Tag Archives: mental illness

The East Mississippi Correctional Facility Is ‘Hell on Earth’

By Carl Takei, Senior Staff Attorney, ACLU’s Trone Center for Justice and Equality

March 5, 2018

E. Mississippi Correctional Fire

At the East Mississippi Correctional Facility, where Mississippi sends some of the most seriously mentally ill people in the state prison system, even the most troubled patients are routinely ignored and the worst cases of self-harm are treated with certain neglect. The conditions at EMCF have cost some prisoners their limbs, their eyesight, and even their lives.

In 2013, the ACLU, Southern Poverty Law Center, and prisoner rights attorney Elizabeth Alexander filed a class-action complaint on behalf of all the prisoners held at EMCF. As the case heated up, the law firm of Covington & Burling LLP joined as co-counsel, providing major staffing and support. Despite years of attempts by Mississippi to derail the lawsuit before our clients even saw the inside of the courtroom, the case will finally proceed to trial Monday.

The lawsuit against EMCF describes horrific conditions at the facility: rampant violence, including by staff against prisoners; solitary confinement used to excess, with particular harm to prisoners with mental illnesses; and filthy cells and showers that lack functional toilets or lights. It also sheds light on a dysfunctional medical and mental healthcare delivery system that puts patients at risk of serious injury and has contributed to deaths in custody.

Nowhere was this institutionalized neglect more clear than in the life, and death, of T.H., a patient at EMCF with a history of severe mental illness and self-harm. On Jan. 31, 2016, T.H. stuck glass into his arm. Instead of sending him to the emergency room, a nurse merely cleaned the wound with soap and water. The following day, he broke a light bulb and inserted the shards into his arm. This time he required eight stitches.

Less than two weeks later, he cut himself with a blade hidden in his cell and then tried to hang himself. It was only later that month, after he reopened his arm wound with more glass, that mental health staff finally placed him on special psychiatric observation status.
Yet, because he wasn’t properly monitored, T.H.’s series of self-injury continued unabated until April 4, 2016. Early that afternoon, he stuck his arm, dripping in blood, through a slot in his cell door and asked to see the warden. A lieutenant saw T.H.’s bloodied arm, but, rather than call for emergency assistance, simply left the area. Two hours later, T.H. was observed unresponsive on the floor of his cell.

E. Mississippi Correctional Blood on the Door
In response, the prison warden opted to call for a K-9 team to enter the cell with dogs before letting medical professionals examine the patient. By then it was too late — T.H. was dead, having strangled himself with materials from inside his cell. He never once had a proper suicide risk assessment or any treatment to address his self-harm.

The lackadaisical and unconstitutional approach that EMCF staff takes toward prisoner healthcare cost T.H. his life and has caused well-documented suffering among countless other mentally ill prisoners. And it all happens in the context of a prison rife with violence, where security staff often react with excessive force to mental health crises and allow prison gangs to control access to necessities of life, including at times food.

The Constitution requires that if the state takes someone into custody, it must also take on the responsibility of providing treatment for their serious medical and mental health needs. This means, among other measures, hiring qualified medical staff to provide necessary care for people with mental health disorders, creating systems for access to care so sick patients can see a mental health or medical clinician, and making sure that medical care is provided without security staff impeding it.

The ACLU and our co-counsel are fighting to ensure that such care is available at EMCF, where the state of Mississippi has continued to lock some of the most vulnerable prisoners in dangerous and filthy conditions and deny them access to constitutionally required mental health and medical care.

I witnessed those conditions firsthand when I visited EMCF in January 2011 with fellow ACLU attorney Gabriel Eber and two medical and mental health experts. At that time, we were horrified to discover that Mississippi’s designated mental health prison was closer to a vision of hell on earth than a therapeutic treatment facility.

When I walked into one of the solitary confinement units, the entire place reeked of smoke from recent fires. I tried to speak to patients about their experiences, but I could barely hear them over the sounds of others moaning and screaming while they slammed their hands into metal cell doors.

Despite repeated warnings from nationally renowned experts brought in to assess conditions at the prisons, a meeting with top Mississippi Department of Corrections officials, and an offer by the ACLU to help MDOC pay to diagnose and fix the problems at EMCF, Mississippi officials permitted these conditions to continue unabated. Rather than take responsibility for fixing this prison, these officials merely switched contractors. In 2012, they swapped out private prison giant GEO Group, Inc. and replaced them with another private prison company, Management & Training Corp., which is perhaps best known for its horrific record of abusing and neglecting immigrant detainees. The state has also switched prison medical contractors multiple times, with little improvement from one to the next.

