Mental health care gets a pink slip in Dayton

This story better have a happy ending.

Right now, a 45 year old service disabled veteran with mental health problems is not in the VA getting treatment, he’s in Sheriff Phil Plummer’s hell hole of a jail. This is where people with misdemeanor crimes end up dead. This is a country that says collectively that 20 veterans committing suicide a day is a problem we’re committed to stopping, and yet, here is a man, who wasn’t trusted with his own shoelaces last week while confined to a psych ward at Grandview, now behind bars for being mentally ill.

People say blame Ronald Reagan for shifts in policy in mental health care that closed down mental hospitals across the country. You can read about the case that was made for deinstutionalization of the mentally ill in this excellent article in the New York Times from 1994: HOW RELEASE OF MENTAL PATIENTS BEGAN or this article from Salon from 2013: Ronald Reagan’s shameful legacy: Violence, the homeless, mental illness either way, the answer is the same, we traded away a broken attempt at government health care into the hands of big pharma who no doubt lobbied their way into the market for their brand of medicine- take a little pill and everything will be ok, which is fine, if the mentally ill people would only act rationally. Which they don’t.

I could take you on a tangent, to go on a rant how this action by the government created our problems with homelessness, the panhandlers, and the growth of our prison population. We’re good at whitewashing our real problems with new solutions that aren’t, as long as it can sound good coming out of a congressman’s mouth- as a paid puppet of which ever lobbying group stands to benefit. The reality is health care for all is, and should be, a fundamental right, guaranteed by the constitution, just like the 2nd amendment guarantees the right for any and all of us, to own a gun. Oh, the irony. Just remember, in the founding fathers days, a gun was a muzzle loaded musket, and “medicine” wasn’t much more than bloodletting and torture at the hands of a “healer” who was really an imposter- pretending to heal while often having more in common with a butcher. It wasn’t pretty.

Legislating based on current best practices depends on also updating legislation based on current best practices. We, as Americans seem to fail to adapt, and we know what Darwin said about those who fail to adapt (or do we?).

Mental health via community control might work if we really did have a foolproof system of safeguards in place. Regular health and welfare home checks would be a start. Mental illness has lots of indicators of oncoming trouble, changes in sleep patterns, weight loss or gain, compulsive behavior, personal hygiene failures, money problems, issues in the workplace, interpersonal tension. Proper monitoring by a trained professional can help catch a crisis before it becomes a disaster, which is where we are now. Jail is not part of an effective treatment regime.

Backstory

Last spring, before my Dad went in the hospital to die three months later, before I became the soul caretaker of my 89 year old mother with dementia, before I found out that a trusted employee and “friend” was neither, I stepped up to help a friend by agreeing to be his power of attorney, both  durable and statutory. I did this while he was in a state mental facility, where he had been transferred after an arrest while manic. This was nothing new for him, he’d been bouncing from ER to ER for treatment of his psychiatric disability for years- totally unaware that as a veteran, he was entitled to not only care at the VA, but a disability pension. As one of his friends, who had a modicum of experience with VA benefits, and the system, as well as a bully pulpit of this blog and connections to people above my pay grade, it became my mission.

If you’ve been religiously reading this blog, you might remember a post last summer about trials and tribulations with both the SSVF program and the Montgomery County Veterans Service Commission. Despite his 3 year plus service to our country in one of the military academies, some bureaucrat misinterpreted the  definition of veteran on their own, without actually checking the law of the land. We’re still fighting a misunderstanding that a veteran is one who served in the military, combat isn’t the defining experience.

Had I not been dogged about my advocacy, we would have had a homeless veteran, and due to the failure of the system, it’s my name that’s on the lease as responsible for the state of his place, not the program that he was entitled to. I have actual skin in the game on this, something I didn’t think was coming with job description. That lease was signed a year ago June- and had things gone according to plan (which they never do) I might have had to hire a house cleaner to get the deposit back, but am now looking at a glazier, a drywall mechanic, a house cleaner and maybe an exterminator, but that’s the least of it.

