Thank you, Deb Fabos, for posting this

Civil Rights Groups File Suit on Behalf of Man Intentionally Denied Mental Health Treatment in Jail, Man Was Abused by Tangipahoa Prison Officials

via ACLU.org

FOR IMMEDIATE RELEASE
CONTACT: Ronald K. Lospennato, Advocacy Center 504-208-4679

NEW ORLEANS – Two civil rights organizations, the Advocacy Center and the ACLU of Louisiana, joined forces to file a lawsuit today on behalf of Dennis Bargher, who, while suffering from schizophrenia and other severe mental illnesses, was held at Tangipahoa Parish Jail (TPJ) for nearly two years without treatment.  The suit was filed in the United States District Court for the Eastern District of Louisiana.

TPJ officials knew that Mr. Bargher was severely mentally ill, that a court had ordered his treatment with prescription medications, and that without treatment, Bargher would quickly descend into psychosis. Despite that, they refused to treat him, held him in solitary confinement for weeks and months at a time, and denied him food until he had lost nearly half his body weight. Bargher’s abuse at the hands of jail officials continued for almost two years until late 2011, when he was discovered – psychotic, emaciated and enfeebled – by civil rights groups and transferred to a different facility.

Miranda Tait, an attorney for the Advocacy Center said “prison conditions are very hard on inmates with mental illness. Conditions of overcrowding, violence, lack of privacy, lack of meaningful activities, isolation from friends and family, and uncertainty about life after prison affect all inmates. These conditions are especially difficult for people with mental illness. The intentional withholding of medical treatment, with callous disregard for the inmate’s medical needs, is tantamount to torture”

According to Marjorie Esman, Executive Director of the ACLU of Louisiana, “Under the Constitution, prisons are obligated to provide inmates with adequate medical care, including mental health care. Officials cannot abuse or neglect inmates, deny prisoners essential treatment or allow offenders to physically and mentally waste away simply out of contempt or because they don’t understand the disease.”

With few psychiatric services available to the public, people with mental illness are increasingly funneled into a criminal justice system that is ill-equipped to address their treatment needs.  Hundreds of thousands of men and women in U.S. jails and prisons suffer from serious mental illnesses such as schizophrenia, bipolar disorder, and major depression. “It’s past time for us to provide adequate care for those with illnesses,” continued Esman. “Dennis Barger was wrongly denied that care, and suffered greatly as a result.” Representing Dennis Bargher are Miranda Tait and Ronald Lospennato of the Advocacy Center, ACLU of Louisiana Senior Staff Attorney Justin Harrison, and ACLU Cooperating Attorney Ron Wilson.

NEW CBS WEB SERIES ON MENTAL HEALTHCARE

The crisis in mental health care is rapidly becoming a featured topic of mainstream journalism.

CBS News has commendably chosen to spotlight this subject as the launch-point of its new experiment in long(er)-form video journalism, making use of its online digital resources. To quote from the network’s announcement: 

CBS Evening News Uncharted: State of Mind” is a new five-part digital series airing in May with new episodes released every Wednesday. The series will examine the state of mental health care in America in conjunction with Mental Health Awareness Month. More than 43 million Americans suffer from mental illness.”

The first episode aired last night, and I repost it here. I was among the contributors, along with Congressman Tim Murphy, former Congressman Patrick Kennedy, and Dr. Glenda Wrenn, the psychiatrist and the director of behavioral health for the Satcher Health Leadership Institute.

Rep. Tim Murphy
Former Rep. Patrick Kennedy
Dr. Glenda Wrenn

 

 

 

 

Not surprisingly, the most compelling figure in this episode is an embattled mother: Rocky Schwartz, whose two sons are afflicted with chronic mental illness.  (The National Alliance on Mental Illness has estimated that 60 percent of Americans suffering from mental illness don’t receive the care they need.)

Rocky Schwartz

Battles with un-cooperative health insurance companies have cost Ms. Schwartz and her husband more than $300,000, draining their retirement, college savings, home equity loans, and other personal savings.

Roman Feeser

 

The series was assembled by a young production team headed by the gifted and determined associate producer Roman Feeser. I am honored to have been a part of the first and some of the succeeding installments in this bellwether experiment in immersive journalism.

http://www.cbsnews.com/news/mental-health-where-are-we-uncharted-state-of-mind-episode-1/

Another Solitary Confinement Atrocity

This horrific story, originally reported by the excellent Milwaukee Journal-Sentinel and picked up by Slate a couple days ago, is yet another demonstration of my assertion in NO ONE CARES ABOUT CRAZY PEOPLE that “too many of the mentally ill in our country live under conditions of atrocity.” Terrill Thomas’s death by slow, deliberate, guard-induced dehydration while in solitary confinement at a Milwaukee County jail is an abomination, and a part of a larger national abomination. Our society must demand an end to solitary confinement!

