Mental Health

Much was made of the tragic, self-inflicted gunshot death, of Sen. Creigh Deed’s son over Thanksgiving. It once again focused attention on Virginia’s broken mental system. I have written regularly about the large number of over-medicated inmates and their “thorazine” shuffle, how prison psychiatrists write prescriptions for “cocktails” of multiple anti-psychotic meds with little or no actual treatment being offered.

      And it is even worse. Forget the long-term health concerns from poorly managed anti-psychotics; there is the lack of coherent mental health care on site that is equally appalling.

      The prison employs three women in a “psychology” office. Problem is, none are psychologists. All three have BAs in psychology but nothing further. They serve as “gatekeepers” – they make “treatment” recommendations – for the D.O.C. psychiatrist who literally is a “Doc-in-the-box.” Medicated inmates speak to the psychiatrist via videoconference for less than 5 minutes every 90 days. There is no other medical treatment except blood work (these psychotropic drugs can cause liver damage).

            The “psychologists” are quick to offer diagnosis and place an inmate in a category: bi-polar disorder; schizophrenia; depression; there is a “top ten” list and men are neatly packaged into them. But, without meaningful one-on-one care all that is done is place the men in a drugged stupor. And these labels – so easy to attach – become self-fulfilling. These labeled men then tell you they can’t “help” their behavior. They have a “disorder.” And they use the disorder as a crutch; and they believe they are entitled to disability and release from prison without addressing why they did what they did. They are lied to repeatedly about their condition and then over-medicated and under treated. They go home and fall back into the same self-destructive lifestyle. And they return.

            That isn’t mental health. Many men here have significant psychological issues. However, the answer isn’t always high doses of mind-numbing chemicals and catch all diagnoses chosen from the newest DSM like one would order off a menu. Legitimate mental health education requires one-on-one treatment and regular assessment and control of prescription medication. That doesn’t happen in here.

            Like most things involving the Virginia Department of Corrections, mental health treatment exists only as words not as a real program. The cost – to provide actual in-patient treatment – would be staggering. Instead, the men are treated like cattle at a slaughterhouse. Each night forty to forty-five of the seventy-two men I reside with line up for pill call. And they have their pills placed in small Dixie cups – Seroquel, Prozac, trazadone, thorazine, the list (and the pill colors) are endless.

            They take their pills, numb their minds, and stagger back to their bunks. Some day they will be released; but what are the ramifications for DOC’s mental health failure? What indeed.

The Senator's Son

A lot of attention was directed toward State Senator Creigh Deeds as Virginia’s new Governor – Terry McAuliffe – was sworn in. In less than one week, the outgoing Governor recognized Senator Deeds return to work during his farewell “State of the Commonwealth” address. Face it; Senator Deeds presents a compelling story. It is a story, unfortunately, that is widely ignored and swept under the proverbial rug except when violence erupts. Then – and only then – do we ask “why?” Why indeed.

            As everyone knows, shortly after Thanksgiving week a 911 call was placed by a neighbor of Senator Deeds. The Senator had been discovered staggered and bleeding as he walked along a rural roadway in Bath County. Deeds had been stabbed numerous times. Police went to the Senator’s house and during a guns-drawn search, found the body of Deed’s son, dead from a self-inflicted gunshot wound.

            Within a day the public learned that the Deeds’ son had suffered from serious mental illness. Interestingly, it has not been disclosed what this actual diagnosis was. A bright, quiet kid, his mental disorder led him to leave William and Mary College and – just days before his suicide – a failed attempt by his father (Senator Deeds) to have the young man hospitalized. For another few weeks (just like after the VA Tech massacre) Virginia’s mental health apparatus was on full display. The picture was not good.

            And now, with Senator Deeds healing from his physical wounds while grieving the death of his beloved son, the politicians gather again in Richmond to kick off yet another session of the General Assembly, and they say, “Something must be done about mental health.” Please, give me a break.

            His name is Gary. Of course, it could be Thomas or Tyrone or a dozen other names. Gary is thirty-five and suffers from schizophrenia. Each day, both morning and evening, Gary takes a combination of psychotropic medications. The pills dull his senses to the point that he sleeps upwards of twenty hours a day. It’s the only way DOC has found to turn off the voices in Gary’s head. That’s right; Gary hears voices, multiple voices. The pills work most times. But, there are other times, like last week …

            So Gary’s up three days straight. Even doped up with enough crap to stun a bull moose, he’s up twenty-four straight hours for three days. He’s fidgety. “What is it?” I ask, when a friend of Gary’s asks me to write up an emergency grievance to get him to medical. “It’s the voices,” the guy tells me. “They’re talking non-stop and telling him all kinds of crazy shit.” So I file the emergency grievance and I put in it, “psychotic breakdown,” words Medical knows Gary doesn’t know, and an hour later he’s called to medical. I see him a short while after that. “How’d it go?” I ask. “Ok. I’ll see the Psych tomorrow on video conference and he’ll adjust my pills.”

            That’s right; the psychiatrist isn’t actually on site. He handles multiple prisons via “video conference.” Five minutes on camera and a new script is written. More pills prescribed. It’s economics. You’ve got over one-third of the men here on psychotropic meds. That’s the extent of DOC’s psych treatments unless you’re unlucky enough to find yourself sent to Marion – that’s the state prison for the criminally insane.

            How bad do you have to be to end up in Marion? Try this: I’m at the receiving unit, also known as “hell,” and there’s a nineteen year old kid so wacked out that every night he’d scream “help me Jesus, they’re killing me!” He’d yell like that for hours until 4:00 a.m. when he would shout like a rooster “cock-a-doodle-doo.” And, paper, bars of soap, and profanity would be unleashed against the front of his cell. That young kid was shipped to Buckingham a level 3 prison. He was crazy, not criminally insane.

            Yeah, mental health should be a priority for the state. Almost half the Virginia DOC inmate population suffers from some mental disorder or illness. Here’s the irony: Tens of thousands of Virginians suffer from a mental disease or disorder and the state uses the criminal justice system to control them. Schizophrenic? Hear voices? That’s no excuse. You break the law, you go to prison. Then, all the prisons do for your mental condition is load you up with drugs. You need mental health services in the Commonwealth? Go to jail. At least you’ll get meds.

            I’m sick of politicians and private citizens wringing their hands every time a young Mister Deeds appears on the scene. Collectively, we don’t give a shit about mental health. It’s only after the poor, sick bastard acts out that we talk about it. You want to see how much Virginia cares about mental health? Come inside a prison during “pill call” and watch the hundreds of zombies stand in line for their hit of Prozac, or Thorazine, or Seroquel, or all three.

            There’s another young Mr. Deeds out there and Virginia’s only solution right now is to let him act out then watch him kill himself or send him to prison. That’s harsh, and vulgar, and way too accurate.