In that year, I managed to get his social security restored, put money in a STABLE account, get him a car, a phone, a place to live, his VA claim submitted, his criminal charges dropped (with help from a local attorney, Enrique Rivera, who took the case pro bono), and with help of another friend- kept him employed part time and for the most part, out of trouble.

The trouble started last time, by all accounts, when Social Security dropped his disability payments because he was “making too much money” and so he took extra jobs to make up for the shortfall. Because he had to stay awake, he stopped taking his meds- which make him sleepy, and one thing lead to another with his eventual arrest on the side of I75 in Franklin county, as he was pulled over and manically searching through his car for something. The cop thought he was drunk, and threw in a public indecency charge since he had no belt and his butt made an appearance. He was in the jail for 3 days before we found out he’d been arrested and already transferred to the psych unit.

It took almost 6 months to get his Social Security restored, which came with a big payout of almost $9K. It was as if he’d won the lotto. Unfortunately, having this much money in your account- also is a dis qualifier for receiving disability, so I set up a STABLE account to legally hide the funds. This is one thing I can credit Josh Mandel for doing right- creating a savings vehicle for those with disabilities, so they can have a rainy day fund. Good thing too, because it wasn’t long before those that giveth started asking for it back- saying they miscalculated. They want almost half of it back. Never mind, they can’t even deposit it in the right bank account, after 6 moths of telling them they putting it in his account instead of the payee account.

For almost a year he was golden. He paid his boss off early on a loan for a $1200 Toyota, he paid his phone bill to me each month (adding him to my account saved him money and made it easier to manage), his rent was paid for the first six months by SSVF, and PIPP and HEAP made his utility bills manageable. One could almost say that the safety net was working, as long as I was staying on top of everything. But, alas, when the warning signs started, I as well as his friends and co-workers, didn’t catch his fall from grace until it was almost full blown, which took about 30 days.

The crash

Mental illness is never a single issue problem. You break an arm, you put it in a cast. Your brain breaks, it’s got so many symptoms and compounding issues it’s triage- deal with the life threatening situations first, deal with the other issues over time.

The early warning signs in our case were an increase in drinking and the draining of the measured amounts of money I was entrusting to his personal account. Buying weight loss drugs from unreputable sources via the internet should have been one huge disaster siren of a wake up call. The nights out drinking watching the Stanley Cup with friends (to which I was the designated driver) were also a bad idea- but, we thought things were going pretty well, and if a few beers makes someone happy and feel like one of the boys- well, cheers.

Psychiatric drugs and hydroxycut (or whatever he bought) are a bad idea, as is beer. There’s a reason it’s a four letter word. When he asked for me to deposit $300 into his account (he’d been living off his paychecks, and a few hundred every month for a year) saying he’d given $200 to his son, should have been a red flag. That money was gone in a minute as well. The charges were so often, so small, and all over the map it was insane. He actually asked for help from me and his boss  on Wednesday the 21st. We sat in my conference room and tried to map out a plan. The next morning he texted me asking me to take him to the hospital, with a stop at McD’s on the way there. He’d awoken in a pond of his own piss. We went to Tank’s instead, where his eyes were bigger than his ginormous belly- and he over ordered and couldn’t even eat his pancakes. In one of those strange coincidences, his former Eastway case manager sat at the next table. They talked briefly- and we left with the decision that he was feeling better and would just take his meds and go to work.

When it came to the coming paycheck, instead of letting him put it in his personal account, we thought it better to go into the payee and be rationed out. This infuriated him, and rightfully it should have, but, when you’re manic, everything pisses you off.

That was Friday the 23rds paycheck. That weekend, he managed to make it to a bunch of his favorite watering holes. East Dayton dive bars where everyone knows his name, and smoking is generally permitted although illegal. One of the things that endears him to people is his generosity which increases when manic or drunk. He’s worked for tips for years, and so he always tips well. I could see what was happening by logging into his bank account, which was constantly at zero or overdrawn.

