Friday, April 29, 2022

Michelle Evans: How can mental health be taken seriously?

Recently Lucy Johnstone, a well-known British psychologist, tweeted about an article in The Guardian. The article leads with a tale of a mother devastated by her son being locked in a cell for stabbing a woman. This situation is apparently unjust because the son had just been to a hospital asking for help with schizophrenia. Shockingly, he had not been helped!

Hmmm. It seems to me that we do lock people who stab people in cells. “Schizophrenia” is only an issue for those who imagine they should be excused for committing violent crimes or other offenses against their neighbors, because they claim to be afflicted by a mythical brain disease that was never proven to exist and is now a discredited, pseudo-medical concept, like “hysteria” or “drapetomania”.

Instead of punishing people who stab people with honest prison sentences, we sometimes prefer to enslave them on plantations that we pretend are “hospitals” specializing in such mythical diseases as “schizophrenia”. That article in The Guardian merely laments in a characteristically British way that we don’t do this more often, because we don’t have enough plantations masquerading as “hospitals”. They figure it’s all politics and money, which is true in that money from the public fisc is controlled, quite properly, through political processes.

If the man who stabbed someone and ended up (so unjustly in his mother’s view) locked in a cell for that violent act had done his ugly (schizophrenic) deed in Chicago, he would have very shortly been consigned to Elgin Mental Health Center (EMHC), the premier plantation pretending to be a “hospital” in Illinois. EMHC is currently overseen by its slavemaster, Michelle Evans. Dr. Evans is a social worker, who has a slightly regal bearing (I would hate to say condescending). She is white, of course (i.e., not African-American, Hispanic or Asian like the majority of clinicians on the plantation), as any real slavemaster traditionally should be.

I will shortly be touring Dr. Evans’ plantation, with herself as my guide! I am very excited for this opportunity. The occasion is a well-financed, formal legal investigation into certain extremely discreditable events that occurred some years ago, which the Illinois plantation bureaucracy has been trying to hide from public view ever since. 

It turns out that there is a great deal of sexual exploitation of psychiatric slaves, and lascivious misbehavior by staff. It’s very hard to cover up stuff like this, so of course it will all probably end up in a big trial covered by the newspapers and TV, somehow. Tom Green will have some busy time, like back in the good old Rodney Yoder days!

Michelle Evans almost certainly is not looking forward to this errand of being my tour guide. It’s a losing, even dangerous, situation for her to be in. I’m not sure she’s actually a doctor, by the way. Lawyers I know call her “Dr. Evans”, but I’ve never seen M.D. or Ph.D. after her name. (People have called me “Doctor” plenty of times, too, so I guess that’s an easy mistake to make when you hang out in the mental health field.) Anyway, I’ll do my best to be empathetic and put her at ease.

Ms./Dr. Evans and I worked together on a case or two, back in pre-pandemic days. She always seemed like a true believer in psychiatry and in the holy mission of the plantation. She also made a few errors in professional judgment, and she seemed willing to lie under oath (a truly terrible idea), but that’s all just typical. Michelle will probably use the link I’ve provided in this blog to read the British article that Lucy Johnstone tweeted about, and she’ll be sympathetic with the mother whose son ended up locked in a cell for stabbing somebody. 

Just think, if that kid had only been American, he’d be a proper psychiatric slave by now, earning federal money for the plantation and contributing his labor and even his body for the advantage of its psychiatric masters!

That’s much better for everyone, right Michelle?

Saturday, April 2, 2022

"The Enforcer" and "Dr. Emperor" -- Sean Gunderson nails it!

From Mad in America

(Published 04/02/22)


Inside a Forensic Psychiatry Unit: Calling in AIR Strikes 

 Editor’s Note: This is the fifth in a series written by Sean Gunderson, who was detained by the criminal justice system for 17 years after receiving a “not guilty by reason of insanity” verdict. The series documents the life of a forensic psychiatry patient—a world that few know, and which has rarely been written about by a former inmate. New pieces will be published the first weekend of each month. The full series is being archived here.

IIn this scenario we will learn about a new “weapon” in hegemonic conflict; that is, conflict that seeks to control others through consent, not violent force. As an inmate, our objective is to survive the detention center (DC) and we will need to employ a variety of tactics to convince the authorities to consent to our release.

