Wednesday, January 06, 2010

Top 100 PAID state workers: one psychiatrist at Western State Hospital

Psychiatrists Among Top Paid State Employees:Austin Jenkins (2009-10-29)





Listen to NPR in the link above:

"On Ward C-7 the day starts with a treatment team meeting.

Nurse: "We're going to start with J.O. this morning. Anxious to go to groups, he is visible on the ward, he's taking his medications "Nurse Vicki Kallahan-Storwick briefs Dr. Daniel Ruiz and the team on the status of the patients.

Ruiz follows up with the diagnosis.Dr. Daniel Ruiz: "This gentleman is new on the ward. He came with significant psychotic symptoms "And a treatment plan for each patient.

Ruiz has been a psychiatrist at Western State for eight years.

He came here straight out of residency at the University of Washington. It's a second career in medicine for him. Before becoming a psychiatrist, Ruiz was a general physician in Puerto Vallarta, Mexico.

His path to psychiatry began with a personal story.Dr. Daniel Ruiz: "I do have a brother with schizophrenia."

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January 6, 2010

Treatment team meeting results:

1. titrate and remove to zero, the Trileptal.

2. acknowledge and treat the current thyroid that is out of balance.

3. Dr. Ruiz will only meet with mother, weekly after today banning patient advocate from meetings due to demanding outside time.

4.WSH psychologist served court order to reside at western 180 days to patient without representation from legal department.

5. patient shall now not be allowed to have mother visit at lunch time as every day since admit on December 21, 2009 due to staff believing patient will not cooperate with them due to anticipation of mother arriving for lunch one hour visit.

6. mother was told to arrive at 4pm after groups and shift change ends.

7. patient was told to take meds, go to all groups, to earn an outside walk time with mother as a reward.

8. the advocate that was banned from future treatment team meetings today was told to write a letter to the legislator by Dr Ruiz, ( the advocate and support person patient has responded to and began to speak again as a result of hours and months of time spent with patient) if advocate didnt like the lack of funding, and proper ability to care for patient in the washington mental health system.

9. patient medications being changed is 2nd reason given to mother for not allowing outside time.

10. staff assured mother they would remind patient mom will be there at 4pm tomorrow.

11. "you're lucky she's on this ward", said Ruiz.

12. due to questioning patients right to have outside time, Dr. Ruiz deemed advocate a "detriment to patients best interest and will only meet with the mother weekly".

13. "if you take her home she loses ALL services".
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http://www.governor.wa.gov/contact/ * (click this link to email a letter or the one written here, copied and pasted) OR

Write Governor Gregoire a letter:

Governor Chris Gregoire

Office of the Governor
PO Box 40002
Olympia, WA 98504-0002
USA

Give Governor Gregoire's Office a call:

Governor's Office 360-902-4111

For relay operators for the deaf or hard of hearing,
please dial 7-1-1

Fax Governor Gregoire a letter:360-753-4110
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Dear Ms. Gregoire,

I am writing in concern of the care of a patient currently at Western State Hospital. The staff, including the doctor have voiced concern over lack of funding for mental health services in the State of Washington, USA.

It is an outrage, and unacceptable, that any patient be denied access to outside time due to lack of funding for appropriate staff to patient ratio. It is unacceptable, that advocates are not heard in meetings where the patient is top priority, and where team members discriminate toward a patient with PDD and non verbal. The patient who is duel-diagnosed with psychosis and a developmental delay, needs family support.

The base of care is funding, and this is a formal request to review the funding for mental health services in the state that you Govern, and it is a request to listen to all patients, not just 1 of approximately 800 at Western State Hospital.

Lindsay was deemed "not a danger to self, not a danger to others", but "a probable danger from society, a person who could suffer harm and exploitation" from society itself, by a King County Superior Court judge.

Lindsay, deserves more than limited/no outdoor time.
She deserves to have all members of her family and advocates be present in all meetings, she deserves far more than this system has given her to date.

She is 22 years old, and a victim of lack of funding, and proper care offered in Washington state, and it is time for her and others to be acknowledged.

Thank you for your time,

Sincerely,

________________

(YOUR NAME)

Further reference article:

Furious Seasons,Some Thoughts For Western State Hospital, DSHS,Philip Dawdy reporting


11 comments:

Radagast said...

"...7. patient was told to take meds, go to all groups, to earn an outside walk time with mother as a reward..."

OK... I defy anybody to argue that this is anything other than reeeaaaally bad psychology. It's coercive - forced choice. That is, Lindsay MUST do as she's told (even if she doesn't like it, and perceives it to be detrimental), or she will be punished through the withholding of (an admittedly limited), freedom. She's not a prisoner, there. How many times does that need to be stated?

"...12. due to questioning patients right to have outside time, Dr. Ruiz deemed advocate a "detriment to patients best interest and will only meet with the mother weekly"."

Well, this is just beyond credibility. What kind of control freak is this Ruiz guy? "The patient's best interest" is probably best assessed in association with the patient. Or perhaps Ruiz reads minds, too, and doesn't need to seek patient input? It's about time that Ruiz realized that patients don't exist in *his* reality, they exist in their own, and he should stop seeking to influence it.

Matt

Radagast said...

