Posts Tagged ‘psychiatry’

Documentary about current practices in Psychiatry

(I’ve reblogged this documentary because I believe with all my heart that psychiatry needs to evolve in radical ways.  I am personally very distraught by the care that is available to people, like my family, who do not have the financial means to access private care and/or are without support from extended family, leaving ‘us’ with only one option, which is the current practices in modern-day America’s mental healthcare system).

Everything Matters: Beyond Meds

The producer of this film, Lise Zumwalt,  is looking for funding to continue making it. See here and donate please, even a small amount.

Powerful commentary and documentation on the coercive nature of psychiatry. 

If you’re not aware of just how brutal and coercive psychiatry can be, you should really watch this. This may seem extreme to those who’ve not seen it happening but it’s very common and the bottom line is psychiatry, in general, at best, is subtly coercive. Drugs are generally presented as necessary rather than one, often far less than ideal, possibility for treatment.

CLINICAL SUMMARY: THAT’S CRAZY is the story of Eric and two others who are on the frontlines of a revolution in mental health. They are part of a new phenomenon – a growing number of people who say we need to rethink mental illness. The critics are the patients.

STATUS: Eric, a genetics major…

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The Patient Patient

dogtimeTwo months had passed.  He was their, “model patient.”

He hadn’t read the patients’ rights literature.  He believed, as I did, that exercising those rights would only bring trouble.

“He’ll be our star,” the psychiatrist and social worker told us, referring to the transition unit they were recommending for him. 

The program on the unit sounded pretty good when they first told us about it.  As with much of what they told us, details were revealed later, after decisions had been made.  We soon learned that a patient normally waits (in the hospital) nine or more months to get in. 

The other part they didn’t tell us was that patients in that particular unit are more deeply under, “the motherly care,” of an institution.  The doctor and her team were as elusive about how long he would stay in the different unit, as they had been about how long it would take to get in.  After speaking with a few professionals, I learned they could keep a patient as long as they deemed necessary.  I understood this meant however long it took to convince the patient that he or she had to take medication, no matter what, every day for the rest of his or her life, aka, compliance.

A patient can say no to medication in a psychiatric hospital, but if the treating psychiatrist believes drugs are necessary, then almost always, medication it is.  

He took the medication.  He was quiet.  He went to classes, most of the time, except when the medication sedated him to the point that he could not stay awake.  He gained almost sixty pounds.  His blood tests changed from normal to abnormal.  He accepted gracefully, “No,” when he asked if he could take a lower dose or change medications.  He came back from the passes they gave him to go out with his family. 

Hospital psychiatrists basically have their own government.  If a patient says no to recommended treatment, the psychiatrist simply goes to the hospital’s court, which occurs weekly and presents his or her case to their judge.  The doctor usually has several other medical team members present; psychologists, social workers and nurses, to aid in the request for forced treatment.  The patient has the right to contest, and is given either a legal advocate or an attorney, but hospital judges almost always give the requesting psychiatrist permission to “treat” the patient.

We chose not to contest the necessary court hearings for a few reasons, the first of which was, that the social worker revealed only pieces of what they were asking for and ultimately, we believed we wouldn’t win.  At least, not until after I could come up with a solid plan to present to them.  A plan that would offer their patient, my son, equal and better “treatment” than what they had in mind for him.  We could only hope they would do the right thing, which was to help us in outpatient planning for treatment in the community.  I worked rather obsessively on creating, “A Plan for Recovery.”

It was amazing really.  All the things the psychiatrist and her colleagues came up with to use against him, some of which were fabricated stories with threads of truth either exaggerated, misinterpreted or grossly over-approximated.

“The county is getting tired of,” the social worker had said the first time we spoke.  I interrupted her.  I couldn’t help myself.

“Which county would that be?” I asked her.  My son had been tossed around in several counties since we turned to psychiatry for help.

“He’s been in the hospital,” and she grandly stated a specific number of times to justify why, “the county was tired.”  Even if her number had been correct, which it wasn’t, it was still relatively low according to what I had learned in NAMI’s Family-to-Family education.  I felt lied to in a way.  Betrayed. 

I’d taken the classes, which are strongly recommended by these same psychiatrists, hospitals and institutions.  What I had learned was the best thing to do for a loved one in a mental health crisis was used against my son.

