Sydney Coleman

Sydney was a delightful, happy, giving, talented and treasured child. She had many friends. She was on the ski team. She loved her brother, she loved her dad, she loved her mother, she cared about her friends. Sydney was happy and beautiful and brilliant. She had many talents and gifts. She helped people. She had great wisdom. She acquired great knowledge. She shared her knowledge and perspective willingly and graciously. She painted my son’s room for him. She was a gifted painter. An artist. A photographer. A good and generous friend.

I remember the drama when rain came into her life, incessant rain, and it all happened so metaphorically. It made the news. Their home lost its foundation, a classic Portland tragedy, and most of the back yard and the large deck of that old home literally slipped away from the foundation and down that slope into abyss. Proverbial slippery slope. The family was wrecked. The parents divorced. It wasn’t sunny anymore. Times were not easy. There were oh so many changes, now into middle school years, and it was hard to navigate for awhile.

When they were freshmen (or sophomores?) Hilary and Sydney decided to go to the prom. It wasn’t their time for prom, but they wanted to do it, and they pulled it off. The photos of those two girls with their dates, whom I think they had randomly inveigled into the role of prom date, are fond memories of their uninhibited enthusiasm. I am so sad for my daughter, who conveyed this news to me last night in great sadness. Friends, all of you, I urge you to make expression to each other and to Sydney’s loved ones. Whenever you will. Death will become less recent, that’s all it can do. It does not end.

Tragedy again, when as a senior in high school, Sydney suffered a trauma in a car accident, again rolling down a hill. She told me she had suffered a head trauma but did not think it was serious and did not seek treatment for it. She was unable to graduate with her class. She did not go off to college as the other Lincoln High grads did, but she worked to complete high school, and finishing was a tremendous point of pride.

It surprised me to learn the course her life took next. I don’t know the origin of the decline, but young Sydney was committed and lived in a psychiatric hospital near the Convention Center for most of several years. Normal was gone. Being heavily medicated and living in community with other psychiatric in-patients became the “norm” Sydney tried to fit, with the other in-patients, mostly young adults, but also some veterans of the psychiatric culture. Sydney was popular, as always.

I am sad to write this. Sydney lost her life yesterday morning when she was hit by a Max train, in the rain, while listening to her ipod, her head covered by a hoody, apparently oblivious to the train signals.

She had a child. I am so glad that she was able to know him and to love him. She was able to raise her son and love him, with the help of family. She regained the privilege of her freedom in halfway houses, but years of in-patient psychiatric treatment take away so much, especially for young adults (or children) whose brains are still developing, as was the case for Sydney, only 24 years old when she died, on February 26th.

Despite her partial recovery, Sydney was subsumed into sadness over her circumstances. There were many pressures on her. She called me several times over the last few months. She was emotionally not a 24 year old, like her peers, but it was wonderful to see her catching up. She could have made her life into what she deserved for it to be. Her own art. She was very talented.

I believe that her death was from inattention, only, but my sense is that the inattention which caused her death was a consequence of sadness. And the sadness was from circumstances which she did not create, and became her prison.

A child needs to be free to fail, to fall, to fly. Acceptance is everything. Sydney was a responsible child; she was also an earth child, a hippie child, a bohemian. She was so good at all of that. If only . . . . but her light . . . and now it’s gone. One of the future leaders of her time. Long since unrealizable. So the question matters . . . what can we, her people, do to replace that lost promise? Only learn from it. And go on without her.

One cannot hide from the needs of one’s soul. The soul is the eternal companion to the body/personality/self. Sensitive friends, please pay heed to your soul’s expression, whether it be madness or sadness or joy or confusion. Allow it; do not repress it. The soul will find expression regardless how the mind may try to refashion it! Sadness, differences, even dangerous thoughts must be allowed, if the spirit chooses them. It is the unforeseen which is a danger; not the unwanted.

Be in peace, Sydney Coleman. I know that your soul has made for you an honorable choice in your sad circumstances. You are greatly loved! Be free. Love well. Stay in tune, dear sweet young Sydney. We will miss you often and think of you always. I will not forget the date you died. Love to you on your unleashed journey. Bring us art and joy and the happiness you deserve. I know you will!

