Posts tagged ‘Abuse’
Some time around 6:30 am, two years ago today, Esmin Green was involuntarily admitted to Kings County’s psychiatric ER where she was ignored for 24 hours, the last of which she spent face down on the floor — writhing at first and ultimately dying in the presence of the staff members whose job it was to care for her.
Think about that as you glance at the clock, going about your day today — how far 6:30 in the morning seems from your lunch, the end of the workday, prime time television. Think about where you’ve spent your day and how it compares to where Esmin was all that time just two years ago.
I’m still outrageed, still disgusted that we live in a society that allows that and — as long as it’s just those mentally ill over there — accepts it. We’ve created a line and carefully keep who and what lies on the other side out of our sight –as if there really is an us and a them. There isn’t. As long as we have a class of people who can be treated by force we have a public that cares little about what happens to them behind closed doors but there is no class and public. There’s just us and what we do to others, we’re doing to one of our own.
The only real rarity in this story is that it was caught on video. If it hadn’t been you would never have known about it. It would just be another death in another psych hospital — with no one to cry foul. KCHC has been operating like this for decades and even now, in their costly new building, under federal monitoring and with new accountability policies in place — the abuses continue.
I’m going to Brooklyn today — to King’s County. I’m going in remembrance of Esmin Green and in protest of an institution beyond reform. I’m going to stand aside others who won’t accept the state of the system and are standing up in the streets, demanding change — and when I glance at the time, I’ll know I’m where I need to be. Will you?
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How convenient it is to label someone mentally ill. You seldom have to worry about their rights. Whether legally supported or just socially allowed by way of a quiet acceptance (usually both), a label of mental illness separates you out to a lower and less free class. I know — it’s nothing I haven’t said before but until it changes, it’s not the kind of thing that goes without saying.
The Sydney Morning Herald reports that things could be changing for the worse for Australians deemed mentally ill. Again. Australia doesn’t exactly have a good track record in terms of protection and rights for people with perceived mental illness — and frankly anyone interested in preserving their rights to any kind of due process should be concerned.
Leading psychiatrists warn that the civil rights of mentally ill people could be severely eroded by plans to extend the length of time patients may be held in locked wards without legal review.
The NSW Mental Health Tribunal is poised to introduce a new system which will mean a patient can be detained for up to one month before their case is reviewed by a lawyer.
At present someone who is compulsorily detained for emergency psychiatric treatment is reviewed by a magistrate within a week or so of admission.
A week “or so” and now a month? Being locked in a hospital is no less a method of incarceration than being locked in a jail. If you’re allowing someone to sit behind a locked door for a month before determining whether there was any legal validity in doing so, the pretense of medicine and the presence of doctors don’t mean a thing. It’s the lock on the door that counts. This is a staggering blow to the idea of basic rights and liberties and aside from those obvious issues, a month of being held anywhere against your will is going to seriously impact your well being, family stability, reputation and of course, your employment and finances. The world keeps going by outside while you’re locked up.
“The delay in independent review will mean that people with mental illness, and the public at large, will not be able to have the same degree of confidence that their rights will be protected in our psychiatric hospitals – and for no gain but a minimal dollar saving,” the doctors argue in a recent medical newsletter. “Abuses have occurred in the past … Reducing our vigilance can only increase the possibility of another Chelmsford or ward 10B type scandal”.
An associate professor of psychiatry at Sydney University, Anthony Harris, also opposes the changes, saying they are a cost-saving measure that will remove a ”quick way that a patient and their family can query the system”
There is no us and them. This is not just for the “mentally ill” to worry about. If anyone can have their rights stripped away by a label, then everyone should be wary of how easily that label could applied to them. History has taught us many things. Even the strictest of systems can be corrupted and abused, much less a system that leaves this much room for indiscretion and is so imbalanced as to disregard your rights from the start. It’s a crime that it happens and a shame how often we quietly allow it.
You may have heard — you should have heard — of a woman named Esmin Green. She was involuntarily admitted to the psychiatric emergency room of Kings County Hospital, a place already known for a long record of violence, sexual assault, abuses and neglect. Unfortunately for Ms. Green and countless others, when you are someone who is allowed be shoved into places against your will, you have no say about which places and what standards, if any, are upheld there. Esmin died face down on the floor of the psych ER after being neglected for more than 24 hours.
As a telling video of the staff’s complete and ultimately fatal disregard for her was released, they had little choice but to go into public relations overdrive. They agreed to make all kinds of policy changes and rules about accountability as if adhering to policy and truthfully recording their actions was something they were good at. Knowing that if you throw money at a problem people read it as care, they also built a $153 million replacement for the notorious G building where all of these abuses were happening. Not surprisingly, the horrors continue — even under federal monitoring. Kings County’s Building R is little more than a multi-million dollar snake pit.
