Ontario Hospitals Need to Give Their Head a Shake

I wonder what goes through the minds of patients who are pushed off hospital property to smoke in the cold with the public driving by.

Am I to believe I am valued as a person when certain aspects of myself are banished? It is quite like making a child stand in a corner to contemplate their unacceptable behaviour. It becomes difficult to see the love and respect for patients when they are relegated to the road and rain coping as they know how and finding pleasure and escape in a cigarette. These individuals have serious and persistent mental illness and we are worried about them smoking? Privileged individuals are instituting their values on marginalized individuals. Some will never quit so I suggest we stop shaming them.

When I was a forensic patient I really didn’t want people knowing I was such. I found it humiliating having to ride in the “big white vans” because most people in St. Thomas knew where the “big white vans” were from. They were part of the community consciousness and on more than one occasion I heard the “big white vans” used as amusing putdowns.

Privacy is a premise of dignity. When I am placed beside the road like a pathetic pylon I eventually become recognizable to repetitive travelers and commuters. This scenario makes community integration difficult and it compromises patient safety. What if a prospective employer, landlord or lover recognizes me from standing beside the road five times a day? It makes what is already difficult more so. Will I find employment or a date if I am publicly exposed as belonging in a forensic hospital? Nobody deserves a scarlet letter let alone for an unhealthy habit. Are we compromising patient confidentiality by placing these individuals beside a public thoroughfare?

At the old forensic hospital a friend and I ordered a pizza on a summer’s evening. We decided to eat it at a picnic table in front of the hospital. We were well back from the highway but a car full of fools drove by yelling obscenities at us. Not all motorists are mature or well meaning. Some motorists barely know the meaning of a STOP sign but we expect they will comprehend and be sensitive to STIGMA? Forensic patients are prone to abuse and discrimination and placing them beside a road is nothing more than facilitation. Having these individuals within distance of garbage being hurled at them is dangerous and unfair. St. Thomas is fairly accepting of Southwest Centre for Forensic Mental Health Care but it only takes one.

When I become a fixture standing at the end of the lane leading to a forensic facility I become recognizable. If and when I am allowed to wander other avenues I am still recognizable. We might as well dip these smokers in orange dye to further accommodate their prospective discrimination. These individuals are already compromised and marginalized and I find it shameful that an organization with a mandate to assist them is in fact harming them.

Unfortunately, these well meaning but overbearing boardroom bureaucrats fail to fathom the positives and pleasures of smoking.

I had a friend put a bee in my bonnet. It could be argued that it was always there but I shall defer a degree of credit to him. The issue is hospitals making smoking illegal for psychiatric patients.

My health or lack thereof is still “my” health. When we crowd individuals with serious and persistent mental illness off hospital grounds to smoke the message is, “we want to make you healthy and we refuse to enable non-healthy behaviours.” It appears to be an admirable avenue but it is still a slippery slope. If non-smoking initiatives are embraced it enables preventing patients from any behaviour including ingesting pizza and pop.

Obesity is as problematic as smoking. Will it be next or can we continue to consume chocolate? A serious and widespread side effect of some psychiatric medications is weight gain. If it is prescribed by a psychiatrist there seems to be no dilemma but if I thrive on soda pop it is unacceptable. I knew individuals who were policed for their pop consumption. The one individual I recall most was allowed to drool uncontrollably but liquid running in the other direction was monitored and measured.

If your argument is that second hand soda doesn’t affect others I would have you stand at the side of a highway or avenue and measure the cocktail of car exhaust you breathe in. When I first arrived at the forensic hospital in St. Thomas we had smoking rooms with cushioned chairs and TV’s. I quit for a period and don’t recall any smoke in the hallways. The smoke was contained in a humane way using air exchangers. The smoking rooms were closed while I was there but the asbestos and lead paint didn’t seem problematic.

Unfortunately, these well meaning but overbearing boardroom bureaucrats fail to fathom the positives and pleasures of smoking. We can all relate to the benefits of joining friends for a beer or meal and smoking is no different. Should relative health supersede happiness and free will? Even the executioner has the mercy to offer the beneficiary of bullets a cigarette as a last wish. Smoking is unhealthy and slightly disgusting but for a depressed patient it may offer four minutes of pleasure. It can be a reminder of normalcy and freedom in a situation of caregiver custody.

