Hope you have a good weekend everybody!
Hope you have a good weekend everybody!
While I was working as a social worker on an inpatient psychiatric unit, I became disillusioned and shocked at the extremely high rate of readmissions by patients. Even though the typical length of stay lasted less than a week, it seemed as though I was caring for the patients on a long-term basis. Whenever they returned, we picked up where we had left off since they were last discharged.
I learned if they followed through with the previous recommendations made by the psychiatrist, nurse, and myself. The recommendations included taking their prescribed medications, attending structured therapeutic groups, attending appointments with their psychotherapists, psychiatrists, nurse practitioners, and rehabilitative outreach workers. Sometimes they were expected to access government benefits, such as food and shelter, by completing applications.
I often encouraged patients to use their state-funded Department of Mental Health (DMH) rehabilitative outreach workers as much as possible. These workers were expected to help their clients access housing (e.g., 24-hour supervised group residential programs), vocational services, transportation, and outpatient treatment providers. And I listed these services whenever I recommended DMH and offered applications to patients.
As I revisited the patients revolving through the door of our broken system in mobile emergency services, I caught a glimpse of how seriously mentally ill patients on inpatient might be worse off than when I was working there. Recently, a social worker and friend who works on inpatient psychiatry expressed her belief that DMH should be doing a lot more to resolve homelessness. I agree with her. Her patients tell her that their DMH case managers tell them, “We don’t help with housing.”
Really? Disillusionment sets in again. If they don’t help with housing, then what does DMH help with? Without supportive and supervised housing, seriously mentally ill people will inevitably have difficulty taking care of themselves, leading to further hospitalizations. Instructing your clients to go elsewhere for help with housing is not acceptable. DMH is supposed to care for and protect the most severely ill. Yet, they’ve fallen short.
I wrote the book, Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry, to expose the injustices that I’ve seen in the field. Breakdown closely exposes barriers to patients getting the help that they need. The shortage of inpatient beds, increased rates of criminalization, overly restrictive involuntary hold criteria, premature inpatient discharges, and insufficient means to ensure that patients adhere to their outpatient treatment plans make for a broken system. Consequently, too many patients end up homeless, jailed, harming themselves, harming others, or even dead.
My book educates the public about the plight of those who need the most help. Increased awareness of a problem tends to inspire change. My greatest hope is that my book motivates people to advocate for legislative improvements of the system. Please tell your legislators about Breakdown and give it to them.
Click on link below to access Lynn’s book on Amazon:
Breakdown: A Clinician’s Experience in a Broken System of Emergency Psychiatry
Sunday I visited Travis (BB8099) for the first time in 2019. It was a clear, like-spring morning, 59 degrees, and sunny. The roads from my house to Folsom Prison are back roads. I drove past ponds, weathered barns, horses, riding stables, vineyards, orchards, ducks, and geese. Cyclists were out solo and in groups. I wanted to keep driving on these roads. I didn’t want to stop my car to walk into a depressing cement building surrounded by wire fencing and spotlights. I didn’t want to deal with X-ray machines, guards, and clanging sets of locked doors. But Travis was waiting. And Travis is housed in the depressing cement building surrounded by wire fencing and spotlights. He lives with X-ray machines, guards, and clanging sets of locked doors every single day. I only had to stay for a few hours.
As I parked my car, a young African-American woman stepped out of the car next to mine. She was wearing an attractive orange tunic, black leggings, and stylish shoes. She looked pretty. The guards agreed. She looked “too pretty.” Her leggings were “too tight.” She had to leave. Later, I’d see her, again, visiting in white slacks.
Travis walked down the steps into the visiting area with a big smile. We hugged and then cut to the chase. He was looking toward the vending machines. “Do you want to get a sandwich, Travis?” A quick nod and we were off to the opposite side of the room. Our relationship’s evolving.
Travis asked about my holidays and I described my crab feed for my family. He asked about my book. He said his mom likes the white cover better than the blue or gray. I asked him how he was after his Abilify medication was stopped abruptly. “I had a tough month of withdrawal but I’m feeling better and I like my new psychiatrist better than the old one. She seems engaged. She seems like she cares.”
“I have a new cellie I really like, too. His name is Will but everybody calls him ‘Rooster.’ He’s Hispanic, 39 years-old, and grew up in Fresno. And you know something else? Rooster has one eye. When he was 16, he was playing Russian roulette with his friends. He shot himself in the face and destroyed his eye. But he’s a good guy. He’s a christian, and he tries to help others. We read the Bible together every night.”
I asked more questions about Rooster — how he got a gun at 16 (“I don’t know”), and if he has family somewhere (“Yes”)? “Rooster is a political junkie. He watches all the stuff about the wall and the shutdown and he wants to talk about it all the time. I tell him not to. The news unsettles me and I need to take care of myself. I don’t want to trigger my depression. I’m in prison and there’s nothing I can do to change things.”
