An Open Letter to the Colorado House Health, Insurance and Environment Committee RE: HB1386

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To the Colorado House Health, Insurance and Environment Committee

RE: HB1386

VIA EMAIL
I ask you to vote against HB1386.  I write with a moral obligation to inform you of research findings which were recently defended through the PhD Program in Environmental Psychology at the Graduate Center, City University of New York. Over seventy people were involved with this qualitative research, which used video as a research tool, is an Environmental Community-Based Participatory Action Research project. The final title of the written dissertation is (de)VOICED: Human Rights Now (Volumes I, II, and III, 645 pages). People who participated in this study were from the United States, worked in ‘peer’ roles, and had psychiatric histories. Some of these people were Coloradans.
Throughout this research process, I repeatedly gave examples of people who participated who were silenced and retaliated against for expressing their expert perspectives about the public psychiatric service delivery system.  The statement of the problem that the research focused on, in fact, was how people who are users or survivors of psychiatry are silenced in their attempts at making psychiatric systems change. Having worked inside of the New York State Office of Mental Health (1999 – 2003) I was acutely aware of these practices and wanted to see if this problem extended beyond New York. This study showed that this silencing of dissenting voices is a national epidemic that all citizens ought to be concerned with because if our public servants are unable to speak freely while creating and carrying out policies, regulations, and laws, as a society we are in extreme jeopardy. Of grave concern is that this silencing extended to people who were reporting abuse of people who were involved with the public psychiatric service delivery system.
It is my understanding that the Colorado House Health, Insurance and Environment Committee has been informed that there is stakeholder support for this bill. Based on the findings of my research and my general knowledge concerning psychiatric systems change, I must say that either people who would contest HB1386 were not invited to be part of a selective group of stakeholders, or their voices were not recorded. I can say with complete confidence that there are stakeholders who do not support HB1386 and many of them were involved with stopping HB1253 from going forward.
I have devoted the last ten years of my study to problems posed by psychiatric environments that utilize force, court-order, and uninformed consent. Prior to pursuing a PhD, I spent twelve years working in psychiatric systems change. I can say with convincing evidence, beyond my own research, that institutional environments are deleterious to people. The use of institutions must be abandoned, not broadened. The iatrogenic effects of psychiatric drugs are routinely discussed in the literature. (de)VOICED, however, also shows iatrogenic effects of being involuntarily subjected to psychiatric places.
Today, we see the treatments of the nineteenth century as barbaric. Historical trends for ending forceful and coercive psychiatric treatment date back at least to the nineteenth century in the United States, and the seventeenth century in Europe.  In fact, in the last hundred and fifty years, the discipline of psychiatry has persisted, continually re-cloaking itself when public attention is focused on its actions: the poor and alms house non-system to the asylum system to the hospital system to the mental hygiene system to the psychiatric system to the mental illness system to the mental health system, and in many place now, to the behavioral health system.
(de)VOICED shows evidence, dating back to the nineteenth century, of how people who had been subjected to the asylum system fought back against it and were silenced. A few people though, had their personal accounts published, and these publications caused asylum system change. (de)VOICED also shows evidence for how this persists to this day, in the United States and specifically in Colorado.
The findings of (de)VOICED also confirms earlier research. Specifically, this study confirms what Erving Goffman (1961) showed in Asylums is still occurring. Asylums, of course, was a catalyst for psychiatric systems change in the 1960s, to move toward voluntary, community-based services. However, we extend Goffman’s findings which focused solely on people who were involuntarily institutionalized. (de)VOICED extends these experiences to people who were involved with psychiatry on a voluntary basis.
Eliminating the word ‘imminent’ from ‘imminent danger’ and changing the civil commitment criteria to make it easier to commit people will indeed be a setback for Colorado and the people of your State. This is a surprising move for such a progressive and forward-thinking State. Involuntary psychiatric treatment is tantamount to torture. I am sure you are aware that many of the practices of psychiatry, when used with force, such as electroconvulsive treatment, psychopharmacology, restraint, seclusion, and aversives have been said to constitute torture or ill treatment by the Special Rapporteur on Torture in the report on the Convention Against Torture (2013, 2008).
I am happy to supply references for anything I mentioned in this letter. I am available to discuss this matter further. Please protect and promote human rights of people in Colorado and vote no on HB1386.Sincerely,Dr. Lauren Tenney
Environmental Psychologist