There are more productive pleasures but who doesn’t choke on other people’s ideas of what they should be doing with their Loonies, lungs or legs? Autonomy must be complete and absolute wherever possible and practical or else patients are essentially prisoners.

I was in Stratford Jail when the province issued a smoking ban in those institutions. I remember a notice in Admitting and Discharge:

“The jail will be smoke free as of November 22nd. We suggest you either quit smoking or stay out of jail.”

Hospitalization is not a choice or a poor decision. To deny a patient a pleasure they are likely addicted to on the street is punitive, cruel and misguided. If you choose not to smoke I admire you but don’t deny me the dignity of my own decisions. Don’t put me in the cold and rain on the side of the highway in the guise of care or because of your self-righteous beliefs and behaviours. Others are not stupid or wrong they simply have other priorities, likes and habits.

To deny an individual dependent on tobacco as a coping pleasure is nothing more than institutional primacy which places patients beneath the institution.

Her hands were huge and I often marveled at the contrast between red painted nails and a bale of hay being hurled about.

I’m not one to gossip for I know its sting. My step-mother was a sheep rancher or shepherd depending on your latitude. She was a remarkably physically hard working woman even into senior years. She had the misfortune of hands larger than most men. She wore gloves to my father’s funeral and I found nothing but comfort and strength there.

I was doing a flooring job in a stranger’s home and two people were talking about her and finding disgust in her thick fingers. I listened to her being belittled on not much more than her hands. Those hands helped deliver lambs, those hands bottle fed orphans. Those hands nourished and comforted my father, brothers and self. Her hands were huge and I often marveled at the contrast between red painted nails and a bale of hay being hurled about. It was a childhood paradigm shift. Femininity could be included with the strengths I was then aware of.

To be thick of finger is a badge of honour in my world. I was and I know many people who toil with their hands. Many layers of my flesh are a slowly built temple to tasks I have accomplished. I used to even have calluses on my knees. Today one of the few to remain is on my finger. It sits next to my pen as I think in ink and clarify among the bits and bytes that connect and confuse.

In case you’re wondering if I stood up and defended my step-mother, I did not. I knew the individuals would know my father’s name if they knew her. I left them my business card.

Johnathan Sher”lock” of the London Free Press calls himself an “investigative bulldog” all the while missing even simple hospital signage.

“Health Care: Ministry wants more done to protect nurses, patients in psych ward” was the headline on the front page of the London Free Press yesterday.

I have been a mental health consumer for over 30 years and I have never been on a “psych ward”. Apparently writing at a grade six level isn’t enough for the London Free Press and they have reverted to making up their own words. Unfortunately, these words carry meaning for many.

I would like to ask Johnathan Sher”lock” or his exaggerating editor which hospital they have observed signage directing the public to the “psych ward”? If a hospital has enough sense to be sensitive and current the same should fall to any reporter. I would not fault a reader for such references but an award winning health reporter should be ashamed and admonished. Sher”lock’s” misconceptions and sensationalism unfortunately have an effect on the general public. There must be a scarcity of space in the London Free Press and words like psychiatric need to be pruned. We all know it is on purpose. Sher”lock” and his editors have made a cheap attempt at an attention grabbing headline and the casualty is everyone who has, will have or is on a mental health journey. The social impact and perpetuation of stigma are incalculable.

Do we refer to the ICU as the Intensive Care Ward? Is there such a thing as a Neonatal Ward? Governments, organizations and individuals spend an inordinate amount of time and money to combat stigma and we have Sher”lock” and the London Free Press printing phrases that all but dismantle those efforts. There’s an award for that right Sher”lock”?

Sher”lock” calls himself an “investigative bulldog” all the while missing even simple hospital signage. I have a dog and all I know is it is full of feces twice a day. Thankfully the London Free Press does not have an evening edition. Often people’s misconceptions are solidified by headlines. A headline is a means to grab attention but it should be factual and current. Sher”lock” the “investigative bulldog” has stopped at the hydrant of hype and drenched the psychiatric community in stigma.