I studied the visitors and inmates sitting around the room. One inmate, older with long grey braids, held hands and spoke softly with his female visitor. Another swept the floor, laughing and joking with people as he swept around them. He seemed friendly and so all-American. How did this young man come to be in here? In the highest security block for criminal offenders? I wanted to talk to everyone and hear their stories. Wishful thinking.
For two-and-a-half hours, Travis and I chatted and sometimes sat in silence. Comfortable silence. I found out Travis likes to play pinochle and I told him I play bridge. He wanted to hear about the game. He thought it sounded like a card game he’d enjoy.
“We put on a play this week in church. One of the inmates wrote it. It was about a prisoner, John, who was denied parole and how he handled it. I played my guitar and sang ‘I lift the Lord’s name on high.’ The play ended with a big, tall, inmate (John) singing a praising song to Jesus. Everyone was swaying and clapping their hands. Even the guards. They said, ‘We usually don’t have happy stories to take home and tell our families but today was different. Today we have a happy story to take home.’”
Travis changed the subject. “When I get out of prison, I want to get a dog. A lab. A puppy to cuddle with. More than a dog, I want a wife and family. I’m a grown man. I’ve left my mother’s house. That’s the hardest part of being in here. I see a beautiful woman on TV and say, ‘Oh man, I hope I get a second chance.’”
When it was time to go, Travis wished me a good month until our next visit. I told Travis I’d try to find a beginning bridge book to send to him. Other than that, there were no promises — Travis still has five years to serve out his sentence. For the moment, however, I sensed we were both grateful for his feeling better, for his new cellie, Rooster, and for an original, jailhouse play.
A gentle day. Sometimes gentle days must be enough.
You can read more about my visits with Travis. They’re listed in the Archives on the right.
Travis looks forward to receiving mail. You can write to him at this address: Travis Christian
California State Prison-Sacramento
P.O. Box 290066
Represa, CA 95671
Hope you have a good weekend everybody!
There is much confusion around mental health and when someone will ask for help. I often hear this: "He will get help when he is ready," or, "She will finally say yes to meds when she realizes the damage bipolar is doing to her life."
No. This is not how it works with SMI — serious mental illness.
Mental health is not addiction. The idea that a person has to hit rock bottom before they will ask for help is one that might work for alcohol and drug abuse — but it never works for SMI. Here is why:
1. Most people with SMI have a lack of insight (anosognosia) that comes and goes depending on our symptoms. I fight this lack of insight regularly and I'm someone who has enormous insight as compared to others. If I suffer with lack of insight, imagine what it's like for people who haven’t spent the past 20 years on management.
2. Denial is not a part of SMI when a person with SMI is really sick. Denial implies that a person knows what is happening, but chooses to ignore the signs. For example, a person with a severe alcohol dependency might have total knowledge that if he keeps drinking, he is going to ruin his liver, but he keeps drinking despite this knowledge. There is no judgement here, but this is denial. In SMI, a person can have teeth rotting out of their head, long, dirty fingernails, matted hair, and a sleeping bag for a bed and still say, “There is nothing wrong with me. You are the one with the problem.”
There is no rock bottom for us as rock bottom requires self-awareness that is simply not available when we are sick.
Don't expect this from someone with SMI. Those of us with bipolar disorder, schizoaffective disorder, and schizophrenia need people and a society to make decisions for us when we are too sick to ask for help. Without this, our rock bottom is death.
3. The whole idea of individual rights is skewed when it comes to SMI. The idea of rock bottom is based on the idea that individuals are always able to make a choice about life or death situations. I completely, and I do mean completely, disagree with this and believe in society over the individual when it comes to mental health treatment. We are not in our right minds when we are sick. The concept of individual rights doesn't apply to someone who is not in his or her right mind.
If you love someone with SMI, you have tough decisions to make. Waiting until that person sees the light, knows they need help, asks for help, or finally hits rock bottom means you might see the person you love lose everything or die.
Get involved, change HIPAA, think of our society and work with me to get help for people at home and on the streets who are too sick to get help. I hope that people at the ACLU, people in the anti-psych movement, and those who believe in individual rights above society rights can see that the world this creates is not sustainable.
I want society to make decisions for those of us with SMI. I believe in required mental health treatment, anti-psychotic shots, and safe places for people with SMI to live.
We can work together to create long term treatment facilities and homes for people who are ill. They were called asylums for a positive reason — a place of refuge. We need them again. Rock bottom is not dignity. Help us.
The situation in these photos is what led me to write this piece. I was in my car and looked over and saw a man fall and hit his head. He then threw up. No one else stopped and I questioned if I wanted to get involved. Portland, Oregon is completely out of control when it comes to homelessness. The majority on the streets here are seriously mentally ill.