Monday, I called his case manager at Eastway. She’s new and I hadn’t met her yet. She, unlike the old case manager, didn’t know who I was, didn’t have that any idea that I was POA- and now claimed that POA wasn’t enough of a justification to talk to me. She needed me to be a guardian. There were supposedly some forms that she needed me to sign- and she was going to be over in the next few days to do that after I emailed her the PDF copies of the POAs that I keep handy in my dropbox.

Next thing I hear is she has gone to his house, and pink slipped him ( a medical 72 hour hold for evaluation), instead of taking him to the VA as I’d discussed with her, she took him to Grandview. Newsflash- sources tell me that Premier/Miami Valley Hospital no longer accepts psych patients via pink slip, putting additional stain on the already inadequate system.

A friend of his who happened to be there when the case manager and cops showed up, helped keep things calm, and he went willingly. After the door was locked, the friend decided to break in to shut the a/c units off- and instead of going out the way he came in- left the front door unlocked. So now, I had to find the keys. A trip to Grandview that night, I came up empty handed, when the nurses said he didn’t have them. I dropped off my POAs. He didn’t want to talk to me or have a visitor- I got the one finger salute through the safety window.

His car was in a bar parking lot, about a mile from his house. How he got home the night before, I still don’t know. The car had been having problems keeping the battery charged since a welfare driver hit the drivers side outside his work and somehow secrewed up the drivers door just enough that the door ajar light would keep draining the battery that really needed replacing. I had it towed to Carl’s body shop- to get that fixed, the A/C fixed (he had been complaining) and to possibly fix the front bumper since it was held on with duct tape. This was also to keep the car out of his hands until the drunk driving wasn’t going to be an issue.

A trashed kitchen serves as an indication that menal health intervntion might be a good idea

Signs of mental illness. This is his kitchen

By Wednesday night I get a call, an apology and that they had his keys I come get them and  go to the house and get disgusted. Clothes everywhere, trash everywhere, food everywhere. His mattress is standing on edge. The place is worthy of a haz mat suit. I try to find some clothes, put things sort of right, and make sure his only item of real value- a 55″ TV I bought him in a January sale for $300 was still there- in the box (he’d not gotten it out because, well, he’s mentally ill and couldn’t ask for help). I find some clothes, bring them home and wash them- along with everything I’m wearing- as I head directly to my shower, fearing bugs.

The next day, I bring the clothes and “snacks” because, well, a man’s gotta have snacks when he’s locked up. He wants to talk this time. He’s not wearing shoe laces- because- well, they don’t trust him not to kill himself. I talk about transferring to the VA. I’d emailed all the honchos Monday night when I heard he’d been taken to Grandview. I’d talked to the head of social work, who told me to ask their transfer team to coordinate things- the only problem is- Grandview’s people didnt’ want to talk to me either- again saying my POA wasn’t enough- I needed to be his guardian. No one from the VA came out to evaluate him while ill. No one from Eastway was returning my calls. Thursday, just after noon, while I’m talking on the phone to the people at the VA trying to get him to go directly thee- he walks into my office, and sits down. They’d given him bus tokens and sent him on his way.

Yesterday, no shoelaces. Today, bus tokens and a boot out the door. No, he didn’t want to go to the VA. I drive him home. He doesn’t want me to come in. He had confessed the night before that he’d also put a hole in the drywall. I ask if I can arrange for people to come help clean it up, he says he’ll do it himself.

I forgot to mention that when I got the keys, I was also told that he’d been to a bar in Centerville on Sunday night, before he was at the bar where he’d left his car. He’d run up a $35 tab and left his drivers license and debit card there. I should go and get them- and tip at least 20% because he’d done what he did. His tab had one sandwich and beers, shots, well drinks- he was definitely drunk when he left to to the other bar where he had gotten in a fight in the parking lot, smoked some weed and also lost his smart phone that wasn’t even paid off yet.