Johnathan Sher”lock” of the London Free Press reports that “Ontario’s Labour Ministry has ordered London’s biggest hospital to do more to combat violence and overcrowding…”

When I was being admitted to a jail I was placed in solitary confinement because the jail was at capacity. One of the female guards said “a full jail is a happy jail.” This is, was and always will be an oxymoron. I have been in lock-down situations and stacked three men to a cell and if my experience counts for anything the Labour Ministry, London Health Sciences Centre, Johnathan Sher”lock” and the London Free Press only need to understand one thing. If you address overcrowding you have little need to address violence. They are near being mutually exclusive.

Unfortunately, I can speak to the issue of overcrowding, segregation and the suspension of privileges and personal privacy and freedoms. Each and all have an effect on any individual but they are amplified by symptoms and serious mental illness. If individuals with physical symptoms were exposed to a similar environment we would see similar behaviors. The violence occurring at London Health Sciences Centre is environmental more than mental. Psychiatric units under normal conditions are not a breeding ground for beatings.

If Johnathan Sher”lock” was truly an “investigative bulldog” he would have sniffed out reality. Possibly Sher”lock” could have sniffed out statistics surrounding violence in Alzheimer’s patients and individuals experiencing dementia. The psychiatric community holds no ownership on violence. Head trauma can also result in personality changes and problematic behaviour but we paint psychiatric patients with a brush we would not use on other individuals in society who are also vulnerable and compromised for fear that they might be tarnished.

Sher”lock” reports that the “Ontario Nurses’ Association this week accused the hospital and the Labour Ministry of sitting idle while attacks on nurses last year surged 20-fold..”

Firstly, I am saddened by this as my mother was a psychiatric nurse and during my journey I have met dozens of nurses who deserve safe working conditions for themselves and to accommodate the great work they do. My issue again falls to language. Sher”lock” has a legal background and the word attack does not appear in quotations so I can only assume legal relevancy flew out the door when they brought in sensationalism. People are not charged with “attack”, they are charged with assault. Call a spade a spade. Surely not all of these incidents were “attacks.” Any logical person would assume some of these incidents are a harmful or offensive contact with a person. I understand there have been severe incidents but to call them all attacks is stigmatizing and sensational. To use this language to invite change is one thing but to use it to sell a newspaper is prostituting language. Only an overzealous crown attorney or a defunct defence lawyer would refer to an assault as an attack. In a court of law inflammatory inferences are often objected to and sustained. A lawyer writing for a newspaper should also be reminded of their contempt.

London Elect: You’ll all look swell when you’re sworn in. Thankfully only the mayor will have to pull something over his swollen head.

I’m a little perturbed by our local politicians. Elected, incumbent and future. As I have stated earlier, I enjoy being alone and I am slightly agoraphobic. I like it out there but I am more at ease between my own walls. That being said or in fact re-said, I don’t often poke my head far from the perimeter of my property. For others it may seem odd but to someone who has spent a few days in cells of confinement, it is endless acres to stride and stretch about 200 feet by 75. I can run a marathon with such dimensions.

This is my present and most thought out excuse for not getting out to meet the candidates. It makes me wonder how many citizens with disabilities that make “getting out to meet the candidate” more difficult than my anxieties, were accommodated in some way?

I hope it happened. It must have. It did! My mistake. It must have been in the small print on the thousands of signs I saw posted about the city. My windows were rolled up when they were shouting and waving from street corners to tell me the number to call if you have political and or municipal concerns you want to share with a candidate but are somehow disadvantaged.

I’m sure the city has accessibility plans for people with disabilities but how many candidates had that as part of their mandate and operating platform?

It does seem a stretch to accommodate someone politically who has a disability. Sure, you’ll pick me up and almost cast my vote for me but what about what I think? What about my ideas? Disabled may be a political disadvantage but it is rarely an intellectual challenge that would preclude being listened to. I know a man who uses a computer to speak and his wit is unquestionable. Did anyone take the time to listen to him? He is a citizen of this city. We can make voting accessible for him but democracy is lopsided when a citizen does not have the opportunity to speak. Asking questions and making your ideas and feelings known is what gives flesh to bone. Maybe my vote won’t count. Maybe my candidate won’t win but if I should be able to voice my ideas and concerns.