Last year, I attended a vigil in Esmin’s memory and a protest of the hospital’s neglect and continued abuses against people labeled mentally ill. It was organized by We The People and was as successful as we might have hoped, though the work is not done. Survivors of psychiatric abuses had an opportunity to speak out — and what some of these survivors had to say is not to be missed. I heard from several people that have helped inform and shape my approach toward activism and human rights.
This year, two years after her death, We The People will not let it drop as the problem clearly continues and I intend to stand with them in protest of a place that, for all their talk and money, is clearly beyond reform. We need to stand in solidarity with those behind locked doors and let the ones with the keys know we’re watching. Come out June 18th – 19th and demand justice, choice and human rights in mental health, voice your disapproval of the current standard of care and show them that there is a growing opposition in the public. Human rights are universal and a diagnosis cannot be allowed to erode that or even worse — invite abuse. When we look back in the light of hindsight at an era that saw basic human and civil rights denied people labeled ill and how many times we’ve collectively turned a blind eye to staggering amounts of abuse, we will look back in disgust. At least I’ll know which side I was on.
See below fliers for details and feel free to copy, repost and display them in support of the event.
Kendra’s Law, a controversial New York state law enacted in 1999 under the Mental Hygiene Law, is due to sunset in June. If you hear about it from both sides enough, it’s easy to overcomplicate things and muddy the waters but what it really comes down to is that Kendra’s Law enables the state to drug people who they think might become criminals. Kendra’s law is in place solely to allow the forced treatment of people deemed mentally ill using fear of violence, however unfounded, as its leverage. It enables the state to strip people of their rights based on a diagnosis. Last I knew, the constitution (at least on paper) applied to all of us and not just those the state deems mentally qualified to share in the rights it’s meant to guarantee. That is a very scary path to be on and make no mistake — we are on it.
While its future is unclear, Kendra’s Law might very well be extended for another five years but not without a fight from a grassroots organization (no, not that one — a real grassroots organization) formed to protect the rights of people regarded as mentally ill — We The People. I, for one, hope they are able to help turn things around. They’ve been making their presence and stance as advocates for rights in mental health known and are taking part in meetings with Assemblyman Felix Ortiz in an effort to help restore the rights and dignity of New Yorkers.
From the Legislative Gazette:
Bill opponents, such as We The People, a group describing themselves as survivors of psychiatric atrocities in the mental health system, said this bill would extend the reach of the law to further encroach upon the civil rights of those from lower socioeconomic backgrounds unfairly labeled as “mentally ill.” Especially, they said, because it removes a provision that requires a physician to testify at the court hearing.
We The People want another woman to be remembered besides Kendra — Esmin Elizabeth Green, a mother of six who suffered from depression. She collapsed on the waiting room floor of the psychiatric ward in Kings County Hospital Center in June 2008. She died soon after, unattended and unnoticed by hospital staff.
This incident is just one example of the mistreatment of the mentally ill, law opponents say, because the assisted outpatient treatment system amounts to coercion, oppression and “torture.”
I’m not sure why the author felt the need to put torture in quotes. It reads like undue editorializing to me — as if to say it’s a stretch to call it torture. There’s a reason there’s a survivor movement and it’s not because the system has a healthy way of dishing out a healthy version of care. These drugs wreak havoc on your body, alter your mind and take you over in so many instances and in so many ways.Of course, once you become someone for whom force is considered an option, these things are just details, secondary to your being kept under control. Force does something sinister that rights and law can’t quite touch. Where you were once a person worthy of care, you become a problem to be solved.
Lauren Tenney, a coordinator of We The People, said, “They designed this [assisted outpatient treatment] to make it sound nicer. It was designed to fool the public to make people think it stops people from killing people, but they’re just getting drugs and no support. The research is entirely flawed.”
AOT should be referred to as IOC, she said, involuntary outpatient commitment.
She said the law is coercive and denies people their civil rights because it forces people into taking psychotropic drugs without their consent and does not provide the proper therapeutic support.
“I’ve seen people tortured and dead from their medication,” said Tenney.
If you have something to say, sign on to add your name and voice to the action We the People are taking. Contact Assemblyman Ortiz directly. Time is limited. Do you really want the kind of guy who wants to ban salt in restaurants making decisions regarding your mental health rights? Probably not, but that’s the situation. Don’t let it happen while you sit quietly. If you think you’re out of reach because you don’t live in NY, think again. Forced treatment laws are being introduced or strengthened all over. This is not just an issue of mental health rights but basic human rights and civil liberties. Drugging to prevent crime? That’s one step too far and a decade too long.