“That’s not correct information you have,” I told her the next time she made use of the number she grabbed out of thin air.  Instead of looking for the accurate number of times he had been in a hospital, she divided her fictional number by two.  By this time, we were almost out the door, so I let her have her number.

I called a meeting with the psychiatrist and her colleagues to present an outpatient treatment plan, even though this is not how things are usually done in a psychiatric facility.  A family member can most certainly meet with the doctor and/or team of professionals caring for a loved one, but normally, social workers are responsible for outpatient planning.  They refused to help us with outpatient planning because they wanted him to stay.  They said if I wanted to come up with a plan, then they would listen, so I did.

“What if he doesn’t make it at this work-study job?” they asked me during the meeting.  “We’ve been informed that if he can’t make it on time, then he’ll be terminated.”

I reiterated to them that the ACT team worked with him for years and never even got him a job interview.

“This is a work-study job at a meditation retreat center,” I told the group of scrutinizing psychiatric professionals.  “He’ll be outside, learning carpentry, landscaping and building maintenance skills,” I told them.  I didn’t focus on the spiritual teaching that would be offered as part of the work-study job.  I was afraid they would come up with a reason that this wouldn’t be good for their patient. 

“We are afraid he won’t make it,” they kept saying. 

They should have said things like this several years ago, when I was asking for their help. 

They talked as if they expected the world to suddenly be perfect for my son, whom they had repeatedly neglected for many years.  The hospital didn’t have visits from anyone offering jobs in the community, much less directors offering one of their patients a much desired position that would nurture personal and spiritual insight, community involvement and meaningful work.

“He’s been sleeping in groups,” the psychiatrist said.  She was grasping at strings.  Very thin ones, I thought.  She looked over at her patient.  He was sitting at the end of the long table, obviously, without any confidence that he might get released from their toxic care.  In a righteous way the psychiatrist asked him, “How can you function in the real world if you’re falling asleep in our (interesting and stimulating) groups?”  It was more a statement than a question.

He looked around.  He didn’t have an answer.

They were giving him a dosage of medication that I had seen caused him to not be able to walk.  I had seen him staggering, falling against walls, half asleep in the middle of the night, while stumbling to the rest room.  Plus, they were giving it to him in the morning! 

I had asked my mother to be discriminating about what she said during the meeting, because they would use everything against us.  She had been quiet, although, I later learned she hadn’t heard everything, so maybe that’s why, but she responded in defense of her grandson’s rights.

“Maybe he’s bored in those groups,” she said.  “He won’t be bored when he gets out of here.  He can come to my house.  I have everything,” and with that conviction, she had waved her arms in the air, communicating the vastness of what she had to offer compared to the hospital’s unit the doctor was advocating.  “Y’all don’t have any of the things we have,” she added.

Mother looked at me.  I knew she wondered if she had said too much.  I didn’t think so.  My sister chimed in about that time, remarking on the weight he had gained from the medication and not exercising.  “I’ve seen what gaining weight does to people.  They get tired.  Uhh, he’s gained a lot of weight since he came here.  We can see that.”

I was glad they had come to the meeting!

“Which classes is he falling asleep in?” I asked.

The doctor didn’t know.  Her sidekick, the psychologist who wanted every single person he met to know he held a PhD, murmured something under his breath.

“Does he fall asleep in the Yoga class?” I asked, while they were still thinking.

They looked at each other.  The social worker shook her head no.

“He’s never liked lecture classes.  He likes hands on learning and experiential education,” I told them.  “He thrives outdoors,” I added.

I had told the psychiatrist, before the meeting, that I couldn’t understand how she could keep my son when he was not a danger to himself or others.  I hadn’t meant to say that, but when his liver panels continued to come back abnormal and his cholesterol and weight were rising like a flood, I became upset.

“It isn’t even legal.  What you are doing is unethical and illegal,” I told her.

We hadn’t spoken again, until the day of the meeting.  She still didn’t say much to me.  She did look at the photo I brought with me.  It was of my son, smiling, shortly before he was admitted to their hospital.  “He was much happier and healthier,” I told her, which he was.

My son was discharged shortly after the meeting. 

Thank you for visiting Dogkisses’s blog!

Changing Seasons

on the journey, the path.

PHOTO CREDIT: Heart & Soul Photography

Several days ago I found a box of frozen juice bars that I bought not long before my most recent post in this blog.  It was mid-summer and as usual, hot and humid.  I’d accidentally left them at my son’s apartment.  They’re in my freezer as I write, but they don’t look nearly as tempting as they did in July.

