after all, standards for admission
They have to be met!
And if we cannot determine his Axis One
He doesn’t meet the standard.
But we’ll never determine his Axis One
If all he does today during this meeting
is just sit there –
Crying.
READ AT THE: Mad Pride Festival / Held at Wisdom House / Litchfield, CT / 13 July 2007
The smartly dressed psychiatrist
Practically yelled across the room.
WHAT IS HIS AXIS ONE?
She cried out, the sharp glint in her eyes
almost bouncing light off her
Severe
designer earrings.
WITHOUT KNOWING HIS AXIS ONE
I’m not certain we can treat him
There are, after all, standards for admission
They have to be met!
And if we cannot determine his Axis One
He doesn’t meet the standard.
But we’ll never determine his Axis One
If all he does today during this meeting
is just sit there –
Crying.
READ AT THE: Mad Pride Festival / Held at Wisdom House / Litchfield, CT / 13 July 2007
Labels:
madness,
mental health,
poetry,
social injustice,
will brady
poetry - EASTERN
EASTERN
When I was a kid
the place where I lived
was a squat cinder block building
they called “the Cottage”.
Inside there was a rubber room
with thickly lined walls
one could slam ones’ self into
without really doing much harm.
I got to spend a bit of time there
when I was bad.
This was nothing like the room they used
the next door over
for the really bad kids.
When a really bad kid went into that room
the Counselors would call the rest of us together
in the hallway, outside the room
where we could look through the window in the door.
Through that window
we could see, four feet above the floor
the brown tinged blocks
as we would watch
a fresh application get added
to the otherwise white walls.
“If you are really bad
You’ll get to go in there too!”
lesson learned.
If you were only partly bad
You get the rubber room.
At least, there, you get to be left alone.
READ AT THE: Mad Pride Festival / Held at Wisdom House / Litchfield, CT / 13 July 2007
When I was a kid
the place where I lived
was a squat cinder block building
they called “the Cottage”.
Inside there was a rubber room
with thickly lined walls
one could slam ones’ self into
without really doing much harm.
I got to spend a bit of time there
when I was bad.
This was nothing like the room they used
the next door over
for the really bad kids.
When a really bad kid went into that room
the Counselors would call the rest of us together
in the hallway, outside the room
where we could look through the window in the door.
Through that window
we could see, four feet above the floor
the brown tinged blocks
as we would watch
a fresh application get added
to the otherwise white walls.
“If you are really bad
You’ll get to go in there too!”
lesson learned.
If you were only partly bad
You get the rubber room.
At least, there, you get to be left alone.
READ AT THE: Mad Pride Festival / Held at Wisdom House / Litchfield, CT / 13 July 2007
Labels:
madness,
mental health,
poetry,
social injustice,
will brady
poetry - Therapies I have known
Therapies I have known
Valium - How nice. I really don’t care if I’m caught dancing naked in the street
Mellaril - Itchy scratch brain. Itchy scratch brain ...And I can’t do anything about it
Haldol - New exercises for my tongue!
Thorazine - Dense grey tarpaper wrapped around my medulla oblongata
Navane - Bright blue pills that enhance the effects of marijuana
Zyprexa - How’d that bowling ball get in my belly?
Psychiatrist - Six months of silence and he speaks, but only briefly
Concrete blocks and sledgehammer - Hours of concentrated slamming creative destruction leads to extreme fatigue and blissful, rested sleep
Friendships - That works.
READ AT THE: Mad Pride Festival / Held at Wisdom House / Litchfield, CT / 13 July 2007
Valium - How nice. I really don’t care if I’m caught dancing naked in the street
Mellaril - Itchy scratch brain. Itchy scratch brain ...And I can’t do anything about it
Haldol - New exercises for my tongue!
Thorazine - Dense grey tarpaper wrapped around my medulla oblongata
Navane - Bright blue pills that enhance the effects of marijuana
Zyprexa - How’d that bowling ball get in my belly?
Psychiatrist - Six months of silence and he speaks, but only briefly
Concrete blocks and sledgehammer - Hours of concentrated slamming creative destruction leads to extreme fatigue and blissful, rested sleep
Friendships - That works.
READ AT THE: Mad Pride Festival / Held at Wisdom House / Litchfield, CT / 13 July 2007
Labels:
madness,
mental health,
poetry,
social injustice,
will brady
21 June 2010
harm reduction - Restraint + Seclusion Training
A couple of years ago the facility where I work established a goal to eliminate the use of mechanical restraint and seclusion.
