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Karin Cather.
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October 24, 2021 at 5:46 pm #7567
Dick Dunseath
ParticipantMy son was admitted to St Luke’s Behavioral Health Center recently due to increased psychosis. I spoke with him daily during his one week stay and he continued to be detached from reality – said staff was physically abusing him and that I was abusing him telepathically. A staff member called me with concerns regarding his psychosis. Suddenly his doctor declared himn ready for discharge. As guardian I disagreed. We “negotiated”. I agreed to a discharge directly into St Luke’s’ “Momentum” program, a 5-day per week all day in-person program designed to maintain progress regarding psychosis and substance use. After two days he was ejected from Momentum because he was considered too psychotic for that program. I filed a grievance and he was readmitted to this program only to be ejected again as “too psychotic”. I protested that St Luke’s reneged on our understanding he was discharged from in-patient on condition he would participate in its Momentum program. Disgraceful.
October 25, 2021 at 5:35 pm #7571acmigold15
KeymasterI am so sorry that you are experiencing this. I wish the situation you described was an outlier, but I fear it is not. I hear this far to often to have these situations be outliers. It is a shame that hospitals seem to suffer no consequences for premature discharges. There are real consequences to untreated psychosis (we have webinar material covering this material).
There are penalties in general healthcare that penalizes the hospital and physicians for bad outcomes. We need to hold the behavioral health providers to the same standards. Our system should do better in protecting our most vulnerable.November 9, 2021 at 7:33 pm #7652Karin Cather
ParticipantI am the guardian of my almost-20-year-old son, Noah, who is SMI, DDD, with an IEP and in a special education private school, and living in a BHRF. He has been institutionalized continuously since January 14, 2020, when he was suicidal and had to be talked into dropping a butcher knife. He has 25 or 26 inpatient hospital stays, two RTC stays, and has been on a PHP day program.
Noah’s first inpatient hospital stay was at Phoenix Children’s when Noah was 10 years old, in 2012, and then again in 2013, and from there, it was at least twice a year.
In 2018, when Noah was 16, Noah was hospitalized at Banner Scottsdale. There, they took him off all psychotropic medication. They initially sold it to me as “We’ll do a med wash and start from scratch.” Since he’d been on so many medication cocktails, I agreed for the hospital to figure out what medication would work. Almost immediately, Noah became manic.
For example, Noah told me that he planned to emigrate to the UK and live in London because a friend on YouTube lives there and the most important thing is that there is English candy with real sugar and he wants to be able to go right to the corner store and get some real British candy and no he didn’t want to order it on Amazon dot com, he wanted to be able to buy the candy with real sugar right at the corner and he could do that if he moved to London [repeat]. He was fixated on two other topics, though, and he went rapidly from thought to thought. For instance, he wanted a bearded dragon because they are omnivores and he isn’t afraid of mealworms now and he also wants to adopt a flock of “messenger pigeons” because a fellow patient said that she had [no, you don’t want to know] to a pigeon and he wanted to do something nice for pigeons. And he wanted to buy a huge farm and adopt all the pigeons. [repeat, then back to the candy, then back to the bearded dragons]. To be fair, a bearded dragon is an actual species of lizard.
Then Banner Scottsdale said they were discharging him. I told them they can’t discharge him on no meds because he’s not stable and Jason McIntyre, the hospital social worker, said, “You can’t cure autism with a pill.” Noah went out on a little bit of Seroquel for sleep. Not even a therapeutic dose for sleep.
Jason didn’t take the subsequent car ride to Noah’s psychiatrist’s office (that’s Dr. TeeJay Tripp) during rush hour at highway speeds while Noah was agitated and scary and ended up in Aurora Tempe.