The summer was like one long day.  One filled with near constant telephone calls, online research and intense email communications.

Having reached out and asked for help in the medical community led to my son’s lengthy and rather unfortunate stay in a psychiatric hospital.

My son is doing okay and maybe even quite well.  He’s out of the hospital, which is very good!  He’s in recovery and I’m processing the fear that those psychiatrists instilled in my mind.

The inpatient psychiatrist and her personal team of professionals claimed that my son was there for symptoms of mental illness, but technically and truthfully, he became their patient because of, “a note left on the (local) hospital’s computer,” written six months before the evening he arrived in the emergency room for help.

The note shaped the next months of his life, and mine.  It almost shaped a few years.

I’ve learned that time is different for me than it is to the psychiatrists we had to deal with.  In their time, a few years of my son’s life can be discussed and measured in days, as in, “up to thirty days,” or, “for one-hundred and fifty days…”

In my time, one hundred-and fifty days equals five full moons, three important family birthdays, one Thanksgiving, one Christmas, days and weeks of walking in the fresh air, one Autumn, thousands of shimmering and glowing leaves to see, two dogs’ lives worth of days to enjoy, two semesters, one Winter, several snowmen and at least, three bowls of snow cream.

In their time, one hundred and fifty days is long enough for them to mythologize, diminish or selectively forget about the United States Constitution, including the Bill of Rights.

Something inside of me changed as the days turned into weeks, and finally months.  Faith is more present in my heart and I like that.  Both my son and I are on a different, yet comfortably familiar path of holistic healthcare.  We are working with a Taoist Alchemist and have better access to an open-minded, progressive thinking neuro-medical practitioner.

I’m more cautious than I was before about our modern-day Western approach in the treatment for mental illness.  It doesn’t work the same for everyone.  Personally, accepting what psychiatry offers, requires a separation of my heart and mind.  I’ve never been good at that.  As long as my heart is still there, I’ll be listening to what it has to say.

Dealing with the mental healthcare system has been a rather political process and, one which I don’t want to repeat.  I’m sure my son feels the same way.  I hope and pray that he doesn’t have to deal with those people again.

Mental illness is as physical as any other illness is.  There can be a hundred different reasons the brain malfunctions and a hundred different causes for each reason.  Treating a person’s brain is complicated medicine.  The field of psychiatry needs a revolution.

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Schizophrenia and forced treatment.

A Beautiful Free Spirit, A and B Larsen orchids, Wiki Commons

  PHOTO CREDIT:  Arne and Bent Larsen via Wiki Commons

I was hopeful when my son began receiving services with an Assertive Community Treatment (ACT) team, even though the way their relationship came about was not the perfect situation.

My son was in the hospital, having been admitted to the wrong floor.  The inpatient attending physician wasn’t happy to learn that he’d been admitted to her unit over the weekend when she wasn’t working.  The unit was for treating “disorders” such as depression and perhaps bipolar.  The other unit is where a patient went if he or she made reference to or exhibited signs of hearing voices, having hallucinations and/or signs of a cognitive thinking process deemed abnormal or delusional.  

The treating psychiatrist had a poor attitude.  She admitted to me that she had told my son that if he said anything she didn’t like, she would send him to another hospital that was not as desirable as the one he was in.

During a meeting she told my son the only way he could get discharged right away was to agree to sign on with an ACT team, which is what he did.

Before entering the hospital he’d been working with another team of mental healthcare providers that we both liked, but he was rebelling and not conforming to rules, after having been transported from the place we had called home for about six years. 

I felt that the earlier team gave up on him when symptoms of the illness they were treating him for flared, but they said the ACT team could serve him better.

Several years have passed since then.  I can’t be sure the good outweighs the bad in our personal experience of having ACT services.  There were good social workers who my son was very fond of, but they didn’t have much time.

Communication with this ACT team has been frustrating so much of the time.  For extended periods they’ve neglected my son.  They call this being, “engaged observers,” and always have either an excuse, such as too much paper work to get to him, or they blame him for not being easy to find on the downtown streets, which is how they often catch up with their clients.

I communicated with them once that my son needed help.  They agreed.  He was not doing well.  Their approach that time was to suggest that I leave him alone, at least for a couple of weeks or, “however long it takes for him to deteriorate,” his social worker suggested.  I liked the social worker, but I didn’t like the suggestion.

