Archive for February, 2010
I was jarred awake with disgust this morning as I sat down to my computer though I learned long ago never to be shocked or surprised. Larry J. Taylor, an employee of the notorious psychiatric unit at Kings County Hospital Center, was arrested yesterday for the rape of a developmentally disabled, deaf and mute man in the shower. Taylor faces two felony charges, a first-degree criminal sex act and third-degree sexual abuse. This just a month after the hospital agreed to federal monitoring for its systemic failure, abuse and neglect. From the Gothamist’s article on the assault:
Last year, the Justice Department released the findings of a year-long investigation of the East Flatbush medical center’s psychiatric unit, which revealed a lengthy record of violence and sexual assault. That study included reports of forced sex acts, brawls that left patients needing surgery, and staffers administering simultaneous injections of medications despite the possibility of overdoses.
What can I possibly say to that? In the midst of their being investigated for all manner of egregious failures, Esmin Green died on their waiting room floor after being ignored for more than 24 hours. In response to the public outrage, they built a $153 million replacement for the notorious G Building, had a few meetings and agreed to clean up their act and accept outside monitoring. It doesn’t look like any of that has had an effect on the staff whose long list of crimes, indiscretions and abuses continue. Sure — terrible and ugly things happen everywhere but at Kings County it’s systemic and they’ve gotten very comfortable with the way they do things. It is the snake pit you thought went away in the fifties.
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New York Civil Liberties Union‘s summary of Kings County Hospital with link to the original lawsuit 2007 and the findings of the Department of Justice.
I watched this on Beyond Meds, a great blog and the product of a very valuable mind. Go there, catch up on the archives and check back often. It is a video of a speaking engagement at TED by Temple Grandin on valuing the diversity of minds and the real-world usefulness of different types of thinkers. Grandin, diagnosed as autistic, has used her fixations and visual thinking in a great number of ways and her approach has lead to many children’s gifts being fostered instead of shrugged off as deviations. I had seen her on television years ago and not heard anything since. It appears she’s been quite busy. Thank you, Gianna for posting this.
While I don’t think most would place me on the autism spectrum, I can relate to certain traits and perhaps more importantly to learning and thinking in a way that was not valued in my school years (for what it’s worth, I was labeled an ADD kid later into my schooling). There will always be a larger spectrum of human thought and experience and I will always wonder what things might have been like if there were a way for me to learn with my natural tendencies instead of in opposition to them. I am blessed to have found a career and a small group of peers that find value in the very traits that made me the subject of ridicule, separation and even physical restraint (another story for another time) in a broken school system.
If there are to be labels for children and the way they think, let them be used to offer more and better options and a greater understanding of their gifts, not to measure their distance from an imaginary center held as the ideal approach to learning and socializing. As it stands, normalcy is defined by a child’s adherence to a broken, outdated and narrowly focused system and virtually everything short of that is a disorder at worst and disruptive at best. If we begin to change our views and our establishments to suit the endless resource of young minds, everyone wins. If we stifle them to suit an old educational and social framework, everyone loses — everyone.
Anyone who’s picked up an issue of Hi Fructose, Juxtapoz or any other modern/pop/whatever art magazine lately is no stranger to the work of Camille Rose Garcia. She’s constantly producing and always reinterpreting her vision while her unique style remains a common thread. Also, if you’ve paid any attention to art and followed the ripples outward to craft and street fashion, you know she’s inspired a sea of attempted imitators as art in semi-mainstream press is known to do. If, however, she was under your radar seven years ago (I believe she was either under mine or just getting picked up), you may have missed her four part spread in Blab! 2003. It was a series on our drug centered approach to depression in American culture. Here is panel 4. I’m pretty sure her prints were out of my price range by the time anyone cared enough to press them but I would love to have gotten my hands on these. Who knew our feelings-damning, pharmacentric culture could be so visually appealing?
Also, on the topic of drugs and the places they take you, Check out the her take on illustrating Alice’s Adventures in Wonderland (scroll up and click her name to get to her website). If you’re on the west coast, you may be able to attend a book signing in march.
While the use of antipsychotics as chemical restraints is nothing new, charging health care professionals with assault with a deadly weapon for their misuse is. From the LA Times:
In an elder abuse case described by one investigator as the most outrageous he has ever seen, three former top managers at a Kern County nursing home have been arrested in the deaths of three residents who allegedly were given needless doses of psychotropic medications.
The state attorney general’s office contended in a criminal complaint that more than 20 residents at a skilled nursing center run by the Kern Valley Healthcare District were drugged “for staff convenience.” Many of them experienced side effects that included dramatic weight loss, slurred speech, tremors, loss of cognition and even psychosis, according to the complaint.
Arraignment is scheduled this morning for the center’s one-time medical director, Dr. Hoshang M. Pormir, former nursing director Gwen D. Hughes and former chief pharmacist Debbi C. Hayes. They were jailed in Bakersfield on Wednesday.