Via Slate.com

Guards Who Left a Prisoner to Die of Dehydration, After Water Was Cut for Seven Days, Could Face Charges

Read the full story here: http://www.slate.com/blogs/the_slatest/2017/04/24/guards_who_left_milwaukee_prisoner_to_die_of_dehydration_in_cell_could_face.html

Voices From the Sub-Universe

Today I introduce a new, occasional feature to my blog. Please see below:

Ron Powers

Voices from the Mental Illness Sub-Nation

Near the beginning of my recently published book about mental illness, “No One Cares About Crazy People,” I write: Too many of the mentally ill in our country live under conditions of atrocity.

I grew convinced of this over the three years of my research into schizophrenia and its related brain afflictions that include schizoaffective disorder and extreme bipolarity. My examples in the book cover the spectrum of atrocity: mis-diagnoses (often “drug overdose”) by doctors; judges who order young victims into jail instead of treatment centers; beatings, deprivation of medications, and the torture of solitary confinement behind bars; death on the streets from bullets fired by untrained police; the daily fog and helplessness of the untreated insane.

These and some other areas—arenas—pretty much covered it, I was convinced. The spectrum of atrocity suffered by the mentally ill in America.

I was wrong.

I had limited my investigations to the barbarities visited on the “crazy people” themselves. Only after the book’s publication in March did a companion realm swim into focus for me: the realm of ordinary people whose lot is to care for the afflicted. These include mothers, fathers, siblings and friends of the helplessly impaired thousands whom our social bureaucracies have neglected and rejected and crushed. In many ways, these family members are damaged and abject as the loved ones they seek in vain to rescue.

No one cares, to coin a phrase, about those who care about crazy people.

This realm rushed at me in emails to my Facebook page and to the blog I created that related to the book. It swelled up within certain websites that I, as a writer about mental illness, was invited to join. These sites are closed off to anyone but relatives of madpeople; an enforced set of agreements keeps their conversations private unless they grant specific permission.

The writers on these sites are almost exclusively mothers—a fact that in itself merits contemplation. Mostly middle-class, they span several income, educational and racial categories. They are seldom “natural” writers, yet no one could mistake what they have to say. They write with the rare pitch of truth-telling passion that James Agee memorably described as “the cruel radiance of what is.”

What they have in common is a collective story more urgent, more morally devastating, more viscerally real, than be expressed by the modes by which outsiders receive information about mental healthcare: statistics and news items and policy statements and political press releases, delivered in detached, passionless prose.

Today, this blog commences an occasional compilation of these mothers’ voices (and those of other relatives as they are available). I have obtained permission from each source quoted, and have withheld identities, although some gave permission for that as well.

My hope here is twofold. One is that the reader will feel the same emotions as I have: shock and indignation that such chaos and neglect exist in America’s mental health-care systems, causing such a vast archipelago of misery and terror. The other is that these voices will encourage others to throw off fears of stigma and shame and begin hurling their own voices, their own testimonies, into the world. Only by putting human faces and voices upon the statistical morass of this ongoing atrocity can we hope to begin decisive, lasting reform.

 

We will begin with an example of the commonplace indifference and buck-passing at the community level that makes a mockery of the very phrase “mental healthcare system.”

 

“I have only enough strength this morning for a few lines. [My daughter] was discharged in 2011 with no psychiatric follow up appt. We scrambled to find someone, but before we could, she was readmitted to a second hospitalization. She had to drop out of school for a second time. She was too far behind. The [caregiver] had put her on a drug that literally made her bang her head on the wall. Then she was hospitalized another two weeks, and upon discharge the social worker made no referrals or linkages for her in the community, and would not respond to my inquiry about her diagnosis. I asked and her response was, ‘What does that matter?’

“She came home with us, and for the next two months, it was awful. In February, she was psychotic again, and ran out of the emergency room when I tried to get an evaluation. She was noncompliant with meds, and thought she was pregnant. She spent two weeks in one hospital and I threw a fit about her being sent home to us again because I had a 14-year-old at home to protect. She had become physically aggressive as well. They sent her to a state hospital after my totally pissing them off, and she stayed there for two months.