It would be a double stretch to accommodate let alone seek out a community advocate. I don’t have enough cash to propel a politician but the sadness is that none of the candidates had enough cents to question my questionable self.

I know many first thoughts will be: “the vanity of this fool.” I won’t argue vanity (though my baldness is a statement in itself) but this fool has been fairly front and center in the London community when it comes to mental health. It wouldn’t be impossible to overlook me but it could be argued that not a single candidate paid much attention to the citizens of London who have or do suffer from serious and persistent mental illness. I think it’s safe to say none were sought out and queried as to how to best serve them on council.

Can this city influence, progress and promote better mental health for its citizens?

I’m a fool for this page so I shall step on my tongue as to how but possibly one of these politicians elect can make up for not considering people who are marginalized and stigmatized; in their political vision.

For Immediate Release: Documentarian John Kastner To Issue Public Apology

http://www.cbc.ca/q/popupaudio.html?clipIds=2547280251
http://www.theglobeandmail.com/globe-debate/forensic-psychiatric-patients-are-ill-not-evil%E2%80%94and-we-should-stop-hiding-them/article18205568/?utm_source=Shared+Article+Sent+to+User&utm_medium=E-mail:+Newsletters+/+E-Blasts+/+etc.&utm_campaign=Shared+Web+Article+Links

I am calling on one of Canada’s most respected and accomplished documentary filmmakers to issue a public apology to those he seems to advocate for. The four-time Emmy Award winning John Kastner should have no issue with saying sorry to the forensic patients he claims to care about.

I am not calling him out as someone who has been found Not Criminally Responsible On Account of a Mental Disorder (NCR); I am calling John Kastner out as the 2014 Canadian Alliance On Mental Illness And Mental Health Champion of Mental Health.

Please read and listen to Mr. Kastner. If his own syllables do not solicit indignation to everyone involved in mental health I can only assume you don’t mind using stigma for a serviette.

Mr. Kastner has not lived up to the standards of respect and empathy for those affected by the issues. His words are not only offensive but in their context they are thoughtless and a serious error in judgment. Using his own words they are “grotesque stereotypes.”

Many seem to be shouting about how great Mr. Kastner’s productions have been but we’re so busy patting each other on the back that we have failed to realize we are seeing John Kastner’s reality. Has anyone stopped to consider the cognitive bias, confirmation bias and facilitated communication that went into these films? I suspect the presence of all three when even one would undermine a documentary’s validity.

Thank the heavens for ratings and awards or the voice of John Kastner may never have been heard. The public would be bankrupt of his beneficial benevolence or is it barely bull? It brings a tear to my eye to have someone so informed and sensitive to my situation and experiences refer to me as a glassy eyed lunatic who spouts gibberish. Such a saint deserves recognition and awards from other incestuously informed liberals and cultural trendsetters. “Look what we did for the monsters and freaks.” I can hear the martini glasses clinking among the society that at least Sean Clifton is included in.

I don’t know about other individuals who are marginalized and disadvantaged in some form but I find it incredibly insulting to be considered not eloquent enough to defend myself. It isn’t exactly empowering to have someone who sees the world through an eyepiece speak for me. Further, even if I was tongue tied I don’t think I could do a worse job.

I can think of no other disability or minority whose self proclaimed spokesperson in fact has no personal experience or stake in the issue outside of wanting to be placed on a pedestal for personal promotion. Having Mr. Kastner speak for me is like having someone with two legs explaining the meaning of amputation and the problems of a prosthetic. It would be profoundly presumptuous for me to sit in a wheelchair and walk away singing the sorrows of being dependent on one for mobility. Further, to take that self-righteous responsibility on myself would denigrate that disadvantaged person and vanquish their voice which may be where they excel; where they dream and dance.

John Kastner is not a patient nor a psychiatrist, therapist or clinician. He has no relevant experience or education related to forensic mental health. It is obvious to me that while he was looking through his lens of presumptions he missed the entire reality of possibilities. When John Kastner speaks it is like asking the horse what it’s like to be a fish. John Kastner felt a raindrop and now he thinks he has gills.

John Kastner could make a dozen movies about NCR and never understand patients. He clearly doesn’t comprehend their feelings and is without any argument not even clinically trained to appreciate what is actually happening to these individuals. Awarding this author of stigma is an affront to my efforts and the abilities of all Not Criminally Responsible individuals. Thanks for the help but it is in fact harm.