My son was living alone and certainly needed help.  I needed help helping him.  He was not, “sick” enough to be committed to a hospital psychiatric unit at that time.  The idea was to get him some help if he was an inpatient, they said.  I’ve since learned that this means forced medication.

The social worker told me they (his ACT team) believed that me inviting my son to my home, where we would have dinner and spend time with the dogs, one of whom is his, was helping him to stay well or rather, not letting him deteriorate to the point where they could have him involuntarily committed.  They suggested that I stop visiting him or inviting him to my house. 

“Just don’t answer the phone if he calls,”  a social worker told me.

I think this social worker had good intentions, I guess, but he just didn’t get it.  He didn’t have children yet.  None of the social workers on the team had any and many of them are younger than my son is.  We need some elders in these jobs.

ACT teams strive to keep people (consumers or clients) out of hospitals and in the community, but involuntarily commitment remains a common practice for social workers and ACT teams.

We were all in agreement that one of my son’s assets and at that time, probably his only asset was family involvement.  I am his family.  And our two dogs.

Their evidence-based treatment submits that patients who have family support fare better than those who don’t have it.

The ACT team have suggested several actions they believed would help my son since they became my son’s treatment team, a few of which made sense and some of which, I felt that I had no alternative but to agree with. 

I couldn’t go along with what felt to me like abandoning my son so he would get sick enough for a commitment.  I tried it for about a day and a half.  I decided not to go against my gut and my mother’s instinct.  I would not take away the only connection my son had to the outside world so that he would get worse.  Nothing about it makes good sense to me.

“You won’t always be around,” I was also told.

“Well, I’m not dead yet!”  I told the young social worker.  I’m not even a senior citizen yet.  I still have time to help see a difference in the healthcare my son receives, I hope, along with a change in American cultural perceptions about people whose brains work differently than “normal” brains.

The ACT team and I have also had disagreements about whether my son should have had antipsychotics forced on him.  I do not support this treatment for my son.  I think it is against his human and civil rights.

One time he went to the hospital for symptoms of depression.  The ACT team wanted him to be committed for a long-term stay, even though the hospital’s rehabilitation unit was closed at that time.  The hospital said if he stayed he would spend all his time in the day room watching television.  They said he would not receive therapy, but that they could force injections of medication on him.

I prayed.

creative mindsThe inpatient psychiatrist assigned to my son the next day was awesome.  He did not force antipsychotic treatment on his patient.  He said it would be like breaking his spirit. 

He spoke candidly with me about his opinions, which I agreed with and was truly grateful to hear.  He said he could not in his good heart force drugs on my son after having met and talked with him several times.

The doctor said something like… Your son has a free spirit.  He also has a strong adverse opinion about this medication.  He talked about the fact that my son was not a danger to himself or others, that he had not committed a crime or even bothered anyone.  Forcing a medication/drug on him didn’t feel right to the doctor nor myself.

The doctor was kind to speak to me while my son was there.  The only reason my son had to stay more than a few days was because I was trying to get the ACT team to come up and join us in an outpatient treatment planning meeting.  Everyone agreed that we needed a different plan.  The ACT team never showed for a meeting, and the doctor wished me well in pursuing other avenues of healthcare for my son after discharge.

He may not live the life you had expected, the doctor had told me, which I realized, but he has the potential to have a good life, without antipsychotics.  We discussed the fact that sometimes the side-effects of those drugs are worse than the illness, which in my opinion is a rare conversation to have with a psychiatrist.

The ACT team did not like that medication wasn’t forced on my son after he’d stated he did not want it.  They said it was most unfortunate that my son had this particular doctor.  I was aghast.  They said it only enforced my son’s belief that he does not need an antipsychotic drug.  I totally disagree.

I told them that I welcomed the doctor’s honest conversations with me.  I appreciated that he saw my son instead of a number or rather, a diagnosis waiting for a pill or an injection.

The ACT team’s psychiatrist told me this scenario (my son having access to a listening and caring psychiatrist) wouldn’t happen again.  She said she had many contacts at that hospital.   She said the next time my son needed medical attention that she could make sure he would be assigned to a psychiatrist whom she was acquainted with.  I didn’t think this was a good thing, and I would discover, eventually, that I had been correct.

