[Hpn] Re: A little rant on Kaiser Medical, lifted from another list.

Thomas Cagle nh-adapt@juno.com
Fri, 25 Aug 2000 09:31:44 -0400


Hi Linda,
I will have to confess that I don't have an URL at my fingertips
summarizing commit to community, or involuntary outpatient commitment 
(as it is called in some states). I have however forwarded this onto
another national list (on homelessness) where this subject has had a long
and continuing thread. I am sure that someone there can get you to where
you want to go.

All generalizations are false. With that said, a quick recap is going to
read something like this.

Rather than provide the services appropriate to supporting people with MH
diagnosis, something like 35 states have passed this sort of CtC law.
creating a statutory requirement for people with MH diagnosis to receive
(under threat of confinement to a psychiatric hospital) their meds at
mental health centers. I suppose if this had ANY of the requirements of
"proven dangerousness to self or others" that NH probate law has it would
be a more or less good thing. In fact all that I have read have NO such
requirement. Instead all have fuzzy language that could just as easily
mandate CtC for being outspoken in any political or philosophical view,
as well as any neurological and or physical disability that may have at
any time lead to depression (no matter how episodic or singular) or have
its roots in any form of numerological disability. To use myself only as
an example, because I have MS, and people with that diagnosis sometimes
have depression, and MS IS a neurological condition AND I have spoken out
against treatments and support systems that do not reflect the actual
needs of disabled people, I could be forced to take nueroleptics
involuntarily IRREGARDLESS of the fact that they have no benefit to
people with my diagnosis, AND I would have utterly no recourse under the
laws. I could either take them, or be committed for not taking them, Not
based on my actions or diagnosis. All of the above actions could well be
disbursed by people with no training what ever in my diagnosis.

In short this will stifle free speech, create an inflexible and
unreactive support system. It will confine and medicate people who have
nothing wrong with them beyond a disability for no useful or productive
result. Plus it totally ignores the root reason why there are people on
the streets today who are exhibiting obvious signs of mental illness.
They are there because damned few of them can access the supports they
need. Modern psychiatry will when its being honest tell you that not
every person with a psychiatric diagnosis responds well to any one course
of treatment. A big chunk of those obviously ill people you have seen are
where they are due to both a waiting list for services and or have drug
resistant illness. A few of them can be dangerous, I am here to tell you
that they can be damned dangerous. THAT behavior not their diagnosis
should be the fish-or-cut-bait of confinement, and or involuntary
treatment.

Overwhelming workable support systems by under funding them and adding
whole other diagnosis and populations by the use of a paintbrush so broad
that it would include otherwise nonaplicable people is not good
psychiatry, social science, or politics. Right now the CtC laws could
just as well cover just about any minority. It reads more like Stalin era
psychiatry, than anything to do with the last half of the last century. 

Plus it's going to cost. In NH, and I will freely admit this is only a
guess new hampshire hospital would have to reopen every single bed it
ever had and build a lot more beds, possibly thousands of new beds.
States like california have done this by turning it's prison system into
dual facilities, filling tens of thousands of beds in the prison system
into psychiatric wards by default.

This should stir someone from the homeless list to responding to your
questions. I have expectations of my government. I expect them to spend
money prudently and to good effect. Disability purging is neither.