We have already learned about our standard issue weapon, awareness, as well as the Mother of All Tactics of Hegemony (MATH). While our standard issue weapon is ready to be used at any moment, it is not all that powerful by itself, certainly not to convince particular staff who promote the medical model ideology that we are appropriate for release. However, the MATH is such a complex and powerful tactic that it is not always practical to use it in situations where the standard issue weapon alone is insufficient.

Here, we need to find a tactic that is somewhat more powerful than our awareness alone, yet far easier to wield than the MATH. In this scenario we will discover the importance of Advocate Intervention Response (AIR) Strikes. These AIR Strikes are precise operations, so we will need to learn how to effectively call them in.

While I was detained in the Elgin Mental Health Center (EMHC), I became the go-to inmate to call in AIR Strikes when needed, and I did so with significant efficacy.

Briefing

In the Illinois mental health system, there are two advocacy agencies for people with “disabilities” which includes those with so-called mental illness. One agency, the IL Guardianship and Advocacy Commission (IGAC), is a state agency that is tasked with, among other things, investigating claims of rights abuses within forensic psychiatric DCs. The other agency, Equip for Equality (EFE), is a private agency that is part of the federally-mandated and funded Protection and Advocacy (P&A) system that has generally the same task as IGAC.

It is worth pointing out that both the state and federal governments recognized that abuse of people with so-called mental illness was so common that specific agencies needed to be designated by law to protect them. It is these agencies to which we will be calling in our AIR Strikes.

The challenge with an inmate attempting to call in an AIR Strike is that IGAC and EFE are not just understaffed to meet the demands placed on them, but also that they have to play a complex game of politics that resembles a chess game with the DC Administration (ADMIN). That is, in order to help an inmate on one issue they may have to give in to ADMIN on several other issues brought by other inmates.

It turned out to be a relatively effective negotiating tactic, even if it disappointed numerous inmates in the process. However, many inmates could not handle this disappointment as many of them brought legitimate issues in their darkest hour of need. They felt abandoned and resentful of IGAC and EFE and I would hear numerous inmates openly refusing to work with these agencies.

The mental fortitude required to not react emotionally in the face of a refusal to help or a shoddy investigation that resulted in a favorable ruling toward ADMIN was so great that even the strongest of inmates would routinely give up on IGAC and EFE. I was not one of those inmates as I saw a great potential if one could learn to tolerate the disappointment.

Scenario

One of the few things in the DC that I could honestly say helped me was the activity therapy. I loved going to the gym and weight room. It allowed me to forget about the nightmarish circumstances in which I lived for an hour or two in the day. When I was playing basketball or soccer or in the weight room, I was in my own world. It did not matter where I was, I was working out. I could have been playing a pickup game of basketball at a local gym, park, or the gymnasium of a DC. Location did not matter as we inmates were there to have fun playing sports and exercising, we just happened to be in a DC while we were doing it. It was my near-daily escape from the psychological pressures of daily life in the DC.

Activity therapy was a unique phenomenon while at EMHC. It was simultaneously acknowledged to be a legitimate form of treatment to which inmates had a right, yet it was also acknowledged to be enjoyable, so it was subject to restrictions if an inmate violated rules. Moreover, on and off-unit sedentary group therapy always took precedence in the minds of the staff over activity therapy.  If an inmate broke a petty rule, like sharing a protein bar with another hungry inmate, then they would be subject to various restrictions, including being unable to attend the gym or other activity therapy department events. Such restrictions generally did not apply to therapy groups.

I do not care much what the official reason was. On the ground, in the minds of the inmates and staff stuck in a class struggle, the reason was that inmates enjoyed the gym and not sedentary groups (in general) and so, as a means to control the inmates through consent, special restrictions could be placed on activity therapy that could not be placed on group therapy. Put simply, staff recognized that inmates liked the gym and not group therapy, so for that fact alone activity therapy was restricted as a form of punishment.

I made it a point to frequent the gym as much as possible. Other inmates generally had difficulties with their respective treatment teams when they wanted to attend the gym. Generally, for inmates, if gym time conflicted with a group session, then the inmate would be coerced to attend the group, even if they wanted to attend the gym. I was generally able to avoid such coercion as I built a strong micro-narrative over time that the gym was my preferred form of “treatment” and that I would be rather difficult to deal with if I was not allowed to go to the gym. Most staff recognized that it was more trouble than it was worth to try to coerce me to go to a mental health group instead of the gym.

