Wednesday, February 21, 2018

Corcoran undermines treatment & staff morale

At DSH, “the administration” often makes treatment decisions that should seemingly be made by unit treatment staff. “The administration” means James Patrick Corcoran, no doubt supported by Richard Malis and maybe one or two others. Corcoran and Malis are MD psychiatrists, so they’re getting away with this for the time being. But each patient’s own clinical unit treatment team includes an MD psychiatrist, and it’s obvious that the clinicians who actually see somebody every day know much more about him/her than other staff or administrators who don’t.

Corcoran and Malis have an agenda that goes beyond helping a patient, and that often conflicts. They need to enforce and protect an orthodoxy which includes the dictum that every patient at DSH must comply with recommended psychiatric drugs. Anyone who’s not drugged just can’t leave.

There is a wealth of research showing that this orthodox medical-psychiatric view is not generally conducive to long-term recovery from severe mental illness. It doesn’t matter to Corcoran and Malis, they don’t read and will not believe the science. They don’t have any illusions about helping patients, but consider first of all that it’s their job to control patients. The drugs disable people who once did bad things, and this is considered good control, because sufficiently disabled people might be unable to do bad things.

So what happens is, “the administration” has a list of patients who threaten their (obviously very unstable) control, by not taking meds or not effectively professing full faith in the psychiatric interpretation of “mental illness”. Corcoran and Malis look for any way to intimidate and invalidate those particular patients, and they try to hold them back, punish them, and stop the courts from allowing them to have expanded privileges or release, etc.

Of course, this makes no sense under the law, and in all likelyhood Corcoran and Malis can’t even recognize that they’re doing it. They probably think I’m paranoid/delusional, and my clients are paranoid/delusional, and “the administration” is just expressing expert clinical opinion about patients’ “mental illness” (meaning brain diseases that only psychiatrists can identify, which haven’t been discovered yet despite over 100 years of attempts and virtually unlimited research funds) and appropriate “treatment” (meaning neuroleptic drugs, drugs, drugs, and occasional electric shocks).

I have one client who is apparently being held because his psychiatrist (none other than Dr. Malis) thinks he has a “delusion” that he’s the king of Egypt. But this patient never asserts any such delusion, and he actually does his best not to mention the subject at all, although Malis relentlessly tries to taunt him about it. My client has had some minor rule violations over the last few years, but he’s been almost a model patient for a very long time. No fights, no threats, no arguments really. He gets along well with everyone at DSH, causes no trouble.

Several years ago, this patient’s judge signed an order requiring the facility to formulate a plan enabling the patient himself to participate in his own treatment, a plan that does not necessarily require psychotropic medication. Before the court specifically ordered this, DSH had never been willing or able to do what the law clearly intends. I mentioned this order today during a staffing, and showed it to Dr. Malis (who was not the treating psychiatrist until much more recently).

Malis’ immediate, knee-jerk reaction was to pretend the order doesn’t really say what it actually does say. To Malis, it was simply inconceivable that the law could interfere with his holy psychiatric judgment. He also suggested that there may be a drug that can cure the specific delusion of believing one is king of Egypt. So who is really delusional? It sure seems like Malis to me!

On another clinical unit at DSH, a couple high-functioning patients, one of whom is my client, are in some kind of weird competition or opposition to each other, vying for approval from staff and loyalty of other patients. The treatment team seems to believe my client is the one ready for release, and the other guy is the trouble-maker. They want to move the other guy to a different unit.

Well, guess what? The other guy dutifully takes his psychiatric drugs, and my client doesn’t. So “the administration” (again, Malis and Corcoran) are refusing the treatment team’s request, overriding the judgment of the psychiatrist who is there every day, who knows both patients best, by far... “the administration” actually hopes  to punish my client for not taking drugs that his doctor isn’t prescribing anyway and has repeatedly stated are not needed. They hope maybe the trouble maker on the unit will provoke some reaction from my client that they can then label “symptomatic”.

Malis and Corcoran disrupt treatment plans about which they have no insight, and they insult other DSH doctors by second guessing and overriding their competent judgment. These two guys make an already terrible institution, a veritable slave plantation, even worse.

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