On November 2, 2021, Noah called 911 himself from his group home to report that he wanted to hang himself. He was taken to Banner Thunderbird, where he has never been before, on a 72-hour hold. On Friday, November 5, 2021, I got a call from the hospital social worker, Stephanie C. Kyle, and I expected to hear that Noah was ready to discharge. Instead, she told me that Noah had not been given any psychotropic medication since he got to Banner because, basically, no one at the hospital bothered to call anyone. Or they were doing a stealth medwash and didn’t want to tell me. It’s an even bet which. The story was that one of the four medications, Vraylar, wasn’t in the hospital pharmacy, but they could have called the group home and the group home would have brought the medication over in blister packs. And instead Banner Thunderbird was giving him nothing. Stephanie Kyle talked over me and constantly interrupted me, including to talk about her credentials, and I said, “STOP. You have to listen to me if you’re a social worker.” Instead, she told me that Jason McIntyre was her supervisor now and that he said hi. Then Dr. Monga, the unit psychiatrist, got on the call, which by that point was on speaker phone, and Dr. Monga told me Noah is “doing fine” while taking nothing but levothyroxine for hypothyroidism and not needing PRN Zyprexa. The most either of them would say about doing absolutely nothing to ensure an adult they knew was SMI, in a BHRF, with a guardian got his psychotropic medication was “I hear your frustration.”
I have a printout of all of Noah’s hospital stays from late 2018 onward, with a sentence about the reason for the hospital stay, and I sent it to Stephanie Kyle. I demanded that Dr. Monga have a doc-to-doc with Dr. Tripp, and I cc’d Dr. Tripp’s office.
That doc-to-doc took place and Dr. Tripp rightly told Dr. Monga to leave the medication as it was and that happened.
So Noah went in to Banner Thunderbird on November 2, 2021, on a 72-hour hold and didn’t discharge until November 9, 2021.
As an aside, Noah’s previous hospital stay was in August and the hospital stay before that was in March, where in response to internet bullying, he ran out of the hospital and lay down in the middle of 51st Avenue at night and a Good Samaritan called 911 to report a dead body. Noah wasn’t hurt, thank God.
So this is not an adult who needs to be off meds. I guess Dr. Monga could say that he didn’t know any of that and that’s true, but given that he knew nothing of Noah’s history except that he was an adult who is SMI and living in a BHRF and has a guardian, he should at the very least ensure that Noah has his medication, and certainly not by neglect or intentionally effectuate a medwash.
I did report this to the Joint Commission, by the way, not that I think the Joint Commission will do anything.
Noah is with Lifewell, now, but I have to switch him to Copa because Dr. Tripp is private pay, and Dr. Tripp recommended Dr. Trudy Dockins, who’s with Copa East Valley, so that’s in process.
Anyway, thank you so much again!
Onward and upward,
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This reply was modified 2 years ago by
acmigold15.
November 22, 2021 at 9:45 am #7668acmigold15
KeymasterKarin,
I am so sorry that you have had such difficulties getting appropriate care for your son Noah. It is frustrating when hospitalizations start over with medications but from what you reported it seems like it has happened on more than one occasion and hasn’t resulted in even short term stability. I hope you have filed grievances with the SMI system, Mercy Care on these instances.
Here is the process to report a grievance:
RHBA- Mercy Care Grievance and Appeals- If you prefer to file your grievance in writing, please send your complaint to:
Mercy Care Grievance System Department
4500 E. Cotton Center Blvd.
Phoenix, AZ 85040
602-586-1719 or 1-866-386-5794
Fax: 602-351-2300ACMI
November 28, 2021 at 6:28 pm #7916karincather1
ParticipantRe: Complaint about Banner Thunderbird as to Noah Daniel Cather (DOB 11/25/2001)
To whom it may concern:
I am the guardian of my 20-year-old son, Noah, who is SMI and living in a BHRF. Noah
• has been institutionalized continuously since January 14, 2020, when he was suicidal and had to be talked into dropping a butcher knife
• carries diagnoses of bipolar disorder with a history of psychosis, autism, an anxiety disorder, ADHD, and PTSD
• takes Depakote, Vraylar, gabapentin for anxiety, and an antipsychotic
• has been at Orion BHRF since April 14, 2020
• has been institutionalized all his adult life
• has had a guardian (me) since he turned 18
• still hears voices after having no access to drugs for a year and a half, but says that on medication, they are “quieter”
My complaint is that Noah was admitted to Banner Thunderbird on November 2, 2021, on a 72-hour hold and didn’t discharge until November 9, 2021, because neither the unit psychiatrist nor the hospital social worker saw to it that he got any psychotropic medication for the first 3 days. Furthermore, both the hospital social worker, Stephanie C. Kyle, and the unit psychiatrist, Dr. Monga, communicated this in a totally offhand way.
