You Say “Healthcare,” I Just Shake My Head and Cry

I have no “craving” to return to the issue of smoking on hospital properties and it seems a lost cause but I will. Let’s just consider it a “bad habit.”

I was on hospital property myself yesterday. When I left the architectural brilliance and heat of the building itself I noticed a gentleman in his 70’s hunched over in a wheelchair. He appeared to weigh something near his age and seemed somewhat compromised. I imagine his struggles are profound even within hospital but he was attempting to smoke in the wind and cold about 40 feet from the hospital entrance.

It has been minus “21 Forever” here in Ontario and yesterday was no exception. No exception seems to be part of the problem. This man was breaking hospital rules and even the old rule of not smoking within 60 feet of a hospital entrance. I don’t imagine he had a rebellious heart or complete disregard for rules, I think he may have been unable to make it off hospital grounds and the temperature itself may have been a further hurdle. If my ears nearly freezing are evidence of anything his wheelchair wheels may have been frozen.

There needs to be more communication between agencies in the region. When the Health Unit and police agencies issue a cold weather advisory and warn people to stay inside it may be prudent to apply this information to hospital staff and patients. It may even be important to ensure that 70 pound patients in wheelchairs have a safe and suitable place to smoke. Maybe the blankets were being laundered but this gentleman was under dressed for what I barely endured with half the exposure. This individual is unlikely to quit smoking in his 70’s or in his proximity to illness. It may be a bad habit or a long time pleasure.

We can all be proud of moving in the direction of a “Smoke Free Ontario” but my grandfather shouldn’t be run over in the process. He wasn’t my grandfather or I would have brought him home from the illusion of healthcare he was enduring. He is however someone’s grandfather, “bully for you.” I hope some idiot or at least the compassionate committees who have brought us this far find satisfaction in such an individual being tortured in the guise of health and healthcare. If you think smokers are going to hell it is no less sinful to expose them to anything similar here on earth. Perhaps we should pray on this.

I wanted to take a photo of this poor gentleman but I did not want to remove my gloves which he was without. I also respect patient confidentiality and it would have been a blurry shot as he was shaking so hard. Oh well, the rightless wretch will soon be dead and we will not be so uncomfortable in our conscienceless ideals. The grandchildren who attend his funeral will no doubt find peace that his last days were dignified and comfortable. They will hopefully find comfort that he was “exposed” to the most advanced and compassionate healthcare available.

I’m not saying hospitals are being heartless but providing a wheelchair becomes ironic and disingenuous when a 70 year old patient is allowed to suffer from exposure and near frostbite. I was in the same elements for a shorter duration and in an appropriate winter coat and I couldn’t wait until I reached my frozen car. This gentleman was under dressed and unable to access proper shelter or even stamp his feet to provide a sense of warmth.

I don’t know how we get around ridiculous rules but I would suggest those who are making them spend 6 minutes in a wheelchair, in a jacket, in minus 20 degree weather. It may provide enough exposure to uncover enough empathy to enable true compassion if not sense.

Ontario Provincial Police (OPP) Mental Health Strategy, Ect.

I don’t often advocate for the police. They have unions and each other so I don’t view them as disadvantaged or marginalized. They are not on my radar so to speak 🙂 I usually defend those who are unable to stand up for themselves or who do not have the opportunities and advantages that I do.

In my recent encounter with Ontario Provincial Police officers I have softened and expanded some of my views. Few of us have the honour or opportunity to share a meal with the police and their humanity is nourishment itself. I don’t want to disappoint those who find me a refreshing prick with a pen but I have a few points for us all to consider.

Most people do not know that since I was a child, I dreamed of being employed in law enforcement. I know of few better examples of irony. I also have several friends from my youth who are police officers. I can name at least seven who I played high school football with. I am fairly outspoken regarding tragedies that involve mental health but do not think I would not be as upset to hear of an officer falling in the line of duty.

Many of us have an uninformed sense of what the police are like. They are the brutes who give us speeding tickets. I agree that it is an annoying pastime of theirs but they are attempting to keep their families safe as well as yours. We do not blame the baker for making us fat.

