Alienation and brutality

Alien Boy documentary

Alien Boy: The Life and Death of James Chasse is a documentary, available on Amazon Prime, about a man with schizophrenia who was killed by police in Portland, Oregon.  This film was funded by The Mental Health Association of Portland and over 1500 individual supporters, which I thought was pretty impressive.  It’s an extremely disturbing example of policy brutality against a man who had done nothing wrong except be mentally ill.  This wasn’t just an isolated incidence of brutality by two officers who had previously been named in police brutality lawsuits, but rather an indication of much broader problems with use of force and police attitudes in general when it comes to people with mental illness.

James, or Jim Jim as he was known by family and close friends, began having psychotic symptoms in his mid to late teens.  He lived in a series of group homes in her early adulthood, but got stabilized on medications and was able to live independently.  He was a regular at the public library, and he enjoyed drawing comic books.

In the couple of months leading up to his death, he had stopped taking his medications.  His mental state deteriorated, and his hygiene and self-care were very poor.  He had lost a significant amount of weight.

On the day of his death, police approached James in a public area.  They noticed that he was stiff legged and rocking side to side.  One of the officers later said that he was “hunched over, and his hands are towards his waistband like somebody either urinating or just starting to finish and do the shake”.  When addressed he looked at the police with “sheer terror” in his eyes and the cops  suspected he was going to run.  James had good reason to want to run; he had been beaten up by police in the past.

He did run, and police gave chase, with one of the officers tackling him.  The officer (250ish pounds) later said in an inquiry that he pushed James down but denied that he landed on top of him.  Witnesses commented that “it literally looked like 2 people shaking out a rug”, with knees to  his chest, punched in the face, and kicked.  He was then tasered and he passed out, lying in a pool of his own blood,

Photos taken by witnesses show James on the ground, handcuffed and with leg restraints.  Fire and ambulance personnel were standing around with police, two of whom were holding cups of coffee.  Meanwhile the police were heard by witnesses making false statements about James having drugs.  Paramedics were not informed of the force used or the tasering.  They found his vital signs were normal, and left it up to police to decide if he should be transported to hospital or taken to jail.  They chose to take him to jail.  As the paramedics were packing up to go, James cried “don’t leave me, don’t leave me” according to witnesses, although the police denied this in the inquiry.

Video from the jail shows the cops carrying him in, arms and legs restrained, like you might carry a duffel bag, with a spit hood over his head.  Once they had him in a cell he started breathing and started seizing.  They called the jail nurse, but didn’t take the spit hood off.  When she showed up, she decided that she couldn’t take responsibility for him, so the cops decided to drive him to the hospital, which was 15-20 minutes away, still restrained and with the spit hood on.  They stopped to talk to a sergeant on the way out, and did not have lights and sirens on for the drive to the hospital.  Along the way, James died.

The state medical examiner found that the cause of death was blunt force chest trauma.  He had 26 breaks to 16 ribs, including in areas that aren’t necessarily that easy to get at.  She suspected he likely would have survived had paramedics transported him to hospital rather than police taking him to jail.  The toxicology report showed no drugs of any kind, including medications.

A grand jury review of the in custody death resulted in no criminal charges.  After an internal review by the police bureau, the city requested a Department of Justice investigation into bias in how the local police dealt with mental illness.  That investigation concluded that the Portland police did use force excessively, including tasers, and this force was often used in dealing with minor offenses committed by people with mental illness.

Oh, and the officer who tackled James?  He later ran for county sheriff and was elected.

Police have a hard job to do.  But this kind of thing should never happen.  I can understand that on the rare occasion someone who’s highly psychotic and brandishing a weapon may not be able to be safely contained without legal force.  I can accept that.  But James Chasse?  He did absolutely nothing except be mentally ill.  I suspect that an animal would have gotten better treatment than did Mr. Chasse, a man who was ill and needed to go to hospital.

I think prosecutors and governments need to really reflect on how they make decisions about pursuing prosecution when it comes to in custody deaths, particularly when it comes to marginalized communities, like people with mental illness, like racial minorities.  The police should be there to protect the most vulnerable, not to take their lives.  Change can’t happen soon enough.

 

Have you checked out my book Psych Meds Made Simple?  It’s available on Amazon as an ebook or paperback.

International Women’s Day: Balance for Better

International Women's Day: I will maintain a gender parity mindset

Today is International Women’s Day, and the theme for this year’s theme is #BalanceforBetter.

To me, feminism is about tearing down the gender norms and stereotypes that divide us and marginalize people who don’t fit into certain boxes.  This is not about sameness, because we are all unique, although as human beings there is more that unites us than divides us.  It’s about our merit being assessed based on who we are, not what’s between our legs.

In my mind #BalanceforBetter is about having the same opportunities available to us regardless of gender.  Where we choose to go in pursuing those opportunities will reflect our own unique selves, but it should not be dictated by stereotypes.