That isn’t entirely true. Stephanie Kyle tried to talk over me first when communicating this information so that I couldn’t talk to her—in order to give Noah’s history and insist on a peer-to-peer with Noah’s outpatient psychiatrist. I had to raise my voice and insist that she listen to me first—which, in Noah’s 18 years needing clinical intervention and 10 years in the mental health system, I have never needed to do before.
Dr. Monga told me that Noah was doing fine without psychotropic medication.
While Noah was sitting in a hospital he should have been discharged from after 72 hours, he was missing school and DBT therapy. Noah is already a senior in high school as a 20-year-old because he’s missed school due to hospital stays.
On November 2, 2021, Noah called 911 himself because something in his day triggered him and a 72-hour hold would have been sufficient. His private psychiatrist, TeeJay Tripp, DO, had prescribed psychotropic medications that were working: Noah was attending his senior year of high school and doing well and participating enthusiastically in DBT therapy, and he had even stopped having near-weekly violent episodes at the group home, given that his last one was in June 2021. Noah says the voices are “quieter.”
It’s an even bet whether, since Noah was getting his levothyroxine at Banner Thunderbird the whole time, Banner Thunderbird was taking him off all psychotropic medication intentionally or whether they were just neglecting a patient.
Dr. Monga would be the second unit psychiatrist who decided Noah was doing “fine” off medication (and the last one was at a different Banner hospital and involved the same social worker) given that he presents well. That’s because his medication had been administered by group home staff for the past 18 months as directed so, as Noah has said, “the voices are quieter.” It’s also because he has bipolar disorder, not schizophrenia. He had not come in off the street. He has no access to drugs in Orion BHRF.
The reason I think they were doing a med wash without my consent and countermanding Noah’s own psychiatrist is that Stephanie C. Kyle’s supervisor, Jason McIntyre, was the social worker in 2018, when Noah was 16, at Banner Scottsdale. At Banner Scottsdale in 2018, they discontinued all of Noah’s psychotropic medication. They initially sold it to me as “We’ll do a med wash and start from scratch.” Since he’d been on so many medication cocktails, I agreed for the hospital to figure out what medication would work. But Jason McIntyre said, “You can’t cure autism with a pill” and had a conversation with me about the fact that Noah had autism, not mental illness. Noah was discharged from Banner Scottsdale in November 2018 on no medication.
Jason McIntyre didn’t take the subsequent car ride 28 days later during rush hour at highway speeds while Noah was agitated, psychotic, and scary and ended up in Aurora Tempe for 3 weeks.
Only at Banner Scottsdale and Banner Thunderbird has anyone said that Noah doesn’t need medication (or didn’t care whether he got it) and Noah has been in the mental health system since he was 10 years old.
Then Noah was admitted to Banner Thunderbird on November 2, 2021, and he was given none of his psychotropic medication until I demanded that the Banner Thunderbird unit psychiatrist have a peer-to-peer with Noah’s treating psychiatrist. And the Banner Thunderbird hospital social worker’s supervisor is Jason McIntyre, who told the social worker, Stephanie C. Kyle, to tell me he said hi and who told me in 2018 that Noah only had autism and not mental illness.
The story was that one of the four medications, Vraylar, wasn’t in the hospital pharmacy, but they could have called the group home and the group home would have brought the medication over in blister packs along with the pharmacy prescription list. They could have done anything other than nothing.
Then Dr. Monga, the unit psychiatrist, got on the call with Stephanie Kyle, which by that point was on speaker phone, and Dr. Monga told me Noah is “doing fine” while taking nothing but levothyroxine for hypothyroidism and not needing PRN Zyprexa. The most either of them would say was “I hear your frustration” about doing absolutely nothing to ensure an adult they knew was SMI, in a BHRF, with a guardian got his psychotropic medication.