Furthermore, by this point in my detention, most staff recognized that I was not going to earn my release the “traditional” way through unquestioning obedience to the treatment team and ADMIN. Rather, it was well accepted that I was either going to die in there or find a non-traditional path to my freedom.

I knew that the gym helped me to deal with the adverse effects of being detained; it also helped me to work through my so-called mental illness. You see, in the gym I was allowed to express myself more fully and forget about what was going in within and around me. This small, yet consistent reprieve from daily life in the DC gave me inner space to work toward being a better person. However, as a result of my regular gym attendance, I needed a lot of clothing.

I prided myself on being a clean person while in the DC. Not only was it an expression of who I truly was, it also helped build a micro-narrative that I had good hygiene. Indeed, poor hygiene could be interpreted as a sign of so-called mental illness, so I was incentivized to stay clean to protect myself. I would shower every morning soon after I woke up. I would also shower after the gym. I always made sure to put on clean clothes after my showers.

As I was working out in the gym, yard, or my cell 1-3 times daily, I was going through a lot of clothes on a weekly basis. At EMHC, there was a laundry room on each unit and inmates were expected to do their own laundry. For years, this was not an issue. I took responsibility to keep my clothes clean and all my clothes were able to fit within the storage space provided.

However, as I neared the end of my detention, EMHC ADMIN decided to come up with a new restrictive policy. As inmates at EMHC, our lives were characterized by policies that allowed us to have a decent amount of personal property which was slowly being whittled down by ADMIN over time. When I left EMHC in 2019 we were allowed far less personal property than when I first arrived in 2005.

As ADMIN came up with new rules frequently, inmates would be left with a choice to acquiesce to the new rules and give up some of their personal items or resist and advocate for the upholding of their rights that initially allowed for the personal items. This was an ongoing years-long battle that I doubt will ever end, unless ADMIN is able to take nearly everything from inmates and there is simply nothing left for them to take.

As my petition for release was playing out in the court system over the course of about 18 months instead of the 4 months required under Illinois law, ADMIN decided all of a sudden that they wanted to come after inmates’ personal clothing items. At first, my unit, N unit, was unaffected. As the new policy came down through staff channels, it arrived on other units first. Some unit cultures were more conducive to new restrictive policies as the inmates were not strong advocates.

However, other units, including my own, were not so easy. Usually led by me, the inmates on N unit would complain, write petitions, contact outside agencies and even file pro se lawsuits (the MATH) to defend what little we had. I used to garner support among both inmates and staff by explaining that these restrictive policies served little purpose and that they were analogous to stealing personal items from a homeless person that one would see on the street. That is, as inmates already had so little, to take from us was cruel.

Upon hearing from other inmates that a new clothing policy was being implemented on their respective units that allowed for a mere 10 outfits, I struggled with what to do. Not only did I have an ongoing court petition for release, at this point the policy had not yet been implemented on my unit. Using my position as the unit liaison, I conferred with the unit staff in my “Staff Hinder Interference, Effectively Limiting Destruction” (SHIELD) defense. (By this point on N unit, the SHIELD defense that I began on M unit many years ago had extended to nearly all the unit staff, save for a handful.)

I received a general consensus of these staff that they did not want to implement the new policy. However, they acknowledged that there might come a point when they could not refuse to implement it.

I decided to do nothing. I had seen policies that were in full effect on other units, but never made it to N unit. I was able to go on like this for a few months. However, at one point the unit staff were directly pressured by ADMIN to implement the policy. As all the unit staff knew that I would not tolerate this policy, they decided to move in to implement it when I was off the unit at the gym on a Saturday morning.

I had gotten advance word that this was coming, and I was prepared to be civilly disobedient by telling the staff to take my clothes instead of me handing them over to them voluntarily. However, this did not come. I arrived back on the unit to stories of other inmates advising me of the implementation of this policy. I waited all day for the staff to come for my clothes and they never did.

Days later, the 3pm-11pm staff were ordered to take my clothing. First, the charge nurse advised me that they needed to take my clothes. I pleaded with her to allow me to keep my clothes, making it clear that this would result in a situation of neglect whereby I would end up living my daily life in dirty, sweaty clothes as I would not have enough clean clothes.