Like everyone I am influenced by the media. With the media preoccupation with the sensational we are force fed and filled with any and many officer mistakes. To make an analogy it is no different than hearing that the Toronto Maple Leafs have actually won a game and concluding that they are having a great season.

I tried digging up some real numbers to provide some perspective and fairness. There are over 26 thousand police officers in Ontario. The few we hear about as having fallen short in their duties would be statistically minute and invisible on almost any graph.

I was aware that police officers are trained and informed that a person with a knife can be lethal at a range of 15 to 20 feet. I might be spatially disabled under such conditions. Officers are trained to use lethal force in these instances. I will still argue that a greater distance should be maintained where possible and appropriate but it is comprehensible that such situations do not always work out. I would imagine that any officer who had to make a lethal decision would be haunted by such and it is understandable why officers also suffer from Post Traumatic Stress Disorder.

I have argued against the use of Tasers on mentally ill individuals as they are often disabled and it is a health condition. We need to guard against Tasers being used too often but in speaking with an officer I see their value. An individual with a knife who charges at a distance of 20 feet will still reach the officer even when shot with a gun. This is a no win situation. The Taser if successful will stop that same individual in their tracks. I would rather have to deal with psychological and temporary agony than find myself and or someone trying to help me in a coffin. I have a family as do they. The consequences of the lethal use of a firearm are far reaching.

We can point out that 92% of officer fatalities are committed with a firearm or that police homicides occur 23% of the time involving robberies and 3% occur apprehending psychiatric patients but I’m not sure those numbers would make me feel better if I was faced with a knife and I am unlikely to call on statistics or probabilities when I see that knife waved in my proximity. Any weapon is problematic.

I could only find numbers from Vancouver but they may still be relevant. One third of all police calls involve people with mental health issues. Let’s assume that the Ontario Provincial Police are dealing with similar numbers. I think the police have been put in a place and are being called on to remedy issues that are not theirs to own. Mental health is increasingly involving agencies that were never meant to be mental health service providers; police and corrections.

We can scream and shout at them both but the solution doesn’t entirely lay with altering what they do. We need a number other than 911 to call and we need to prevent and protect individuals from entering the justice system as a result of their addictions and mental health issues. Thirty percent of individuals come into contact with the police in their first experience trying to access mental health care. We don’t change the diaper when an infant needs to be burped.

There are agencies better suited to serve the mental health needs of Ontarians. These organizations and agencies need to be better coordinated, better funded and more accessible. To keep things as they are is monumentally more expensive fiscally and socially. We will have less need to call 911 if mental health care can be obtained prior to crisis. The police will always have a place and we need to be grateful for that. It is an unenviable position and a difficult duty. It is unfair to the police and Ontarians to make police an automatic selection for mental health issues.

I am showing my support to the Ontario Provincial Police not because I now know several more outstanding officers but because I deeply desire better outcomes for Ontarians. I will still point out problems and they may be the target of my often sharp and ill timed sense of humour but in the case of the Ontario Provincial Police and specifically the Elgin County Detachment I see compassion, promise and an active engagement in improving the mental health outcomes of Ontarians. Is the Ontario Provincial Police Mental Health Strategy perfect? Possibly not but I am inspired and I believe community stakeholders can co-operate and implement something of an improvement.

The quarterback doesn’t throw the ball because he is incompetent or incapable of making headway; he knows the receiver stands the best chance of the most advancement. Community stakeholders are the wide receivers. We have been calling the police for help with mental health matters for decades. Community stakeholders are now being called on. I believe they can handle the pass.

We Can Find A Limp In Anyone But Especially When We Use Our Own Gait As A Measure

I was checking out Twitter and clicked on a link to:

“6 Things That I Have Noticed About People Who Change and Recover From Mental Illness.”

I was excited by the prospect of change and recovery. After I battled with the Pop-Up screens where Barry Pearman was flogging his free book, the wind was knocked out of me. Barry’s first life changing “great stride” was:

1) They make their bed every morning.

