Safety in Mental Health Facilities *Warning: Graphic Photos*

 I've been following the story of safety in California state mental health facilities. In October of 2010, a patient who had permission to walk around the Napa State Hospital grounds cornered a social worker between two buildings and beat her to death. Employees there said that each one of them had been assaulted by patients.
Today, NPR did another story (linked here) about the California state mental health facilities, particularly one in Los Angeles. The employees picket at lunch time, gathering support from those who drive by. They had talked about it's not if they get assaulted, it's when they get assaulted. Even though California is in debt, they were able to give an extra $10 million dollars to the state facilities. I'm not entirely sure how many state hospitals there are and if this includes any state hospital or just the mental hospitals, but if there's more than 10, that's about or less than $1 million dollars each. They are the only state facilities that are hiring during the time of debt because there are great issues with safety. In the article, Diana Dooley, the secretary of California's Health and Human Services Agency, says that even $100 million dollars isn't enough "in terms of advocates of the patients and the workers and the need." No, no, I think that $100 million dollars is enough to hire more people, have police presence, and to ensure safety regulations and precautions of both workers and patients.

I wonder about the facilities that are not state run. In the 1990's, many state run facilities in CT were closed. Some former patients are still being reintroduced into society and trying to make it work with some state supported agencies. Others had difficulty and were sent either out of state or to other in-state facilities. There are a few for-profit, privately ran facilities remaining in CT. Although the state and federal government can give money for certain things such as becoming a teaching hospital or accepting patients with state insurance, there is little that can be given in the name of safety.

This is the arm of my coworker, Mike, after a rough code from a young patient. Codes are when patients' behavior are out of control.

I worked at a privately run behavioral health facility for over 2 years. For two years, they worked me hard and often criticizing every little detail while not showing much appreciation for me or many other workers. At some point, they decided it would be better if they were a hospital that accepted patients with state insurance. For all of its history, it had been a place for upper class (wealthy) people to go to when they were mentally unstable. It had been a place where there was a sense of community and stays were long. Over the course of the years, the length of stay became shorter and shorter and the patients have become increasingly hostile and physically aggressive. Once the state insurance was accepted, patients who had been in prison and who were low income were admitted. The staff was concerned at the onset that there would be issues with people who had previously been to jail for violent crimes.

I saw many fights, heard of many attacks, and witnessed some of these attacks on patients and staff. The administrators were saying that they were not admitting violent patients while all staff knew they were. In one instance a patient (Patient A) was isolated from the community because he attacked another patient (Patient B). And staff and administrators blamed the Patient B for flirting with the Patient A. They did not point out that the Patient A waited for the chance when no staff would be around so that he could attack her. It could be that the administration's definition of violence was different from the rest of the staff.

Administration felt that they would be best to cover their own butts. They made every person who worked for the hospital, including the desk clerk, secretaries, and people who worked in the gift shop, to attend a safety meeting. They gave lots of cock and bull stories and emphasized that everyone had a role in safety. After taking this course, any incident that caused harm to a patient or staff was blamed on every staff who was around. This included the injuries sustained to a security guard who was injured while pulling two patients apart during a fight. He was blamed for the injury because he was doing his job. This safety meeting was developed after they had lawsuits on their hands (Isn't that a big surprise?-- sorry, had to get sarcastic there for a second).

This is another angle of Mike's arm after a rough code.

The fact is that many of the nurses and mental health workers say repeatedly that there aren't enough staff, especially for evening shifts and on weekends. An evening weekend shift has the least amount of people. Patients pay attention to these things. If they were to make sure of a calculated time to attack others or to get out of control,  they would do it at that time.

Administrators and doctors have the most control over policy. They also tend to have numerous biases and lack understanding of the duties of mental health workers and nursing staff. I challenge any of the doctors or administrators there to work as a mental health worker at mental health worker pay for a week. I would expect that after experiencing the difficulty with duties as well as  lack of  good pay, appreciation, and other staff around, there would definitely be changes. On a side note, many mental health workers work 16 hours and go home for 8 hours only to come back for another 16 hours. If you've ever been up for that long, it doesn't make for a good, alert worker. I would hope that doctors and administrators would have a better understanding of the difficulty of a the job of a mental health worker or worse if they could even imagine being in that job.

