| Article about mental health system & abuse upto 1990's
In New Zealand "Bad Medicine" about a teacher who was submitted to a mental health facility in New Zealand. The article desribes the attitudes towards mental health at the time. How far behind new Zealand was. It also helps to undertsnad why new Zealanders are perhaps h further behind in their undertsaning and perception of mental illness in society as a whole. When considering that one in 5 New Zealanders will suffer from mental health issues at some time in there life or if not that will by statistics know someone close to them who does how can we continue to joke about it?
Serious illness is politically incorrect to put down. One would not dare to comment on the look of a cancer patient or loss of hair from radio therapy, yet we easily toss depression, anxiety, anorexia, and bulimia around as if they were merely words likee any other.
Do you know what is the biggest killer of young woman under the age of twenty five? Eating Disorders and they are interrelated with depression, suicide , and self injury. Do a google search for New Zealand see how many sites discuss openly issues of self injury or eating disorder without fear for recrimination in some form. And men dont think you are safe or your family. There are nearly as many young to middle aged men who email me with concerns about weight, diets, obsessions, depression, and self mutilation than their is woman. We are fighting an epedemic and unless we learn to open our minds and increase the breadth of our vision as a whole then we will lose sight of what we need to help our families and those we love grow safely.
We have allowed the media and the corporation to control us through gluttony and greed. We are fed an idea and we accept and pay for it. Since when did a person become only what they own.
<a href="http://www.stuff.co.nz/stuff/0,2106,3236129a7144,00.html">http://www.stuff.co.nz/stuff/0,2106,3236129a7144,00.html</a>
<strong>Bad medicine 03 April 2005
</strong>Teacher Kathy Simpson was admitted to an Auckland hospital's psychiatric unit in 1990 to cure the headaches that doctors said were caused by years of sex abuse. She came out five months later, emotionally destroyed. The story of Claybury House during that time has never been publicly told - until now. Donna Chisholm reports.
Some would write off Kathy Simpson's story as the obsession of a psychologically damaged woman. They would look at the litany of sexual abuse she suffered as a child and adult - from both inside and outside her extended family - as proof she is a victim waiting to be victimised; a complaint waiting to be laid.
Then there are those who have heard her story and are appalled by it. They do not doubt its truth or the toll it has taken on the health of a loved mother and former primary school teacher of gifted children.
Simpson's experience illustrates the isolation and ignorance surrounding psychiatric practice in our public hospitals as recently as the 1990s. There have been other high profile horrors - Dickensian attitudes, fatal electric shock therapy at Oakley, physical abuses of patients at Lake Alice - but the story of Claybury House suggests questionable experimental treatments existed in mental health units much later than most of us believed.
Patient complaints about their experiences at Claybury - a unit of Kingseat psychiatric hospital - sparked a secret, 10-month internal inquiry by the Auckland Area Health Board in 1991. It found that a group of well-meaning but inadequately-trained staff had run a live-in therapeutic community which was largely unmonitored and unsupervised.
In 1997, the board apologised to Simpson and two other patients and, after mediation, paid them tens of thousands of dollars in a confidential settlement.
Today, even the notoriously tight-fisted Accident Compensation Corporation regards Simpson as 70% permanently disabled - damage defined as equivalent to full body burns. Damage which the ACC found was caused in part by medical negligence at Claybury.
The Sunday Star-Times has spoken to experts who believe the psychotherapy techniques used at Claybury on around 1000 patients had the potential to cause irreparable harm. The health board inquiry chaired by then lawyer, now district court judge, Philip Recordon, found staff of Claybury short of the numbers and experience to run the programme and said some of the so-called psychodramas it ran would have been terrifying for a sex abuse survivor such as Simpson.
Psychotherapy, the hearing was told, could potentially inflict greater harm on patients than "the wrong pill or ECT".
The Sunday Star-Times asked GP, physician and senior psychodrama practitioner and educator Peter Parkinson to review Simpson's claims and the response of Claybury staff as presented to the inquiry. "What was practised at Claybury House was not psychodrama," he said.
He likened the practices to a blind experiment that had the potential to dangerously retraumatise the sex abuse victims who comprised a large proportion of its patients.
Asked if he was surprised by what was done at Claybury, Parkinson said: "I'm horrified."
The 20-bed Claybury unit, where patients stayed for periods averaging six months, ran with little external or professional scrutiny from around 1969 until it became a community-based unit in 1993, was renamed and later quietly closed.