Neglect is a “reportable offense” to the Illinois Office of the Inspector General (OIG) and could result in serious disciplinary action if substantiated. My implication to her that this was neglect bought me about 1 week as the charge nurse could not find it in her heart to take my clothes and risk her job in the process.

Finally, ADMIN got word that I still retained my clothing. They personally came to N unit to order the treatment team (who were now on my side, advocating for my release) to confiscate my clothes save for 12 outfits as the policy had been amended prior to its implementation on N unit. That evening, the same PM shift charge nurse advised me that she had no choice. I reacted with my civil disobedience and allowed the staff into my room. I instructed them to pack my clothes and they asked me which ones I wanted to keep.

The AIR Strike

All this time I had been advising EFE on the situation. I had learned many years ago that the most effective way to get them or IGAC to help me in a time of distress was to develop an ongoing rapport with them and be seen by them as an accurate source of “on the ground” information. One of the greatest challenges for these agencies is that they are dealing with secure institutions that restrict the flow of information.

Even though state and federal laws allow staff of these agencies to show up unannounced at a DC and inspect whatever they want, they still had trouble determining what was really going on. They would often get conflicting reports from inmates and staff and sadly many of the inmates just did not have the ability to clearly and effectively relay information to them.

I had decided early on in my dealings with EFE and IGAC that I would not let any negative emotions shine through and that I would always use my attitude of gratitude sight (AGS) to identify what parts of my interactions with them were positive. This allowed me to maintain good rapport with them, and I am confident that it also gave them a morale boost as I believe that throughout the years many disappointed inmates let EFE staff hear their disappointment without a filter.

Sometimes as an inmate one was so controlled by the staff in the DC that any opportunity to let one’s emotions out without inhibition was prized. Some inmates would even brag about how they told EFE or IGAC how they really felt, as displaying such emotion to DC staff was rare and dangerous.

From about 2012 until my release in 2019 I gradually developed such a strong rapport with EFE that I convinced them to regularly attend Inmate Council Meetings (ICMs) These meetings allowed for elected inmate representatives to meet with ADMIN to discuss anything and everything about life in the DC, including new restrictive policies. They were very powerful and prestigious positions for inmates to hold, and I was consistently elected as a representative by other inmates.

As the laws governing EFE and IGAC allowed them to show up in the DC whenever they wanted, ADMIN could not stop them from attending the ICMs. I recall that EFE began attending our ICMs in or around 2014. This could be understood as the DC equivalent of the “Shock and Awe” campaign in the Iraq war. ADMIN never expected this, and it effectively made their corrupt behaviors far more difficult to realize on a regular basis.

At first, ADMIN found ways to outright avoid attending the meetings with EFE. While this was somewhat inconvenient, it also gave inmates some breathing room from new restrictive policies as ICMs were the appropriate forum to announce and discuss implementation of new policies. It took years for ADMIN to regain composure and be bold enough to attempt their corrupt actions with the presence of EFE at the ICMs.

This was the context into which I called in the much-needed AIR Strike regarding my personal clothing items. EFE trusted me to provide them with accurate and useful information and I did not let them down. I maintained contact with them as I heard of this policy being implemented on other units, although they could not open an investigation into possible human rights abuses until my clothes had been taken.

I had devised a long-term strategy to get my clothes back. I was going to continue my high level of physical activity and when I ran out of clean clothes, I would put on the dirty smelly clothes that I dug out of my hamper. I was confident that no micro-narratives would be constructed against me by unit staff; however, I could not so easily predict what ADMIN would do if they found out I was engaging in such civil disobedience. I also planned to let ADMIN know how abusive their new policy really was by writing an internal grievance each day that I had no choice but to wear dirty clothes.

At first ADMIN tried to appease EFE and me by allowing my unit to have 2 days for inmates to wash their clothes instead of 1. Normally, each unit was responsible for determining how many wash days inmates had and the times they could access the laundry room; however, in this situation ADMIN ordered my unit to allow inmates 2 separate days to wash clothes. I knew that this would not eliminate the problem but would result in slightly fewer internal grievances. This worked out well as I was able to wear dirty clothes less often, but still maintain the regular internal grievances and keep the EFE investigation open.