Friday, we go to look at his car and see if we can find his phone in it. It’s a moving waste basket. No phone. The car also has a new dent on the rear passenger quarter panel that he says he did.  I get him a new SIM card and hand him my parents old flip phone with his number on it. Keeping tabs on him was critical. How else could I find out if he was ready to go to the VA? He’s not going in to work just yet- he’s not ready, and neither are his co-workers, who are all rooting for him.

Friday night- he’s burning through his $20. Saturday night he calls from an Oregon District bar, he’s drunk, he’s a a drunk, he’s happy, and he ran up a $35 tab and left his license and debit card again. I get this message at 12:30 am- and go to get him. He’s not there. I know the bar owner and he can’t find him either- and promised me he’d 86 him from the bar in the future. I pay the tab. Can’t find him. Go home. Next day I go over to his house at 1pm to meet the people who were going to help him clean the place. The plan was to gather all the clothes- go to a laundromat and do them all at once, while others cleaned and organized what was left. But, as I go up the street on the way there- I get a text-

helper: Nevermind David this guy is definitely not interested in any help he’s a little upset that things go the way they do and obviously that’s a conversation you and him need to have but we attempted we had everything ready to do this and not going to go into a situation where it is definitely not wanted on that person’s part sorry
David Esrati: Sorry. I’m here now. I thought you were going to be here at 1
helper: Well I stopped by a few minutes early to see what exactly we were going to need so that we would have everything but he was not open or agreeable to having us do anything

I knock on the door- he comes out screaming at me. He’d taken his beard trimmer and cut a swath from his lower lip straight down to his chin, giving him a wild fu manchu short beard- there was a hunk of green snot above his upper lip- he was shaking, he was mad, he threw things at my minivan, he told me to leave or he was going to punch me- there was already a recliner on the parking pad that he’d thrown out of the house, I got in my vehicle to leave as fast as possible- dialing 911 as I turned out of his alley.

I wanted the police to come and pink slip him again. He’d threatened me- he wasn’t trusted with shoelaces in the last week- what’s the magic phrase “are you a threat to yourself or others”- I thought he’d met all of those conditions. The first cruiser meets me around the corner, an older male cop and short female. They start assessing- and call for the cavalry. In the next ten minutes no less than 10 cops show up- including a few sergeants, and a guy in plain clothes who identifies himself as a hostage negotiator. They mill about. Talk to me, talk to each other. Call in to central. At one point, the pissed off veteran screams down the alley- and throws the recliner for effect- he’s now shirtless- we hear something that sounds like a baseball bat beating the shit out of something twice.

The cops tell me I’m not the guardian. They don’t think they have grounds to violate his constitutional rights. They don’t even go up to talk to him. This is crisis management at half-a-blocks length. I offer to walk up and try to talk to him- so they can observe, to which they tell me I’d be the instigator- and it would be my fault. They say crisis care can pink slip him- I call them, they talk to the cops- they say the cops need to make the call. They drive off.

I call 911 and report their inaction. I tell them specifically, on record, that if anything happens to him in the next 24 hours, I’ll sue them to kingdom come. Sorry, not our problem, we’re the sheriffs bitches, call DPD. I ask to speak to a supervisor- they take my number.

I’m back at the office cleaning my a/c unit. I get a call from one of his co-workers. He’s walking down Wayne Avenue in boots, his underpants and a hockey helmet with “something that looks like a weapon, slung across his back.” I call 911 again- and head that way. I spot him changing on the street corner at Park Drive. The hockey helmet is on the ground, he’s pulling on a shirt, he has a backpack, I’m on the phone to 911 when the supervisor finally calls me back as I start to talk to the first officer that’s shown up. He’s moved around the corner to a parking lot and is talking to his co-worker- I have the hockey helmet in my car. They talk tot he supervisor on my phone, we end the call, the hostage negotiator shows back up- and they start a conversation with the mad man. At one point I step out where he can see me and he immediately starts going ape shit- the cop tells me to step away. I go get the hockey helmet- go back and set it where they can see it and leave.