But the nightmare might soon be over. Over seven years since we first visited the cesspool that is EMCF, our clients will be allowed in court for the first time, asking that their constitutional rights finally be recognized. That recognition won’t undo the great harms they’ve suffered. But by fulfilling the Constitution’s promise of protection, we can stop new harms and horrors at EMCF, of which there have been too many for too long.

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It’s ‘digital heroin’: How screens turn kids into psychotic junkies

By Dr. Nicholas Kardaras

August 27, 2016 | 7:54pm

 

Image result for IPAD FOR KIDS

“I walked into his room to check on him. He was supposed to be sleeping — and I was just so frightened…”

She found him sitting up in his bed staring wide-eyed, his bloodshot eyes looking into the distance as his glowing iPad lay next to him. He seemed to be in a trance. Beside herself with panic, Susan had to shake the boy repeatedly to snap him out of it. Distraught, she could not understand how her once-healthy and happy little boy had become so addicted to the game that he wound up in a catatonic stupor.

There’s a reason that the most tech-cautious parents are tech designers and engineers. Steve Jobs was a notoriously low-tech parent. Silicon Valley tech executives and engineers enroll their kids in no-tech Waldorf Schools. Google founders Sergey Brin and Larry Page went to no-tech Montessori Schools, as did Amazon creator Jeff Bezos and Wikipedia founder Jimmy Wales.

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Mental Health Bill Caters to Big Pharma and Would Expand Coercive Treatments

Friday, 06 November 2015 00:00 By Oryx Cohen, Truthout | Op-Ed

Rep. Tim Murphy (R-Pa.), right, and former House Speaker John Boehner (R-Ohio) during a news conference about the Affordable Care Act at the Republican National Committee headquarters in Washington, Oct. 23, 2013.(Gabriella Demczuk / The New York Times)

Rep. Tim Murphy (R-Pennsylvania), right, and former House Speaker John Boehner (R-Ohio) during a news conference about the Affordable Care Act at the Republican National Committee headquarters in Washington, October 23, 2013. (Gabriella Demczuk / The New York Times)

On its surface, the mental health reform bill introduced by Congressman Tim Murphy of Pennsylvania looks promising. Murphy is the only licensed psychologist in Congress, everybody agrees that our mental health system is not working, and we would all like to help families in crisis.

On closer inspection, however, the Helping Families in Mental Health Crisis Act (HR 2646) – commonly known as the “Murphy Bill” – appears to cater more closely to the desires of pharmaceutical companies than to the actual needs of people in psychological distress, perhaps because of Murphy’s connections to key lobbyists.

Murphy’s financial supporters include the American Psychiatric Association, psychiatric hospitals and the National Rifle Association, and his campaign contributors include no less than nine pharmaceutical companies and a law firm that represents Big Pharma.

The bill was marked up Wednesday in the House Energy and Commerce health subcommittee and passed by that subcommittee, despite strong objections from almost all the Democrats on the full committee. The next step is for the full Energy and Commerce Committee to vote on moving the bill forward, followed by the House vote. A timetable has not yet been set. Although the bill is gaining momentum, there is substantial opposition, so passage is still uncertain.

If the Murphy Bill is passed, psychiatric hospitals and pharmaceutical companies will reap huge financial benefits as a result of increased hospitalization and forced treatment. One way the bill will do this is by creating a financial incentive for states that implement “assisted outpatient treatment”: court-ordered treatment (including medication) for people whom a judge deems as living with “severe mental illness” and unlikely to willingly take prescribed psychiatric medications.

Psychiatric hospitals would also benefit from the bill’s proposed elimination of the “Institutions for Mental Diseases exclusion,” which currently makes mental health institutions ineligible for funding through Medicaid. By enabling psychiatric hospitals to access this funding, the Murphy Bill could usher in an unprecedented era of re-institutionalization, going against the recommendations of the Supreme Court’s Olmstead decision, which asserted in 1999 that people with mental health issues have the right to be in the least restrictive setting possible. If passed, the Murphy Bill will lead to large-scale re-institutionalization in hospitals for longer periods of time for people who now generally have the right to live in supportive communities of their choosing.

