Hospitalized and Heading Toward Homelessness

25
2163

This story has a mostly happy ending. However, it did not begin that way.

It is a personal story, which begins with the police knocking on my door in Cary, North CarolinaĀ late one night in February 2017. I was sleeping and it was around 2 am, but the police forced me to go to a Crisis and Assessment Center in Raleigh, NC.

I questioned why this was happening but the police said they did not know, and that ā€œthey were just doing their job.ā€ While I was at UNC WakeBrook, I asked to see the involuntary commitment order that allowed for me to be forced into treatment. The staff refused to show the papers to me.

I was held for 72 hours, given shots of Haldol, and then I was taken by Sheriff Deputies to Central Regional Hospital over an hourā€™s drive away in Butner, NC, just south of the Virginia border. Upon arrival at CRH I was sent to the Geriatric Unit where those with dementia are held. I was there for one week, and then transferred to the Geriatric Unit next door.

I still was not allowed to see the commitment papers, and I was not allowed to go before a judge to get a legal decision on my commitment for another seven weeks.

Since my lease was ending in a few weeks, and I had no idea how long I would be hospitalized, I decided not to continue renting my apartment. My daughter visited to sign some papers and to clear out my household goods and store them. Vacating the apartment made me ā€œhomelessā€ under some DHHS service definitions, and truly homeless in my own mind.

As I was on the Geriatric Unit for almost two months, I got to know a few of the other patients on the unit and in the therapy groups fairly well. I also learned a lot just by observing activity on the unit. I asked several of the patients on my unit where they lived and how long they had been on this hospitalā€™s unit for elderly patients.

Their answers were disheartening. Most had been there two years or more. One had been at Butner in a former hospital even before CRH was opened many years ago. She told me she had been there at least 12 years.

Another patient told me how he longed to return to his home, but how he had given up hope. He asked me not to say anything he told me, as he feared reprisals from staff. I have described his and other patientsā€™ mental state as ā€œdowntrodden,ā€ although I feel sure staff would describe them as ā€œdepressed.ā€

I also learned some of what was going on in the hospital from those with whom I attended groups in art therapy, music therapy, and a writing group. These groups had patients from all units, and I saw them come and go during my stay. The music therapy leader played ā€œHappy Trails to Youā€ on her guitar and sang to patients ready for discharge, as an uplifting send-off.

However, on my own unit, only one person that I can recall was released in the weeks before I and my next door neighbor on the unit were discharged on the same day. She went to a nursing home. I went to a motel.

The various treatment types I received at CRH were both among the best and among the worst in my experience. This was the latest of a long history of inpatient treatment, so I was surprised at the good part that the Recreation Therapy of art and music provided. Also, I was allowed to work in the enclosed courtyards where the plants needed weeding and replanting. Many patients worked a few hours a week for the hospital for minimum wage jobs. These were the good surprises.

However, I am not a ā€œcompliant patient,ā€ as I do not accept that forced treatment is the best way to treat any patientā€”not just myself. Everything I did to try to get released only further antagonized the Geriatric Unit staff and made them dish out more subtle retaliation.

Theoretically at least, I should have gone to court before a County District Court at the hospital within 10 days of my legal commitment. That did not happen until the day before my release from the hospital, when the judge ordered my release against the staff’s medical advice.

Where is the ā€œPerson Centeredā€ part of Discharge Planning?

North Carolinaā€™s Department of Health and Human Services staffā€”in their written suggestions for providers of behavioral healthcare who design treatment plansā€”have repeatedly and over many years used the words ā€œperson-centeredā€ as the basis for mental health treatment. I rarely saw that from my psychiatrist or other staff who exhibited instead a ā€œcookie cutterā€ mentality to providing care. I raised this issue with my assigned staff to no avail.

My assigned social worker was supposed to follow my wishes, but declined to do so. She instead spoke privately with my adult daughter, who had been given legal Power of Attorney (PoA), often without my knowledge or even against my explicit wishes. My social worker told me I could easily and quickly be released, if I only would cooperate and go to a group home and not insist on returning to the community in an apartment.