Final report from the coworker, the cops thought it was ok for him to walk around in his underpants with a hockey helmet- he hadn’t broken the law. A woman can legally walk around topless too. They took him to his bicycle.

Bicycle? What bicycle? He had said he wanted me to get him a bicycle, for exercise. The last one I got him was when he was in the halfway house after the arrest- and it got lost in one of his pink slip visits that time. Turns out, he’d pawned the TV in the box for $200 on Saturday afternoon, and got a bike- and probably some cash to blow before he’d run up the bar tab in the OD.

Monday, I’m calling Eastway and the VA. No one is answering. I’m emailing. I’m worried that he’s going to end up either dead, or in jail again.

You already know he’s in jail. Happened around 10:30 am on Tuesday July 4th. I still can’t find any police reports from any of the encounters. He started with an M-4 and M-5 and a $1000 total bail. By later in the day, it said he had a whole bunch of charges:

bond.

# COURT CASE NUMBER CHARGE DESCRIPTION CHARGE DEGREE CHARGE STATUS JUDGE BAIL TYPE BAIL AMOUNT DISPOSITION DISP DATE NEXT COURT DATE
1 MONT-DMC () MENACING M4 WAITING COURT ACTION *Not Entered* TEN PERCENT 500 *Not Entered* 07/05/17 01:45 PM
2 MONT-DMC () DISORDERLY CONDUCT M4 CHARGE CLEARED *Not Entered* TEN PERCENT 500 RELEASED BY PROSECUTOR 7/5/2017 07/05/17 01:45 PM
3 MONT-DMC () MENACING M4 WAITING COURT ACTION *Not Entered* TEN PERCENT 500 *Not Entered* 07/05/17 01:45 PM
4 MONT-DMC () AGGRAVATED MENACING M1 WAITING COURT ACTION *Not Entered* TEN PERCENT 2500 *Not Entered* 07/05/17 01:45 PM
5 MONT-DMC () AGGRAVATED MENACING M1 WAITING COURT ACTION *Not Entered* TEN PERCENT 2500 *Not Entered* 07/05/17 01:45 PM
1

All of these aren’t crimes, they’re signs of mental illness.

And I, despite being assigned duties of Power of Attorney, am helpless in being able to do anything.

Bailing him out, won’t put him directly in treatment, and frankly, I might be on the receiving end of an ass kicking instead of a thank you.

Yesterday, I called everyone I could to try to get an intervention. No one from the jail staff picked up a call- from the medical people to the director, to the duty sergeant. The Dayton Chief was in meetings, Col. Ecton didn’t call me back. The VA tried to send a person to the jail- a “Veteran Justice Outreach Coordinator” tried to see him, but was thwarted by the shift change, and would be trying again this a.m. No one returned calls from Eastway either. Several hours of my time wasted, all while also dealing with no a/c at home or my rental (I’m looking at $1750 to fix both- and while my tenant had a/c last night- I woke up at 4:30 sweating my rear off- and wanting to share this story of woe).

I had thoughts several times of calling the national veterans health care line. I also thought of sending an email to the head of the VA. In the past, I’ve actually gotten a response from former VA Chief Bob McDonald, but the other Donald fired him.

We’ll see what today brings, but I hold little hope for help for this veteran.

Had things worked out right, I would have thought that the first time I reached out to the VA saying there was a veteran on suicide watch in a local hospital, an action team would have sprung into action to make sure all is done to safeguard that vet.

Why am I still an optimist?

When will America realize jails make lousy psych wards? That health insurance isn’t the same as health care? And, mental health is actually treatable and shouldn’t be considered a stigma, but a measure of society values- in how we treat and take care of those who are less fortunate.

To anyone of you who read all 4310 words of this TL/DR post, thank you. Do me a favor- please leave a comment, even if it’s just one word. America, we have a problem, and it’s crazy to think it’s going to go away by itself. Thank you.

Pray for a veteran.