After I gave my notice to terminated my employment there, there were more out of control patients, security guards who usually work at night would be called in for earlier shifts, and more of my sweet coworkers were attacked. A known violent patient was admitted while the doctors and administrators were surprised and said they didn't know how that happened. In the following four days of this patient's admission, he assaulted at least two staff and knocked out another. He was supposed to be in chemical restraints, which meant that he was on a great amount of medication that made him too drowsy to do much than sleep. He went to a facility for violent patients where staff receive hazard pay and can retire at an early age because of the difficulty of their work. As time has gone on, I have encouraged all of my coworkers to demand hazard pay. At this point, I'd love to see them picket and watch administration scramble.

At this point, the LOS is very short, staff is burning out fast, and the administration is only looking at the bottom line and to protect themselves. They appear to me to have little interest in the well being of staff or patients. It's gotten the feel that staff just baby sits and can't do anything while patients act out or require higher levels of care than the facility can't provide.

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As you can tell this is a subject that I'm very passionate about and will continue to write about.

Thoughts on Videos of Draco Reptilians

About two years ago, a patient was admitted to the mental health facility. She was about 17. At times, she could keep herself together and other times, she would talk about the evil and reptilians she had read about on the Internet. To say the least, I was curious about these things she had read. I had been told many times that the two bumps (I assume they are from using expired eye make up) on my eyelid scare people because it reminds them of a lizard. I was fearful that she would think I was a reptilian person.
Here's what my eyelid looks like:

Lately, a friend on Facebook has been posting videos and articles about the Illuminati and Reptilian people. Since most of the video clips are from youtube, I tend to get lost in looking at them. I've seen a lot of Reptilian videos where the person assumes that if you are watching it, you know what to look for. I saw one that was explained what to look for (the link is here ). This and other videos include:
1. Blinking more than 3 or 4 times.
2. While blinking, "whatever they wear over their eye" is pulled upwards.
3. As they change on camera, they put their hands in their face or divert away from themselves.
4. A green tint around their eyes or mouth.
5. Scaly skin particularly around their eyes.
6. Eyes look cat-like or reptilian.
7. Teeth appear to come and go.
8. There's a large amount of Reptilian women who are in porn and their eyes and body change right on camera. 

First, the blinking. There are many politicians and news anchors who blink a lot. It might be because they are lying, nervous, or it's a character flaw. It's a difficult thing to overcome and control.

Second, none of this stuff is at all contributed to camera, computer or processing glitches. Many of the videos, (an example is here ), can be contributed to just glitches. I try to put myself in the theorists place. A few explanations that I can think of are that their energy field affects the camera or an overall, "that's what they want you to believe." At one point, I even thought if it happens to the same person over and over again then maybe it's more than coincidence. Then, I did see incidents happen again and again, with two different reporters. I thought about the likelihood that one of the reporters has the same equipment on scene with her all the time since she is often "on scene."  The other one is often reporting from all over the world and the feed is not so great so there are glitches.
Third, a lot of points three through seven are tough. The video quality is usually bad-- from either the original recording, the recording of the original, or by the pixilation from their tampering with the video and image. I don't think anyone accounts for stage lighting or angle. I've seen some videos where people are moving around quite a bit and in some angles their eyes and teeth look one way when in another they look completely different two seconds later.

Fourth, the women in porn. Yes, this again. Eyes change a lot depending on mood. What they were showing in these videos were women giving blow jobs (that were delicately removed from the video to only focus on the face of the woman) and when she looked up at the guy, her eyes changed. Maybe she's just really into it and that's why her eyes are changing.

Some thing that I keep in the back of my mind is that a lot of these videos have either some soft music (and usually does not match my taste) or nothing at all. Now, maybe you haven't had these experiences but there are videos out there where it's quiet and you're looking at a scene, focusing really hard when image quickly comes on the screen, screams and scares the bejubus out of you. I find myself staring so hard at the screen and it's usually quiet that I start jumping ahead in the video to make sure that there's nothing that's going to pop up to scare me.

In the end, I think if I could see a well polished video with some admission of skepticism, I might really consider these theories. Right now, it's easily dismissed with simple psychology, as well as lighting, cameras and computer glitches.