By Kathleen O’Brien, February 27, 2010

From the Salem Statesman-Journal, February 26, 2010

A blistering federal critique of patient care at the Oregon State Hospital wasn’t shared with a new hospital advisory board before it appeared this week in the press, prompting anger and complaints from members of the governor-appointed panel.

“I was pretty disturbed that I read it in the Statesman Journal, and that as a board member I didn’t hear about it in advance,” said Robin Henderson, the director of behavioral health services at St. Charles Medical Center in Bend. “As a board member, I have a right to see those types of reports. It’s part of my responsibility. Otherwise, what am I?”

Board member Mike Adelman, a former state hospital patient, said he fears that the panel is being kept in the dark about lingering problems at the Salem psychiatric facility.

So far, he said, the panel has mainly received rosy reports from hospital officials during three meetings held in October, December and January.

“If we’re going to be worth our salt, we need to do something other than just listen to them talk about how well they’re doing, when obviously, according to the feds, they’re not,” Adelman said.

Amid the flap, OSH Superintendent Roy Orr said Thursday that “there’s no cover-up going on here, there’s no sweeping anything under the rug.”

The hospital chief said he didn’t share the federal critique of OSH with the board until after it was reported in the press because of confidentiality ground rules set by the U.S. Department of Justice.

“From the outset of our relationship with the Department of Justice, they’ve been very clear that they do not want any of their correspondence, which I would emphasize is attorney to attorney, made available publicly,” Orr said.

“I’m very respectful of the somewhat fragile nature of our current relationship with the DOJ. … If we don’t abide by some of the ground rules they have given us, we will become one of those state hospitals around the country which has gone from being under their watchful eye to being sued in federal court.”

The feds have been investigating Oregon’s main mental hospital since mid-2006.

The 2009 Legislature created a state hospital oversight board after patient care and hospital conditions were assailed in a report issued by the U.S. DOJ’s Civil Rights Division in January 2008.

The report alarmed state officials and spurred reforms, ranging from the hiring of hundreds of new hospital employees to the opening of centralized treatment malls designed to give patients better treatment.

New criticism of the 127-year-old institution surfaced in a federal review of care for patient Moises Perez, who was found dead in his bed Oct. 17 at the psychiatric facility.

Perez, 42, died in a secure treatment unit in the hospital’s forensic psychiatric program. An autopsy determined that he died from coronary artery disease.

A federal review of the deceased patient’s care, conducted by scrutinizing hospital records in the year leading up to his death, found that therapists, nurses and staffers consistently failed to provide him with adequate supervision, nursing, medication, medical care and psychiatric treatment.

Shanetta Cutlar, chief of the Special Litigation Section of the U.S. DOJ’s Civil Rights Division, outlined the care defects last month in a letter to the Oregon Department of Justice. She said the gravity of the case triggered federal alarm about the overall health and safety of OSH patients.

Cutlar’s Jan. 7 letter to the state arrived before the hospital advisory board’s latest meeting, held Jan 21.

Orr talked about aspects of Perez’ care at the meeting but made no mention of the federal critique.

“He didn’t even bring it up,” Adelman said. “That’s very troubling. It’s like he’s hiding stuff from us.”

State Rep. Carolyn Tomei, D-Milwaukie, a non-voting member of the hospital advisory board, said she was taken aback by the newspaper report that detailed the federal critique of OSH.

“We did talk about the young man’s death at the last advisory committee meeting, but I had no idea that the feds were looking into that, nor did I have any idea they had written this letter,” Tomei said. “I guess I would have appreciated knowing that there was such a missive from the federal government.”

Tomei said she was dismayed by the litany of care defects cited in Cutlar’s letter to the state.

“That’s terrible,” she said. “That’s very discouraging.”

Senate President Peter Courtney, D-Salem, who has championed the Legislature’s financial support for hospital reforms and is a non-voting member of the advisory board, did not return a phone call seeking comment on the new federal criticism of OSH.

After this week’s newspaper story, Orr e-mailed to all the advisory board members Cutlar’s Jan. 7 letter and a Feb. 12 state response letter written by Micky Logan, a senior state assistant attorney general. The e-mail stated: “From the onset, the USDOJ has asked that none of its correspondence be disseminated. Our attorneys will continue to honor that request. By law, however, we are bound to release records that are public when a request, such as the one from the Statesman Journal, is made.”