Act II- update, 3:30 AM Saturday July 8, 2017

Late in the day Thursday, I get a call from the DPD officer who specializes in mental health emergencies. She, and a case worker from Eastway had been called to the veteran’s home early on Tuesday July 4th. He’d broken practically every window in the place- with his bare hands. He’d threatened the neighbors screaming “you go get your weapons, I’ll go get mine” and the place is an even bigger mess. Now, his box spring is sitting outside, one air  conditioner is next to the house- with broken expansion panels. The other A/C unit is in the house- among the squalor.

  • The bathroom
  • The TV- shrine of OTC weight loss
  • Start a fire?
  • Who needs A/C when you break every window?
  • Gumbo for the flies.
  • The kitchen floor.
  • Broken glass- not sure if the bars were bent before.
  • “This” is mental illness?

The cop and social worker go looking for him- and find him half dressed in a nearby park, covered in his own blood. He’s raging. They pink slip him again. The officers get him into a cruiser, where he does the classic crazy “bang your head against the windows” as we’ve seen in the bad behavior reality show “Cops”- of course, new cruisers now have back seats built for this- you can literally hose out the back of the car, and the whole interior is basically ballistic plastic.

They take him to Miami Valley Hospital- to get treated for the bleeding- and to admit. He’s sedated in the ER- and then things get murky, he’s not admitted. Somehow, the hospital thinks he’s good to go and begin to release him. Some officers who had pink slipped him either that day or previously, decide he doesn’t need to be out in public and arrest him and take him to the jail, where he is placed in solitary.

This info, at around 5:30 pm is the first accounting of what happened. I was still unable to pull up the police report online. Got it Friday morning, after I’d gone to the house myself to inspect. The house visit had me feeling queasy. He’d tried to start a fire on the stove top. There was a pan of gumbo on the kitchen floor festering with flies. Ceiling tiles are pulled down. The bathroom is trashed, the sink full of some brackish water. On top of the old analog TV are neatly arranged the OTC weight loss pills that probably contributed to this disaster- they are the only things in the place that seem orderly- as if placed on a shrine for worship.

I go back to the office, wait for my video guy to show up late, and begin working on the paperwork to get guardianship so I can bail him out AND direct him to treatment, since none of the people who’ve been involved in his “treatment plan” seem to have his best interests in mind. I make calls. I’ve pulled almost every person of influence I know into my wheelhouse for help. State Reps, lawyers, my neighbor who used to be the head shrink for crisis care, the PR maven at ADAMHS (our local health and human services admin org). Calls are coming in on two phone lines, but not the ones I need.

We go out and shoot a video- my video guy, who is from a small town in Indiana, can’t quite fathom how this happens. When we get back, he’s warning me to check for bugs, he found one on himself. I go to shower and dress. It’s 11:30 and I still hadn’t had breakfast. The clothes go directly into the wash.

Armed with a stack of papers, I head to the courthouse. Probate is on the second floor- the woman at the desk starts her hands dancing through the papers- I’d put his current case number on all of them- mistake number one. She’s got whiteout tape to fix that. However, I need $50 for the emergency filing and $350 for the full guardianship- which has to be filed at the same time. Here’s another huge stack of papers. I’m going to have to get a background check (but not first thing), bonded, and, btw, you need to have him evaluated by a medical doctor before we can accept the paperwork.

Before I go to Eastway to bow and pray that his doc will sign off on this, I go up to Judge Henderson’s court and talk to his bailiff. She’s compassionate, kind, helpful, but the judge is out until 2- and, frankly, he heard this case on Wednesday and has already entered preliminary charges, it’s unlikely he’ll make any changes to bail or order treatment etc. unless there is a plan in place to manage this mess.

On to Eastway. The skys are darkening, and as I sit in the waiting room to meet his caseworker who wouldn’t talk to me over the last 2 weeks, a security guard walks by saying, “It must be about to rain, DirectTV is out.” Just as the social worker and her boss come out to greet me, the torrential downpour begins. The social worker is wearing dark clip on sunglasses over her prescription glasses, inside. Who is she? Men in Black?