Mental Disability Rights International (MDRI) whose simple slogan is “Disability rights are human rights” has issued a report on the abuses at Judge Rotenberg Center calling on the Special Rapporteur, The Obama Administration and the Department of justice in their effort to put a stop to the establishment’s longstanding abuses against children and adults in their alleged “care”.
You may remember my posting about JRC in the past. The abuses that occur there are astounding and I and many others are left wondering how such abuses can carry on without any outside interference from the governing bodies that are supposed to protect all of our citizens — certainly those among us most vulnerable to mistreatment. In its report MDRI rightfully calls this mistreatment nothing short of torture.
From MDRI’s front page:
Washington, DC – April 29, 2010 – Mental Disability Rights International (MDRI) has found children and adults with disabilities tortured and abused at a “special needs” residential facility in Massachusetts and has filed an “urgent appeal” with the United Nations Special Rapporteur on Torture to demand the United States government end the torture immediately.
MDRI’s latest report, Torture not Treatment: Electric Shock and Long-Term Restraint in the United States on Children and Adults with Disabilities at the Judge Rotenberg Center (JRC),documents the use of electric shocks on the legs, arms, torsos and soles of feet of people with disabilities – for weeks, months and sometimes years. JRC uses punishments as treatment and US advocates have been trying for decades to close the school and end these practices. The school also uses 4-point restraint boards, tying children to the boards while simultaneously shocking them for hours; mock assaults; food deprivation; shock chairs; isolation and long-term restraint. Residents at JRC are diagnosed with a variety of behavioral, intellectual and psychiatric disabilities such as autism, bi-polar disorder and learning disabilities.
Laurie Ahern, President of MDRI and author of the report, states, “The cruelty perpetrated against children and adults at JRC is psychological and physical abuse, couched in the name of ‘treatment.’ The severe pain and suffering leveled against residents there violates the United Nations Convention against Torture. And to the best of our knowledge, JRC is the only facility of any kind in the US – and perhaps the world –that uses electricity combined with long-term restraint and other punishments to intentionally cause pain to children with behavioral challenges and calls it treatment.”
MDRI calls on the Special Rapporteur, along with the Obama Administration and the Department of Justice, to end the abuses against people with disabilities at JRC. MDRI is an international human rights and advocacy organization dedicated to the rights protection and full participation in society of people with disabilities worldwide. Help us put an end to the torture of children with disabilities in JRC.
I sincerely hope this report and urgent appeal are not falling on deaf ears. MDRI presents a clear opportunity for the system to take a stand on institutional abuse and torture under the pretense of care. We need to stop drawing lines across which we’re willing to allow these things to happen. No perceived mental illness or disability can be allowed to take away our basic human rights. This is their chance to show us that human rights are universal. If they can’t do that, what are they good for?
Like all of the major pharmaceutical companies, Pfizer has a history of misconduct, corruption and deceipt but when is enough really enough? They were overdosing children on Geodon in clinical trials marked by almost every kind of failure and misstep. It’s okay though, they got…(gasp!)…a warning.
Among those controversies: Discredited doctors allegedly prepared research on Geodon for the FDA; Pfizer allegedly promoted the drug for unapproved uses in kids; and the company allegedly paid a non-profit mental health advocacy group to promote Geodon for kids.
The FDA warned Pfizer that its trials of Geodon in children were improperly monitored, and that children got too much drug by mistake:
… dosing errors occurred and overdosing extended over several days for all seven pediatric subjects; in one case for as long as 22 days.
…a Pfizer internal document dated October 3, 2007 and entitled “Safety Information on Affected Subjects” refers to the overdosing of an additional six pediatric subjects in study (b)(4) at two different sites…
The kids suffered from nervous tics and a loss of control of their limbs, among other symptoms. Pfizer said it conducts tests globally according to the highest ethical and scientific standards:
HIghest ethical and scientific standards? I would love to know what passes for standards at Pfizer because from where I’m sitting, it’s hard to recognize any. They’re treating children like guinea pigs — and poorly treated ones at that.
Of course the company responded in the industry’s typical own-up-to-it-and-say-you’re-trying fashion with a letter that reads like the kind we were made to write as schoolchildren about how we understood it was wrong to disrupt the class or make messes.
Pfizer recognizes the seriousness of the issues cited by the FDA and is committed to fully addressing FDA’s concerns. Many of the items cited by the FDA were first uncovered and reported to the FDA by Pfizer as far back as four years ago as part of our ongoing clinical trial monitoring and quality assurance processes. Since that time, Pfizer has instituted several new measures designed to improve monitoring and execution of clinical trials, including our oversight of clinical investigators.