Had Dr. Monga had a peer-to-peer with Dr. Tripp before either passively or deliberately stopping Noah’s medication for 3 days, he would have learned that
• Dr. Tripp has already seen what Noah looks like off medication, from his disastrous stay at Banner Scottsdale in 2018
• Dr. Tripp has been treating Noah for 6 years and does more than spend a perfunctory 15 minutes with him
• the treatment team, including the BHRF (which has had the ability to assess Noah over the long term), Mercy Care, and the evaluator who found Noah eligible for SMI services wholeheartedly believe that he is seriously mentally ill and in need of psychotropic medication and long-term institutional care
I have a printout of all of Noah’s hospital stays from late 2018 onward (there are 22 of them), with a sentence about the reason for each hospital stay, and I emailed it to Stephanie Kyle. I demanded that Dr. Monga have a peer-to-peer with Dr. Tripp, and I cc’d Dr. Tripp’s office.
That peer-to-peer took place and Dr. Tripp rightly told Dr. Monga to leave the medication as it was and that happened.
At least Noah has the insight to know he needs medication and his insight isn’t so fragile that having a unit psychiatrist he’s never met telling him he’s fine without it didn’t convince Noah otherwise.
I have attached a copy of the latest guardianship renewal order giving me mental health powers (case number PB2019-001551).
I have made a prior Mercy Care complaint, but it was on the phone, and the complaint that was transmitted from the call-taker was not the complaint that I actually made. For this reason, I made this complaint in writing and I would like to hear from someone at Mercy Care in writing.
Regards,Karin Cather
mother/guardianI still haven’t mastered using this forum, although I have my own website using WordPress, so sorry for the lack of paragraph breaks.
Noah hasn’t ever really been consistently stable, which is frustrating, and he’s been on almost every psych med there is with the exception of Clozaril, which he would never agree to take and would have to cooperate with the lab draws, which he wouldn’t.
I just think it’s hard to treat a person with autism and mental illness.
December 6, 2021 at 3:00 pm #7953acmigold15
KeymasterKarin,
I am happy to hear that Noah has the insight to know he needs medication and will advocate for it. Please let us know how the grievance in writing fares for you and Noah. I agree with you that the Mercy care person on the phone should be a transcriber of the information and ensure it is accurately documented.
ACMIDecember 6, 2021 at 7:28 pm #7954Dick Dunseath
ParticipantKarin, I can relate. My son can appear quite healthy during the 3-minute doctor visits in psychiatric hospitals and seem like he doesn’t need meds. Then, an hour later, he can be very psychotic. I always insist on a doc-to-doc consultation of the hospital doctor with his regular psychiatrist as soon as he is admitted to the hospital – most hospitals respect my request but some do not. Your persistent follow-up is helping Noah get the care he needs. Hang in there. Dick Dunseath.
December 1, 2022 at 10:25 am #8706Karin Cather
ParticipantHospitals are nothing but factory farms. They have taken to discharging my son to the street without telling me or (presumably) the case manager even though they have the Letters and Order stating that I am the guardian. Shrinks never communicate with me. Copper Springs was the worst with this. The staffer came out and said, “Can I help you?” I said, “I’m the guardian.” She looked at me like I was a liar and said, “I am not aware that there is a guardianship.” I said,”Here are the Letters and Order.” Then I said, “You know he’s on COT, right?” She looked at me like I was a liar again and I said, “Here’s the order.” I said, “You know he’s an SMI client, right? Here’s a contact list of his providers and a log of his hospital stays.” There were 30 since the age of 10.
He has zero insight and was paranoid but they yeeted him out of there in 5 days, discharged to the street because he refuses a BHRF. He lasted 3 days before I took him to Aurora Tempe. He was incoherent and even more paranoid. No shrink talked to me and they discharged him to the street after 10 days (b/c of the Thanksgiving holiday) without telling me or the case manager.
He is now homeless again, now with zero insight, saying he’s not SMI even though he’s been in the hospital more times than he’s been out of one for the past five months and he is on COT. He’s living in a McDonald’s parking lot. The mental health system is terrible. Mercy Care could improve this if they actually responded to complaints, because they could yank funding from crappy hospitals, but they don’t care.
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