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

9 COMMENTS

  1. Thank you for supporting the citizens of Colorado, Dr. Tenney! Here is my letter to my state’s elected officials:

    Amy Smith
    PO Box 6
    103 South Main Street B Up
    Eckley, Colorado 80727
    April 23, 2014
    Via email

    An Open Letter to the Colorado House Health, Insurance and Environment Committee
    RE: HB1386

    I am writing to protest the expansion of civil commitment criteria in Colorado, and HB136 in particular, which I view as a direct and clear threat to my personal civil liberties as a Colorado citizen. I know that the data do not exist that show that incarcerating people with behavioral healthcare labels increases public safety, nor that it is therapeutically beneficial. These are policies on the wrong side of history. This year, the Special Rapporteur on Torture of the United Nations declared forced psychiatry to be torture. Even on a strictly pragmatic level, Colorado does not have the infrastructure to treat the people clamoring for mental health care and substance abuse interventions now. Why are we expanding criteria in the face of a looming workforce crisis as we expand Medicaid and outreach to at-risk populations? Even as just a consumer of mental health services in Colorado, I can see that this entire process has been controlled and has been made to happen, after years of back room deals and a solid wall of defiance to Colorado’s traditional culture of transparency, honesty and fairness.

    In 2008, I was the director of the statewide mental health consumer organization in Colorado, and I & a staff member spent a day at CMHIP interviewing patients with no staff present. Not only were all the patients hungry, including the tiny little old ladies, there was a general lack of medical care available to patients to the point of criminal neglect. Patients were not allowed access to the outdoors for weeks at a time and there were very few activities including therapeutic rehabilitation, group therapy or recreation. Everyone felt over-medicated, but that is common to nearly all locked facilities in the USA. In addition to writing up my findings, we supplied the organization with audio tapes of the all the meetings. I left that position for a different job soon after, and the new director suppressed my findings and wrote “the consumers of Colorado are happy with their care”. Since that time, a number of patients have died preventable deaths, including from constipation, unobserved prone restraint, and most recently, an infected leg wound. I returned in 2012 to interview patients again under a different authority and found much the same.(more food was available, but it was inedible to me- disgusting) In addition, we found patients with traffic tickets housed in maximum security, barbaric sex offender treatment modalities, (whether that was why they were incarcerated or not) and a general inability to progress as is a person’s civil right. The morale was so bad at that time, the institution had to hire 1.7 FTE for every 1.0 FTE expected on the floor at any given moment. What a gross waste of state and federal dollars, even if you could imagine that such interventions as this can possibly be considered therapeutic.

    I have a somewhat clearer understanding of how behavioral healthcare policy-making in Colorado is crafted than most. As the ‘director’ of Colorado’s then-consumer network, WE CAN! Of Colorado, I was a member of the Mighty Mental Health Coalition. Other members included the Executive Directors of MHAC, NAMI, Federation of Families, CBHC, CPS & CPA. I knew how the back room deals go down, how the answers are decided before the questions are posed and how and who decided who got the funding. Colorado consumers were taught for decades not to listen to the national voice of the Consumer/ Survivor/ Ex-patient (CSX) movement, and that “advocacy” meant to beg for more beds & more meds. I appeared at every event, microphone in hand, reading the bullet points provided to me by the state and the industry. I was Patrick Kennedy’s poster child for parity & testified at a House of Representatives Committee on Education and Labor Subcommittee on Health, Employment, Labor and Pensions with him and Rosalind Cater in 2007. As long as I kept my hand clenched around that microphone and read the bullet points provided to me by the industry, I was treated like a queen. Long story short, when I began to question some of the obviously immoral practices I was observing around me, I was removed from my many positions of power on various councils, boards and advisory groups and although I have been literally begging to be allowed to participate again for over seven years, to the most powerful people I could access, I have not only not been given a seat at the table but have been denied at every turn, save Colorado’s Protection and Advocacy system. No matter that I am considered a subject matter expert on peer services, public policy and behavioral healthcare trends under the ACA internationally, I am not welcome at most policy tables in Colorado today. I asked many times to participate on the civil commitment task force and was denied, clear up to last week when Rep. McCann denied me once again. Coloradans civil rights would have been more carefully looked after on my watch.

    The eyes of the world are on Colorado as we mimic the punitive and groundless fear-based policies of New York State with no vibrant, informed and engaged peer community as they have. Our policy-makers and elected officials are mocked as they buy into the fictional junk science of the Treatment Advocacy Center. Informed Coloradans gasp as our rights are written out of our law books and we weep with frustration and fear as one after another advocacy organization that are charged to protect us sign off with their organizational logos on the task force letterhead.