The Murphy Bill threatens the recovery and community integration practices that current consumers of mental health services and survivors of coercive psychiatric interventions have worked so hard for over the last 40-plus years to create for those most in need. In particular, the bill would dismantle the federal Substance Abuse and Mental Health Administration (SAMHSA), which actively funds and supports important efforts to rebuild the community and family life of people dealing with mental health issues through non-medicalized institutions such as peer-run respites (short-term crisis centers managed by people living with mental health concerns and available to “self-referred” individuals seeking to avoid hospitalization through support from peers). SAMHSA also supports suicide prevention initiatives, trauma-informed practices, Emotional CPR (an educational program aimed at teaching people how to assist others through an emotional crisis), Wellness Recovery Action Planning and much more, all of which would suffer if SAMHSA were dismantled. The bill would also threaten people’s rights by weakening state “Protection and Advocacy for People with Mental Illness” organizations, which offer rights protections, and the Health Insurance Portability and Accountability Act, making it easier to force people into treatment.

Murphy and his supporters criticize opponents of the bill for being “against families.” They fail to acknowledge that families are not united in support of this bill. While the national headquarters of the National Alliance on Mental Illness (NAMI) has come out in support of the bill, many local NAMI affiliates are against it. Activists who identify as current consumers of mental health services or survivors of psychiatric interventions are frequently approached by desperate family members who are looking for alternatives to coercive and institutional responses to mental health crises. We are finding ways to include families because rebuilding strong family connections can be essential to recovery.

Community-Based Solutions to Mental Health Crises

Rosey Padgett in Prescott, Arizona, recently contacted the National Coalition for Mental Health Recovery because her son Nick was trapped in the mental health system. Currently, he is in the Arizona State Hospital.

“Nick has been placed in mental hospitals approximately 30 different times over the past seven years,” Padgett says. “He has been court ordered and placed in many different group homes. All of the group homes have made his behavior worse due to being forced into these situations when these homes are not an environment for healing. No wonder so many people with emotional and mental distress commit suicide: They feel dead inside and hopeless from being forced to take medications that make them feel horrible.”

What has worked for Nick is connecting with other peers and having tremendous family support. A woman from the local Hearing Voices Network has begun visiting with him and providing peer support, as they are both voice hearers. He is doing so much better that the doctors at Arizona State Hospital are talking about releasing him in a few months.

Nick’s story is similar to the stories of others around the country who are languishing in and out of hospitals. Often it is not what is happening in those hospitals that helps people reestablish a life; it is the family and community support they have once they leave the hospital.

Murphy Bill proponents point to a lack of institutionally or medically directed mental health treatment as being a primary cause of the alarming rise of violent acts such as school shootings and suicide. However, when we look at this argument closely, it falls apart.

This argument overlooks the fact that the link between mental health conditions and violence is minuscule, as many studies have shown. Mentalhealth.gov, a website run by the federal government, says:

The vast majority of people with mental health problems are no more likely to be violent than anyone else. Most people with mental illness are not violent and only 3 to 5 percent of violent acts can be attributed to individuals living with a serious mental illness. In fact, people with severe mental illnesses are over 10 times more likely to be victims of violent crime than the general population…. When economist Richard Florida took a look at gun deaths and other social indicators, he found that higher populations, more stress, more immigrants and more mental illness didn’t correlate with more gun deaths. But he did find one telling correlation: States with tighter gun control laws have fewer gun-related deaths.

We should probably be doing more questioning of the treatments themselves. For example, many antidepressant medications, such as Paxil, that are commonly prescribed to young people, have a black box warning that they can increase suicidality among teenagers.

We all want to see violence and suicide go away, but passing legislation that imposes increased mental health screenings and forced treatments (including psychiatric medication) on unwilling individuals is neither an ethical nor an effective way to accomplish this, especially given the risk of medications backfiring.

Standing Up for Peer-Run Recovery

Perhaps Murphy and supporters of his bill should ask those of us who have lived through extreme emotional distress for ideas and possible solutions. Thus far, the many activists who share the concerns I have outlined here have been denied a seat at the table in congressional discussions of the Murphy bill, despite the recommendation made in 2003 by the President’s New Freedom Commission on Mental Health, which said that transformations of the mental health system should be led and informed by consumers of mental health services.

What would survivors of extreme emotional distress say if we were at the table with Congressman Murphy?

Many of us would say that our mental health crises occur when we feel alone, abused and generally isolated from the rest of the world. We would thus raise our concern that, rather than reestablishing social connections, the current mental health system often disconnects us even more and leads us to a lifelong dependence on the system itself.

Let’s take Dan, who as an adolescent contemplated shooting up his middle school. It wasn’t medication or therapy that prevented this terrible potential tragedy; Dan says it was talking to his friends at school and playing Dungeons and Dragons that grounded him and gave him hope. In other words, peer support.

What would have happened if Dan had been flagged as a result of a mental health screening? He likely would have been removed from his social circles and placed in an institution, perhaps becoming permanently dependent on the system.