Things I take into consideration when it comes to porn

Porn is one of the many issues that feminist tend to have heavy debates over. There are certain facts I agree with the anti-porn feminists about- 1. porn is tough work and 2. people are exploited when they do it. Most anti-porn feminists want porn banned. I definitely do not agree that society would be better if porn were banned.

One of my main concerns is that if porn gets banned, where does the censorship stop? Many people know the saying that they can't put into words what porn exactly is and how it becomes obscene or offensive but they know it when they see it. My imagination goes to the extreme-- when would a picture or painting of a naked body be allowed? I worry that people would become very sensitive to any nudity, whether or not it was art or porn or artistic porn, and that there would be no naked pictures. Two areas that I'm concerned about is where would people find informative pictures about their bodies and would videos about techniques or "how to spice up your sex life" type movies be allowed? I also wonder about romance novels and erotica literature. Do they get banned too? I don't have the answer for those questions. In the past, when porn has been banned from being mailed, great works (such as Playboy and Lady Chatterly's Lover) as well as information about women's bodies and birth control were constricted. I am very concerned about this happening  again if porn were banned.

If there were no naked pictures, there would be some consequences to this. One, people would not be informed about their own body. There are some medical artists who would be able to do justice to an informative representation of a penis, vagina, or breast. It would not have the same effect as seeing real pictures of the body. While the medical pictures can be descriptive of what is average, it cannot entirely describe the variety of vaginas and penises that are out there. Two, there are people out there who aren't great at socializing. It may be because they are mentally or physically handicapped or just socially awkward. You may or may not know someone like this. Without porn and without nude photos, these people would be at a disadvantage. Just like everyone else, they have the right to happiness and for some, that can be masturbation in leui of a relationship with another person. Most of the time these articles written by anti-porn feminist are focused on the perceived inner workings of violent men. They make claims that men watch porn, begin treating women like objects, and raping and murdering them. And there are a few people out there like that. Those people also watch TV and drink water (yes, that was a flippant statement, made in jest). Those aren't the people I'm talking about. I'm talking about the sweet people. The ones who yearn for relationships. The ones who go into their fantasy world of having wife or husband or lover, someone who takes care of them, someone who they would love and adore. They're the ones who want sex and to make love. Yet, they don't. They don't have that and that goal may or may not ever be achieved in their lives. They have the right to view porn, if they choose. I dare say, it can even be healthy.

The other main concern is that if porn continues, there needs to be strict standards. Companies should be boycotted if they allow actors and actresses to wear out their bodies i.e. work for hours, doing multiple penetration, etc, to not wear protection, and not get independent health check ups on a regular, 3 months at least; 6 months at most, basis. There are some porn companies who already have these type of standards. What I would really like to see is people going into Russia to change their porn industry. I understand this is a big thing. I have found Russian porn is the most offensive. They really do make you believe that they are raping and murdering women. If it's not the real thing, it sure looks like it.

An important factor that I consider if how much more women are paid compared to men in the porn industry. Most research focuses on men watching porn and women as the actresses in porn.  I tend to focus on the opposite-- women who watch porn and men as the actors in porn. In all the research and opinion articles, women who watch porn are ignored. There is little said about the men in porn movies. It seems that others dismiss them. By ignore them, it could be possible that these writers are objectifying them or minimizing their role. I imgine that the reason is "Oh, they're just a penis" or "They enjoy having sex with women anyway."

All-in-all, it's best to consider the other ways that porn impacts society. Allowing porn to continue opens up the pathways to have easy access information about the human body. Porn also benefits those who are socially inept. Still, there needs to be better standards of care for all actors and actresses who choose to work in this industry.