I stopped and helped the man. I knew not to touch him, but I talked to him and said I was calling 911. The dispatcher asked me to see if he was alive and asked me to stay until the paramedics showed up. I found out that his name was Scott and he was 30. He was living on the street. I could see his garbage bag with a CD player and his shoes. As I talked to him, he rolled in a ball under his shirt.
When help arrived, they didn’t look at me, thank me, talk with me, or give me any indication that they needed information from me. They are so used to this that they acted as though someone who looked like he was dying on the street was normal. I’m not judging them. Just observing how truly terrible it is in Portland.
The young man tried to punch and kick the paramedics and they said he had to calm down. He finally did and accepted help. The cost of this one incident will run in the thousands of dollars. The hospital will not be able to do anything due to HIPAA laws and Scott will be released back to the street in a few days. I wouldn’t be surprised if I saw him again today.
I have to cut my emotions off from my work. That is what I did in this situation. I turned off my heart and let my mind do the work that was needed. Someone had to help and this time it was me.
Note: Julie is a writer at BP Magazine for Bipolar and a blogger at Psychology Today.
I am at my wit’s end. I can't take it anymore. I have a mentally ill son, Christopher, who will be 17 in February. I was a victim at 13, and he was born at 14. I read so much when I found out I was pregnant — everything that would tell me how I should have the baby and where there would be help. I thought I was doing the right thing. Fast forward. He’s now at a residential treatment facility. Since he was seven or eight, my son’s been receiving treatment for mental illness. It was a battle every day to make sure nothing made him mad, and when he did get mad, we followed safety plans to a “T.”
Christopher has bipolar disorder, ADHD, intermittent explosive disorder, and possibly, and probably, more. When he gets mad, he physically assaults people and it happens out of no where. He's gone after his infant siblings, strangers in the street, classmates, and teachers. He will attack anyone who’s around. He says, “I will kill everyone.” His main desire is to stab people to death. He attempted to stab me. He hid in the house with a butcher knife my grandmother used and forgot to lock back up.
We’ve exhausted all mental health services, and I mean all. I even drove him out of state to be hospitalized. The residential treatment facility is the last thing that can help, but I can't afford it. Child Protective Services, therapists, other family members, and medical providers all agree he needs this, but insurance won't pay for it unless he is a drug user.
So here we are. All involved agree my son cannot be in my home. It's too dangerous for me and his younger siblings. He’s strong and over six-feet tall. I love him, but I'm deathly afraid of him. So are my two daughters who he attempted to sexually molest as well as physically assault. The state of Michigan would help me pay for his treatment, but here’s the catch: I'm being charged with child abuse and child neglect. Authorities say it’s the only way to keep everyone safe and to get him help. They’ve put me on a child abuse registry. I won’t be able to go back to working with children (I previously worked in an elementary school.) I can't go on field trips with my other children because my name is on that list. My trial isn't until January 10. The attorney they gave doesn’t seem to care about my right to a fair trial. He's only showed up for two hearings, talked to me less than 90 seconds each time, and has never looked at my son’s medical documents and other evidence that I carry with me to every hearing.
January 1, 2019: I just now looked at my mail that didn't come until late yesterday evening. There is a letter from the court. It says a pre-trial management conference was scheduled for 12/18/2018 and that all witness lists and evidence were due by 12/21/2018. My attorney has none of this information and I'm being informed by mail that wasn't sent out until 12/28/2018 (stamped on the envelope).
To make matters worse, the state promised me they wouldn't involve my rapist/abuser, a man I’m greatly afraid of. They said it would be in my son’s best interest not to involve him as he has a lengthy record. They lied. The letter I just opened says they sent a copy stating my name, my information, and the date for trial, to this man. He ruined my childhood and essentially scarred me for life. I never put him on my son’s birth certificate. I am scared to death, angry, and hurt. It feels like a set-up.
Everyone I talk to feels bad but no one can help. The problem is legislation. I've contacted all local officials, from my local state representatives to the governor’s office. However, because of elections and terms being close to an end, no one could help. Here I am. I’ve never been in trouble with the law in my life. Now I’m being persecuted for having a mentally ill child, and not being able to afford the $300-a-day treatment he needs. Seems there’s no way to help a parent get the treatment her mentally ill child needs without charging the parent (me in this case) and labeling her as a child-abuser. The state’s stripping me of my parental rights, and sending me a bill for my son’s expenses while he’s in their care.
I have a therapist and, after he looked at all my documents and heard the story, he was in shock and felt bad. He said, “Nothing can be done.” It's a Catch-22. Usually, he tries to help his patients work toward a goal, but he doesn't have a goal for me to strive for. He can only allow me to vent which, at this point, isn't enough. God help me. I don't know what to do anymore. It feels like the state of Michigan wants me dead.