Just before I was about to flush my anti-psychotics, mood stabilizers and anti-depressants down the toilet I thought about it for a minute. I started to wonder how many individuals Barry Pearman has seen change and recover. My next question was what the hell is Barry doing in all these bedrooms? Is he a sleuth or a slut?

According to Barry I shouldn’t “drift into the day” but like the Navy Seals who are renowned therapists in his world, I should start my day with “a drilled in positive habit.” I have had suicidal months and been immobilized by depression. It was not a matter of preferring to stay in bed; I in fact could barely get out. Had I owned a bedpan I would have used it. I have also been psychotic and my bed was as likely to have been a magic carpet as anything I would tidy and tuck.

Dear Barry,

If you are going to speak about mental illness please consider the vast array of degrees and diagnoses. What you consider positive may be worlds away from what I value or consider positive. I don’t make my bed for the same reason I do not do the zippers up on my pants when I fold and put them in the drawer. It is to me slightly illogical, a waste of my time and a pointless make work project. When I do not pull my sheets up and tuck them in each morning it enables me to refrain from pulling them back out each evening. You say illness I say efficiency.

I’m sure you’re sure I am destined to a state of illness but I personally look back at my life and see that I have “changed” my mental illness and I have enjoyed prolonged periods of recovery. Obviously this has nothing to do with making my bed.

I am as illiterate as you but in my estimation recovery is not always a destination. Further, it is my belief that recovery is a highly personalized process that can be different for each of us. I can look at another person with mental illness and “should” on them but their habits and efficacies can still qualify them as recovering or recovered. Some individuals with or without mental illness are comfortable to leave mustard on their shirts. We can find a limp in anyone but especially when we use our own gait as a measure. If any measure is to be used it must originate mainly in the individual. If an individual with or without mental illness is able to find meaning and arrive at whatever points of personal satisfaction they set out for themselves they are in no small way thriving. Is it “change” or recovery? I cannot answer that and neither “should” you.

Kind regards,
Brett

Since my neck was not in a noose (though he had no way of knowing) he didn’t know who to call or what to do.

Some names have been changed or omitted to protect the idiotic.

As some of my readers will be aware I was not in a good place mentally last week. One of the individuals who reached out to me asked around for some assistance for me. I ended up with a number to a local agency who provides a Crisis Response Line. I am feeling somewhat better and it is counterintuitive for me to reach out as assistance has not always been so.

I called the Crisis Line and ended up speaking to Barney. I explained my recent difficulties and was inquiring about what services I could access. I wasn’t crying which seemed to confuse Barney. I asked if he was a counselor and he explained he had some training but was not a counselor. He searched for some numbers and suggested next time I should call the Distress Line. “Oh, so who would I end up speaking with if I called the Distress Line?” ”ME” was his answer. What the hell? I wanted to reach out and shake his head for him. Firstly, when I am unwell I might not have the insight into whether I am in crisis or distress. They are literally and figuratively the same damn area code. Further, what is logical or logistical to his mandate and procedures are irrelevant to someone in crisis or distress. I would never tell Barney what to do but I would recommend suggesting the value in reaching out rather than suggesting what he values.

I told Barney some of my story and he could have easily engaged me. He was given several paragraphs to build a conversation. I was silent a few times which were long and awkward and I could sense Barney’s discomfort. The only input he made into the conversation was to inform me “we are here to listen not make you feel better.” What the hell? They might as well use an answering machine if all they do is listen. Wouldn’t a few well placed questions uncover the extent of my crisis or distress?

This gentleman knew and found out nothing about me including my name. What supports do you presently have? Do you have a family physician? Are you able to access services? Do you live alone? Are you in a safe environment? Have you ever been suicidal? Are you able to care for yourself? Are you on any medications? Are you having any disturbances of thought? Are you experiencing hallucinations?

If we are going to train these individuals to refrain from attempting to alleviate difficulties or offer advice we should definitely train them not to make assumptions about the degree of crisis or distress an individual may or may not be experiencing. The consequences could be tragic. I was safe and possibly he interpreted me as healthy. I can baffle you with brilliance in full blown psychosis. People don’t call these numbers to order ice cream. I realize he was not a professional which is a problem in itself. There are often not answers or solutions but being an ear doesn’t do much good when I need a comforting voice.