Whether we’re talking about mental illness, other disabilities, or gender, we all deserve not to be constrained by the labels people choose to apply to us.  Instead, we deserve to be recognized as the amazing individuals that we all are.

Legislated stigma

infographic of scales of justice

Stigma can be found in many places, even places where we might like to think it shouldn’t be.  One such place where I have found it is in government legislation, hence the title of this post, “legislated stigma”.

As a registered nurse, my professional license is through the College of Registered Nurses of my Canadian province, which is covered by the provincial Health Professions Act.  This legislation applies to many different health professions, and addresses multiple aspects of professional practice, including health professionals whose ability to practice is impaired.  Health professionals are required to report to the appropriate regulatory college if they have reason to believe another health professional poses a risk to the public related to impairment due to any sort of health condition.  A provision along these lines is typical for health professions legislation in many jurisdictions.

My province decides to take things a step further with its legislation by including a provision that doesn’t exist in any form in any other province in Canada.  If a health professional is admitted to hospital for psychiatric reasons or substance abuse, the hospital is required by law to inform the patient’s regulatory college, and the regulatory college is to treat this as a complain about the individual’s fitness to practice.  Full stop.  No assessment of risk, just mandatory reporting based on diagnosis.

I initially found out about this during my first hospitalization in 2007.  My mom was regularly checking my mail, and brought me in an envelope that had come from the College of Nurses.  The enclosed letter stated they had “received a complaint about [my] fitness to practice”, and I was given the non-choice of voluntary giving up my professional license or having it taken away.  I was gobsmacked.  Who had complained and how could I possibly be a risk to anyone but myself?  It’s not like I could have wandered away from my involuntary hospitalization and  somehow found some patients to start providing care to.  Oh yeah, these aren’t hospital PJ’s, they’re nurse’s scrubs, and the hospital socks are just because they’re comfortable!?!?   I was frantically asking different hospital staff, trying to find out who had been low enough to do this behind my back.  Eventually I found out it was the nurse manager of the unit, and her explanation for why I hadn’t been informed was that it had happened shortly before I was being transferred to the psych ICU.  Great.  Thanks a lot.

When I (and my community psychiatrist) eventually managed to convince the College of Nurses that I was no longer crazy, they slapped a bunch of conditions on my license. One of these was that I share those same conditions with my employer.  Even though the conditions didn’t spell out details of my mental illness, the condition that I had to see a mental health team and get regular reports submitted by my psychiatrist blew any chance of privacy I might have hoped for straight out of the water.  And those quarterly reports the College required my psychiatrist to submit meant that I ended up lying through my teeth to him.  When I decided to go off meds, I didn’t say a word about it and kept picking them up from the pharmacy at regular intervals to back up my lie, because I didn’t want the College of Nurses or my employer to know what I was doing in terms of my own health.  I’m not sure how that situation helps anyone…

My next two hospitalizations were at a different hospital, where either they didn’t know about or chose to overlook the mandatory reporting requirement.  During my fourth hospitalization, I was again reported to the College and given the non-choice of giving up my license or having taken it away.  The doctor who initially reported me didn’t have the cojones or consideration to actually tell me; I had to find out about it later from someone else.

So, privacy is all fine and dandy right up until the government decides it isn’t.  It’s worth mentioning that at no point did anyone treating me ever express concerns that I was posing a risk to anyone besides myself.  If I was hospitalized for a neurological condition like brain cancer or epilepsy, there would be no requirement to report me, but because my brain condition happens to be psychiatric, all of a sudden I am deemed to present a risk to the public, full stop.   No professional judgment allowed on the part of treatment providers; if I am hospitalized for depression then that is more than enough to determine that I am dangerous and people need to know about it.

Add this to the rest of the negative experiences I’ve had in hospital and I’ve come to a few conclusions.  One, I will never voluntary admit myself to hospital.  And two, I will never knowingly say anything to a doctor that is likely to get me committed to hospital.  That means I never disclose to doctors when I’m having thoughts of suicide.  Again, not sure how that situation helps anyone.

When I was a little younger and a little less jaded, I tried to campaign to change the legislation.  I was in grad school at the time and one of my courses touched on policy briefs, so I wrote a policy brief citing legislation from other jurisdictions and relevant case law.  I sent it to anyone that I thought might be willing to read it.  My provincial nurses union and professional advocacy association didn’t even have the courtesy to respond with an acknowledgement.  A couple of organizations expressed an interest and did take the issue to the government, but didn’t get anywhere.  I don’t know what else is in my power to do.

The fact remains, though, that this is discrimination specifically against people with mental illness that is enshrined in provincial legislation.  And no one seems to care.  For all the talk by government-mandated organizations like the Mental Health Commission of Canada about addressing stigma, I’m living in a province where, because I struggle with depression, I am considered a second-class nurse who doesn’t deserve the right to have my private medical information stay private.  There is something really fundamentally wrong with that, and it means that indirectly the government is putting my health at risk.  And that should never be ok.

 

Image credit: johnhain on Pixabay