“The next chance I have, I want you to know that I will advocate for a long-term commitment with forced medication for your son,” the psychiatrist told me in an angry tone.

I told her she should not act out of anger or frustration when it came to my son’s care.  He should not be committed because she was/is angry that things didn’t go her way or that the inpatient psychiatrist did not agree with what she wanted.  And most certainly, a commitment should not be planned for an indefinite time, before one is even needed.  That’s like a threat.  No, actually, it was a threat.

I’ve never had the same amount of trust in ACT services as I had before that conversation with their psychiatrist.

Thank you for visiting Dogkisses’s blog.  Please see link above for photo credit and copyright information for the beautiful orchid via Wiki Commons. 

 

What is right?

My heart beats too fast and my hands shake when I think back remembering all the hospital admissions, the doctors, the pills, God… the pills!  As I write, my gut feels like it’s being ripped apart.  What if I made a mistake?

What if I made such a huge mistake that my only beloved son shall never forgive me?  And if he does forgive me, has my mistake(s) ruined some of his life already?  Has it already carved out part of who he is?

I just don’t know what is right.  I don’t know what to do.

Join a group?  There’s pretty much only one to choose from, which is through NAMI.

“Forget his liver,” I remember the young psychiatrist telling me.  Was she suggesting that I’m neglecting my son by not neglecting his liver, I wondered.  Sometimes psychiatrists think in strange ways.

“We can treat liver disease, diabetes and Tardive Dyskenesia,” the young psychiatrist said, “but we can’t treat schizophrenia without antipsychotics.”

That part about treating liver disease, well, I don’t think so.

My son’s liver panel always changes when he takes the type of medications recommended by psychiatrists.  His family physician told him, once in front of me, “never take antipsychotics again.”  He told us that they would damage his liver.  

In response, my son’s ACT team social worker and a psychiatric intern at the hospital told me that we should get a new family doctor.

“You must go against your gut,” I’ve been told by professionals in the psychiatric community.  “You must abandon everything you understand as a mother in making decisions to advocate for treatment,” a well-respected social worker once said to me. 

“Treatment,” ultimately can mean forced injections.   The social worker added that if she was a parent in my shoes, that she truly didn’t know what she would do.

“We’ll commit him for not taking medicine and keep him there until he gets so tired of it he will do anything to get out, even accept regular injections of anti-psychotics.  We’ve had to do this many times with patients like your son — who are consistently non-compliant in taking their meds,” his psychiatrist has suggested.

“He wouldn’t have rehabilitation there,” I told the psychiatrist after she threatened to send him there if he, “made one wrong move.”  My son is not a criminal.  He gets sad and lonely and out of sorts.  He isn’t out breaking the law. 

The doctor had a bad attitude and let her personal feelings get too involved.  She was angry because the day before my son had gotten out of a car in town, instead of going to his apartment, while riding with one of the team’s social workers.  He’s an adult and can get out if he wants to whether anyone likes it or not.

“The only thing he would be able to do up there since the psychiatric rehabilitation unit is full would be sit in their community room all day, watching television with patients who are much worse than he is,” I told her.  She reminded me again that this was an effective technique to get some patients to decide to take medication.

I feel like I’ve had to give my son over to the enemy.  I feel like I agreed to join them too — but never with my whole heart or without the ongoing feeling that there must be a better way to do things than the way our modern-day psychiatry does them.

I stopped going to the support groups because there is a collective attitude that supports denying another person’s human and civil rights.

I once told my son’s psychiatrist about research suggesting that people with diagnoses, such as schizophrenia, can recover.  She hadn’t heard about the studies nor had she ever read anything about treating schizophrenia in ways outside of antipsychotic medication.   Personally, I find it disturbing that she’s been a psychiatrist for more than twenty years, yet hasn’t taken time to read about other forms of treatment. 

We need an alternative.  My son and I, and possibly many other families, need people to join an exploration in healthy ways to treat “mental illness” and we need to start a conversation about recovery.

“What causes schizophrenia?” someone asked a famous psychiatrist who was speaking at a meeting I attended.

“Nothing,” the doctor replied.  “Nothing and everything causes it.”

I don’t have the answers.  I do believe that if we had places where we can find what a former professor of mine called, “The Three Ms’,” that healing could happen.  “Meaning, Mastery, and Membership,” he called them.  “People will go crazy without these things,” he said to our class one day.


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