Tom C

On Thu, 24 Aug 2000 17:27:06 -0400 "L Misek-Falkoff"
<include@worldnet.att.net> writes:
> Hi Tom, can you possibly provide a URL so I can read some background 
> on
> this? I have none, but am interested  in learning about "involuntau
> outpatient treatment," as affects people with psychiatric 
> disabilities. What
> are the inequities? I searched the Internet for about an hour and am 
> not
> proving very effective, so if you can give me a link here or 
> comment, I'll
> be grateful. :) Linda.
> 
> <=email from:  ldmf =  L.D.Misek-Falkoff, Ph.D.,J.D..
> include@worldnet.att.net  NYState,
> http://www.egroups.com/group/ChronicPainCooperate
> http://www.egroups.com/group/Poems_of_Pain_and_Promise
> http://www.egroups.com/chat/ldmf-chat
> ----- Original Message -----
> From: Thomas Cagle <nh-adapt@juno.com>
> To: <NH_ADAPT@egroups.com>
>> 
> 
> > Some readers have wondered why I am so opposed to involuntary 
> outpatient
> > treatment for (CtC commit to community laws) competent adults, 
> What
> > follows is an articulate reason why. My best assessment of any of 
> the CtC
> > laws and existing mental health centers, and a longish working
> > relationship in New Hampshire Hospital, leads me to the inevitable
> > conclusion that without equal funding for psychiatric disabilities 
> we are
> > working hard at not treating people with disabilities but 
> destroying them
> > by failing to support them adequately. in short do we want these 
> people
> > supported in their jobs-homes-families or do we want them confined 
> solely
> > for the profitability of HMOs?
> >
> > Tom C
> >
> >
> > >Dear Sharon,
> > >
> > >Count me in, re: getting involved with ANYTHING that can 
> positively
> > affect
> > >the lives of people with disabilities, re: legislation,
> > advocacy...ANYTHING.
> > >I don't know where to go, etc., but I need to be involved - its 
> either
> > that
> > >or give up and die.
> > >
> > >I have Moebius syndrome (congenital oculofacial paralysis) - the
> > disability
> > >that Chelsey ("the Smile Girl" who had surgeries so that she 
> could
> > smile)
> > >has.  While Kaiser got really good press with that surgery, the 
> media
> > >utterly failed to show the fight her mom had to go through to GET 
> the
> > >surgery, or the DISCRIMINATION another adult with Moebius had 
> when HE
> > wanted
> > >the surgery,  Kaiser refused to authorize it for him, even though 
> they
> > >already had authorized it for several children... the ONLY reason 
> he got
> > the
> > >surgery was that he called Chelsey's mom who happened to be 
> having the
> > crew
> > >from "Good Morning America" over later that afternoon ... and SHE 
> called
> > >Kaiser and told them they had an hour to authorize it, or she 
> would tell
> > the
> > >world that Kaiser DISCRIMINATES against others with the same 
> disorder.
> > >
> > >Part of Moebius (a physical disability) is its brain-based nature 
> - it
> > >affects the cranial nerves, and there are people with Moebius who 
> also
> > have
> > >Asperger syndrome, mental retardation and depression.  I deal 
> with
> > >depression - a very treatment resistant one, made far more 
> chronic
> > (IMHO) as
> > >a result of Kaiser's substandard  care, as well as FAILURE to 
> provide
> > the
> > >care as included in both my health benefits AND AB 88 ('mental 
> health
> > parity
> > >law').  My father AND HIS father both committed suicide; so did 
> two
> > people I
> > >know (one was a close friend) who also had Moebius.  So  there is 
> a
> > >significant genetic and biological link to depression.
> > >
> > >I'm NOT 'just' a "consumer of mental health care"... I'm a 
> teacher (LA
> > >County Office of Ed) and work with children affected with 
> orthopedic
> > >impairments.  I am finishing my 4th and 5th teaching credentials; 
> I am
> > an
> > >effective advocate and respected teacher.  I BELIEVE in what I do 
> as a
> > >teacher (and as a PWD) ... but things get incredibly difficult 
> when I am
> > >denied access to decent mental health care.
> > >
> > >My father had no mental health care; he killed himself by driving 
> his
> > car
> > >into our family garage and leaving it running - my little sister 
> found
> > him,
> > >dead.  HIS father likewise had no mental health care - and hung 
> himself
> > in
> > >jail after having been arrested for drunkenness (I believe).  My 
> friend
> > >Frank had no mental health care - he shot himself in the mouth in 
> June
> > of
> > >1999.  Another person I knew, John, (who also had Moebius) poured
> > gasoline
> > >on himself and burned himself to death in his car.  He didn't 
> have
> > mental
> > >health care either.
> > >
> > >But I, allegedly, do.  it is absolutely substandard - medication 
> has
> > ONLY
> > >been changed when *I* insist (long after it should have been 
> changed!).
> > I
> > >had a therapist "intern" who was NOT trained or provided ANY 
> support.
> > >Kaiser REFUSED to allow me to change therapists, and when I 
> finally
> > refused
> > >to see this 'therapist' any more (LONG after writing letters, 
> calling
> > Member
> > >Benefits several times, their 'hot line', etc.) ...STILL nothing
> > happens.
> > >WHY?  Because the CA Insurance lobby must be so strong - there IS 
> NO
> > >accountability with regard to mental health care.  There are 
> laws, but
> > the
> > >ONLY way they are enforced is when one has the tenacity to seek 
> legal
> > >recourse.  They authorized "ECT" ('shock therapy') - willing to 
> pay the
> > $$$
> > >for 6 - 12 of those, plus hospitalization for 2 - 3 weeks (ECT 
> was only
> > give
> > >a 50/50 chance of working because of the brain-based nature of 
> Moebius;
> > the
> > >doctor also didn't know what potential damage could occur if I 
> had it)
> > ....
> > >but absolutely refuse to authorize a trained therapist (or tell 
> me why
> > not!)
> > >
> > >So Sharon, count me in.  I live in Southern California (La 
> Puente) - my
> > >e-mail address is sandygo4it@earthlink.net --- its either get 
> involved
> > or
> > >have no one to blame when nothing continues to happen!
> > >
> > >Sincerely,
> > >
> > >Sandy Goodwick


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