As time went on, I wrote more and more grievances. ADMIN stood their ground in their responses and the facility director made it a point to respond to nearly all of my grievances, which when it was all said and done amounted to around 50. Despite ADMIN attempting to appease me and EFE by allowing a second wash day for all inmates on N unit, EFE refused to settle for this. They continued to assert to ADMIN that this was a facility-wide problem that affected all inmates, not just me.

EFE recognized that I was the ideal case to use as the basis for an investigation as I was the most adversely affected inmate in the entire DC by this policy. Indeed, both EFE and I were well aware of this the entire time as no other inmate could have brought such a compelling argument. I was literally coerced to live in my own filth. Of course, ADMIN tried to blame me for choosing to exercise as much as I did, despite unit staff consensus that it was integral to my ongoing “treatment” and “mental health.”

Staff in my SHIELD defense empathized with me and would routinely overlook my attempts to sneak in more “contraband” clothing. Under state law, inmates could “receive, possess, and use personal property” unless it was deemed a danger to oneself or others. I convinced staff in my SHIELD that if 12 shirts were not dangerous, how could 20 shirts be dangerous?

My parents would drop off packages of personal property for me weekly, which included snacks and other items like clothes. When security opened and inspected the contents of the package, they would check for real contraband like drugs or weapons and then advise the unit staff that they had the responsibility, not security, to keep track of how many outfits an inmate had. In this manner, I was able to sneak in a few extra outfits.

I did not want to call attention to myself, as by this point I was writing a few grievances weekly. If this stopped all of a sudden, ADMIN could have figured out that I circumvented their policy and retaliate. Furthermore, it was in the interest of all inmates that I resolve this issue. This meant that I had to continue wearing dirty clothes even though I could have snuck in enough clothes to avoid this.

After several months of this terribly abusive living situation, the AIR Strike finally came fully to fruition. EFE had completed their investigation and determined that EMHC could not create a blanket policy restricting the number of clothing items for all inmates. As inmates have a statutory right to “individualized treatment,” such blanket policies that could directly affect the treatment of an inmate were considered illegal and a rights violation.

As a result, ADMIN was forced to amend the policy to allow the respective treatment teams of inmates to determine how many outfits were appropriate for them. In practice on N unit, this effectively opened the door for inmates to have as many outfits as they wanted. Generally, N unit staff did not want to bother with policing the number of outfits an inmate had. Other units adopted a similar attitude; however, other units continued to enforce the 12-outfit rule.

I continued my subversion by distributing copies of the new policy to inmates on all units. While I was not in a position to continue to fight this battle for them, I did give them the tool they needed to stand up for their rights themselves. This act compounded ADMIN’s hatred for me as they made it a point to limit inmates’ access to any and all policies, despite them being considered public documents. Indeed, this got so bad that several years prior to this issue, ADMIN had stopped giving me copies of policies upon request and advised me to submit formal Freedom of Information Act (FOIA) requests to obtain them.

With the policy change, I was able to return to being the clean individual that I was. I never had to wear a dirty outfit again in there. However, I knew that ADMIN was very upset with this, as I had rarely seen them stand their ground so firmly on a new policy. I had obstructed their long-term plans and belittled their egos in the process.

While an inmate must remain hypervigilant in a DC under normal circumstances, I was a little extra vigilant as I knew ADMIN wanted to retaliate against me. I had always dealt with their retaliation in the past, so while I was confident that I could triumph over it, I nevertheless was extra concerned about this one, in part because I had an active court petition for release.

In this scenario, the retaliation came in the form of a very bold ambush on my court process for release. I had honestly expected the retaliation to be “in house”; that is, that it would happen in the DC itself. I suspected a room search, as these were the most common ways to harass inmates. I had seen numerous room searches that appeared to be ordered by ADMIN as retaliation against me or other inmates. When I suspected such retaliation, I would hide fewer “contraband” food items in my room so that they were easier to conceal during a room search.

However, ADMIN’s ambush this time took retaliation to a new level.

The facility director was a man whom I will call “The Enforcer” as he would act as an enforcer for the whims of a much more powerful member of ADMIN who preferred to remain in the background while pulling the strings. I will call the master of The Enforcer “Dr. Emperor.” The Enforcer was called by the prosecutor to testify against me in my petition for release.

