Monthly Archives: June 2015

Opinion – Arizona’s Mental Health System: In Need of Psychiatric Intervention

The Front of the SAMHSA building at 1 Choke Ch...

The Front of the SAMHSA building at 1 Choke Cherry Road in Rockville, Maryland. (Photo credit: Wikipedia)

The State of Arizona‘s public mental health system is in dire need of a complete overhaul, from top to bottom, with more focus on the top.   The system is divided into multiple layers of bureaucracies,  and on each level, large salaries are involved.  The first level, is called a provider, which are several outpatient mental health clinics which provide services to persons who require mental health services.  Those providers hire individuals to provide services such as counselors, therapists, and so forth. And each provider has a number of sites, headed by clinical supervisors who are in charge of seeing that those services are provided to the parties. One would hope that the services would be provided fairly and consistently among those individuals in need. However, that hope is dashed by the overwhelming power vested into the clinical director, who is allowed to do as he or she pleases without facing consequences.  The group which allegedly suffers the most at the hands of these agencies in Arizona are African-Americans who need assistance.  They are provided with the least amount of services, and much less than their White counterparts.  For example, there are housing programs, for mental health clients who are homeless, or need help with maintaining stable housing. A homeless African-American is not provided with those services, whereas other races and ethnicities who are homeless are provided with those services.  African-Americans have been denied without even the opportunity to apply.  Other races are provided with hefty amounts of financial assistance, while African-Americans are, in rare instances, provided with small amounts to assist them.  When the clinical supervisor decides that she wants to save some money, she decides, unilaterally, which housing services will be discontinued for the person of her choosing, and if she decides to make up a reason, she can do so without facing any consequences.  That is the first level.

The next level is an organization called CPSA, ( Community Partnership of Southern Arizona ). This is where the party can file a grievance regarding issues such as referenced above. However, the grievances rarely find that the rights of the part have been violated.  But, with the notice of Decision, the party has a right to appeal.  Yet, first, there is an informal conference, during which, the clinical supervisor is essentially in charge.  A complete waste of time and money, for it is just that supervisor standing up for her decision, with CPSA having no authority to do anything other than ask them what they want to do.   The next level is the actual state agency, Arizona Department of Behavioral Health.  But that level is the same as the prior. No real authority to do anything other than ask the clinical supervisor what it is she wants to do.  (Getting my drift here?) So the only level left within the state hierarchy is a state administrative hearing.  Arizona Office of Administrative Hearings.  (This is where the fun really begins.)

Bearing in mind that the party who is appealing has mental health challenges, they attend the hearing, expecting at the very least, a fair, impartial hearing, lacking bias.  What they get instead is an Administrative Law Judge who does not even bother to hide their bias.  They interrupt the party, and, if the party is about to catch the witness in a lie, the ALJ springs to the defense of the party, essentially telling them to ‘shut up’ and/or ‘hurry up’.  For someone with mental health challenges, this sort of conduct becomes too much to bear and seem a futile undertaking. The ALJ makes it clear that their goal is not for justice or fairness, but to look out for those state employees.   One ALJ, (Kay Abrahmson), rushed a party to hurry up and finish, interrupted questioning, and refused to allow the party to address all of the issues which had been sent up on appeal.  She apparently was in a hurry to go home.   The party discontinued participation in the hearing, ended up crying and distressed, and feeling hopeless.  So, this is what happens to a client who is attempting to fight for their rights?  They are pushed to beyond their limits?  They are forced to accept falsehood upon falsehood without being allowed to challenge any of them? And treated like crap by the person who is supposed to be in charge and lead by example? Such a sad shame.

This should not be so.  The same bias encountered on the first level, finds itself present at every level, and the party is left stunned at the measure of disrespect shown.  If the system were fair to all parties on the first level, there would be no need for all of this, but the system is rigged, and those who are a part of it, are fooling themselves via pretending among themselves that they are doing a good work, when they are merely earning a salary, while allowing a group of people to be discriminated against and mistreated.  A group denied services based upon whims.   It took the state of Arizona 33 years to settle a lawsuit. Arnold v. Sarn, which was regarding the mental health of Arizona residents.  I suppose that further illustrates the problem in Arizona.  The good news is that is was finally settled, but many in the state, (Southern Arizona), are refusing to embrace it, and clinging to the hope that they will not be affected by it, even though, clearly it is supposed to be in effect for the entire state of Arizona.

If there were a way in which a state agency and all of its tentacles could receive psychiatric intervention, this would be the group who would benefit most.  Unfortunately, there is no way to do that, so people either leave the system and not get the medical care which they need, or, they stay within the system, being treated like they are nobodies.  Which is worse?

Michelle Obama’s address at Tuskegee University says it all.  It does not seem to matter what position African-Americans are in, they still have to deal with the bias of so many people who refuse to treat them or see them as equal human beings, worth of being treated fairly. From the White House to all others in this country.  When will things become just plain and simple, fair? Mental health professionals should not be allowed to engage in this sort of behavior.

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Filed under Injustice, Opinion, Radar Opinion