I had been receiving monetary help to pay my rent from my brother, whom I had seldom seen or heard from him in years. Yet the staff relied on his advice through my daughter, who felt she should listen to him and not me. She apparently assumed that since I was in the hospital she could make all my medical decisions. This is not what PoA laws state, but what she was told by her uncle, who is also an attorney.

When I had been in the ER for observation at WakeMed Raleigh just before this forced treatment, the doctor ordered my release. My brother told hospital staff that night in the lobby where I could hear that I ā€œwas off my meds,ā€ and that as an attorney he could get me committed. He had no idea of my situation, as we had not seen each other in overĀ three months. But who do staff believe? A mental patient or the family member?

In my home state, NAMI rules, and hence family members also rule. We have a high level of hospitalization, yet NAMI NC leadership clamors for more state hospital beds and more mental health units in community hospitals.

Given that I was hospitalized miles from home, I had no visitors except once when my son and my daughter came in for the same weekend. Even though I was a former PAIMI Coordinator for the Protection and Advocacy Agency in North Carolina, Disability Rights NC declined my requests for anyone on their staff to visit and see firsthand my unit and get a copy of my commitment papers for me.

I have learned that it is not only DRNC that refuses to help any clients with Involuntary Commitment issues, but that this is the position of the National Disability Rights Network for all states. I did have some former PAIMI Council members who refused to stop calling and advocating on my behalf. As a result, when there was a suicide at CRH that spring, a DRNC attorney finally visited me during her investigation visit to the hospital. I later asked for and read her notes on the visit which quoted the staffā€™s evaluations, and which dismissed my complaints completely.

Once my attorney assigned by the Administrative Office of the Courts actually began to assist me (weeks into my incarceration), I learned that the IVC orderā€™s section for ā€œreason for commitmentā€ were completely blank. All that was on the page was a note that read ā€œsee attached.ā€ No statement had been attached.

In other words, from the very beginning my forced treatment had no valid legal basis, and all the staff could have and should have been aware of that. I also believe that what my psychiatrist called ā€œmaniaā€ was extreme anger, and that staff used my anger against me. I believe my ā€œnon-complianceā€ (or resistance) to my assigned psychiatrist also led to the fiasco that awaited me upon the day of my release.

The Transition to Community Living Initiative (TCLI)

As I said before, there were a few loyal and vocal advocates who were trying to get help for me. One of them served on a board where she became very familiar with the court settlement between the stateā€™s DHHS and the US Dept. of Justice.

Although the lawsuit that led to the settlement was centered on the warehousing of patients in what are called ā€œadult care homes,ā€ the legal agreement led to inclusion of those held in state psychiatric facilities as well. I had known of the lawsuit, but I was not familiar with the complicated details of the stateā€™s program called Transition to Community Living or its potential benefits for those in the program.

The TCLI program relies on the coordination of care between the three state-operated psychiatric facilities and the seven local Managed Care Organizations (MCOs) across the state. The intent of the program is to provide persons who have not been in the communityĀ for months or years not only monetary assistance, but social supports in the transition back to community living. Assistance is supposed to begin with an ā€œIn-reach Specialist,ā€ often a Peer Support Specialist, who advocates for the patients at the facilities in the MCOā€™s geographic area.

On paper it is complicated. In the real lifeĀ of someone who is hospitalized, it is even more complicated. My assigned TCLI in-reach person was not proactive. When asked if she was my advocate or the staffā€™s advocate, she answered that she was there to advocate for me. It did not seem that way to me.

When staff kept refusing to heed my wishes to find an apartment, and when my psychiatrist supported this by recommending a stay of not less than 90 days, no one at the MCO assisted me. In fact no one in local or state government did, either, despite written pleas to many at DHHS whom I knew personally.

Hello Homelessness

My not having a true advocate precipitated a true crisis for me upon my release, as the staff only gave me my discharge papers in a sealed manila envelope, after we arrived at a motel in Raleigh. I had been told that the hospital techs riding in our van had all my belongings,Ā which I could not have while at the hospital.