It's Unethical

Being a therapist and counselor puts me in a field with some amazing people and with some people who know how to get through school and take tests. I have known people who will do anything for their patients/clients and have known people who have no idea what they're doing. I seem to have a never ending "a therapist did that!?" list.
One of those moments came a few days ago. I saw video of Dr. Drew talking about Charlie Sheen. Dr. Drew said that he had not spoken to Charlie Sheen. Dr. Drew made it a point to mention his 20 years of experience, he has seen this many times so he is able to talk about the symptoms and his diagnosis of Mr. Sheen.
Although I've been in this field for a short time, I find it offensive that Dr. Drew is being his usual entitled and intrusive way. Dr. Drew not only felt it necessary to give an opinion about someone who he has not talked to but felt that he needed to justify it with his expertise.
As a part of my education, I had to take an ethics class. This usually meant having more questions than answers. There were some absolute guidelines. Most of those were surrounding the client/patient. However, we discussed at length about boundaries. There are lots of boundaries in this world. And one of them is to not to make assessments or diagnoses on people who has not met with a particular therapist. Another is that even if you have an opinion about someone, keep it to yourself.
One thing that stood out to me is being aware of myopia. When a therapist becomes myopic, they only see what they know. I had a supervisor who only worked with people diagnosed with schizophrenia or schizoaffective disorder. Eventually, she only saw art work in terms of psychosis. She once had a patient who drew a fountain the day before he tried to commit suicide. So, every colorful fountain seem to be a symbol, in her mind, of suicidal thoughts. While I respect any therapists' years of experiences, it may mean that they might only see what they want to see and are used to seeing.
In my experience, people are different when they are a celebrity, in the public eye all the time, and expect cameras to be around than when they have privacy and are in their own home. Everyone has a public persona have a private persona-- i.e. differences between being at home, at a doctor's office, and being at work. To judge only what one person does in public is not getting the full picture of the person.
I saw another doctor on Access Hollywood on a clip from the show "The Soup" (seen here ). The Soup's host said that the doctor was not dressed like a doctor and sarcastically said "Access Hollywood did the responsible thing and had a doctor diagnose Charlie in a completely unprofessional setting off a poorly made video, edited together with scary music." I think even Joel McHale can sense the unethical nature of these doctors who are willing to go on TV to diagnose a celebrity or someone who they have not met.
There's two issues I want to talk about briefly here:
One is that often the TV media outlets have a list of professions in various fields. For example, one of my professors had been on a TV show talking about robbery. When Winona Ryder was caught shoplifting, someone from the media contacted my professor, who had to explain she could not give her opinion about shoplifting since her expertise was in robbery (and the difference between the two). Anytime a TV show needs a professional, they go to this list. I have seen some crazy things on shows that use these lists.

The second item I want to bring up, which I have written about before, is when a person asked an art therapist to judge someone's artwork without watching the artwork being made. A woman approached me and asked me to do this regarding colors. I don't think that one color means the same thing to everyone so I didn't say anything about color. I did talk briefly about the patient's focus and what she said about the artwork that was made. In The Secret World of Drawings, author Gregg Furth does just this. He goes through various children's pictures as well as some pictures by famous artists. He writes a "how to look at pictures and analyze them" type of book. While there are some insights he makes about artwork, there are others that are very much up to interpretation. Basically, I wouldn't feel comfortable using his insights in practice. I would want to talk to the person, observe them making the artwork and if I couldn't do that, I'd at least want the person to tell me about the artwork.

Bottom line here is that these TV doctors have to keep up with boundaries and understand that diagnosing someone without talking to them is unethical. It seems that there are many doctors and therapists who have boundary issues and who feel entitled to diagnose or make assumptions based on whatever they find important or intriguing. I hope that these are just a few bad examples and that most people can see that this is all wrong.

CT from a CA perspective

I grew up in California. Currently, I live in Connecticut. I'm starting to "pass" as a Nutmegger or New Englander. Yes, the people who are from Connecticut or live in Connecticut are called Nutmeggers. In the winter, I seem to notice the particular differences between CA and CT.
One of the first thing I noticed was the hooks and coat racks. When people are out dinning, they can either leave their coats at the door or they put them on hooks conveniently located around the place. I've seen this and had to do this at bars and restaurants. Since the winters in the Bay Area and on the coast of Southern California are mild compared to the East Coast so, these hooks are not required.

I lived with roommates and during the fall, they started making comments about the weather and the leaves. This is part of the culture of a East Coaster. As kids are growing up, they watch the news as they comment on how the weather is going to effect the color of the leaves. My crazy roommates were saying that it was too dry and the leaves were going to turn brown. I didn't care much for this. I didn't see the big deal. As I drove my 30 minutes to work, I noticed the trees along the side of the freeway were in various states of green, yellow, orange, red, and brown. There are some great undulating roads, perfect for seeing the foliage.