They are very nice. She was out at the house on the 4th, has no clue why MVH dropped the ball. Agree that he doesn’t belong in jail. His Doc isn’t in today, but his old one is. He liked his old doc. I go in to see her, and she’s this sweet woman who says “beautiful” a lot as I describe what I’ve been trying to do to help this veteran over the last year. I had mistakenly filled out the form for the doc in the pile of papers – why not play doctor like on TV? No one else has effectively cared for him. She reads it over, nods, but says, “I can’t sign this because I haven’t seen him lately” and asks me what to do? Me. The amateur social worker/friend/legal beagle wannabe/crisis care interventionalist without a paycheck, me.

I say, you could sign it- knowing from experience and interviewing me and your social worker who saw him Tuesday as reference, or you could (hold for the long shot, pie in the sky request) “go see him in the jail and evaluate him.” She says, well, “I can do that, my incoming patient can see a nurse.”

Damn. I love this woman with her “beautifuls” and her eastern European lilt in her voice. She says to say hi to my neighbor who used to run Crisis Care- and that she missed him. I’m thinking I just hit the lottery. I’ll go back to my office and fill out the half inch of paper, while she evaluates him and by the time she gets done, I’ll be done, run to the courthouse, file and miraculously, the judge will act, and I’ll be able to haul him out on bail and have him taken to the VA for inpatient care.

An hour later, as I finish the paperwork, except for getting the form from his son agreeing that I should be the guardian (I’ve been communicating through his brother, who is also suffering from the same bipolar diagnosis- as is the son), the case managers supervisor calls. “We saw him, he was lucid, he said he didn’t want you to be his guardian, she’s not signing the paper.”

Meltdown. The energy generator that’s been burning in my belly to get him out of the “criminal justice system” (and yes, that expression is either ironic as hell or the best oxymoron since “military intelligence” or “jumbo shrimp”) and into our third world nation mental health care system just got encased in concrete and doused with as much water has fallen from the skys of Dayton this last week.

I failed. The imaginary system failed too. Despite the facts according to the Doctors own caseworker- that he should have been in a psych ward, and that he’s in jail, with restraining orders from his neighbors, and that he’s done enough damage to clean out all the money I’d managed to put away to help him do something like get his own place- psycho boy gets to call the shots, and I’m not the designated hitter.

I could get mad at the doc. I could get mad at myself for not doing the guardianship when he was healthy, but hell, I thought that was what the health care POA was for. No one told me it wouldn’t be enough to manage his treatment when he’s obviously ill.

I talk to my friend, his now former boss, who tells me I’ve done more for him than anyone else- by getting his SS money back, by setting up a STABLE account, and most importantly, getting him into the VA system, but, I’m not the first to give up on him or get blamed for man/boys bad behavior. “Just clean up the mess and let it go” is his advice.

The brother thanks me. He understands my position and plan that’s being formed for me.

First steps: reglaze the windows, get the trash hauled out, get the clothes gathered, laundered and packed. Fix the broken stuff in the apartment- the stove, the ceiling tiles, the miniblinds, the kitchen cabinet drawer that’s in pieces. Put everything in storage, turn in the proverbial key (no one has it right now- or at least is able to get it). Pay the storage bill until his money runs out and turn over POA to someone that feels like being the next punching bag.

A friend who owns a glass shop has a guy coming on Saturday (today), another friend, a veteran, who calls himself a “Debris-ologist” will be there at 9am to start the haz mat removal. His line always makes me laugh, “satisfaction guaranteed or twice your junk back”.

My stomach, which is usually made of iron, is churning and feels like the stuff in a lava lamp. This isn’t what’s best for the veteran, but, I’ve got my 89 year old mother with dementia, a business, employees- that have to come first. There is a long rambling message on my home answering machine from him, thanking me for everything I’ve done for him- and that he didn’t mean anything he said while manic. He left that last week after the first pink slip. Maybe I’ll make it into an MP3 and post it- if I can stand listening to it anytime soon. The words of anyone who is radically bipolar all come with footnotes, that may or may not contradict their actions, or even what they are saying in a span of a voicemail.