As it turned out, my cell phone, my IDs, and my Mastercard were not with my belongings. Instead these were locked in a safe back at CRH. I was dumped at a motel with no ID, no money or method of payment, and not even a cell phone to call friends or family for help. It was late on a Friday afternoon. I threw a fit, but the staff nevertheless drove off and left me there, saying nothing could be done before Monday.

I could write all the details of the next five months of homelessness, but suffice it to say it was a ride down a very bumpy road. Getting any help from the Alliance Managed Care Organization staff or my assigned providers was difficult much of the timeā€”and impossible at other times. I found a long-term stay hotel and used my personal funds (not spent while in the hospital) to pay the weekly rent for two months, then advised the MCO that I could no longer pay for this and I planned to move into one of the few homeless shelters for single women in the city of Raleigh.

Only then did the TCIL staff approve emergency housing funds to pay for my hotel expenses. I could have been in a studio apartment starting in May, but my In-reach Specialist (for reasons never explained) refused me the funds to pay for an apartment application fee and the deposit. I complained to the MCO, and her co-workers said they disagreed with her decision to refuse funds, but by that time, the apartment I had located was rented to someone else.

Some have asked me how I would suggest improving things in NC and at my MCO so as to reduce homelessness among those with mental health diagnoses. First and foremost, I would ask, ā€œWhere are the real advocates for more low-income housing?ā€ And where the hell have they been for those who are incarcerated, whether it be in jails and prisons or mental facilities? There is no mental health client group in NC, and there has not been an effective and viable one for many years. NAMI NC claims to be ā€œTHE Voice for Mental Illnessā€ in NC. However, it has become just another extension of the state and the DHHS, as it took on contracts with the state to provide services and became dependent on state funding. With that dependence, any semblance of true advocacy went by the wayside.

In my opinion, even feel-good groups like Habitat for Humanity are just fig leaves covering up the lack of truly effective lobbying for money for producing low-income housing. There are a few experiments in low-income housing funded by foundations or private organizations but no statewide policy. After the Republicans took over the General Assembly eight years ago, talk about social improvements such as building more low-income housing falls on deaf ears.

There are some good parts of my story, and they result from a few truly conscientious and proactive Care Coordinators at Alliance MCO. Chief among these was Renee King-Torres. At our first meeting I was hostile. My recent experiences with MCO staff had been very discouraging and frustrating. I let her know I did not expect anything else from her.

She proved me wrong.

In October 2017, I signed a lease for the apartment where I now live. It is a very small apartment in a very large complex. I live in the area of Northeast Raleigh I had chosen, and my complex has many amenities including a pond behind my building. I am able to feed the songbirds and watch the ducks. Just this week three new goslings appeared with their flock. This gave me cause for joy.

Life is good, and this would have been impossible without my TCLI financial assistance and my moving-day assistance from Renee and others from Alliance.

But when will such housing assistance become the rule and not the exception? When will those still behind bars or barbed wire fencesā€”like at CRHā€”be able to hope for a day on the outside in a home of his or her own?

The answer will not come from me, but only when many others wake up and realize that the patients incarcerated who are ā€œout of sight, out of mindā€ need help and need strong advocates to promote more community funding for housing and more community supports.

***

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

25 COMMENTS

    • But creating homelessness by the “social workers,” as well as the psychiatrists, psychologists, and thieving globalist banksters, is so much more profitable for the “mental health professionals” and banksters. Two groups, whose writings claim they want to be in control of this entire planet. But both the “mental health professionals” and the globalist banksters are being pointed out as fiscally irresponsible, as well as sick pedos and/or pedo profiteers, all over the internet these days.

      I guess we take it back to that old song of my youth, “everybody wants to rule the world.” But the question should be asked, who should actually rule the world? I’m quite certain it’s NOT the psychiatrists and their DSM, drug induced, iatrogenic illness creation system. Nor is it their fiscally irresponsible, war mongering and profiteering, globalists bankster masters. Because those globalist banksters are not intelligent enough to know that the first rule in how to properly manage a bank, or a country’s monetary system in general, is don’t give out bad loans. And this lack of banking insight did result in the globalist banksters needing a 2008 bailout.

      The bottom line is we could, should, and hopefully will all some day live in a better world. We just have the wrong humans unethically fighting for control of this planet right now. When in reality, God and His people, should be in charge. And I still hope and pray for that day.