Pfizer has communicated with the FDA about our conduct of clinical trials and, over the next two weeks, will provide an outline of new and existing processes for preventing similar issues with Pfizer clinical trials in the future.
It just sounds like more talk about writing up new policies of the type they’ve already proven to be capable of sticking to. I guess when it takes the FDA five years to get around to giving you a warning when you’re abusing children with drugs, the sense of urgency kind of goes out the window, doesn’t it?
If the dosing wasn’t enough, it would appear as though their application for Geodon use in children was “intentionally misleading regarding its cardiovascular effects.” On top of that they were accused by the DOJ of marketing off label (but then who doesn’t these days?) and stated in a DOJ statement:
The government alleges that Pfizer also promoted Geodon for use by unapproved patients, including pediatric and adolescent patients, and promoted Geodon for higher dosages than were approved by the FDA. This conduct included direct promotion by Pfizer sales representatives and promotion through the hiring of physicians, or “key opinion leaders”, to give promotional talks to other physicians about unapproved uses and dosages of Geodon. Specifically, these talks included encouraging doctors to prescribe the drug for children, and to prescribe the drug at substantially higher than approved dosages.
There is a lot of money in the sale of antipsychotics, particularly among children, a captive market that seldom has the option of saying no to the drugs. Pfizer pays a lot of money to doctors and other promotional outlets for one simple reason. They stand to make a lot more. They’re paying millions to make billions. Doctors selling other doctors on off label drugging and groups like NAMI promoting the notion to the patients for which they claim to advocate affords the company a kind of sales force that even the slickest of television and print ad campaigns can’t match.
One doctor was paid $4,000 a day to fly his private helicopter to meetings where he promoted Geodon off-label, according to a separate whistleblower suit, which Pfizer also settled.
And Pfizer allegedly gave more than $1.3 million in funds to the National Alliance for the Mentally Ill, a non-profit advocacy group, and hired the president of the organization as a paid speaker, according to another whistleblower suit. In an amazing coincidence, NAMI published a web page which advocated off-label use of Geodon in children.
So when is enough enough? if a company (really an industry) can lie about health risks, experiment on children, abandon ethical and scientific standards and engage in all manner of misconduct — what is too much? Why does it seem that all issues relating to pharmaceuticals and mental health seem to be relegated to smaller outlets of information and opinion put out by people who already have a position on one side or the other? Openly corrupt companies overdosing kids is not a special interest piece specific to mental health but a statement on our mistreatment of our nation’s youth regardless of the methods. I guess it’s easy to quell the outrage now that a warning from the FDA has set everything right again.
The controversial Dr. Kifuji, prescribing psychiatrist for Rebecca Riley, appears to have evaded any criminal responsibility by exchanging her testimony for immunity. She is, however, up against a malpractice suit and some of the things that have come up are startling in terms of just how Rebecca’s very early death transpired and the role Kifuji played in all of it. I know I’ve brought up the doctor’s role in this before but every new fact that comes out is more frightening and infuriating than the last.
The Patriot Ledger ran an article that covers many of the almost too-bad-to-be-true circumstances that point to the fact that if Rebecca and Dr. Kifuji had never met, Rebecca might still be here. Regardless of your opinions on children and drugs, this case was wrong all around and the result of at least three people’s indefensible actions. Kifuji was more a drug dealer than a psychiatrist and while that’s not particularly uncommon, the young ages of her patients makes her a standout, even among the over-drugging crowd and the predictable end result in Rebecca’s case shows her to be both reckless and ill qualified.
From the Patriot Ledger article:
Years before she became a board-certified psychiatrist, Dr. Kayoko Kifuji was diagnosing children as young as 2 as bipolar and hyperactive – and prescribing powerful cocktails of mood-altering drugs to quiet them.
By the time Kifuji finally passed the psychiatric board exam – on her fourth try – one of her youngest patients, Rebecca Riley, had a little more than a year to live.
The lack of involvement on Kifuji’s part was shocking. She saw Rebecca primarily for twenty minute sessions to adjust doses. Often she just used these sessions to put on paper her approval for the adjustments her mother was already making, having increased doses on her own and experimented with drug cocktails using drugs prescribed (also by Kifuji) to Rebecca’s siblings.
She relied almost exclusively on what Carolyn told her about the kids when diagnosing them and ordering increasing amounts of drugs for them.