Four Claybury patients took their own lives within one to three years of leaving the programme. While that does not necessarily indicate fault on Claybury's part, it seems at odds with a 90% cure rate claimed for patients.
After her discharge in December 1990, Simpson and another woman who was at Claybury during the same period spent nine months in private therapy at Dunedin's Ashburn Hall - at Auckland Area Health Board's expense.
"I was one of the success stories," says Simpson. "Four of my friends are dead."
We are five minutes from the gates of the old Kingseat Hospital when Kathy Simpson begins to sob.
The woman who climbed into the back seat of the car an apparently confident, well-dressed and articulate 55-year-old, sheds 50 years on this road. She sips from a water bottle she clutches like a baby. Then she begins to rock and tremble.
"Do you want us to stop the car?"
"No. Keep going."
It is June 2003 - 13 years to the day since she was first driven down this road to start treatment at Claybury House, a residential community for sex abuse victims and other psychological refugees.
It was bitterly cold then. Just like today. "As you got down the road it got colder and colder as you got closer to Claybury House."
She wishes she had heeded the omen.
Today, Simpson is returning to Claybury to exorcise her demons. She is determined to revisit the place that she says ruined her life. She wants, finally, to bury Claybury House.
She was a teacher with headaches when she went to Claybury. She has been unable to work again.
When she sought help at Auckland Hospital's pain clinic, they prised from her a history of sexual abuse. Claybury could help her, they said. Because it was run by Kingseat Hospital, it was free - and, Simpson figured, as a public hospital programme, it must be kosher. No fringey, new age remedies for her.
So keen was she to make a good impression at Claybury's assessment interview - to grasp this chance for "cure" - she'd worn her best peach suit and grey high heels.
She wore Peach Silk lip gloss - a colour the admitting doctor had described with a verbal frown as "thick red lipstick". The comment was, says Simpson, a signal of the attitudes among staff at the time - that sex abuse victims had a part to play in their own victimisation.
When Simpson arrived at Claybury in June 1990, another patient was making up a wirewove bed for her in the dormitory of the old farm building she was to share with 11 other patients who included teachers and nurses. The building was condemned, but the patients stayed for three months before moving to the old superintendent's house near the main buildings. When it rained hard, water poured through the light switch in the bathroom. One patient later suggested they hold hands and turn on the switch.
Claybury staff described their therapeutic role-plays as psychodramas or sociodramas. Experts in the field, however, say they were anything but. Psychodramatist Peter Parkinson, who read the women's descriptions, said they could best be described as party games.
In some, women had to pretend they were baby animals and be pawed by other patients. In others, they were blindfolded and groped by patients or had to fend off unwanted advances from men by pretending to be women defending an island. In others, women were dragged across the room by their heels.
It is these memories that, even 15 years on, make former patients shudder (see role-plays sidebar, right).
Two days after she arrived, Simpson says, she had regressed so badly that at times she was operating at the level of a pre-schooler. She continued to do so for the next two years.
Parkinson said he saw nothing in the role-plays that "the slightest bit emulates psychodrama".
"Having an untrained and unsupervised person doing psychodrama or sociodrama is akin to asking a man in the street to do heart surgery."
A key tenet of psychotherapy was never to expose patients to the potential to "retraumatise" by inappropriately reliving a psychologically damaging time. He believed many of Claybury's dramas did just that.
So was it out of step only with the benefit of 15 years' hindsight? Parkinson and another senior Auckland therapist and director of the Auckland Psychodrama Training Institute Dale Herron do not think so.
Herron told the ACC that the Claybury methods were "pretty horrifying". She regarded the work as "some aberrant form of something" which she found indescribable.
The ACC reviewer also heard evidence that though Simpson gave her consent to be treated at Claybury, it was withdrawn on a number of occasions but she was forced to participate in sessions against her will.
Claybury patients have told the Sunday Star-Times that at nights they could help themselves to a box containing each patient's weekly supply of medication - dubbed the lolly trolley - which was left on a table in the dining room.
Two patients overdosed from the lolly trolley; one of them killed herself after she was discharged.
The Sunday Star-Times has spoken to the survivor - now a qualified family therapist and trainee psychodramatist - who overdosed on antidepressants from the box. "I just kept popping tablets out and I swallowed them all - but not enough to kill myself." The next day, she said she and the other woman were "told off" by the staff who said they had jeopardised the programme.
She said the lolly trolley was about allowing patients to take more responsibility - but that was a misjudgement.
"When I went in there, I trusted that it would be a safe place. It wasn't - it was very unsafe."
