Using Housing To Get Patty Into Treatment: Part Three of Skid Row Doctor’s Story

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Image of random homeless woman by Wolfgang van de Rydt from Pixabay

(6-11-21) This is the third and last in a series of guest blogs written by Los Angeles Skid Row doctor Susan Partovi about Patty. As with all guest blogs, the opinions expressed are those of the writer. Please post your thoughts on my facebook page. What do you think about Dr. Partovi’s actions?

“Treatment First, Housing Second”

By Susan Partovi, M.D.

I hadn’t seen Patty for several weeks.  I had made a very difficult decision. If she came to me for help, I would only put her into a hotel if she agreed to begin taking a long acting injection version of the antipsychotic she had been trying to take orally. I struggled with this decision.

Am I manipulating her into taking her medications? Am I using a human rights need as a carrot in order to persuade her into taking her medications? 

No.

The only way she could stay in a hotel without destroying it or getting kicked out was for her to be mentally stable.  Otherwise we would just be wasting our grant money. Yes, she was safe when she was in a hotel, but her behavior was so unpredictable that she would continue to get kicked out.

It was a very difficult decision.

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Tormented By Voices But Is She Gravely Disabled? Part Two: Patty’s Skid Row Story

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Photo courtesy of NAMI

(6-9-21) This is the second installment of a three part series about Patty as told by Los Angeles’ Skid Row doctor Susan Partovi. You can read part one here.  As with all guest blogs, the opinions are that of the writer.

Marinating

By Susan Partovi, M.D.

I wasn’t going to give up on Patty.

I began putting her in motels paid for by Homeless Health Care LA while waiting for her to get into interim housing. She stayed in one for a month but eventually was kicked out due to damaging the TV and having “inconsiderate” friends.

She tracked me down and I put her back at the original hotel where I’d housed her. I didn’t give her any antipsychotics this time, due to me being too tired and thinking if she wasn’t using, maybe she wouldn’t act out. Five days later I received a call from the manager saying she was “crazy,” but he didn’t speak English very well, and I didn’t take the time to try to understand what he was saying.

The next day he called me again, saying she had to leave. I said that I would get her in the morning. When I arrived, her door was open, her bed and bed frame were on their side, there was trash everywhere, the TV was shattered, the pictures were off the wall and destroyed; it was a disaster zone!

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Meth & Mental Illness: Patty Relapses On L.A.’s Skid Row: Part One

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(6-7-21)  This is the first of three articles this week written by Los Angeles Skid Row doctor, Susan Partovi. As with all guest blogs, the opinions are that of the author.

I Meet Patty

By Susan Partovi, M.D.

“I’m your new assistant,” Patty announced one day in 2006 when I arrived at the Homeless Health Care LA’s (HHCLA) Needle Exchange clinic in skid row, now called the Center for Harm Reduction.

She was short, soft spoken and a fast learner who could anticipate my needs in LA’s skid row. I was “the doc” who treated heroin injection users. Each week, dozens would arrive for help with skin infections and chronic wounds.

“That used to me,” Patty confided one day. “I was addicted to crack and was homeless on skid row.”

It was hard to imagine this bashful woman as a hard-core drug user. She would talk about her kids, especially her son.  When you work together helping the most difficult patient population, you form a bond. Kind of like war buddies. I remember one day, a regular came in with scabies….again. His hair was long and stringy. He was skin and bones. We stripped him down and Patty and I slathered the anti-scabies cream all over his body.

“You look like a wet puppy,” Patty kidded, causing all of us to laugh.

Another day, we saw a patient with a foot infection. He was a diabetic, but he couldn’t afford his medications. He was crying because he was in so much pain.

“Quick Patty, get me a basin with water and Betadine,” I said after he took off his shoe. We placed his disintegrating foot swarming with maggots in the tub as Patty proceeded to dash out of the room holding her hand over her mouth until she got to the restroom to throw up.

Like I said: we were war buddies!

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Boosting Morale At SAMHSA: It’s A Challenge That Middle Management Needs To Address

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(6-3-21) When it comes to employee happiness, the federal agency responsible for mental illness and substance abuse programs has historically ranked at the bottom of federal polls – even years before COVID. A SAMHSA officials says it will be up to middle-management to find ways to boost morale. As with all guest blogs, the opinions are solely those of the writer. 

SAMHSA’s Important Work Can Be Strengthened with Cultural Change

Guest blog by Mitchell Berger

For a decade the Substance Abuse and Mental Health Services Administration (SAMHSA), an operating division of the Department of Health & Human Services (HHS), has ranked near the bottom of the Partnership for Public Service’s Best Places to Work in the Federal Government which is based on data from the annually administered Federal Employee Viewpoint Survey.1

Currently, with the 2020 results pending, the Agency ranks number 417 out of 420 among Agency components and subcomponents.2

The federal government’s lead organization for mental health and substance use disorder must be at its best to effectively serve the vulnerable and traumatized populations that are the central focus of its mission. 3,4

In my view, the ultimate key to potential improvement at SAMHSA lies with its ‘middle management’ layer– the branch chiefs, team leads, office directors, special experts, senior advisors and division directors, and their equivalents — that layer of management which is most numerous and comprises those with whom SAMHSA staff most typically and frequently interact. 5,6

It is to these mangers whom many staff look day-to-day for guidance and leadership.

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Gabe Howard: Still Fighting & Winning His Battle With Bipolar’s Symptoms

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(5-28-21) One of my favorite advocates recently talked on an Ohio television station about his bipolar diagnosis and suicidal thoughts.  Gabe Howard, is a certified peer specialist, dynamic public speaker, and popular podcast host. He recently wrote  Mental Illness Is An Asshole, about incidents in his life.

Gabe is a frequent contributor to this website. Recently, he expressed his frustration when confronted by people who treat him differently because of his diagnosis.  From “I’m Tired”:

For the purposes of understanding and professionalism, I call myself a mental health advocate. That description is not inaccurate, but it’s not the job I actually have.

My actual job is to wake up every morning and attempt to prove to the world that my life has value. That my needs are important. That helping me, and others like me, is a worthwhile thing to do.

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Why Does Our Government Keep Denying How Prevalent Schizophrenia Is Among Americans? The Answer: $$$

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(5-xx-21) Dr. E. Fuller Torrey has spent much of his career writing and researching Schizophrenia. He is the author of Surviving Schizophrenia: A Family Manual, long-considered the bible about the disease. Guest blogs reflect the opinion of the author.

The NIMH Saga Continues: How Many People Have Schizophrenia?

By E. Fuller Torrey, MD

Since attempting to make 2 million individuals with schizophrenia disappear in 2017, the National Institute of Mental Health (NIMH) has continued to rely on studies that directly contradict its own claims, thus embarrassing itself yet again.

How many people in the United States have schizophrenia?

This should be a straightforward question for the nation`s leading mental illness research agency. But it is not.

The question was recently raised again by a study from the Johns Hopkins Bloomberg School of Public Health. Based on Medicare and Medicaid claims, and using the 2010 census data, it reported that the one year prevalence of schizophrenia in the US was 1.62% among adults (ages 18 and over) or 3.8 million individuals. (1) * The author of the Johns Hopkins study acknowledged that it did not include individuals incarcerated in jails or prisons. If we were to add these additional individuals based on other studies, the total number of people with schizophrenia would be about 4 million (2).

But wait! NIMH claims there are fewer than 1 million people with schizophrenia in the US, a fourfold difference between the estimates. What is going on here?

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