“My biggest frustration is no linkages, no follow-up, no support, etc. We were treated like nosy people wanting to meddle in our child’s life but, she was sent home to me to deal with every time. And, each and every time, I felt more inadequate to help her and to protect my other child. [Her sister] was terrorized and slept with her bedroom door locked. She also became angry with me, her mom, for not being able to protect her from her sister.”

 

 

Sometimes the afflicted family member is not a child, but a parent. Whether or not that parent has consented to treatment—and often they have not—the strain suffered by the spouse and children can be overwhelming. This eloquently written post offers an example:

 

“I must say that helping my kids to navigate their life in relation to their Daddy’s serious mental illness is serious emotional work. Tonight I held my 10 year old ‘Baby’ girl as she opened up and told me that sometimes she just starts feeling sad and then ALL of her sadness comes over her at once. I held her as she sobbed and sobbed. ‘Why can’t we have a normal family?’ ‘Why can’t we live in our own house where I could have my own room?’ ‘Why did my Daddy have to get sick?’ ‘Will it ever be okay?’ ‘Why can’t the doctors just fix this?”

“I want to know too.

“She voiced the little girl version of the questions that claw at my own heart and mind. The grief and loss come at us in waves. Tonight we sat and cried together. Her tears streaming down my chest and mine in her hair. . .”

 

 

 

The mother below and her son are casualties of grotesque, yet pervasive laws that place the “civil rights” interests of a person in psychosis above the right of a doctor or psychiatrist to order antipsychotic medication and/or involuntary commitment to a center for treatment. In most states, such a patient may be treated against his will only if he “demonstrates a danger to himself or others.” Given that virtually the only way to “demonstrate” such a danger is to enact it, this misbegotten law often has the effect of pushing psychotic young people into criminality.

 

“When my grandson was 11, we begged for help to keep him safe and out of trouble. Several psychiatrists later and many tears and meds for him, we were told: wait till he gets in trouble with the law. Then he will get help. His school told us the same thing. No one understood that what they were telling us was our fear!! We didn’t want this sweet soul of a kid getting into trouble with the police! We were not that kind of family, he was not that kind of kid! We were not going to let that happen! We would fight, pray, restrict him, take him to every doctor we could find. . .

“When mental illness takes hold of our kids we have no control. Mental illness wins over and over again. He is now 20 and hanging with some more worldly friends, friends whose families must have said and fought for the very same things. We must fight and tell the world how our kids didn’t have a chance. They did not pray for mental illness any more than one would pray for cancer. We need to fight for hospital beds in which to keep our kids safe. Our kids need to be able to have safe places to live, affordable meds, support and understanding of their illness. God hear my prayer!!!”

 

 

 

From this message, and others, it is clear that not even psychiatric doctors can be automatically trusted to have the competence and temperament necessary to help their patients.

 

“A bad day at the doctors. Our city had to basically shut down [its psychiatric care center] because of diverted funds, but after waiting a year, my loved one got an appointment, which was today. In the past year, we had seen a private psychiatrist who didn’t [ participate in my state’s Medicaid program], but would prescribe anti-anxiety meds to help [forestall involuntary confinement]. But she would no longer see him.

“The appointment started off badly as this new doctor called for security before my son even went into the office—possibly because of [troubling] paperwork he had filled out or because of his unusual look. In any case, the security thing set him off more than usual and the doctor made him leave and he is not allowed to return. I listened to the usual four-letter tirade all the way home, my son saying he would never go to another doctor again and don’t ever ask him to. He got out of the car before I came to a full stop at the house. I am so not looking forward to what will happen tonight. De-escalation armor on.”

 

 

 

And then there is the judicial system. As with psychiatrists and doctors, judges are commonly assumed (by outsiders and families of the afflicted alike) to be specifically educated in the neuroscience of chronic mental illness. They are assumed to recognize their moral duty to proceed with exceptional care and knowledge in adjudicating the fate of the most helpless people on earth. Doctors and jailers, of course, are bound by the same expectations.

 

A special test of that duty is their understanding—or lack of it—of the fact that the single most destructive action against a mentally ill inmate (in fact, against any inmate) solitary confinement, which quickly trigger and/or deepen psychosis.

 

Judging by the content of this mother’s message, her schizophrenic son has been failed by everyone in this chain. Both he and his mother have paid the price.