Dan is now a part of a peer-run recovery community called the Western Massachusetts Recovery Learning Community. He has his own place to live, a job, friends and a life, and is starring in the documentary HEALING VOICES. The Recovery Learning Community helps people to establish much-needed social connections and gain a sense of belonging. This community is there when Dan needs it, and he doesn’t need a diagnosis or a referral to attend the many support groups and wellness activities: the strength of places like the Recovery Learning Community is that they an integrated and open part of the broader community and not separate from it.

But if the Murphy Bill passes, places like this might cease to exist. By requiring expensive clinical oversight and unprecedented congressional control over federal grants, the Murphy Bill targets consumer-run organizations and peer specialists, making it likely that national consumer-run organizations will be shut down, severely restricting what peer specialists can do and posing a threat to local peer-run organizations such as the Recovery Learning Community.

Critics dismiss many opponents of the Murphy bill as being “anti-medication,” but in fact many of us take medications and have found them useful. Our philosophy is that people should have accurate information to make informed choices, including the choice to use alternatives to medications. With the increase in violence and suicide and the alarming fact that people in the public mental health system die an average of 25 years younger than the rest of the population, shouldn’t researching and supporting alternatives be a priority?

Current consumers of mental health services and survivors of psychiatric interventions are willing to share our knowledge and expertise.

Is anyone willing to listen?

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    Why Are So Many Veterans on Death Row?

    By Jeffrey Toobin

    A new study shows that at least ten per cent of death-row inmates are military veterans.

    The death penalty has always provided a window into the darkest corners of American life. Every pathology that infects the nation as a whole—racism, most notably—also affects our decisions about whom to execute. A new report from the Death Penalty Information Center adds a new twist to this venerable pattern.

    The subject of the report, just in time for Veterans Day, is the impact of the death penalty on veterans. The author, Richard C. Dieter, the longtime executive director of the invaluable D.P.I.C., estimates that “at least 10% of the current death row—that is, over 300 inmates—are military veterans. Many others have already been executed.” In a nation where roughly seven per cent of the population have served in the military, this number alone indicates disproportionate representation. But in a nation where military service has traditionally been seen as a route into the middle class—and where being a vet has been seen as more of a benefit than a burden—the military numbers are especially disturbing.

    Why are so many veterans on death row? Dieter asserts that many veterans “have experienced trauma that few others in society have ever encountered—trauma that may have played a role in their committing serious crimes.” Although this is hardly the case with every veteran, or even the overwhelming majority of them, Dieter goes on to relate several harrowing stories that follow this model. Because of such traumas, many veterans suffer from post-traumatic stress disorder, for which they have too often received poor treatment, or none at all.

    Veterans who kill are not, by and large, hit men or members of organized crime or gangs. They very often lash out at those around them. Dieter notes that a third of the homicide victims killed by veterans returning from Iraq and Afghanistan were family members or girlfriends. Another quarter were fellow service members. This record suggests that, if these veterans had received adequate mental-health care, at least some of them and their victims might have had a different fate.

    But it’s possible to see, in the D.P.I.C. study, an echo of another recent high-profile study. Anne Case and Angus Deaton, of Princeton, found that the death rates for middle-aged white men have increased significantly in the past decade or so. This was largely due, according to the authors, to “increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis.” The Princeton study fits into a larger pattern in American life, which is the declining health and fortunes of poorly educated American whites.

    That cohort has gravitated to military service for generations. And while, again, most veterans never commit any crime, much less crimes that carry the death penalty, the sour legacies of our most recent wars certainly play into the despair of many veterans. Earlier generations of veterans came home from war to ticker-tape parades, a generous G.I. Bill, and a growing economy that offered them a chance at upward mobility. Younger veterans returned to P.T.S.D., a relatively stagnant economy, especially in rural and semi-rural areas, and an epidemic of drug abuse. And they came home to a society where widening income inequality suggested the futility of their engagement with the contemporary world.

    In an interview with Vox, Deaton said that the death rate for members of this cohort had increased, in part, because they had “lost the narrative of their lives.” This elegant, almost poetic phrase can be read to include the lost promise of military service—the vanished understanding that veterans earned more than a paycheck, that they also gained a step up in status, both economic and social. The reality has been that many veterans returned to lives that were materially and spiritually worse than the ones they left, and far worse than the ones they expected.

    According to the Princeton study, a shocking number of poorly educated whites turned their rage inward, in the form of drug abuse and suicide. But a small handful inflicted their rage on others, and an even smaller number wound up on death row. They are different groups of people, and their individual stories are even more variegated, but it’s possible to see across them the symptoms of a broader anguish.

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