“These people maliciously violated the trust of their patients by holding them down and forcibly administering psychotropic medications if they dared to question their care,” state Atty. Gen. Jerry Brown said.
All three have been charged with elder abuse. Hughes and Hayes, who are accused of administering shots by force and without consent, also face charges of assault with a deadly weapon.
Three residents died and many more were drugged into a stupor in the interest of “staff convenience, ” truly being treated as members of a disposable class. I think you trade in convenience when you take on the task of caring for the elderly. When being vocal is read as being disruptive and being in disagreement is being combative and your rights have faded away over time, you don’t stand a chance. Questioning care is the cardinal sin of forced treatment but no one admits it — and it is force regardless of the age or state of mind of the patient/victim. Never mind the inherent danger and barbarism of forced drugging or that people have every right and reason to be unhappy separate from the lives and people they’ve known. It doesn’t matter that the drugs don’t make you happy, only quiet. The end result is the same — compliance. While this type of “care” is not universal, it is rampant and often with a kinder, gentler face making it harder to see. Hopefully, with cases like this coming to light and to trial people start to wake up to the scale of such abuses.
The complaint paints a bleak picture of a facility dominated by nursing director Hughes, 55, who is accused of seeking to drug all but the most docile residents. Medical director Pormir, 48, allegedly rubber-stamped Hughes’ orders for medication, failed to examine patients and was “either willfully or naively ignorant” of his proper role, according to the complaint. Pharmacist Hayes, 51, told investigators that she went along because Hughes had wide experience in psychiatric hospitals, the complaint says.
Hughes had been fired from a convalescent home in Fresno in 1999 for allegedly overmedicating patients there, according to state officials.
If Hughes was fired for overmedicating what may be the most overmedicated group of people in the US, she had to be doing the same thing then as now and should have been stripped of her license ten years ago. Clearly ten years and a dismissal have had little effect on her. While the other two might claim to be ignorant and deferential at best, any human being half paying attention can see when drugs are being administered carelessly, let alone aggressively and punitively — and when lives depend on what you do, you don’t get to plead ignorance.
At the Kern Valley facility in Lake Isabella, she ordered medications when the elderly residents — most of whom had dementia or Alzheimer’s — glared at her or spoke disrespectfully, according to Samuel Obair, a pharmacist who helped in the state’s investigation.
“It is beyond appalling to me,” he told state officials. “I have never gone into a facility and seen psychotropic medications and mood stabilizers . . . being used on so many patients, and so blatantly” without a legitimate diagnosis or careful documentation.
God help the generation that made us when they spend their last days being drugged — some of them to death — for not bowing and scraping when a self exalted staffer, just a kid in their eyes, barks orders, or if they don’t like the food, their roommate or knowing that they are at the last long portion of their lives. At what point in one’s life does it become mandatory to be compliant without exception? I hope for the sake of all who counted on these three for care, that they are held accountable. Also, I can’t help but think that if people can see drugs as weapons, there is a potential for greater implications in the future. If forced drugging is an assault to one body or twenty, it is an assault to millions.
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California Advocates for Nursing Home Reform (CANHR)
When I first heard that the Asperger’s syndrome diagnosis was going to be dissolved and absorbed into the autism spectrum disorders, my first thought was that people with the Asperger’s diagnosis were not going to be pleased. As it turns out, I was right. Aspies, a name many with the diagnosis have adopted, have an identity and a community wrapped up in the diagnosis around which many rally in mutual support — a diagnosis that’s been the source of some contention as its legitimacy has been debated and now its existence as a stand-alone disorder is in question. I’m not one for labels, in large part because they tend to be divisive but I firmly believe that we should be able to define ourselves as we see fit and the Aspie community has done just that — or at least they’re trying. In a time when thousands of people are trying to shake off one label or another, Aspies are clinging to theirs. Many diagnosed with Asperger’s fear that their collective identity will suffer a hit, even be lost entirely if they are to be lumped in with the Autism spectrum.
From Lindsey Tanner for the Associated Press:
Some parents say they’d welcome the change, thinking it would eliminate confusion over autism’s variations and perhaps lead to better educational services for affected kids.
But opponents — mostly older teens and adults with Asperger’s — disagree.
Liane Holliday Willey, a Michigan author and self-described Aspie whose daughter also has Asperger’s, fears Asperger’s kids will be stigmatized by the autism label — or will go undiagnosed and get no services at all.
Grouping Aspies with people “who have language delays, need more self-care and have lower IQs, how in the world are we going to rise to what we can do?” Willey said.
With any diagnosis comes assumptions preconceptions and often stigma. You are one of these, therefore I can expect this of you and these are your limitations. That’s the power of labels and that’s why some people are fighting so hard for some measure of control over the labels attached to them. While incorporating the Asperger’s diagnosis into the autism spectrum may have some benefits that are not currently available to those with an Asperger’s label, many disagree on how to amend the situation. Do we change the label or the distribution of services? And what, if anything, is a reasonable trade-off?