Note: Sarah cancelled her court appearance for 1/10/2019. She says, “I'm too afraid to go to trial Thursday and risk being found by my childhood abuser. My concern is his being in front of me at the trial, possibly following me home, or getting my address while at the trial. I was told by the judge's secretary they would ‘try not to disclose my address.’ However, I don’t put it past the courts that they would hand him a document with my mailing address on it, or say it out loud during the trial.”
Stopping by Woods on a Snowy Evening by Robert Frost
Whose woods these are I think I know.
His house is in the village though;
He will not see me stopping here
To watch his woods fill up with snow.
My little horse must think it queer
To stop without a farmhouse near
Between the woods and frozen lake
The darkest evening of the year.
He gives his harness bells a shake
To ask if there is some mistake.
The only other sound’s the sweep
Of easy wind and downy flake.
The woods are lovely, dark and deep,
But I have promises to keep,
And miles to go before I sleep,
And miles to go before I sleep.
Hope you have a good weekend everybody!
Note: As of January 1, 2019, all works first published in the United States in 1923 entered the public domain including this poem by Robert Frost.
I’m trying to choose the color for the cover of my book. Which color draws you in — blue, white, or gray? Thanks so much for your help. I have no objectivity about this and appreciate your feedback.
Why the carnation? The carnation is the official flower for Mother’s Day. Pat used to give me and his sisters white carnations on Mother’s Day. White carnations represent pure love. Pink carnations represent a mother’s forever love: “I will never forget you.” My book is dedicated to Pat and his sisters, and to the mothers (millions of them) who fight, every single day, for their children who live with serious mental illness.
P.S. If you receive this post twice in your email, it’s because you’re subscribed to my stories blog and to my diary blog. I try to not duplicate posts often. Thanks for subscribing to both blogs.
November 6, 2018: Our son, Joseph, was gone again since Wednesday last week, but not before he broke my husband's computer and my PC monitor. He’d previously broken my laptop. We called the police. They came and talked to him and determined he was not a threat. They didn’t take him. This is getting so old.
He called over the weekend. He was taken to the mental hospital. Eventually, I was able to ask how he got there. He said, “I was darting into traffic trying to get a ride out of ‘here.’” Then he said, “I was darting into traffic trying to end my life.”
This is the worst he's been since his initial onset back in 2012. I know, if he gets treatment and is stabilized, things will be better for a time. I know this illness is a rollercoaster. I asked him if he mentioned his intent to hurt himself to the police and the hospital. He said, "Yeah, I told them." Then he became adamant that he needs to be out of there ASAP. Maybe now, with his words, there might be some serious effort to treat him? I ask, once again, for your prayers.
November 9, 2018: Feeling absolutely hopeless. We visited our son on Wednesday at the Riverside mental health unit where he’s been for three days since he was found jumping into traffic. He’s psychotic and delusional. He was admitted because he was threatening to harm himself.
Today I get a call from the police in Indio, 75 miles away. Apparently my son was transferred to a voluntary treatment facility on Thursday and he simply walked out. The facility eventually called the police. He’s being reported as missing. I attempted to fill the officer in on my son's condition, but he had to get off the phone because he had another emergency. I’m literally loosing my mind! Why, Why, Why is this happening?
December 27, 2018: Hope for the new year! As you have read from my past posts, my son was on a downward spiral for the last six months. He’s been in and out of homelessness and the hospital with no real treatment. These photos are a month apart. One is after two weeks of homelessness. He has an injury to his leg (fractured). This is a bit of a mystery. He was tired and weary.
Joseph was home for a few weeks and then, 10 days ago, he was taken back to hospital. He was transferred to another facility for treatment and he finally agreed to take a long-lasting injection.
We brought him home today. The photo is after a warm shower. I’m hopeful for him and I thank you for all the support and prayers. As we all know, we’re never out of the woods, but I did want to share some good news. The last six months have been trying times. Finally, something good to report. Keep praying for all our loved ones who are like my son and deserving of a good life.
One of my favorite memories from 2018 — my hummingbirds, Mama and Peek. (RIP Poke)
In the photo, they look like they’re talking. I imagine their conversation in my poem…
What are the clouds?
What is the sky?
Where are the flowers?
How do I fly?
The clouds are magic
The sky is blue air
The flowers are growing
You can hum everywhere.
I like my nest.
How did you make it?
I see spider silk in it,
How did you take it?
The nest is your home
I made it with love
The spiders were smiling
They could see it above,
Tell me more of the things I need to know.
How to stay safe and how to let go?
What will I do when you fly away?
I’ll grow up soon but I wish you would stay.
I’ll teach you everything about being a bird,
I won’t leave till you’re ready, I give you my word.
We’re tiny and swift and clever and smart,
I love you, sweet baby, with all of my heart.
Hope you have a good 2019 everybody!