Incidentally, it would be interesting to know when and where this concept of "treatment" was developed, because if it's down to Ruiz, I'm concerned.

If one person is responsible for the way that patients are treated and the hospital run, viz patients, then the hospital will be a representation of that person's mind. It is impossible that it is any other way, because one cannot organize something differently to the way that one thinks - thus the hospital is a visualization of the management's collective mind, possibly personnified by Ruiz. The way that Ruiz subordinates the interests of patients/patients' carers tells me all I need to know about the way he organizes his own priorities...

What do patients represent, in Ruiz's mind, such that they should be subordinated (eg, vulnerability?)? That is the question. On the other hand, he may be doing the best he can, given the tools at his disposal, but he won't get anywhere with the strategy he's employing, at the moment, because the patients are seemingly unable to counter his constructions and probably wouldn't be allowed to (such is their lack of status, in Ruiz's mind), even if they had the necessary linguistic skills.

Matt

PS It's probably worth noting that it's unlikely that Ruiz is unique, in his approach to patient "care".

sallyfrussell said...

Usually when a doctor leaves another medical specialty to go into psychiatry it's because of medical malpractice and/or substance abuse limiting his practice alternatives. Have you checked into this wiht Ruiz?

I'm sending a letter.

Lisa said...

Stephany, does Washington have a non profit legal advocacy group that fights for people with disabilities? I was able to get policies changed at the hospital where I was treated by getting this non profit organization in my state involved. The hospital may not listen to you (or their patients), but these guys tend to listen to attorneys. There was no financial cost to me.


It's outrageous that they are depriving her of fresh air and sunlight. She needs to be able to go outside. She has voiced the harm this is doing - feeling like a hostage, feeling caged etc.

It doesn't matter what they do with her medicine if they keep causing harm by depriving her of her basic human rights.

Incidentally, these places often use threats to get compliance. They tried to prevent me from seeing my personal therapist while I was inpatient, threatened me with loss of "privileges" to go outside, etc. The concern is not for the patients' wellbeing but for the convenience of the staff, as well as this intrinsic need some of them have to show the patients (and/or family members) who is boss. I really wish they would stop calling these places hospitals and start calling them prisons - because that's what they are.

linea said...

I just sent a letter to Governor Gregoire. A family friend of ours has recently had the same difficulties with her daughter's time in Western. She is finally out, but it was hell when she was in there. Her family had to fight to the end just to get her out again. If you have time you can read more about it on my mom's blog (http://cindajohnson.blogspot.com/2009/11/solemn.html).

I am bipolar and have been in both Harborview and the UW Med Center, (luckily not Western), and it was through my time in these that I knew that I needed to start working to make a difference in the mental health system. So I want to thank you for such intelligent and heartfelt posts. You are truly making a difference simply by sharing such stories and your own experiences. Good luck and I hope that things start to improve for Lindsay.

Take care,
Linea

Stephany said...

Thank you, Linea, for your thoughts and for the letter. As you know, this system is difficult to navigate to receive care and it is also difficult to advocate without repercussion while in the process of care. It's a long hard road, and one goal is good care for everyone, and of course that cannot happen without Olympia's dollars and funding.

Many people have no where to go from western, because of the severe lack of housing and placement options, that is the core of the problem, the revolving door WILL stop, if enough appropriate care options out patient were available to many, many people.

Hopefully, the Governor will hear that message.

Until then, be well and take care.

Cinda said...

Another letter of support has gone to the Governor's office! Daughter Linea and I have been beating the drums for advanced medical directives, advocacy, services and support for people with mental illness. I am so sorry for Lindsay and her family. I weep for the families with sons and daughters like Lindsay and who are unable to speak up, speak out, and seek help. When we have the skills I think we have a moral obligation to do so. It is not only for our own children (however old they may be) but for all of those without a voice and without any power what-so-ever. I have written to Governor Gregoire and thank you for your work on this.

Cinda said...

Oh, my, seems comment box didn't work so if there is a repeat comment from me, please delete. Daughter Linea and I have been working hard to reduce the stigma of mental illness and reach out as best we can with resources and support. I am so sorry for Lindsay and her family. I am grateful that you are making this public. I have sent a message to the Governor's office. I do so for not only Lindsay but all the sons and daughters and their families who do not have the skills, ability, or power to advocate for themselves, send messages, fight for services, or even ask questions. Thank you and take care. Cinda

Cinda said...

Third time...Daughter Linea and I are doing all we can to reduce the stigma of mental illness and provide any resources, support and hope to the many, many families that are struggling with these issues. I have added my voice to the letters to the Governor's office. Thank you for doing this not only for Lindsay but for all the sons and daughters and their families that are not able to advocate for themselves, ask questions, find resources or help. I am so sorry that Lindsay and her family are going through this and send you all thoughts of love and care. Cinda

Stephany said...

Thank you, Cinda, i just returned from a walk and posted the comments (i post them when i am home/online) thanks for your support, it's been quite grueling this week, under the magnifying glass of the hospital, due to my advocacy.

But, it's my daughter that is the focus, and hopefully they are all now seeing that.

Stephany said...

1.14.10 no outside time yet, though moved to new ward 1.11.10 based on "access to outside enclosed basketball court area so she can play and have time outside, and a flight risk."--(social worker phone call 10am 1.11.10)