Patients were so frightened, she said, that one slept with her eyes open. She remembers Simpson sucking her thumb and a woman in her 50s speaking like a baby.
Staff told the patients, she said, that there was always a child's part to play in any sexual abuse. "We were told that it was partly the child's fault, there was a payoff for the child, that they really wanted closeness and that's how they got (abused)."
Claybury was conceived in the 1960s by British-trained psychiatrist Graham Evans, shortly after he arrived in New Zealand. Former staff said Evans "experimented" with the unit, starting it "with a few high grade defectives - an IQ of 45-50". But Evans wanted a unit for what he called "neurotics" - a novel concept at the time.
There is evidence the role-plays were devised by nurses with no experience in psychotherapy. Indeed, in one affidavit obtained by the Star-Times, a former staffer remarks: "We didn't actually know how to carry out group therapy or psychotherapy. I never had any formal training. We started doing play readings and one of the occupational therapists suggested we start creating our own plays. Dr Evans saw this and became very excited by the idea. He liked the sort of reactions produced in the patients.
"My training was on the job and from my own reading. In essence, it was my personality that ran the unit."
This psychotherapy on the hoof continued relatively unchanged for the next 20 years, despite little evidence of therapeutic value or peer review.
Certainly these were the early days of sexual abuse therapy. Claybury patients were asked to consider how they may have contributed to their sex abuse and what they got from it.
One former nurse at Claybury said in an affidavit that "those who were sexually abused also had other problems including being selfish, stubborn, shut down, ungiving, angry . . . and if we allowed them to hang their hats purely on the sexual abuse then other problems weren't resolved".
Said another of the shipwreck island drama: "This was carried out when we had dominant women to . . . confront them with how much they hated men and how extreme their behaviour could become against them. Patients who were victims of sexual abuse could use this drama for revenge against men or to take control of a situation. It could be very empowering. The drama underlined the patient's bad relationship with men and showed them they were being left out of having a full life . . ."
Blindfolds, she said, helped people become more aware of shades of communication; the island drama was designed to "get co-operative feelings going" when anti-male feeling emerged. Animal dramas transcended the need for verbal communication.
Claybury was run by Evans until 1987 when he was succeeded by another Briton, Dr Roger Elliott.
In a paper for his membership of the Royal Australian and NZ College of Psychiatrists in 1987, Elliott said Claybury helped patients discounted as disastrous and chronic cases.
Claybury, he wrote in the paper titled "Of Leopards and Spots and Wolves in Sheep's Clothing", was often a "deviant" patient's last chance. Psychotherapy was an alternative to abandoning these patients to the psychiatric scrap heap.
The reality was, say the patients, that Claybury clients were often young, white, middle-class, professional women who had been in fulltime jobs for many years - jobs to which their employers hoped they would return. Four or five of those treated during Simpson's time were recent rape or physical abuse victims, others were incest survivors.
The four staff and dozen patients at the time of Simpson's hospitalisation were absorbed into a community which developed a culture of its own.
Therapies appeared to be constructed ad hoc - staff used information on patient progress week by week to "design a psychodrama or sociodrama for the afternoon".
In weekly pool sessions, patients were encouraged to play water sports with physical contact, but three women complainants told the Claybury inquiry the activity made them feel sexually threatened.
Claims of inappropriate physical contact were vehemently denied at the inquiry, which did not uphold allegations of sexual misconduct. However, one former staffer's affidavit said that patients called the pool time the "grope session". Another former staffer said that the pool was "threatening" for 30-40% of the women patients.
The theory behind the pool sessions was that close physical contact was more socially acceptable in the water and paved the way for closer relationships back at the unit.
Simpson has spent the last 15 years fighting for the story of Claybury to be told - she and nine others have filed a total of 25 complaints or lawsuits with 11 different disciplinary and legal bodies. The staff and their lawyers have successfully fought them all.
Court suppression orders preclude the Sunday Star-Times from outlining details of several cases.
The last acts of this tortuous drama were played out in 2001 when Simpson won a high court case allowing her to continue with a Claybury lawsuit in the face of an application to have the suit thrown out. Ironically, Simpson herself had to give up the fight in 2003 because she was mentally, physically and financially exhausted.
Some earlier cases failed because courts and disciplinary bodies believed the allegations could not be reheard after being dealt with at the internal inquiry.
Simpson's lawyer in her most recent court cases, Antonia Fisher, said there was ample evidence to support Simpson's allegations. "I was impressed with her integrity and veracity - had she been emotionally stronger she would have pursued the matter."