Kifuji also trusted the mother to keep tabs on Rebecca’s heart rate and blood pressure for signs of problems with the four drugs she was on. Kifuji, a pediatrician who later became a psychiatrist, told Novotny during the deposition that she didn’t realize she had a blood pressure cuff in her office and could check the girl’s vital signs herself until after Rebecca was dead. She said she didn’t take Rebecca’s pulse with her fingers because Carolyn Riley told her the child’s pulse “was within normal range.”
Even a well intentioned mother shouldn’t be solely in charge of monitoring a child’s heart rate and blood pressure let alone a woman hell bent on gaining access to more and stronger drugs at the expense of her daughter’s health. Also, any pediatrician turned psychiatrist should think of performing such simple tasks as second nature. If not that, then what is a doctor for? How do you not even know you have basic medical equipment in your office? How does a doctor fail to check a child’s pulse? Oh, that’s right — her mother said. If that’s all there is to doctoring, it’s no wonder some might see her as just a drug dispenser. They can do the rest at home, it’s a mere technicality that you must be licensed to prescribe.
- Asked why she didn’t report Carolyn Riley to child welfare authorities after learning that the mother had increased the children’s doses at least twice without checking with her first, Kifuji said: “I just can’t report to the DSS. I need to … my role is to work with the parent and not judging them.”
- Asked if she ever told Carolyn not to give Rebecca cold medicine on top of all the drugs the child was on, Kifuji says no, “but it’s because Rebecca didn’t get sick, and I was never asked ”
Right — let a mother chemically abuse and experiment on a child but whatever you do, don’t judge and certainly don’t give them any more information than they asked for. The article goes on to point out other times that Kifuji refilled prescriptions before they should have run out, never asking for an explanation, just dishing out more and more drugs.
She prescribed clonidine – the drug that killed Rebecca – during the child’s first visit to control the “impulsivity” that Carolyn Riley described. Rebecca was 2 at the time.
Impulsivity at two hardly makes a child a psychiatric oddity but when you look at some of her notes regarding Rebecca’s apparently troubling behavior it’s easy to get the notion that Kifuji sees childhood as a disorder unto itself.
“Then consistently hyper all the time. Climbs up to top of jungle gym without any fears and thinking. Gets into everything. Just walk up to someone and smack them. Never gets aggressive. Hits kicks and spits when she’s being disciplined and laughs. Started to say things scared her. Whines and fusses a lot.”
Kifuji described the toddler as dysarthric, meaning she could not properly pronounce some words.
“A bit tired since yesterday. Coming down on flu. Fine as long as she takes clonidine. Sleeps throughout. Without clonidine gets very hyper and impulsive.”
“Climbs up on top of bureau. Tantrums or sobbing when she was told to clean up her toys” and “she wasn’t listening to her mother.”
This child was drugged for one reason — she was stricken with a case of toddlerhood. Dr. Kifuji seems to see no distinction between behavior and disease. Now that psychiatry has largely gotten away from talk therapy, we’re supposed to see psychiatrists as doctors of the brain — linking behavior to dysfunction in the brain. If that’s the case, Kifuji doesn’t make it very well. She’s like a mad scientist but without the science.
She explained that some researchers believe the area of the brain called the amygdala is different in people with bipolar disease. But she admitted she didn’t know where the amygdala is in the brain.
Of course you don’t need to know the brain at all to dispense drugs in the manner that Kifuji had begun making a career of (there is a timeline of Rebecca’s “treatment” at the bottom of the article). You only need to know that if you sedate a child enough, you can drug the behavior out of them. Sure, that child may be a “floppy doll” sitting in the corner but a quiet floppy doll and certainly not disruptive and if enough people will pay you to drug the childhood out of their children to one extent or another, then you’re in business.
Yes, the parents physically gave the drugs to Rebecca but they were used as a weapon and that weapon was provided by Dr. Kifuji. If she had given them a blackjack instead and told them how many times you have to hit a kid for effective behavioral treatment, this would be a different case entirely. Our view of prescribed medicine as care makes us resistant to the notion that drugs can be poison but they clearly can be and often are, particularly with psych drugs. When this happens, we need to respond accordingly.
There are no less than three guilty parties here in a case of chemical assault that ended in a child’s death. It’s bad enough that Dr. Kifuji was granted immunity making it impossible to hold her criminally accountable, even as more facts come to light pointing to her role not in anything resembling care but in a death. If she is not held civilly and professionally accountable, we’re saying her actions are acceptable, even desirable and we’re signing off on a prescription for some seriously detrimental treatment. I’m relieved to see she’s at least going to be made to answer for her actions. She’s certainly got a lot to answer for in this suit. Now we’ll have to wait and see what passes as accountability these days.