Just One More Suicide in Montana.

Of My Premature Discharge from The Montana State Hospital on February 16, 2017; and of suicide in the state of Montana.

I will die before any of you read this. 

Yet again, 2016-17, the state of Montana has the highest suicide rate in the United States. 

I obviously am in the right place to die.

Patrick Paolo Pickens. February 26, 2017.

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BECAUSE I AM MENTALLY ILL:

They would imply that I am a fraud because I care as much about others as I do myself . 

That it is not mental and emotional anguish that leads me to ask for their help, but rather...

Some nature of selfishness that puts them at risk of being exposed for who they are.  

That... as one mental health evaluator named Brooks put it the other day: 

"It is very hard to tell if you being more a patient advocate, or a patient."

As though that matters. Speaking out as and when I do about the abuses of persons affected as I am by serious mental illness. While having the gall to suffer as well from mental illness.

They hate that. How dare I.

BECAUSE I AM MENTALLY ILL:

They would see my history as anything other then that of a human history, and portray my sense of ethos and performance as deceptive. 

Because they have no ethos in their own right, and are incapable of beauty in the name humankind.  

BECAUSE I AM MENTALLY ILL:

They would paint  my character as anything other then that of a man who can see well enough to weed out abject ineptitude and depraved human nature when it bowls me over in alleyways hidden to the greater public... 

Because I do so, strive to do this as any situation may demand, and ask nothing more then repeat not for these efforts, but because I am in need.

To cover their asses, they would declare
that any of my sincere attempts to die by own hand are not fact.

As though  I never wanted to die.

YES I AM ETHICAL.  

YES I AM ALCOHOLIC. 

SO THE FUCK WHAT? 

DOES THIS MEAN THAT I AM NOT ALSO AFFECTED BY MENTAL ILLNESS? 

ARE YOU THIS MIRED IN THE HISTORY OF BRUTAL DISCRIMINATION AGAINST THE MENTALLY ILL? 

BECAUSE I AM MENTALLY ILL:

I am faced with all of the above. My given illness is sharp as a razor, and my desire to die as keen as a new born sun.  But those who I have turned to in recent days into weeks into months have virtually laughed at me, have sought to turn me away. "Back into the community" is the catch phrase they use, "Fit and safe for discharge and outpatient treatment" is the parlance they rely upon. In their paperwork. On there various forms. 

Not hearing me when I state in no uncertain terms "I should be dead by now, this is plain fact, and I wish I was."

I have tried to pull out of it all. For the good, for what I call "the living side of this forsaken game." I see a calling for me or someone like me to make these issues public. To put these people on the proverbial chopping block. Because someone has to, and nobody else will.

They have done this, and will strive to continue doing so, because it is in there nature. Skin of reptile, Machiavellian afterbirth. 

You know who you are: 

-Dr. Richard Holt. 

-Doctor of Nursing Carlie Hillenbrand.

-Program manager Jeff Pfluge. 

-Patients' lawyer Craig Fitch. 

-Patient grievance committee chairperson -Kathleen Duganz. 

-Unit manager Mark Proxell. 

-MT State Hospital CEO Jay Pottenger.

-MT Director of Addictive and Mental Disorders Division Zoe Barnard. 

And on this list can go.

Each one of these individuals, and many more who work as entrusted members if the montana health care system, know damn well:

That I am still suicidal and have been for months. That I am still at high risk of harm to self and have been for months. That I have twice been prematurely discharged from the Montana State Hospital, most recently on February 16, 2017, after only twenty days of in-patient treatment and in graphic defiance of my stating my intent to kill myself. 

And that the only reason I am not dead today is because I have been willing to trust you. All of you.

BECAUSE I AM MENTALLY ILL:

Each of you have worked together in deciding to characterize me as a person not legitimately at risk of suicide. In order to preserve status quo, you have all done this. Opting even if somewhat logically to risk erring on the side of risk/death over erring of the side of safety. 

And each one of you knows that you simply don't want me in your fucking hospital because I know how to names names. Your names. It has nothing at all do with my wellbeing. Nothing. At all. 

And you all know it. 

Yes, I have tried to pull out of it. My ongoing, current struggle with suicidal ideation. I have remained sober. I have sat on my hands.  So much that this struggle is no longer a struggle, but a need. No person should have to live with what I have tried to live with. Including the presence of these particular monsters in my "life". It is no way to live. 

I will die before any of you read this. 

Yet again, 2016-17, the state of Montana has the highest suicide rate in the United States. 

I obviously am in the right place to die.

Patrick Paolo Pickens. February 26, 2017.

I will die in large part because of you. 

But I am human. 

Your names are known, and you won't get away with it. 

paoloreed@gmail.com

MONTANA STATE HOSPITAL ALMOST LOSES ITS LICENSE TO OPERATE.

THE FOLLOWING WAS EXCERPT PUBLISHED IN THIS BLOG FEBRUARY 18, 2017.