The newspaper recently obtained Cutlar’s letter and Logan’s response to it through a public records request filed with the Oregon Department of Justice.

Orr assured board members that he is committed to providing them “with timely information about OSH, and whenever possible, advance notice of news coverage.”

But several board members said they intend to raise concerns about what they perceive as a lack of critical information coming before the board. They plan to bring it up at the board’s next meeting, set for March 18.

Henderson, a veteran administrator at psychiatric hospital units in Oregon, said it’s essential for the board to delve into problems affecting patient care.

“Those are things that need to see the light of day,” she said. “I’m intimately familiar with how things work in inpatient psychiatric units, and I’m very concerned that we’re not privy to pieces of information that would help us be of assistance, real assistance, at the state hospital.”

Bruce Rogers, a Salem City Council member who serves as chairman of the advisory board, said the panel still has to figure out its role and determine what information can and can’t be discussed at its public meetings.

“I think that’s the dilemma we’re working through,” he said. “We’re not a confidential committee. Everything that comes to us is in the public arena.”

The Oregon State Hospital Advisory Board is not competently chaired. Eight months after its formation no roster of members has been released to the public, no meeting announcements, no agenda, no minutes from meetings have been issued. The scope of work of the Board, the names and contact information of staff, it’s objective and powers are entirely obscure. Until these basic organizational tools are implemented by chair Bruce Rogers, participation breeds contempt.

Joe Anybody’s made a good documentary video about the Albina Ministerial Alliance’s rally about the shooting of Aaron Campbell, from February 17, 2010

Part I

Part II

Part III

Part IV

Part V

From the Salem Statesman Journal, February 24, 2010

Federal investigators have slammed Oregon State Hospital again, citing “alarming” failures in care for a patient who died at the Salem psychiatric facility in October.

The U.S. Department of Justice found numerous flaws and failings in hospital care provided to Moises Perez during the year before his death, documents obtained by the Statesman Journal show.

Writing last month to the Oregon Department of Justice, a U.S. DOJ official said the case has triggered concerns about the overall health and safety of patients at Oregon’s main mental hospital.

Breakdowns in Perez’s care mirrored hospital problems that federal investigators reported to the state two years ago, wrote Shanetta Cutlar, chief of the Special Litigation Section of the U.S. DOJ’s Civil Rights Division.

“Given the amount of time that OSH has had to remedy these deficiencies, we are particularly alarmed by the failures that appeared to have occurred in this case,” she wrote. “We urge OSH to take immediate measures to address these deficiencies in order to prevent similar harm to other patients and to comply with OSH’s obligations under the U.S. Constitution, the Americans with Disabilities Act, and other applicable federal laws.”

On Oct. 17, Perez, 42, was found dead in his bed in a secure treatment unit in the hospital’s forensic psychiatric program. His death was discovered about 7:35 p.m. by a staffer delivering his evening medication.

Perez’s death sparked complaints from other patients and mental health advocates who alleged that staffers neglected Perez and that he was dead for hours before anybody noticed.

A state police investigation found no criminal wrongdoing. An autopsy determined that Perez died from coronary artery disease.

The U.S. Department of Justice reviewed Perez’s care as part of its ongoing investigation into patient care and hospital conditions.

OSH therapists, nurses and staffers consistently failed to provide Perez with adequate supervision, nursing, medication, medical care and psychiatric treatment during the last year of his life, Cutlar wrote. His care “failed to meet generally accepted professional standards” and “consistently fell well below constitutional and statutory standards,” she reported.

The federal agency has concerns that similar defects in care may “likewise violate patients’ rights and foreseeably could give rise to serious harm or death in other situations,” states the letter.

The Statesman Journal obtained Cutlar’s letter, along with a state lawyer’s response to it, through a public records request filed with the state Department of Justice.

The federal review of the case stopped short of concluding that any treatment flaws or failings directly contributed to the patient’s death.

“We understand OSH is conducting its own review, and we respect that process and await those findings,” Cutlar wrote. “We received a limited amount of information, which did not include autopsy reports. We therefore refrain from making any determination as to whether the failures that occurred contributed to the patient’s death.”

Feds uncover familiar problems

The U.S. DOJ’s latest criticism of OSH comes as the state is building a new psychiatric hospital on the Salem campus. The $280 million complex, billed as a world-class facility by state officials, is scheduled to partially open in the fall and become fully operational in 2011.