 

“My son’s court case is tomorrow. What’s tragic is the fact I begged for help since November 1. I faxed over a Do Not Release letter stating he was a serious harm to himself and me. Now, my son has spent three months in jail and has been allowed to deny all medications. My son suffers from anosognosia [a clinical term meaning “lack of insight into one’s mental illness”]. So, tomorrow, he learns the painful truth that his competency evaluation came back not competent to proceed.

“My son believes he aced [his mental competency test] and is coming home to me. But the doctor found him incompetent. No shocker there! If they had only listened to me back on November 1, he wouldn’t have had to spend three months and counting in jail! Plus, I wouldn’t have been severely beaten and cornered in my own bathroom [by him] for a second time. Now, my severely delusional child has been off all medication for a month. Talk about starting from ground zero!

“What he will experience tomorrow will be criminal. He will learn he’s incompetent, while wearing shackles and handcuffs. I fucking hate our system!!! He doesn’t understand his illness. His rights will be taken away. He will suffer from the phases of grief even though it is he who is lost to us. He will be left in a jail cell awaiting placement in the state hospital, which could take one to three months because the waiting list is so long.

“I begged with my son to call Disability Rights to represent him but he said he didn’t have a disability even though he’s received Disability for 5 years! What’s even more fucked up is that Disability Rights said they could only talk to my seriously delusional child. That is why he had to call! What a joke! I know so many parents who have lost their children with a serious mental illness in jail. So, please pray and send out positive messages into the universe that he makes it through, and finally receives the help he deserves!

 

This mother’s son was a small and thin 17-year-old, when local police arrested him for trespassing. The mother writes that, in a psychotic state, he had wandered into a neighbor’s house and fell asleep on a couch. The neighbors called police, and who, instead of taking him to a care facility, put him in jail. The mother has repeatedly called for compassion and treatment for him; so far, her calls have been ignored.

 

“Today is another day. It’s so hard to move forward with my life. We are stuck in this insane limbo. My son called today [from jail], and says mommy, ‘the inmates that hand out the trays they took most of the food off my tray. The guards were standing there. They said I have to pay a debt. They say I have to pay them if I want to eat. Put money in [X]’s commissary Account so I can eat.’ Over the past month, our son was in solitary confinement for almost two weeks. They stopped his antipsychotics cold for four days. He has psychosis, and is hearing voices. After the assault [by inmates] two weeks ago, he has a concussion.

“He’s been denied an MRI, or an emergency-room visit, despite my pleas. His vision is blurry, headaches, and nausea. He is emotional from the head injury. They will not wake him for his morning antidepressants. Now tonight he has informed us they are trying to extort money by starving him. So he was crying again tonight. We hope next month he sees the forensic psychiatrist.

“[The jailers] extort money for visits, commissary, basic necessities, phone calls, fees, per-day jail incarceration fees, fines, restitution, medicines, doctor fees, etc. Our son was charged as an adult at 17. The boy who dances like Michael Jackson, and plays 5 instruments. He hears voices. He has auditory hallucinations, and Asperger’s. Fifteen times, I tried to hospitalize him. Instead He went to jail where he spent weeks at a time in solitary confinement. He was beat up, his vision is still affected. He still had not had an mri.,. Tonight he sits in jail at just 18. He is not a hardened criminal. He’s a good, sweet kid, he wouldn’t hurt a fly. Every day I pray he will come out of this alive. My heart is shattered!

 

 

Here is another example of solitary confinement used as a blunt instrument—to effectively punish the victim of a jail beating.

 

“I just got off the phone with my son. He was beaten up two weeks ago [by inmates], and the jail’s answer was to put him in lockdown [solitary confinement] for 23 hours a day by himself. I had him agreeing to meds but they gave him the wrong meds and now he won’t trust them. He has been in the county jail for six months, and finally saw a judge for the first time last week. Now they need six weeks’ revaluation. Meanwhile, they keep him alone in lock up. He can call me on his hour out. He just called screaming and crying to get him out. I can only tell him he needs to hang in there and we are doing the best we can. But he’s slipping more. And nobody in the courts seems to care. My heart is breaking. His birthday is Wednesday. I am a single parent, and he’s my youngest.” 

 

And here is another example of the foolish inadequacy of “danger to himself or others.” Given that virtually the only way to “demonstrate” such a danger is to enact it, the law generally does more harm than good.

 

“The doctor told me, “‘Wait, N—, he’s not bad enough yet, he hasn’t committed a crime!’ [And then he said], ‘Your son is an adult. He has the right to be crazy if he chooses.’ 