I also sent a scathing email to the “team” at the VA, suggesting that their failure to intervene will not go quietly. I referenced this initial post. I told them video was coming. I’ve written the head of the VA- McDonald before, and I’ll write Dr. David Shulkin soon. Congressmen and Senators will be contacted, hell, I’ll even tweet Trump (I’ve already talked to my friend Rob Scott who ran his campaign in Ohio.) This will be someones story to tell to use to dismantle the VA, even though I believe that the care I’ve gotten, that my father got, is as good or better than the Cleveland Clinic (dad used to be seen there as part of Kaiser Permanente in Cleveland).

If he dies in custody, or anything else happens to him, rest assured, I’ll find an ambulance chaser lawyer and make him wealthy. The documentation- the call to 911 AFTER the cops wouldn’t even talk to him, the steps I took, all make for a very sympathetic jury. Maybe his son will end up owning the Fairgrounds after Premier has to pay for their mistakes. Remember, I wear a nice watch, that I bought with part of the settlement with the city over Mike Turner’s arrest of me while I peacefully protested their attempts to limit public speech at meetings. I wear it, to remind myself, that we always have time for free speech (and because at 36, I still thought that you could give yourself a medal for fighting city hall and “winning”).

There will probably be a third act in this tragedy. Sadly. Stay tuned.

 

 

Is your psychiatrist doing his part?

VA Choice program fails vets for psychiatric careEvery day in America, 20 veterans are committing suicide.

You can blame the VA all you want, until you realize, that this country is incredibly short psychiatrists. And, no, it’s not because we’re less crazy than the rest of the world.

Psychiatry has gotten short shift by our “free-market, capitalist health care for profit system” – the one where insurance companies decide on what to pay and what not to.

Psychiatrists make less than almost any other specialty. We have a health care system that often treats dental, vision, hearing and psychological as somehow not quite fully medical insurances problem. Really. As if you can’t eat because of bad teeth- the rest of you will be ok?

The Dayton VA is trying to hire 3 psychiatrists right now. They can’t find them.

My formerly homeless veteran needs an appointment- they can’t comply in a timely manner, so he was approved for “Choice care”- the ability to go to a private doctor on their list of providers. The problem, the list is really short, and if you look up the reputation of a few of the providers I wouldn’t send my worst enemy to them.

The problem is that to be able to be a “Choice care” provider, you have to have your computers talk to the VA computers, and apparently, not everyone wants to do that. So, his appointment is made- in September!

There is a NYTimes article today about the stupid political answer- which is to abolish the only good health care system in America, and replace it with the market driven one as a solution. That’s not going to solve the problem. Vets have special issues, and the VA system is built to deal with them.

Two years after a Department of Veterans Affairs scandal involving long wait times at veterans hospitals, an official report has found that the veterans’ health care system suffers from “profound deficiencies” despite billions of dollars spent in recent years to overhaul it. The report says that the hospital system needs sweeping changes, including a program that would pay for all veterans to see private doctors.

In a document nearly 300 pages long released late on Tuesday, the 15-member Commission on Care, created by Congress after the scandal, contained a list of recommendations to improve the nation’s largest public health care system.

“Although care delivered by V.A. is in many ways comparable or better in clinical quality to that generally available in the private sector,” the report concluded, “it is inconsistent from facility to facility, and can be substantially compromised by problems with access, service, and poorly functioning operational systems and processes.”

Source: Care by Private Doctors Among Big Changes Urged for V.A. Health System – The New York Times

Here is the simple answer for the immediate problem: allow private psychiatrists a way to file reports with the VA system via a translation portal- ie. get their output from their current systems and build a port program. And, start denying them access to medicaid and medicare patients if they don’t join the choice care program. You want government money, you have to be willing to take on veterans.

Secondly, for psychiatrists that work for hospitals- that currently get money from the feds- also require them to accept choice care patients.

We can’t afford to lose any more veterans, just because a computer program isn’t compatible, or there is more money not working for the government.