      Thanks for sharing your story, Martha. Absolutely I agree we currently have satanic systems in place in our country, which are intentionally or unintentionally working to destroy humans, which is appalling. But it is very profitable for these satanic systems. These horrendous systems need to be broken up, held accountable for being corrupt and unjust, and destroyed. And unfortunately for us all, these include the systems created by the very powerful, and once highly respected, medical, legal, judicial, religious, banking, and governmental authorities.

      Possibly because these current systems were created by men, who had less than zero respect for women, and the importance of properly raising children. Because they cared more about destroying the American family, so they could tax everyone?

      https://www.youtube.com/watch?v=O6ayb02bwp0

      Report comment

      • Thanks for your comment. Thanks to all who have taken the time to read and leave feedback. That is what makes blogging such a valuable part of the Spectrum of Communications available online.

        I appreciated Mad in America offering an opportunity to share my thoughts widely with others who share my concerns about the way those of us with psychiatric labels are treated by professions–and others, including families and sometimes even peers.

        Report comment

    • I thank Martha for her writing. I don’t think this psychiatric/mental health system in humanity is going to end in our life time. But I feel people like all of you sharing is able to pull a few of us out of this living hell. As it has for me. I was saved from bipolar and then I helped my brother save himself from schizophrenia. We did this all with info through the internet with all you Mad in America people, Dr Breggin and Jim Gottstein. For now keep spreading the truth. It is helping some. And I thank ALL of you. Love the comment that yes construction workers build homes.

      Report comment

    • Good article, another unnecessarily sad tale but so glad to end happy, for now. The current housing shortage across all anglo-saxon countries is devastating for the homeless obviously and the resulting extortionate rental rates are causing huge stress for renters, particularly those in precarious employment, and it even affects those purchasing property as the result is not just higher rents but higher prices for property everywhere. Huge profits for some, obviously and more stress = more ‘customers’ of the mental health industry which must cost enormously. Can this be a deliberate strategy?

      No country has ever housed all its people satisfactorily, at least not for very many years. And of those that do they gave up totall reliance on the market and employed construction workers as required. The results proved amongst the best health care measures as well. Slum clearances and stable housing proved a great boon to people’s physical health through disease control and considerable mental wellbeing is also apparent. We need to seize control of the housing market from those merely seeking to profit and reassemble the atititude of homes for all!

      Report comment

  1. I wish to pin point why doctors need to be stopped. That it is no good going round in circles debating with them over SSRI’s/ other ‘AD’ drugs.

    Does anybody here disagree that Joanna Moncrieff is unware of the evidence for suicide and homicide as a result of Akathisia induced by SSRI’s. She knows full well Peter Breggins work. I think she has been on his radio show a number of times. Are we to believe she has not read is book Medication Madness or the others? The evidence from those who have suffered is legion and from court cases to boot all over the WWW ! We have people compiling correlations to SSRI’s/ and other ‘AD”s from coroners courts right here:

    http://antidepaware.co.uk/

    We have SSRI stories:

    https://ssristories.org/

    AND YET THIS IS THE VIEW OF DR Moncrieff:

    https://youtu.be/k84XEurAtuA?t=2927

    “Suicide is maybe a completely a different issue, I think. My view is that suicide rates are if related to anything, relate to much more fundamental socioeconomic factors, actually, rather than antidepresant prescribing one way or another.”

    So what about the people who died during the drug trials:

    https://www.baumhedlundlaw.com/prescription-drugs/paxil-injuries/paxil-trial-exhibits/

    “Plaintiffā€™s Exhibit 347: Each picture depicts a real person who committed suicide while taking Paxil in a GSK-clinical trial. The red ā€œVsā€ mean their specific suicides were violent in nature. There were multiple suicides using firearms, including a murder suicide by one patient. There were also two deaths from people jumping in front of trains.

    When it comes to suicide attempts, GSK did not keep track of all the attempted suicides in their clinical trials because, according to their company witness, it would be too burdensome. ”

    This is why doctors have got to be stopped. We need a wholesale paradigm shift in thinking on ‘Experts’ and ‘doctors’ who hold positions of power over the public who foolishly trust to them their health in a neoliberal no – real – regulation ‘cowboy’ world.