In June, 2013, the federally managed Center of Medicare and Medicaid Services formally sanctioned The Arizona State Hospital (ASH) on the basis of that long term public mental health care facility's willingness to flaunt state and federal law. Central to the earliest evidence that brought on this sanction was the fact that ASH was failing to maintain required staff to patient quotient (ratios). And while it took another 14 months before the hammer fully came down on ASH (September, 2014 and beyond), this due to the facility's ongoing refusal to bring its operation up to standard, it was indeed the CMS intervention that got the ball rolling. 

Fair warning. 

-paoloreed@gmail.com 
` (END OF EXCERPT)

Fair warning, indeed. 

In recent months, Montana's sole long term public mental health care facility, The Montana State Hospital (MSH) at Warm Springs, has increasingly fallen under the shadow of federal oversight, sanction, and intervention. And consistent with the sordid history underlying the exposure of what some today characterize as "The ugliest public mental health facility scandal in the last seventy five years," it is increasingly apparent that MSH will in some matter of time share the status of The Arizona State Hospital as a result of MSH' administrators and related state officials willingness to try and misrepresent or otherwise hide the truth, even as said truth emerges in the public eye.

"Feds find state hospital put patients at risk, almost terminated agreement."

• HOLLY MICHELS. LEE NEWSPAPERS.
• January 27, 2017.

"Montana State Hospital, the state’s publicly run psychiatric facility, was set to lose its federal agreement in February because of what’s called an 'immediate jeopardy,'' a situation where the hospital’s noncompliance with federal regulations was considered serious enough to risk death or serious injury to a resident."

"After a legal notice was published in The Montana Standard on Thursday announcing the termination – set for Feb. 8 – of the agreement between the Warm Springs hospital and the federal Centers for Medicare and Medicaid, the agency sent the paper a notice of retraction, saying that the situation that put residents at significant risk had been “abated.”

'The hospital is in the middle of a federal survey now', said Department of Public Health and Human Service public information officer Jon Ebelt, so the information that can be made public is limited.' 

Those with knowledge of the hospital said surveyors were on-site this week."

So. State health care officials don't want to inform the tax payers who pay their salaries of what's going on at Montana State Hospital. 

Go figure.

The staff of Montana State Hospital: Montana's Forgotten Suicides have recently been provided with the following data:

1) MSH staff-generated reports circa September, 2016, about alarming  employee shortages led to a formal patient generated letter document that was forwarded in mid October, 2016, to Montana senators Debbie Barrett (R- Dillon) and Ron Elhi (R- Hamilton). That document in turn served to compel the above described CMS investigative process, and a current federal sanction that requires state health care officials to bring the facility up to speed with contemporary medical standards. These staff shortages are still occurring in gross violation of federally required staff to patient quotients (ratio). The risks associated with such violations   continually put MSH patients at direct risk of harm to self or others, while also posing some degree of risk to the facility's direct care staff, namely hospital nurses and technicians. It should be noted that there are no shortages in staff at the level of hospital administrators or related state health department officials (their jobs and salaries are secure), and that this issue also does not pose risk to hospital supervisors or administrators. Go figure.

2) Also in October, 2016, current MSH Chief Executive Officer, Jay Pottenger, was formally informed by members of the MSH Resident Advisory Council of this particular issue and its impacts on patient safety.  Sadly, the man took no immediate action at that time, thus compelling the now in effect federal sanction that MSH has yet to emerge from, at the taxpayer expense. Live and learn, Mr. Pottenger, live and learn. The hard way....

3) Monitoring of patients is a very critical element to mental health care. In reviewing whether MSH staff were adhering to specific state and federal monitoring guidelines, CMS officials determined that the requirement of routine bed room "checks" on an every fifteen minute basis was all but ignored, and have thus imposed a much stricter routine of conducting those checks every five minutes, ostensibly so that hospital administrators will get the point. But even after this particular requirement was imposed on the basis of those findings, MSH staff have still failed to maintain such routine checks, this largely due to the aforementioned staff shortages. One more bright line example of how out of standard that the operation of MSH is, in fact.

4) Due to identified violations of federal medical standards at MSH, client-consumer-patients currently have to ask permission in order to be allowed to use any bathroom located on patient treatment units. Permission... to go to the bathroom. Dignity, anyone?

5) Due to identified violations of federal medical standards at MSH, there are currently no mirrors on any of the patient treatment units. There were mirrors, but apparently , they were not up to par with federal standards. Thus, no means at this time for client-consumer-patients to meaningfully groom themselves. Again- Dignity, anyone? 

The above data is partial. Which is to say that, yes, we have more.

But MT Department of Health and Human Services  Jon "Propaganda Minister" Ebelt can suck on this for now, as can Zoe Barnard and other like ne'erdowells in the department's far broader construct. 

Your time is coming. And you know who you are.

IN CLOSING: FAIR WARNING. AGAIN.

And big thanks to Holly Michels of Lee Newspapers for doing the right thing and bringing this news out of the gutter and into the daylight. Montanans have the right to know. 

paoloreed@gmail.com