Some women told the Claybury inquiry the programme was a positive experience which helped them, but Parkinson said if anyone improved as a result of the work as reported "this would be more a matter of luck and certainly not through following the exacting discipline of either psychodrama or sociodrama, which they so inaccurately claim to be practising".
The Sunday Star-Times spoke to two women who praised Claybury - one who attended in 1981 and the other who had ongoing contact with its programme until the early 1990s and tried to argue for it to remain open.
The 1981 patient, who was seriously depressive after being beaten and psychologically abused by her stepfather, said only a few of the group of 30 with whom she attended were sex abuse or rape victims - a mix which seemed to have changed by the end of the decade.
"The staff just told us a few truths and frequently people didn't like to be told the truth."
The other woman, who spent five months as a Claybury patient in 1984, said the programme worked for her where nothing else did and made her stronger and more assertive. "I wouldn't have survived without it."
Anna, now a trained counsellor, went there after a nervous breakdown and suffered severe depression and anxiety after a violent and dysfunctional childhood. While she had been sexually abused, that was not her primary problem and she conceded some patients could have had a vastly different experience at Claybury.
She saw one female patient groped by a male client in the swimming pool but said he was quickly reprimanded.
She found staff were caring but the programme was tough. "It was 'Here's your spade, dig.' There was a lot of verbal. Today we would call it bullying, but the intentions were always good."
Some of the role-plays would have the potential to retraumatise, particularly sex abuse victims, she said. "But if someone got in a state over it, it showed there was more to work with."
She said she would not use some of the therapies today "because we're 20-odd years down the track. We have more awareness around trauma".
Karolle Gjaltema, the psychologist who worked with Simpson for more than a decade after her discharge from Claybury and gave evidence on her behalf to ACC, says the programme seemed to break down the women's psychological defences in an attempt to rebuild them - an approach that was out of step with current thinking even then.
"In my 15 years as a psychologist I have not come across anyone with a more severe trauma history," she said of Simpson. "Her experiences at Claybury were so devastating because she couldn't even trust health professionals in a public health system."
The Claybury community was closed to outsiders, and patient contact with family and friends, apart from one night a week and at weekends, was restricted.
A former theological student working at Kingseat who was friendly with Simpson before her admission, says after she called out "hello" to some of the Claybury women, Claybury staff complained about the contact.
"There was a sense about Claybury of this walled city, this impregnable secret place. For some programmes to succeed they have to be inhouse, but I wonder if it were not at times a little excessive." Although she spoke to an offsite supervisor of her concerns about Claybury, the woman said she lacked the "courage, assertion and knowledge" to approach someone at Kingseat and say "look into this place".
"I didn't do that then and I wish I had. I felt rather powerless."
She was alarmed by the injuries Simpson reported sustaining during the "psychodramas" and the fact patients were discouraged from attending the chapel when they wished to. "No one was allowed to talk to anyone outside about what was going on inside."
She remembers Simpson and "a posse of escapees" arriving at the chapel one day saying they had lied about where they were going and had come to see her instead. "I remember them saying they weren't happy and had concerns about their treatment."
She has spoken to at least a dozen Claybury patients over the years and said only three found the programme worked for them.
"Some people found Claybury magnificent. But what Claybury did for Kathy was to reaffirm, underline and exaggerate the damage."
She would see Simpson at visiting time on Wednesday nights and said she often appeared "shattered, shocked and afraid".
"I guess I opted - and when I look now it was a little unwise - for a wait and see approach but at the same time I had this disquiet. I was less assertive than I should have been."
Today, Elliott and the nursing staff at Claybury during Simpson's time continue in psychiatric-related work. They did not wish to speak to the Sunday Star-Times.
In a 1999 affidavit for one court hearing, Auckland's former director of mental health, Peter McGeorge, said it was difficult to judge what happened at Claybury "with the knowledge we have (now). We have gained greater sophistication in terms of being careful about the patients selected for various programmes.
"The issue of touch and the appropriateness of touch in psychotherapy is contentious. My own view is that touch should be limited, especially with people who are very disturbed."
While some patients and professionals have advised Simpson to let the case go, she has been unable to without her story being heard. Without accountability, she says, there could be another Claybury.
"My 'treatment' was abuse upon abuse and it has cost the country half a million dollars. I never got justice and now I want the public to know, too, because I could be your wife, mother, sister or daughter. I am white, middle-class and a very ordinary person. If this can happen to me, it can happen again - to you."
|