Although this effort was first met with opposition, and there were a significant number of direct service staff who fearfully argued that such an approach would result in more assaults and injuries, in fact, the opposite occurred. Statistics show that as restraint interventions became less frequent, the number of injuries and assaults went down. Another thing that was done [thanks, in part due to mandates from the Center for Medicare and Medicaid Services] was to dramatically limit the length of time that a person could legally be placed in mechanical restraints.
Perhaps most important, the values that provided the foundation behind the move to eliminate mechanical restraints are based on the premise that people with long term "chronic mental illnesses" often can and do recover; if the treaters would but recognize this truth.
As these values translate into organizational policy [and clinical practice], the state's Department of Mental Health's training manual on "Safe Recovery Orientated Environments", teaches the following:
Safe recovery orientated environments have several essential cultural characteristics. Our focus is on these three:Translating these points into everyday clinical protocols is a dramatic remove from the conventional wisdom practiced at most psychiatric facilities. Instead, industry standards are more often based on the flawed teachings of Dr. Benjamin Rush, who, in 1813 published a treatise entitled Medical Inquiries and Observations Upon the Diseases of the Mind, indicating his recommended treatment for "the Mad."
• Risks are continuously prevented and managed to provide the safest environment possible.
• Care is customized to the individual and is focused on fostering recovery – our focus today is on helping people self regulate dangerous behavior.
• All people are treated with respect and dignity. As such, the use of R/S imposed as a means of coercion, discipline, convenience, or retaliation by staff is not permissible. Instead, everyone works together to find paths to recovery.
“The best way for you to BE safe is to help your patients FEEL safe”.
Rush is widely regarded as "the father of modern psychiatry". His writings first codified his beliefs almost 200 years ago. His premise was that forced, brutal and coercive treatments were what worked best. Even now what continues to pass for inpatient psychiatric care goes back to that, and many still [who work with "the MAD"] do not seem to question Rush's opinions since the day he penned them....if all the means that have been mentioned should prove ineffectual to establish a government over deranged patients, recourse should be had to certain modes of coercion:
1- confinement by means of a straight waistcoast or of a chair...
2- privation of their customary pleasant food;
3- pouring cold water under their coatsleeves, so that it may descend into the armpits and down the trunk of the body;
4- the shower bath continued for 15 to 20 minutes.
If all these modes of punishment should fail in their intended effects, it would be proper to resort to the fear of death. - By the proper application of these mild and terrifying modes of punishment chains will seldom, and the whip, never, be required to govern mad people." page 181 [the chair shown just to the right is what Rush had patented as his "tranquilizer chair"]
Although there is still a coercive tone to the place, in the past decade where I work has changed dramatically. Many staff, if they do not actually embrace these new values, recognize that they are expected to comply with their enactment. And there still remain some who yearn for the "good old days" when they could tie down people for days at a time without any oversight or official complaint. That still has to change ~ not just where I work, but throughout the "system". More sobering, the place where I work is just one of hundreds [thousands?] such facilities across the continent. While progress is slowly being made on eliminating mechanical restraints, there is still scant consideration regarding the widespread use of chemical restraints that are psychiatric medications.
Virtually nothing is done about treatment-induced ailments such as: learned helplessness, clinically encouraged self-absorption or the disdain for self-determination. There are also the traumatizing effects of living with the impacts of cumulative institutionally induced emotional and psychological manipulation and abuse; of being constantly treated and regarded as a less-then-normal patient/person. All these have bearing on a person's ability to get to that state of "recovery".
And I'm not even going to begin to address the total lack of clinical interest in seeking non-harmful interventions that are outside the mainstream, nor the aversion to spiritual quest paths as a means of healing one's self.
Administrators - both in-state and elsewhere, boast we are among the best of the lot. They should not yet rest upon their laurels. And for the "patients" in the other places? We - and society - still has a long, long way to go before truly becoming coercion free.
COMMENTARY SITES ON THE STATE OF THE MENTAL ILLNESS INDUSTRY: 1- Beyond Meds; 2- The Standard Review / Diversity Rules; 3- The Icarus Project
COMMENTARIES ON MIND/SOCIAL CONTROL: Are your thoughts your own? Turn off the TV Set!; Richard Gosden's Coercive psychiatry, human rights and public participation [first published in 1999, ever bit as relevant today.
IMAGE INFO: Dr. Benjamin Rush's "Tranquiliser Chair." Rush, ironically, was one of the signatories of the US Declaration of Independence; Pillhead found online some time ago; source unknown
14 June 2010
mental illness systems

I work as a human rights advocate with and for people with psychiatric disabilities. I got started doing this after watching a friend get bounced back and forth between agencies and medications by workers (from line staff to psychiatrists and administrators) who had scant regard for human suffering. That was 27 years ago.