Rebecca Rubinstein, 23, a graduate student from Massapequa, N.Y., says she “vehemently” opposes the proposal and will think of herself as someone with Asperger’s no matter what.
Autism and Asperger’s “mean such different things,” she said.
Yes and no.
Both are classified as neurodevelopmental disorders. Autism has long been considered a disorder that can range from mild to severe. Asperger’s symptoms can vary, but the condition is generally thought of as a mild form and since 1994 has had a separate category in psychiatrists’ diagnostic manual. Both autism and Asperger’s involve poor social skills, repetitive behavior or interests, and problems communicating. But unlike classic autism, Asperger’s does not typically involve delays in mental development or speech.
Aperger’s revolves heavily around social differences and many who embrace the label embrace those differences not as subnormal or abnormal but as very natural and normal leanings and behaviors viewed unfavorably “neurotypicals” (those outside of the autism/Asperger’s umbrella). While some connections may be made based on the many parallels between the two diagnoses, many Aspies fear the distinction in developmental abilities will be lost in the blur created by blending the labels. The change in diagnosis may prove to be a double edged sword in some ways. We tend to see developmental delays (as with autism) as being objective, legitimate and neurologically based while the traits of Asperger’s are primarily behavioral and lend themselves to a more hazy and subjective reading. For many, there is a struggle to link Asperger’s to autism as an established diagnosis while maintaining its distinction as not meaning limited or delayed developmentally. Still for others, especially parents seeking useful services and placement in schools, the question of perception has to be weighed against very real needs which currently hinge on the little numbered code that accompanies every diagnosis in the DSM.
As I’ve said, I’m not one for labels applied by people other than the wearer and I’m inclined to think the whole situation might be better handled if we throw the book out altogether. If the DSM and it’s hairsplitting, mind measuring scales and labels didn’t exist, what choice would we have but to see people as individuals and not as representatives of their limitations — real or perceived? No one should need to take on a label to get the help they need, least of all children in schools and no one should need to cling to a diagnosis because a collective identity rests in it. Autistic people, Aspies, neurotypicals and beyond, we are who we are despite labels, not because of them.
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You may also be interested in:
Psychology Today: What does this change mean? Don’t people have the symptoms of Asperger’s syndrome any more? Of course that’s not the case. But let’s look at mental health problems as they are reflected in years of DSM editions…
NPR: Right now, the diagnosis often hinges on a person’s language skills. But that’s pretty subjective and can change as a child grows up, researchers say. “The categories are just not used by clinicians in a reliable fashion,” Lord says. A single category for autism spectrum disorder will let clinicians stop agonizing over which diagnostic category to put someone in…
The image at the top is a still from Adam Elliot’s brilliant film, Mary and Max, featuring the voices of Philip Seymour Hoffman and Toni Collette. Go watch it.
I don’t know if this coverage, questioning bordering on critical, is an anomaly or the beginning of the backlash but I hope it continues. It’s an unfortunate fact that television shapes the way millions think. Getting people to question whether human behavior needs a diagnosis can’t be a bad thing and it’s good to see the mainstream media casting even a shadow of doubt on the whole charade as it usually turns a blind eye in the name of its sponsors in pharma. Maybe the medical model has finally jumped the shark with the DSM-V.
“The most urgent need … is not food and water which is temporary. The most urgent need is for psychiatrists.” — From an AP article in the Monterey Herald
Ah yes, food and water are temporary. Psychiatry is forever. Who can forget the great Thorazine famine of Ireland or the poor little Ethiopians with no Zyprexa in their bellies?
As many as one in five Haiti earthquake victims has suffered trauma so great with the multiple shock of lost homes, jobs and loved ones that they won’t be able to cope without professional help, doctors say.
The people of Haiti are grieving. They have every reason to grieve. It’s not an illness. Who are doctors to ascertain who will cope without psychiatric intervention or even to declare that coping is mandatory? No nation that has ever rebuilt itself from ashes and rubble or the widespread damage of war and political land grabbing has psychiatry to thank for their renewal. It has never been a drug induced haze of vague acceptance that spurs people to rebuild but the knowledge that action is required and genuine help from people in a position to offer it. We should be providing the true necessities of survival and the tools necessary to rebuild as they determine the direction of their own nation, not assuming as we have here that we know someone’s needs better than they do and there is a pill for every hardship that’s been thrust upon us. By all means, let’s offer our emotional support but let’s let them determine their needs and act as friends, not crusaders. God help us if our response to grief and loss in every suffering country is the expansion of the lucrative, western and drug-centered psych industry with all of its ills — but then again maybe we can offer a little bit of the peace and happiness synonymous with being a psychiatric patient.