My son has slipped through the cracks in every instance. There’s no consideration for families living with an untreated psychotic person except when it’s too late. We live in fear of our own son.”

ANOTHER MENTALLY ILL INMATE DIES IN JAIL

In NO ONE CARES ABOUT CRAZY PEOPLE, I write, “Too many of the mentally ill in our country live under conditions of atrocity.”

Here is one more among the unending examples of what I mean: Inmate, 23, who died in Orleans Parish jail Wednesday identified.

A VICTORY FOR MENTAL HEALTH REFORM IN CONGRESS—YET MUCH REMAINS TO BE DONE!

mental health
Congressman Tim Murphy. By Timmurphy (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
Parents, siblings and friends are rejoicing over Wednesday’s passage in the House, by a 392-26 vote, of the seminal 21st Century Cures Act, a $6.3 billion bill to overhaul mental health care in America. The bill is expected to quickly pass the Senate and secure President Obama’s signature, transforming it into law.

The Cures Act’s unexpected success thus far signals a radical departure from decades of Congressional indifference toward the mentally ill, interrupted occasionally by maladroit and socially damaging efforts at reform such as “deinstitutionalization.” Its strengths, weakness and potentially controversial sections are superbly analyzed by the pre-eminent mental-health blogger Pete Earley: http://www.peteearley.com/2016/11/30/murphys-family-mental-health-bill-finally-approved-next-step-senate-then-white-house/

The Act incorporates the language of the Helping Families in Mental Health Crisis Act, a measure created and promoted for years by Congressman Tim Murphy (R-PA), the pre-eminent champion of reform on this issue in all of Congress. https://murphy.house.gov/latest-news/breaking-helping-families-in-mental-health-crisis-act-language-finalized-full-vote-to-take-place-next-week/.

Despite the euphoria and likely full passage, even its advocates acknowledge that the 21st Century Cures Act faces strong opposition from several influential sectors. The reliably progressive Senator Elizabeth Warren (D-MA) has criticized it for failing to constrain the “Big Pharma,” the notoriously profiteering multinational pharmaceutical industry, from profligate pricing and lax testing standards for protecting the safety of customers. On the other side of the spectrum, the conservative group Heritage Action for America,which has denounced the “gimmicky nature of the pay fors” in the Act—“the newly creating funding mechanism designed to bypass spending caps, or the overall level of spending.” 

Congressman Murphy pinpointed his satisfaction with the House vote while agreeing that it is far from a cure-all for serious mental illness in America: “We didn’t get everything we needed, but we needed everything we got.” The Congressman, who is a Navy veteran and a practicing psychologist, went to work on his Crisis Act in 2012, following the massacre of schoolchildren in Newton, Connecticut, by the 20-year-old Adam Lanza, who had murdered his mother before the shooting spree and who killed himself afterward.

I have devoted a couple of chapters to Congress’s history of ineptitude and indifference to mental illness in NO ONE CARES ABOUT CRAZY PEOPLE. In Chapter 13, “Debacle,” I examine the lingering social damage wrought by deinstitutionalization, the early-60s experiment in mass removal of patients from the nation’s flawed and overcrowded mental asylums without following through on guarantees that they would be cared for in a vast network of community-based centers operating without government oversight.

And finally, lest anyone imagine that the surviving mental and psychiatric hospitals have solved their problems, I offer the following short list of recent atrocities suffered by mental-hospital patients (all women, interestingly). I will add that my book takes its title from a string of horrific abuses, including at least one patient death by starvation (another woman, for whatever that may mean), that occurred at Milwaukee County Hospital in the years around 2010.

So: let us justly celebrate the House action on Wednesday in advancing the 21st Century Cures Act. But at the same time, let us not forget that much remains to be done—on the Act itself, and in our still-chaotic world of mental health care.

http://www.nbcnews.com/health/mental-health/after-mom-starves-death-questions-about-care-mentally-ill-n569461

http://www.sfgate.com/bayarea/article/Lawsuit-says-woman-died-because-SF-psychiatric-8346738.php

http://www.fox25boston.com/news/family-begs-for-answers-after-woman-dies-unexpectedly-at-psychiatric-hospital/290007987

http://www.wfaa.com/news/local/tarrant-county/woman-suffering-mental-problems-dies-after-shes-tased/185712630

http://www.post-gazette.com/news/health/2016/09/04/Young-woman-s-journey-ends-tragically-in-mental-hospital/stories/201609040069