    Report comment

    • I understand why you feel let down by Dr. Moncrieff. I have the unusual idea that suicide is a choice. While drugs, poverty and segregation (all givens with psychiatric involvement) cause horrible misery we still have a choice. Press on through the torture or end it. Understandably many choose the latter.

      If it weren’t for her writings I never would have discovered tardive psychosis. Haldol and stelazine really were making me crazy! Up yours, you quacks who said it couldn’t be possible! You never took your own poison. I guess I know how it made me feel better than any of you did..mind reading psychics that you are!

      Report comment

  2. I know what you are saying StreetPhoto, but I hope you forgive my naivety in my support for the Critical Psychiatrists. Looking at that debate with Pariante, he basically gave in on most issues and where he wanted to hold his ground he offered up such a feeble case that it fools nobody. He even thought that a bell shaped response curve means that there is a cure in their somewhere – thats a primary school error. I am new to all this, and believe me I wish I had never heard of psychiatry, but I see a shift in the face of a barrage of evidence that has already severely damaged the reputations of Pariante & Co. And it won’t stop until key people step aside.

    What Dr M was saying is that in the overall suicide figures she does not think there is a significant component that is down to AD’s – OK, controversial, but honest. Its not quite the same as saying that AD’s don’t cause suicide, just that the numbers of AD suicides don’t in her view affect the overall rate, which has not been skyrocketing like AD prescriptions have. I think thats debateable, I actually do think AD’s are significantly increasing the rate, but I can’t yet find solid proof of that. I can find proof that they cause many suicides, so I would hope she would modify her position given the chance to explain it further.

    There is good analysis from medical statisticians like Carol Coupland who have analysed the increased level of suicides, and provide help to those of us who are having the most risky drugs pushed in our direction on an ongoing basis.

    So for me, to arm service users against the dangerous BS of the bio-psychos, we need hard data from the medical profession to stop their nonsense, so I wouldn’t want that analysis to stop.

    Before you blast me, think about how, in the real world, service users stand their ground against reckless prescribing.

    Report comment

    • @ConcernedCarer
      “I see a shift in the face of a barrage of evidence that has already severely damaged the reputations of Pariante & Co. And it wonā€™t stop until key people step aside.”

      I see no such shift. And in what way is Prof Pariante’s reputation damaged? He is riding higher than ever, with the full backing of the Royal College of Psychiatrists and the Science Media Centre who will continue to push him forward as a spokesperson for the “profession”. Most disturbing of all, he is now gaining a foothold on the “critical Psychiatry” scene – that friendly youtube double-act with Joanna Moncrieff did him no harm at all.

      And just to remind you, here is a flavour of classic Pariante, in full flow, giving “evidence” to the UK parliament for a Suicide Prevention Inquiry:

      “Clear evidence from studies and meta-analyses over the last 20 years confirm that antidepressants decrease the numbers of suicides… of people dying of suicide. It does it within clinical study settings, the ecological studies show that usually an increase in the prescriptions of antidepressants is mirrored by a reduction in the number of suicides.

      More worryingly, as has been shown in the past few years, a decrease in the prescription of antidepressants, especially in children and adolescents, is actually mirrored by and increase in the suicide rate. So, both the direct head to head clinical evidence, and the historical epidemiological evidence points to the fact that antidepressants are beneficial in reducing suicides. There’s no doubt about it.”

      https://www.youtube.com/watch?v=Tpp4uPDjqDg&t=240s

      Where is all this “evidence”? Such a strong statement to Parliament, he better have it at his fingertips, right? Try asking him. Here’s his e-mail address… [email protected]

      Report comment

        • @ConcerenedCarer
          On a good day, I believe that too… but Hell will freeze over before any of them step aside or are called to account. My only hope is that if we keep chipping away at the foundations, the whole rotten facade will eventually come crashing down on all their silly heads. That I’d like to see!