I believe white people can advocate for African Americans but when they use any and all derogatory descriptors they become little more than a man on horseback with eye holes cut in a sheet. You may not be the one to lynch but you are doing little more than fueling the flames that allow the rest to fasten the fibers that tear my flesh.

I don’t need to speak to each of John Kastner’s stigmatizing statements. I could easily refute “glassy eyed“(should be in medical journals as a symptom) “monster” (meaningless and obtuse), “scary as hell” (like he’s even been to the border of it), “raving lunatics” (what constitutes raving and lunatic is an 1800’s misnomer) “spouting gibberish” (read my blog and letters from solitary confinement) but I will speak to his preoccupation with the “Jekyll and Hyde transformation.” This seemingly real transformation he shouts about from Canadian Broadcasting Corporation’s “Q” radio and the Globe and Mail should be easy for any documentarian to prove. I challenge Mr. Kastner to show me the factual footage of this apparently very real phenomenon. John Kastner spent 3.5 years in a forensic facility so it should be simply a matter of reviewing a few reels.

John Kastner doesn’t seem to poke his head from polishing his awards and promoting his victimizing views so in the meantime any of us should be able to find this transformation on Google if not in a dictionary. If it is a recurring phrase in ‘John jargon’ it is obviously a recurring event that anyone with an interest in psychiatry could uncover. It must be in every psychiatric and psychology textbook in the nation. Even pharmaceutical companies should have images of this remarkable transformation to promote their anti-psychotic pills or in John Kastner’s world, injections. I have mainly experience to fall on so I will eagerly wait to eat my words which is becoming easy when John Kastner thinks he’s the one who should be using them.

A fantabulous film should not excuse the damage John Kastner has done with his mouth. Mr. Kastner calls on forensic patients to “stop the apologizing.” And he should start.

“It is a kind of cold and uncaring environment”

A 30 year old father has died at Elgin-Middlesex Detention Centre. On the surface it seems no correctional officer or administrator can be faulted because it was a suicide and because this particular inmate did not voice an intention or thoughts about suicide. Corrections sidestep the corpse and deny responsibility because protocol was followed. What if protocol in fact hastens or facilitates the death? Following the rules in this case could be considered the smoking gun.

According to London Lawyer Kevin Egan, who represents hundreds of London inmates “It is a kind of cold and uncaring environment.” I hope Kevin Egan didn’t have to research too many legal documents to come up with the understatement of the century.

Inmates are screened at admission about their mental health and suicidality. “Do you feel suicidal?” if answered in the affirmative will bring about a second strip search and the inmate is placed in solitary confinement or for those who like to justify its use, segregation. The inmate is given a tear proof gown and blanket to go with their toilet and 24 hour light.

For any inmate who is familiar with this system of sadism there is only one answer to the question. “No.” Inmates in solitary confinement because of suicidal ideation or behavior are checked on every 10 minutes. Interestingly, it takes about 5 minutes to die. In the case of this young man because he was segregated but not on suicide watch he would have only been checked every 20 minutes in comparison to the usual 30 minutes in the general population. This deviation points to the admission that solitary confinement creates a dangerous situation that needs increased supervision.

I realize Elgin-Middlesex Detention Center is understaffed and poorly designed but is it not possible for “cold and uncaring” correctional staff to ask an inmate if they are suicidal after intake? Surely, while under the arguably tortuous conditions of solitary confinement an inmate could be spoken to and asked if they are suicidal. Would any institution grind to a hault if such a protocol was implemented? It would require conscience and a degree of compassion but it may save a life.

To be placed in solitary confinement deteriorates mental wellness and exacerbates mental illness. This is where it becomes difficult for guards, administrators and healthcare staff to sidestep culpability. This particular inmate was taking prescribed psychiatric medication and was placed in an environment where whatever mental wellness he possessed was compromised. His mental health was compromised by the correctional system which did little proactive to prevent his eventual death.

There have been 16 coroner inquests into jail suicides since 2007 and the recommendations of better screening and monitoring of inmates has been ignored. This is not only a dereliction of duty but it is outwardly reckless and a foundation for legal culpability.