During Spring, the showers of rain are really heavy. They're almost torrential. And people know how to drive in this. They even drive fast. They do not worry about oil on the roads. Sometimes it floods, yet, CT is mostly flat so they don't have to worry so much about the mudslides or flash floods. The hilly areas aren't around the coastal areas and the coastal areas are the places that flood. Also, people know how to drive in the snow.

People know if they have gas, electric, or oil heating. This becomes a debate. Which one is more expensive? I've had mostly electric heating. So, my electricity bill goes up about 100 to 200 dollars during the winter months. I lived in one place with oil heating. The shower was cold for about 15 minutes before it was scorching and then went back and forth between scorching and lukewarm. This did not make for a happy me. When the oil went out, I didn't really notice. The water didn't heat up for about 25 minutes and then was lukewarm. I didn't get the heater to work in my room so, I didn't know it was colder than usual. When it was fixed and I had to learn more about oil and the machinery in the basement that I had formally ignored, it was complicated and weird. It was all pipes, levers, and doodads. "And if it gets cold again, quickly switch this on and off to release the water, it'll be hot." I moved out about a month later. It was around $400 up front for the oil. My coworker recently had problems with his oil and it was $150 up front to get someone to come out to even look at the thing. Some places have free heating. It's definitely a selling point.

"Do you have front wheel or rear wheel drive?" I didn't know this was something important until I moved and was asked about it for the first time. My Toyota was a rear wheel drive. This is good for the snow. I also have drum breaks. This is also good because they don't have as much issues as cars with break pads. The drum breaks also help during the snow as long as snow doesn't get stuck in there. I spun out about three times (one in 2008 and two in 2009 on the same day). The first time, there was damage to my car. I hit the center divide. My coworker had the suggestion to follow trucks because they'll set the pace for what's safe to drive during the snow. The other two times, I was able to remember to take the hands off the wheel and the brake so I wouldn't try to overcompensate and fishtail. Yes, a person basically does nothing when they are sliding on snow and really, it's less scary that way. With front wheel drive, it's difficult to drive in snow.

I bought a car. Now, in California, you shop, you pick, you buy, and you drive away that day. You get a sticker to put in your window and go on your way. The title is on colorful paper with an embossed seal on it. CT is very different. You shop, pick, and then sign. You wait three days before driving off the lot. If you want to drive the car before then, you get to put on "Dealer Plates" with a piece of paper giving you permission to have those plates. Then, you sign, sign, sign, and then you get new plates for the car, they send back the old plates, and you get print out. That is title to the car. I think it's weird to have new plates every time you buy a car. If CT wanted to save money, they could get rid of that whole process and keep old plates on the cars.

The attitudes of people are very different between New Haven and the Bay Area. This was expected. When I lived in the Bay Area, my friends would easily cut me out of their life if I did something they didn't like. It was if they didn't have to worry about having other friends because there were millions of people to choose from anyway. New Haven is a small city. I think New Havenites understand psychology better. Although, they are not always smiling and welcoming as people in CA, they are friends for the long haul-- not superficially. If you mess up, they throw back a beer, either they tell you you f**ked up or they say that things need to change or don't do something and they continue being your friend. My friends and I joke that there are only 10 people in New Haven and you'll run into them at some point. And sometimes, there are only 5 people, it's just that they have different masks that they wear. There have been many a times when I was walking somewhere with a friend only to hear my name being called from a friend to join in on festivities.

I don't know how many people have told me that they either think I'm crazy for moving from San Diego to New Haven because everyone wants to live in San Diego. My thought is, "Yeah? You move there." Many people say they'd rather have tornadoes and hurricane winds than earthquakes. People are afraid of earthquakes. I say, "They're not that bad." I talk about being in the 1989 Loma Prieta Earthquake and some other earthquakes, including one while shopping near the beach in San Diego. There were lots in the middle of the night-- the bed shakes and then it's over. I think it's funny. I can't believe how many people say the same thing-- "They have earthquakes out there."

I don't know where this little gem came from but for a long time, I heard people talk about how California has "that free education." People apparently go out to CA and they have a free college education. I wish I would have known about this because I would have liked to have a free education. However, my education cost significantly less than even the community colleges here. My undergraduate work at San Diego State cost around $1,000 for the first semester (with 17 units) and around $1,300 by the time I was a senior. My graduate courses cost around $3,000 for two classes. Community colleges cost around $300 per UNIT, one class is around $1,000. In San Diego, one class is around $300 for a community college.