Cutlar’s letter demonstrates that federal investigators are far from satisfied about reform-minded efforts at the existing 127-year-old mental institution. It also indicates that tough federal monitoring of the hospital won’t end anytime soon.

The U.S. DOJ’s investigation of the hospital began in June 2006.

In January 2008, the agency issued a scathing report that criticized nearly every aspect of patient care and hospital conditions. The report shocked state officials and spurred sweeping reform-minded efforts.

State officials have touted improved patient care. But federal reviewers reportedly found all-too-familiar problems during their review of Perez’s care.

“Specifically, our review revealed inadequate nursing, medical, mental health, and psychiatric care, including a failure to provide individualized treatment,” Cutlar wrote.

Additional shortcomings included deficiencies in the patient’s medication management, supervision and planned interventions for his risky behavior.

“Unfortunately, these are all issues that we have identified as system-wide issues in our findings letter issued January 9, 2008, and that we largely continued to observe during our latest tour of the facility in July 2009,” Cutlar wrote. “We therefore believe that a pattern or practice of violations of patients’ rights continues to exist at OSH.”

Barring an out-of-court settlement with the feds on terms for hospital reforms, the state continues to face the threat of a federal lawsuit that could place the state-run facility under federal court control.

State lawyer defends OSH

Responding to Cutlar’s letter, an Oregon lawyer acknowledged that Perez’s death stirred concerns, but she defended the state’s push to provide patients with better care.

“Like USDOJ, OSH was and is very concerned about this death,” Micky Logan, a senior state assistant attorney general, wrote in a letter to Cutlar dated Feb. 12.

There’s “no doubt” that Perez’s death brought added momentum to the hospital’s drive for reforms, prompting the facility “to redouble its improvement efforts generally and to focus specifically on several issues that you and OSH each identified,” Logan stated.

Her letter outlined 25 “significant changes” made at the hospital since Perez died, including enhanced patient monitoring, increased medical and nursing staffing levels and new standards for dispensing medication.

Logan, the state’s lead attorney in dealing with the feds, denied the U.S. DOJ’s assertion that systemic hospital deficiencies jeopardize patients’ safety and constitute sweeping violations of their civil rights.

“As serious as this event was,” she wrote, “Oregon does not agree that it demonstrates a pattern or practice of violations of patients’ rights.”

Logan emphasized various hospital reforms adopted in recent years, and she said that members of a federal team who made a weeklong visit to OSH last summer appeared to be favorably impressed with the progress. Logan said she was taken aback by Cutlar’s assertion that the federal team observed lingering problems at OSH.

“This statement comes as a surprise to us, as our interactions with the US DOJ experts throughout their July 2009 visit suggested to us that they were favorably impressed by the significant improvements they observed,” she wrote.

The state attorney complained about Oregon officials being kept in the dark about key federal findings during the prolonged investigation.

“We note that we have requested on multiple occasions that US DOJ provide us with the reports of all its experts,” she wrote. “While such reports (especially the most recent) would be of particular assistance to OSH in its ongoing efforts, we have not received copies of any of these reports.”

Letter from Special Litigation Chief, U.S Department of Justice Civil Rights Division Shanetta Cutler to Oregon Assistant Attorney General Mickey Logan, 2 12 2010

Letter from Oregon Assistant Attorney General Mickey Logan to Special Litigation Chief, U.S Department of Justice Civil Rights Division Shanetta Cutler, 2 12 2010

READ – Letter lists oversights in patient’s death, Salem Statesman-Journal, February 24 2010

Poster for "The Crazies." (Overture Films)

Going to a good horror movie is a great way to spend a Saturday afternoon. And going to a bad one can be even better. “The Crazies,” opening in Portland on Feb. 26, promises plenty of horror–but probably not the kind the filmmakers intended.

In this remake of George Romero’s 1973 parable on the Vietnam War, the residents of a small Midwestern town start to descend into madness, and a small band of neighbors must fight for their lives.

The official movie website says that, as residents start to go insane (due to a mysterious toxin in the water supply), they are turned into mindless, depraved killers with an uncontrollable thirst for violence and horrific bloodshed. The few healthy citizens are plunged into a terrifying nightmare, and must battle their neighbors for survival.