          Report comment

          • The sun is shining, and I think we’re gonna win Auntie šŸ˜‰
            (1) They will have a hard job BS-ing increasingly educated service-users. I’m just an average punter, and for me the game is up. We know the evidence, we know their BS tactics, the imbalance/broken brain/chemical experimentation shenanigans, we know that they are out to suppress not recover.
            (2) The much derided NICE guidelines will increasingly have to point out the lack of efficacy and dangerous side effects. Have a read, for adolescents they already present restrictive criteria – capable of blanching a psychiatrist when he realises he has even failed in terms of the orthodoxy. And when they next review the Maudsley guidelines, Prof David Taylor will be forced to thumb through to page 150 of the Cipriani appendix – thats where his Final Answer really lies. See if he has the lunatic courage to recommend Cipriani’s lethal table topper – he won’t of course, but he may well try and promote the other gruesome top 3, which would demonstrate culpable irresponsibilty.
            (3) Once the drugs are discredited, the psychiatrist is sadly redundant – I’ve seen it – they just don’t know what to say. I say sadly because we need properly trained medics in mental health, and at present these doctors are a waste. Then maybe you get your collapse, if that’s what you want, but I’m not so sure.

            Report comment

    • All Prof Pariante could say in defence of SSRI’s was that they caused neurogenesis (brain growth by upregulating Brain Devrived Neurotrophic factor). Well guess what, there are many other things which up-regulate BDNF such as: exercise, learning a new skill, fasting, even exposure to longer sunlight hours during the summer months upregulates BDNF. And Where is the precise science that shows up-regulating BDNF lifts depression ? It’s all BS that – if you lack the knowledge – a so called expert can hoodwink you over and that is what happens to people who are desperate with conditions known as anxiety or depression. It is a despicable thing to do.

      Report comment

      • Yes, behind Prof Pariante’s “bell curve” and “small but consistent response” nonsense lies a pseudo-belief that they give rise to neurogenesis, and increasing the churn of brain cell regrowth means less depression. I think a baseball bat to the head is similarly therapeutic! (oh wait, isn’t that ECT?)

        I say pseudo-belief because he’s floundering about trying to convince himself, and next year it will be something else (anti-inflammation? body temperature?).

        Above and beyond trying to inform myself and to resist the recklessness of uninformed quacks, what gets my goat is that they show such ignorance and disrespect for science, distorting and contorting arguments in spite of the lack of evidence, or evidence to the contrary.

        Report comment

  3. Thank God youā€™re free and safe today. What I liked most about this piece was how it underscored the true goal of pro-force psychiatry: creating lifelong ā€œpatientsā€. Most people arenā€™t aware that a caging is a caging is a caging. When youā€™re released from a snake pit, youā€™re debilitated, displaced, and stigmatized, just like a felon who has been released from prison. Pro-force psychiatry would prefer to NEVER free a single detainee, but it canā€™t do that. So, it elects, instead, to torture and disenfranchise you, as a short-term investment in your long-term ā€œcomplianceā€ and misery. People, if you can, RUN from the goon squad.

    Report comment

  4. Wow, This piece is very telling about the failure of the System overall. My experience with these state-run agencies and nonprofits is similar. They do nothing at all, back up the state and the psych institutions, do not serve the people, and help no one. Some start off great and die young or sell out.

    There were some good ones that then started kissing butt to the hospitals, then you saw them fall flat.

    I got a position with Crisis Text Line but quickly quit as soon as I saw what it REALLY was. They data-mine user information and pool it. Very sad. That is its real purpose. Don’t be fooled. Not only that, they boast that a bot can be a text responder just as well as a human can. Why not bot therapists, too?

    Report comment

    • Hi Julie,

      We’re sorry you didn’t feel comfortable volunteering with us. Our ultimate goal as an organization is to intervene in crises and provide empathetic support.

      It’s true that we store the conversations we have in the form of data, and use that data internally to improve our service. What a waste it would be to exchange 73 million messages and not make an effort to understand them! The full story on how we use data is in our terms of service: crisistextline.org/privacy.

      We strongly believe that this work is human-first: a bot absolutely could NOT do what our Crisis Counselors do. Could you clarify where we said otherwise, so we can make a correction?

      Report comment

LEAVE A REPLY