CRMH, Western State Hospital and
Independence from the family at all cost
Decisions made in isolation,
Columbia River Mental Health(CRMH) was the main provider for two young men in our town and a very similar decision was made in each young man's case that resulted in serious consequences for both the individual, their family and our community. One of those young men was my son, Siddharta Fisher. Currently Western State Hospital is following this same exclusionary model which I will go into more details below and in another link.
No real meaningful dialogue with family
In both cases the parent felt their input was completely overridden and of little consequence to the mental health team who, in our current dominant mental health model, are empowered to completely overide and/or ignore the main caregivers input.
One of the caregivers/parent would like to remain anonymous, but allowed me to interview her and share her story. I was very interested in her story because our stories are similar in very disturbing ways.
Caseworker fails to attempt
to make a collaborative decision
Young man #1, was in his twenties and was old enough to be independent, but struggled with symptoms that did not allow him to live independently yet. His case worker made the decision that he should live independently. This was not a collaborative or gradual decision involving the counselor, family members and the young man. He encouraged the young man with almost no inclusion or dialogue with his mother.
Counselor should be the glue in collaborative efforts
The counselor or therapist should be the glue in the collaborative effort for positive change and the leader in creating an optimal healing environment for patients and the support network of family and significant others
Independent Living means very little parent inclusion
The young man was basically approached with the idea of living in his own apartment, with cleaning support. The mother had wanted to explore some serious concerns she had, but was barely included in the conversation with the team. The young man was not against her involvement. Perhaps if she had not been excluded from most of the dialogue, the move still could have happened, but with more care, awareness of possible pitfalls, and more thoughtful preparation.
Parent warnings ignored
As it was, the move happened, and his mother was very supportive in allowing the young man to spend as much time as desired in between his own apartment and the family home. He came often in that first month. However, her warnings to his counselor about his severe paranoia attacks that happened when he returned to his apartment after the cleaning support person had moved things around, were completely ignored by the counselor. Independence was the only goal the counselor seemed to be able to see.
Alternative models Collaborate
In alternative mental health models, the patient has the ultimate responsibility for making treatment decisions. However, if the patient is willing and desires it, it is considered critical to include the support network of his/her choice, during major changes. Serious and unexpected reactions can occur during the new adjustment process to big changes , such as despair, rage or confusion, and the patient may be unaware of what is happening. Collaborating with the support network, and paying attention to their serious concerns and observations are critical and can prevent serious crisis.
The mother was not included or ask to sit in dialogue with the counselor and son to express the grave concerns she was witnessing and the son was not aware of the heightened level of his growing paranoia. Sadly, one day, after coming home during his first month of independence and again finding things moved, he snapped, and took the life of his next door neighbor.
The newspaper headlines laid all the blame and shame on the young man and we the community lost two beloved members that day...the innocent neighbor, and the young man who is still locked behind closed hospital doors.
CRMH silent as counselor moves on
And the counselor who was deaf to collaborative efforts? He quit and moved on. Little was said publicly in the young mans behalf by CRMH.
CRMH, another exclusionary and failed independence goal
And sadly, I, Cindi Fisher, experienced something similar in some ways, not so in others, but still it revolved around CRMH and the goal of independence and the exclusionary process surrounding achieving that goal. It was this lack of collaboration that led to harm befalling both my son and myself, and to the "no trespassing charge" , against me by CRMH's lawyer...and this I will explain in detail soon
We need alternatives like Open Dialogue, Soteria Houses and Peer run Respite Homes, which welcome family involvement in the dialogue.