    I have looked the other way over the years as I have identified state budget “errors”, contractual fraud, kickbacks, billing fraud, employee abuse, EEOC issues and much, much more. When Colorado turned back the contracts for Recovery Innovations I knew nothing would ever change, and frankly, that was the last straw in my book. We use the most archaic, expensive, disabling treatment modalities available on Earth. The expense to the state pales next to the human suffering and waste. Colorado legislators must awaken to the dirty sinkhole the Colorado behavioral healthcare system has become, and question these people in a more informed manner, rather than trusting them to inform lawmakers to the best course of action to protect the health, safety and welfare of our citizens.

    Please feel free to contact me with any questions or for further comments or citations.
    Amy Smith

    [email protected]

    • Good for you! Someone referred to these people as the city shadows. What the “normal” and “well behaved” people keep repressed pops up in these who must be hidden away on a low budget. As some one recently put it we are living now in post-legal American where if your social rank is high enough crime no longer exists. Bankers, high public officials, the very wealthy . . . But those in lower ranks must be the whipping boys. Punish them severely so that the amount of punishment will cover their betters. While Obama eats half his $300 sushi these must be put on half rations to make for justice. Temperance.

      What these primitive types who legislate as well as the even more primitive types behind the scenes pulling the financial strings fail to realize is that this behavior is more than expensive. There is a very subtle accounting system that measures these things and the penalties for fraud are very high. If only they knew before they are given the task of undoing the harm they have brought about.

      Whom the gods would destroy they first drive mad.

  3. RE:

    “survivors of psychiatry are silenced”

    “Of grave concern is that this silencing extended to people who were reporting abuse of people who were involved with the public psychiatric service delivery system.”

    Not cool.

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  4. Anyone who read the Millennium Trilogy or watched the Swedish films knows that even in a rather more enlightened state like Sweden psychiatrists have way too much power. In fact while we ridiculed and criticized how psychiatry was used in the Soviet Union the same sort of thing was occurring and continues to occur in the USA and most places in the EU.

    In Colorado the judiciary has a little trick it can use on prisoners awaiting trial who complain about their attorneys. They can have them examined by someone resembling a second rate vet who will pronounce them incompetent to stand trial; they then will be sent to the State Mental Hospital (for the criminally insane, etc.) in Pueblo where they will be drugged as a matter of course and kept confined until they become compliant to stand trial. A judge there will always give the doctor permission to drug against their will and never listens to the defendant. The machine rolls on.

    As Princeton and Northwestern Universities informed us recently the USA is an oligarcy, not a democracy or some other benign form of government. So the question is which oligarchs see a profit in this legislation? That is the only relevant question. All the proof in the world will be nothing unless it shows clearly how the profit will not be forth coming. Or the power.

    Of course it is barbaric or worse as the barbarians were not generally psychopaths or under their influence. What the term is I do not know. America has become increasingly primitive and violent. The Fed gov is so arrogant it is almost impossible to deal with it without having a gun shoved in one’s face. We are not far from a full scale tyranny which will be arranged for our safety. The world is too dangerous for freedom. Sorry.

    • Agreed. One of the best examples is the infamous Otto Wagner Spital in Vienna, Austria. It has a very dark history from the Nazi times :
      http://www.gedenkstaettesteinhof.at/
      (in German) to more recent scandals and abuses:
      http://kurier.at/chronik/wien/die-kinder-vom-steinhof-in-der-psychiatrie-zu-tode-vernachlaessigt/15.817.743
      (in German) In the 80s kids were subjected to institutional neglect ending in many deaths.
      to even more recent including a big scandal in 2005-8 with staff member accusing the hospital of abuse and neglect of acute patients including letting them lie in restraints in feces, patients dying in restraints and other (easy to find if you know German, unfortunately there are no reports in English I know of). This practices have not stopped and continue to this day with abuse being covered up, medical documentation fixed with lies and medical errors and wrong-doing denied. The legal protections that are theoretically in place are a joke and are completely dysfunctional.
      So yes, EU is no better. I can also mention similar affairs in Poland (patients humiliated and made to hear underwear over their heads, kids being punished by saline injections) and Germany (e.g. Gustl Mollath case). Probably a tip of the mountain.