The testimony of The Enforcer did not discount my substantial progress since the finding of Not Guilty by Reason of Insanity (NGRI) in 2005. However, the retaliation that I was waiting for became apparent when the issue of my complaints against the clothing policy were brought up. By this point, the policy had been rescinded months ago and the culture on N unit had all but forgotten this unpleasant detour. At no point was I accused of being “symptomatic” by anyone, including ADMIN, despite the fact that I was wearing dirty clothes regularly for a few months. In other words, the micro-narratives in the DC remained favorable to me.

When The Enforcer got the chance to tell the story of my complaints against his clothing policy in his own words, the picture that he painted to the judge was shocking. Furthermore, in a court of law, I could not cry out that he was lying and misleading the court. I could only strategize the cross examination with my attorney who was well aware that The Enforcer was perjuring himself.

The Enforcer told a story of a confused and mentally ill man who was acting against his own best interests. He portrayed me as complaining that the policy had been changed to allow for more clothes. He tried to characterize me as complaining for the policy to return to its original and highly restrictive form despite it resulting in me wearing dirty clothes. He tried to characterize himself as being the “sane” one who chose to change the policy to allow for more clothes so that I would not have to wear dirty clothes.

His only supporting evidence for this was the label of “mentally ill.” This label allows staff in DCs to concoct any story they want about an inmate and in many circumstances it gets accepted as fact. Had I not been the fierce and articulate advocate that I was, had my attorney not been adequately motivated to provide effective cross-examination, and had the judge mindlessly given deference to The Enforcer as the facility director, he might have gotten away with lying under oath to sabotage my petition for release.

Tragically, in all too many situations, the inmate is not articulate enough, the attorney too apathetic, and the judge too eager to buy into the convenience of the “presumption of correctness” that our laws grant mental health professionals like The Enforcer. This results in the truth getting buried alive along with the inmate in the DC.

My attorney was able to get the judge to realize that The Enforcer had made up the whole thing during cross-examination. While this was obvious perjury, the judge stopped short of such accusations to give minimal respect to The Enforcer and the “presumption of correctness.” Indeed, had the judge made outright accusations of perjury, he would have opened a highly complicated can of worms that he did not want to. He saw how well I was doing during the 18-month petition and seemed eager to finish so that he could grant my release.

However, at the end of testimony that day, when my attorney and the prosecutor were scheduling the next hearing date, the judge made clear that he did not understand what was going on with the staff at EMHC and that he did not like it. This was a huge victory for my attorney and I as we had broken through the societal narrative that justifies the legal “presumption of correctness” and truth was victorious that day.

Debriefing

The actions of The Enforcer are all too common in psychiatric DCs. The label of “mentally ill” is not even understood adequately by the professionals who are responsible for treating it. What chance do lay people have to truly understand the epistemological bankruptcy of the concept of “mental illness” when confronted with the assertions of professionals who expect deference to their knowledge and experience? I like to say that when nobody knows what so-called mental illness really is, then anybody can pretend to know what it is.

Compound this with the “presumption of correctness” that the court system formally gives mental health professionals as well as the behind-the-scenes influence of Dr. Emperor, and it should be clear why The Enforcer believed that he had a chance of successfully sabotaging my petition for release with such a bold and risky action. Indeed, the potential existed for him to be criminally charged for this.

However, The Enforcer overlooked the uniqueness of this situation as I was supported by EFE in my successful AIR Strike. There was extensive documentation of EFE’s involvement and the legitimacy of my complaints. While I had certainly experienced my share of disappointment at the hands of EFE and IGAC, I never gave up in seeing the potential they offered. I had used my “true vision goggles” to see that these were well-intended people who truly wanted to help but who were stuck in a terribly broken system that tolerates all sorts of corruption from mental health professionals who may even honestly believe that they are helping the inmates with their corrupt actions.

I do not doubt the possibility that The Enforcer and Dr. Emperor may have genuinely believed that they were really helping me by providing knowingly false testimony under oath in an apparent attempt to sabotage my release and confine, or “treat” me for years to come. This deranged sort of patriarchal “help” can be seen as analogous to NGRI inmates who harmed other people based on a delusion that they were helping those people. Indeed, in 2002 I was one of those people.

While I learned the hard way that harm is not help, and no amount of delusion can make it such, I pity those mental health professionals who still cannot figure out this obvious reality.