I thoroughly enjoy driving around 3 hours and being in a different state (if not two states), which is way different than CA. The whole length of CA is more than a 12 hour drive.

As my experiences grow, I will be able to write about more differences.

The Travelings of Middle Class White Women portrayed in Pop Culture

I've been reading the book Tales of a Female Nomad. I've been thinking about the culture of traveling to "exotic" places and it's role lately in popular culture. With movies such as "Eat, Pray, Love," "Sex and The City 2," or popular books like Medicine Woman. It seems that women, on the brink of divorce or with nothing better to do, go traveling to foreign (non-Western) countries or to visit non-Western cultures. With the exception of Tales of a Female Nomad, these books and movies include predictions from the very wise non-Western people from these "exotic" cultures. It gives the impression that every older non-Western person must have psychic abilities.
When I think about it, I think that's it's not only rude to the "exotic" culture, it's rude to the people in United States. Where are the movies about the men going on adventures in foreign places, the ones that don't include guns? Where are the movies or reality TV shows about letting a poor person of any race go on a grand vacation to some place they would never dream of or to those hard hit areas where assistance is needed? Where are the documentaries about the countless church goes who are building houses, going to orphanages, and who are assisting people in countries outside the United States? Are there good documentaries about cultures outside the United States, maybe ones where you just observe, no narration about what outside cultures who don't speak the language think that these other cultures are doing? I would rather see those and hear about those than to have these ideals about women in foreign countries and how safe, amazing and bourgeois it is.

Art Therapy and PTSD

PTSD and Art Therapy

With Veteran's day passed, some people have been raising awareness about post-traumatic stress disorder (PTSD). This happens when a person goes through something like war, persistant abuse, rape, and other traumatic events. Sometimes it can be a singular event (a person gets robs at gunpoint) or it could be a series of events (childhood abuse).
There are many symptoms to PTSD such as flashbacks, hypervigilance, anxiety, and depression. If you want to know more about PTSD symptoms, check out: http://www.webmd.com

Doing and Undoing
Freud talked about this as a defense mechanism. Say you thought something badly against someone and to undo that thought, you were extremely nice to them.
There are two ways that this comes out in art therapy:

1. Repetitive drawings.
There was a kid who was in the behavioral health hospital who went through a fire on Christmas. He drew Christmas trees over and over again. Sometimes he cross them out. Other times the firefighters came and put it out; then, the Christmas tree would turn to a scribble of blue. Sometimes the fire engulfed the tree and it turned to all yellow and orange scribbles.

2. Piecing back together
There was a Veteran who saw someone's hand blown off. He made a hand out of clay. The clay messed up. He was in tears, trying to get the hand back together. Eventually, he did put it back together and then was able to move onto peaceful pictures of jungles.

In both cases, the people in therapy were trying to control the things that had happened to them. The construction paper and the art materials themselves were a way for the trauma to be contained. They could regain themselves.

Revealing
The point of therapy is to get out what is on a person's mind. Trauma tends to stick with a person and they can't always talk about it to everyone. Sometimes these events and the issues surrounding the event come out anyway.
Talking isn't always a container. Sometimes when a person talks about events, they tend to feel raw and unsteady emotionally as well as have difficulty calming down. The advantage of art therapy is that people can talk about their art. Sometimes they don't even have to talk about their art or about their issues. They get to keep their secrets. The pictures will reveal what has been on their mind. Art gives a person a chance to reveal something without having to talk about it. This could be important for a person who has difficulty sharing. It may even lead to a person disclosing about traumatic events.

Regaining Control
When a trauma is happening, a person doesn't have control over the event. Some people with PTSD assign a great amount of blame to themselves, more than they actually had, as one way to gain control.
Another way to gain control is to gain mastery over art materials. This could be as simple as making a collage or as learning a new art technique. It also can be that on their paper/canvas, they can do what they want. As was seen with the kid with repetitive drawings, he could try out new endings for the event.


Art can help to manage symptoms of PTSD in several ways, including doing and undoing, revealing and regaining control. In using art, people with PTSD can start to process events and symptoms.