Sound like a satisfying bit of mindless fun? Maybe. Except that it’s part of a genre of psycho killer movies informed by fear, misunderstanding, and deep-seated prejudice.

To put the movie and its message in perspective, imagine this:

What if the residents of a small town, infected by a mysterious toxin, turned into members of any other minority group–and became depraved killers?

What if people started developing any other kind of disability, and then automatically went on a killing spree?

Most people would find it shocking–even for a horror movie.

People with mental health challenges are human beings. They are moms, dads, employees, professionals, community members. They have daily struggles, just like anyone else. They’re a diverse group of people, with individual likes, dislikes, talents, and dreams.

What about the risk of violence, then?

Even among persons with severe problems, including psychosis, an August 2009 review by Martin Grann, Ph.D., found that the risk of violence was insignificant, unless the person also abused alcohol or drugs. Grann reached this conclusion based on 20 studies, which included a total of 18,423 individuals with mental illness and 1,714,904 individuals from the general population.

In other words: mental illness by itself does not predict violence.

Sadly, in the movies, according to a study cited in the Surgeon General’s Report on Mental Health, people with mental illness are frequently portrayed as homicidal maniacs. This perpetuates a stigma that’s more toxic than anything in the water.

According to the Surgeon General’s Report, “Stigma leads others to avoid living, socializing or working with, renting to, or employing people with mental disorders… It leads to low self-esteem, isolation, and hopelessness, [and can even result in] outright discrimination and abuse.

“More tragically, it deprives people of their dignity and interferes with their full participation in society.”

We just noticed – the Oregon Health Forum died back in December 2009. Likely cause? Boredom and a bad board.

When the four-page newsletter first came to our attention in the early 1990s it was a fascinating read, a true dope-sheet with the inside stuff, the real close-the-door-I-gotta-tell-you gossip we all want to read. Who got fired and who got rehired. Who’s suing who. The payrolls of insurance and HMO presidents. On-the-record interviews with the middle-managers who wrote and broke policies.

If you were a health-politic-geek it was a necessary read. Remember way back when, in the olden days, when you would pick up Willamette Week to make sure you weren’t in it, and stay to laugh at the mug shots of your friends and enemies? It was like that. But about healthcare.

The newsletter grew under the auspices of Diane Lund-Muzikant who chose, for reasons we could never quite understand, a nonprofit model. Finding friends and industry-insiders who knew to keep their enemies close, her board also grew. Lund-Muzikant, a hard-headed former Oregonian reporter, knew all the sore spots and kept poking, seeking accountability, transparency, and good government.

The board veered away from independent advocacy and toward industrial-sympathies and in October 2006 Lund-Muzikant was out.

The Oregon Health Forum limped along for a couple of years, and under new publisher Carol Robinson content dissipated, good healthcare writers came and went, and the spirit to write – and bite – was lost. The nonprofit board, now filled with PR flacks from a dozen different agencies suitable for criticism, had won.

In 2009 Lund-Muzikant launched The Lund Report, and wrote the obits for the OHF, see below.

Health, next to government and education, is one of the biggest industries in Oregon. The public spends billions on it each year – and most of us haven’t a clue about the value of our exchange. It takes independent and impartial reporter to bring us this information – so the crack-up of the OHF in 2006 was a great loss. That it finally stopped printing in 2009 was hardly a blip.

Oregon Health Forum Closes Doors – The announcement makes The Lund Report the sole provider of dedicated Oregon healthcare news, December 2009

My Take on Why Oregon Health Forum Went Under – Diane Lund-Muzikant offers her thoughts on the demise of the organization she founded, December 2009

http://www.flickr.com/photos/deadstar/ / CC BY-NC-ND 2.0

Many people think psychosurgery is a thing of the past, and it’s true that lobotomies have become rare. However, psychosurgery is very much alive. Neurosurgeons are trying to rehabilitate the practice, and they may be succeeding.

Because of its dark history, psychosurgery has been restricted and forced to take a low profile. But in 2010, with a new name–“functional neurosurgery for psychiatric disease”–and new techniques like deep brain stimulation, some clinicians are predicting a comeback.

Psychosurgery is now being explored for everything from depression to addiction. In a two-part article, psychosurgery’s grim history–and quiet comeback–are explored.

Read more:

Part 1 – A chilling history, and a possible comeback

Part 2 – From lobotomy to deep brain stimulation