Barney was uncomfortable that I was waiting for him to speak as I believe that was his training. I can tell when someone is directing me to end a conversation and I believe that since my neck was not in a noose (though he had no way of knowing) he didn’t know who to call or what to do. What is your phone number? I will pass on your contact information to a colleague who is aware of community supports.

Barney was mainly giving me information about support groups which I have an aversion to. My mental health is private and some of the things I struggle with are best not spit out in a circle of chairs. Some of these groups are simply the blind leading the blind. I don’t need Darlene’s insight; she’s a damn basket case though I’m sure she knows what is good for me.

I almost feel like jumping off a bridge but I’m going to hunt down Barney first to time the fall. I am not personally upset but I am seriously alarmed for my community. If I call 911 for a physical crisis they do not say “were here to listen until the ambulance arrives.” After determining the severity of the situation they offer immediate and useful first aid information where appropriate. Further, highly trained individuals follow up on the call.

I understand budget constraints. I believe in the value of peer support and volunteers make the world go round but Barney might not be the best person for someone in crisis or distress. My first impression of him is that he probably has difficulty in a drive-through. We would be alarmed if any or even initial acute contact regarding physical health was taking place under the direction of volunteers with a crash course in health care. What’s good for the goose is good for the gander.

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.

Catherine Zeta Jones

An anti-stigma campaign I follow on Twitter sent me a message that “Actress Catherine Zeta Jones has been living with bipolar for several years and rejects any stigma attached to it.” Easy for her to say. It was further Tweeted that Catherine Zeta Jones says there is “no shame in seeking help.” For someone with fame and finances this might even be true.

For Catherine Zeta Jones, mental health stigma and treatment are vastly different from the experiences of many who also suffer from mental illness. For her being open about her diagnosis and experiences is at least unintentional personal publicity. As they say: There is no such thing as bad press. In the case of celebrities a personal persona and public appetite is created and nourished by being a news story. It would appear that Catherine Zeta Jones has thrown herself in front of an oncoming car for the benefit of many but I would argue that the car has already driven by. The lack of blood and guts, spell evidence.

Catherine Zeta Jones is portrayed as some patron saint of bipolar but what has she really risked? Stigma is at a point that it is rarely rolled out for the famous. I am not inferring that there is no such thing as stigma but little if any cuts through fame and favour. Call me cynical but these revelations don’t seem to affect these individuals beyond increasing their brand, public persona and popularity.

If I’m depressed in bed or manic at the mall, am I apt to seek help or find relief in Catherine’s revelations? The rubberneckers look but the rest of us are too busy trying to survive. These celebrities don’t give interviews in their underwear next to dust bunnies; they follow a loose script in their personal libraries in Bermuda. Speaking of which, what meds do I take to find myself in Bermuda with a maid?

I think “Catherine The Great” has been a source of conversation around mental illness but I would argue that her battle with stigma is similar to Don Quixote who mistakes windmills for giants and charges at full speed. My suspicion is that stigma is a word, for Catherine Zeta Jones. For many stigma is no windmill but a true giant. It affects self image, personal and family relationships, employment and status.

When I think about bipolar I don’t envision a person like Catherine Zeta Jones who uses overpriced shoes for bookends because they’re too cute for closets. In my world people with bipolar have their shoes taken away so they can’t asphyxiate themselves with the laces.

I imagine Catherine’s experience with mental illness has been challenging and difficult but in the scheme of things we are talking about First World problems in comparison to Third World problems. Did she have to wait six months to see a psychiatrist? Were the chairs in the waiting room plastic or leather? Did she have to wonder if she could afford her medication? Was she worried about missing work? Did she have to resort to disability assistance to feed herself?

I’m waiting for one of these famous sacrificial lambs to tell us about their hemorrhoids. That experience is the same for us all and if I knew Catherine Zeta Jones used “Preparation H” I could actually hold my head higher at the pharmacy. There’s little fame in swelling so I shall suffer in silence.

“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.