I can't say that much has changed.
Sure, the use of mechanical restraints has been reduced somewhat.
But it was the unnecessary deaths of poor souls held in them for unconscionable lengths of time - resulting in a highly publicized political outrage - that brought that change about, not any great change in public consciousness or caring. Human indifference about the sufferings of "...the mentally ill..." continues to remain a constant.
It is also sobering to witness how those who hold the purse-strings have adopted the words of the mantra first chanted by 1970s era ex-patient activists - that people with prolonged suffering can "recover". Yet the actions of the administrators have not evolved into either effective caring or coping options for those supposed to be the beneficiaries of clinical largesse. MH System administrators (and clinicians) still work hard to hinder their clients' from recovering.
Mind you, I'm not writing about CIA funded psych crimes like MK-Ultra or even the "extraordinary rendition" abuses conducted during the heyday of the Bush/Cheney era Iraq adventure. I'm thinking more of the little tortures, that eat away at one's soul, yet are encouraged and promulgated by folks making life-altering decisions about others yet who completely lack vision or understanding about the impacts of what they do. These little tortures are instead everything from lecturing people about obesity while prescribing drugs that cause rapid weight gain (such as Seroquel). Or denying people fresh air, or pushing clients into low paying careers (it is still the food - filth - filing and tending to flowers that are offered as "job possibilities") instead of trying to discern what people's talents are.
Finally (for now, at least) there is still no safe haven for people in crisis to go to. People still have to wait to when they are no longer able to make thoughtful self-admissions (ofttimes when many are actually willing to seek help) when at the most acute levels of psychic pain, to get into mental health facilities. They have to suffer indignities like social isolation, attempts at self-injury, or even arrest - before admitted in emergency to be shot up with drugs that numb one from reacting to adverse symptoms, but do little to make those symptoms go away.
I have no solution for correcting these societally tolerated wrongs, but I'm still not giving up. My friend still suffers from poorly designed treatment options - conceived mostly by people with no first-hand knowledge or experience what it is like to be on the receiving end; the very least I can do is make sure he isn't also horribly abused.
I can't say that much has changed.
Sure, the use of mechanical restraints has been reduced somewhat.
But it was the unnecessary deaths of poor souls held in them for unconscionable lengths of time - resulting in a highly publicized political outrage - that brought that change about, not any great change in public consciousness or caring. Human indifference about the sufferings of "...the mentally ill..." continues to remain a constant.
It is also sobering to witness how those who hold the purse-strings have adopted the words of the mantra first chanted by 1970s era ex-patient activists - that people with prolonged suffering can "recover". Yet the actions of the administrators have not evolved into either effective caring or coping options for those supposed to be the beneficiaries of clinical largesse. MH System administrators (and clinicians) still work hard to hinder their clients' from recovering.
Mind you, I'm not writing about CIA funded psych crimes like MK-Ultra or even the "extraordinary rendition" abuses conducted during the heyday of the Bush/Cheney era Iraq adventure. I'm thinking more of the little tortures, that eat away at one's soul, yet are encouraged and promulgated by folks making life-altering decisions about others yet who completely lack vision or understanding about the impacts of what they do. These little tortures are instead everything from lecturing people about obesity while prescribing drugs that cause rapid weight gain (such as Seroquel). Or denying people fresh air, or pushing clients into low paying careers (it is still the food - filth - filing and tending to flowers that are offered as "job possibilities") instead of trying to discern what people's talents are.
Finally (for now, at least) there is still no safe haven for people in crisis to go to. People still have to wait to when they are no longer able to make thoughtful self-admissions (ofttimes when many are actually willing to seek help) when at the most acute levels of psychic pain, to get into mental health facilities. They have to suffer indignities like social isolation, attempts at self-injury, or even arrest - before admitted in emergency to be shot up with drugs that numb one from reacting to adverse symptoms, but do little to make those symptoms go away.
I have no solution for correcting these societally tolerated wrongs, but I'm still not giving up. My friend still suffers from poorly designed treatment options - conceived mostly by people with no first-hand knowledge or experience what it is like to be on the receiving end; the very least I can do is make sure he isn't also horribly abused.
LINKS TO FOLLOW: Organizations and people who promote social justice and fairness in metal health: Mind Freedom, Ecopsychology Community, Freedom Center,
Labels:
caring,
mental health,
psychiatry,
recovery,
social policy,
suffering
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